Take utmost care in choosing care facility for elder

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Old 08-03-2014, 01:30 PM
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Default Take utmost care in choosing care facility for elder

When we were choosing a care facility for my mother, after she had lived with us for six years, we went with the recommendation of her Senior Center registered nurse & activity assistants who were familiar with the assisted living facility/community care home in town......(which was the first step before a skilled nursing home Alzheimer's wing for end stage dementia). Their meals were served family style in a homey Victorian style house with porches & rockers to sit in.

Even when her opal ring & diamond wedding rings disappeared, we believed them that she had no doubt flushed them down the toilet. Only later did we find out that although the owner was quite reputable, she was hiring staff who were "doing community service". We were so trusting. Didn't have a clue.

It's so easy to abuse the elderly in ways that do not show. Or, take advantage of their forgetful ways..........often the adult children are unaware.

Actually, the residents themselves were kind to each other.........at least when we were there.......but below AARP article still relevant......as one never knows for sure how your loved one is being treated when you are not visiting.

The end of her long journey with Alzheimers, the final 18 months, was spent in a wonderful skilled nursing home........with true angels of mercy caring for her every need with great compassion & understanding. From the ones who spoon fed Mom, to the ones who bathed her, to the charge nurses & those nurses who sat with me all day as she passed on........we had a good experience with the nursing home.

It was a small one floor modern facility with an Alzheimers wing........not a "warehouse" type building. I was able to wheel her out on the patio into the gardens, etc. The owner of the first place, the assisted living community care home had told me that once we transferred Mom to a nursing home they would put her in diapers & into a wheelchair & she'd never walk again........that was TRUE.

BELOW is something I just sent to our cousin in N.J. who is going through what we went through then........this time with her own 95 year old mother.....moving from an assisted living apartment to a nursing home........a very stressful time for their entire family.
I'm glad that we were in our 50's decade the entire time we cared for Mom.....& not the age we are now.

When choosing a care facility for an elder, remember.................DROP IN AT ODD HOURS WHEN THEY LEAST EXPECT YOU.

Seniors in nursing homes, assisted living facilities face peer pressure from other seniors
From: AARP Bulletin

Today we often read about cyberbullies among young people, but bullying also plagues senior centers, assisted living facilities and nursing homes. Between 10 and 20 percent of residents in senior care homes are mistreated by peers, says Robin Bonifas, an Arizona State University gerontology expert.

If you're sizing up a place, experts recommend asking whether it follows these practices:

Residents are required to sign a code of conduct to treat peers with consideration and respect; resident "ambassadors" help newcomers transition into the community; staff members coach residents on how to handle snubs and aggression; staff members encourage bystanders to act in positive ways when they observe bullying, being respectful of possible physical or cognitive impairment; and offenders receive a written reprimand or, in the case of multiple complaints, stronger penalties.

Seniors are bullying other seniors in assisted living facilities and nursing homes.

Nationwide, that translates to hundreds of thousands of people who endure abuse. Many incidents of name-calling, bossy behavior, loud arguments and, at its most extreme, physical violence go unreported.

"It's very difficult for a lot of our seniors to step up and say something has happened," says Mary Jones, director of elder rights at the Area Agency on Aging in West Palm Beach, Fla. Some facilities adopt practices that aim to preempt aggressive behavior.
 
 
 
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Old 08-03-2014, 04:05 PM
SusanOfWoodbury SusanOfWoodbury is offline
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All the problems would not happen if we did not put our parents in
Facilities!!!!We live in a community with lots of home health care available--
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Old 08-03-2014, 04:22 PM
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All the problems would not happen if we did not put our parents in
Facilities!!!!We live in a community with lots of home health care available--
Maybe, maybe not. No assurance on the folks you hire from these companies either. And quite often someone can live more comfortably in a facility where they don't have to try and hide and cover up their dementia. This is an extremely hard decision for a family to make and it certainly doesn't serve anyone to question or judge their decision.
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Old 08-03-2014, 04:35 PM
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I continue to write on this topic every time it is raised. I will keep saying the following:
1. Work with someone who can assess the needs -physical, emotional and financial, or your loved one. And work with someone who does not take money from the assisted living that gets chosen, as many companies have contracts and then when you choose one of the places they took you, they get paid a month of what you pay to live there as their fee. And they only take you to the ones where they have the contracts.
2. Talk to the other families who are visiting and find out what they have to say.
3. Find out how long the administrator has been there and ask residents and families if they are approachable, accountable, and available.
4. Ask to see the State surveys of the place you have chosen, they will provide you with invaluable information.
5. Find out about staff turnover-if there is high staff turnover, be concerned because they are probably not valued or paid enough to be able to stay there. If you cheap out on staff, you are at risk of losing them because someone else will offer them a better deal after you have trained them.
6. Ask about the food and have a few meals there. Ask residents how they like the food, how flexible meal times are, are there daily specials.
7. How much do they provide entertainment? People get bored. Many assisted livings do not provide much paid entertainment even though it is something residents love.
8. What level of care do they provide and when will they tell you your loved one has to move because they cannot meet their needs?
9. What is included in the base price in regard to care and housekeeping? How much do they charge for levels of care?
10. How often do they increase the rent?
11. How many hours of nursing staff time are there each day and how many days a week?
12. Remember do not think the place is great and worth what they charge because it is graced with elegance. It is the care and caring of the people, not the chandelier in the foyer that counts.
And not all people are best cared for at home. Sure it is great if it works out but there are issues with full time at home care, particularly when there is no family close by. Examples are staff who quit; constant change in staff; isolation of the elder; potential abuse-economic, physical or emotional, when a senior in need is at home alone with a caregiver 24/7; lack of socialization, entertainment, transportation and nursing. And for some people, at home care is a blessing and works great. There is not one answer for everyone.
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Old 08-04-2014, 06:09 AM
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Default From experience, we kept her home as long as we could

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Originally Posted by jane032657 View Post
I continue to write on this topic every time it is raised. I will keep saying the following:
1. Work with someone who can assess the needs -physical, emotional and financial, or your loved one. And work with someone who does not take money from the assisted living that gets chosen, as many companies have contracts and then when you choose one of the places they took you, they get paid a month of what you pay to live there as their fee. And they only take you to the ones where they have the contracts.
2. Talk to the other families who are visiting and find out what they have to say.
3. Find out how long the administrator has been there and ask residents and families if they are approachable, accountable, and available.
4. Ask to see the State surveys of the place you have chosen, they will provide you with invaluable information.
5. Find out about staff turnover-if there is high staff turnover, be concerned because they are probably not valued or paid enough to be able to stay there. If you cheap out on staff, you are at risk of losing them because someone else will offer them a better deal after you have trained them.
6. Ask about the food and have a few meals there. Ask residents how they like the food, how flexible meal times are, are there daily specials.
7. How much do they provide entertainment? People get bored. Many assisted livings do not provide much paid entertainment even though it is something residents love.
8. What level of care do they provide and when will they tell you your loved one has to move because they cannot meet their needs?
9. What is included in the base price in regard to care and housekeeping? How much do they charge for levels of care?
10. How often do they increase the rent?
11. How many hours of nursing staff time are there each day and how many days a week?
12. Remember do not think the place is great and worth what they charge because it is graced with elegance. It is the care and caring of the people, not the chandelier in the foyer that counts.
And not all people are best cared for at home. Sure it is great if it works out but there are issues with full time at home care, particularly when there is no family close by. Examples are staff who quit; constant change in staff; isolation of the elder; potential abuse-economic, physical or emotional, when a senior in need is at home alone with a caregiver 24/7; lack of socialization, entertainment, transportation and nursing. And for some people, at home care is a blessing and works great. There is not one answer for everyone.

Excellent post which obviously is coming from someone with indepth understanding of the subject at hand. Thank you for posting all of the very important information.

I did keep my mom with us for six years, living in our home.
I was her only caregiver in the early to latter mid stages of Alzheimers............81 to about 88 1/2. She passed at 91.

However, I did have a brief respite each day from 7 a.m./8 a.m. morning to 3 p.m. when she would be picked up & transported via van to our town's adult daycare center........returning also by van.
Mon. to Fri. It was a blessing, to be sure.

She was at the center one unusually, unseasonably HOT day on March 30 when the temps rose to 95 degrees.....the activity assistants decided to take the group to get ice cream........well, mom tripped over a parking log.....injuring her arm.

After that, it was kind of down hill as far as being able to bathe herself. I no longer could get her in & out of the tub........she was afraid of the shower...............long story short........we met with the assisted living people & they had a nice room for her.

She was happy there for about two years............however, had stopped eating, talking, etc............next/last step was the skilled nursing home Alzheimers wing for her last 16 months on earth.

As I stated earlier, she was now spoon fed, in diapers & in a wheelchair. Bathing was accomplished by a chair lift whereby the attendant would raise her up and over & down into a large whirlpool type of tub........at first she would cry out, but then she would totally relax & enjoy the warmth of the water. They only did this once a week, with daily sponge baths in the interim.

Her weight came back on , from the 85 lbs back to 125 lbs. as they spoon fed her...........the food was delicious & abundant.....amazingly so for frail elders who eat so little.

My husband was in awe of the quality of the food.......they even had holiday family meals to which all of the adult children/grandchildren would come...........after our own feast at home............just so they would not be alone.

All of the aides who worked there had to request working with the Alzheimer patients......then were trained inhouse. R.N.'s on staff.

My entire nine +++ years of caring for my mom was the long goodbye. She was in good company; her doc's mom was there (an old friend) from the senior center days, plus many other of her town friends. They were also together in the assisted living place.


It is stressful for the family.......even those, like us, who kept their loved ones, through thick & thin, through all the idiosyncrasies of this insidious disease.........AT HOME.........for as long as they could.

For six years. I helped her bathe, dressed her, fed her her favorite foods, entertained her, took her for walks, etc.........rides in the country.......she was part of our family..........but it gets worse.......that is when they need skilled nursing care.

We only had two choices in town; one which was part of our hospital........also nice but humongous in size.....& this small private one..........where angels of mercy cared for the elderly with great respect.............

The only thing I noticed is that near the end, one of the "memory" docs called me & requested that we put her on an "experimental new drug"..........she was now 91 years old..........I did my research on the drug he named....& then told him that I didn't think it was a good idea.........not too long after that, they called to tell me she was no longer able to swallow liquids or food............& that's when the comfort care/palliative care began...........her passing was very peaceful.

Her close friend had just taken the same journey. The internist & I sent each other long sympathy card messages remembering each other's mom........his would bake the very best Lithuanian Christmas cookies for the senior center which my mom would bring to us..........he & his wife would be visiting his mom at the community care assisted living house when we were visiting my mom...........ditto for the skilled nursing facility.

In this town, paths cross each other from cradle to grave.

In hindsight, I doubt if subjecting her to a harsh drug would have changed her health at that end stage..........she could no longer talk, walk, etc.; the drug could case liver damage, etc., etc.

Up until a month or so prior, she still knew who we were & could say her prayers, although in garbled speech.

Still remembered her own mother & father's Ukrainian names (long term memory lives on, while short term memory has been gone for quite some time).

She passed on my father's birthday, which was also her own mom's death date. I still miss her. Nothing like a mother's love.

In this very cruel world, cherish your own moms & dads while you still have them to cherish..........one last thing, caring for a loved one at home, does tend to age one fast.........the frivolous things fall by the wayside as one faces their own mortality in the face of the aging parent...........my heart goes out to all of you now wrestling with what to do with your own aging parents.......since so many of you are still young...........younger than we are, at age 70.

.
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Old 08-04-2014, 06:36 AM
sunnyatlast sunnyatlast is offline
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Originally Posted by SusanOfWoodbury View Post
All the problems would not happen if we did not put our parents in
Facilities!!!!We live in a community with lots of home health care available--
That's real noble and easy to say when your mom or dad can walk, stand, eat and and bathe safely, and they haven't wandered out into the woods or city streets when temps are 100+ or 30 below zero, and the police and fire squads find them covered in mud or half frozen and dehydrated with pneumonia that lands them in a 'facility' like a hospital ICU for weeks.
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Old 08-04-2014, 07:06 AM
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That's real noble and easy to say when your mom or dad can walk, stand, eat and and bathe safely, and they haven't wandered out into the woods or city streets when temps are 100+ or 30 below zero, and the police and fire squads find them covered in mud or half frozen and dehydrated with pneumonia that lands them in a 'facility' like a hospital ICU for weeks.


You are right on target. We had just closed down our home, plus my widowed mom's place.......the moving van had just left.........in the morning we were to board our flight for Sarasota Fl. to purchase our beachfront condo in Venice.........we had no choice but to check into our local hotel........got mom a separate room adjoining ours, locked her front door with the deadbolt....kept our interior room door to hers OPEN............obviously, we had no idea of the extent of her "Sundowners Syndrome" whereas they wander at night.

At midnight we get a phone call from the front desk.
Mom had somehow escaped her room..........God only knows how.
She was 4 feet 11 inches tiny........petite........
She was wearing her nightgown, bare feet, carrying her purse, looking like Sophia in the Golden Girls when she CRASHED A WEDDING at this hotel........by the indoor pool. What a sight.

Thank God she didn't escape the front door of the hotel.
It was 16 degrees out, end of November in Vermont.
Our Miami Fl. home buyers wanted us out before the end of December so that they could celebrate New Years in their new home.


This incident was just the beginning of our realization of just how confused she was...........although to the average observer, she still had her "social skills" during the daytime.........

Florida TOTALLY confused her..........she was used to homes with upstairs & downstairs.........thus could never find the stairs to the bathrooms nor to the bedrooms...........after less than six months, we sold the condo & returned to Vermont........where she felt more at home in our next house......& where her support system was.

Although a sacrifice for us, at age 49, it was the right move back for her as we began age 50 with our new baby back in our old town.

What had set this in motion.........my stepdad had passed suddenly; we had no choice but to take her with us.......had he lived, it would have been like the blind leading the blind as each covered for each other's frailties. Probably we would not have been aware of her confusion.......while we were living in Fl.

On the phone, she sounded just fine.........my own older brother told me, "You read too many books".....when I tried to explain her quirky habits........in these early stages.........when we moved back to Vermont, I asked him to please take her in for two weeks so I could unpack again...........after we bought another house. He wouldn't. Usually, the daughter is the one who ends up with all of the responsibility..........which was actually best for my mom, as stressful as it was for me.

So, all things happen for a reason........I truly believe that. Plans change. People change their minds..........responsibilities come up. People become ill. Nothing is cast in stone.
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Old 10-03-2014, 03:17 PM
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Exclamation putting parents in facility

We would all like to have the resolve to take care of our parents. I could go on a long rant , if you have ever tried too take care of an Alzheimer's patient you will realize it is a24 hour a day job, just to keep them safe and fed and clean. Give up your life my sister did and lasted a year and she's one of the best people I know. My wife knows I would be devastated to think I put someone in that position and embarrassed for myself. Just my take.
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Old 10-03-2014, 03:27 PM
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What are some of the great facilities around here with someone with cognitive impairment?
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Old 10-03-2014, 05:59 PM
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What are some of the great facilities around here with someone with cognitive impairment?
My experience with my mother is the expectation of "great" will only frustrate you. If you are lucky she will be well cared for, kept reasonably clean, have some daily stimulation besides the community tv room, and this is the best I can find for $5050 a month. It is very discouraging when you start experiencing these facilities so the best you can do is find what you think will be the best fit and keep an eye out for a decline in the facility. It happens - they open all bright and shiny and beautiful and everyone on the staff so excited to do a good job and unfortunately the day to day routines start wearing people down and they can no longer keep it new and shiny and that is when either a change in management is needed or you need to move your loved one. Been dealing with this for almost 10 years now.
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Old 10-04-2014, 11:19 AM
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Maybe, maybe not. No assurance on the folks you hire from these companies either. And quite often someone can live more comfortably in a facility where they don't have to try and hide and cover up their dementia. This is an extremely hard decision for a family to make and it certainly doesn't serve anyone to question or judge their decision.
Yes!

Until/unless you've had to walk that path, you can't realize how difficult that decision is. Nor can you realize how difficult and costly it can be to have 2 care givers on duty 24/7.
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Old 10-04-2014, 11:34 AM
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What are some of the great facilities around here with someone with cognitive impairment?
My parents are now at Hawthorne Village in Ocala. Is it perfect? Nope. But they try. The nurse in charge of the dementia unit is great and the staff is motivated. It is not as fancy as some of the places we looked at, but they make up for it in the care they give their patients.

Want to know what impresses me most? The housekeeping person responsible for the wing where my dad is (not on the dementia unit as he is bed ridden and not a "wander risk") is a kind, gentle woman who knows all of the patients by name and their family members. She is never too busy to get water for a patient, pick up something that they have dropped or find the nurse for them.
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Old 12-01-2014, 09:51 AM
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Please join us...Elder Options, The Mid-Florida Agency on Aging, hosts the Villages Fearless Caregiver Conference at The Grand Oaks Resort and Museum on Thursday, December 11, 2014. Support, information and advice for family and professional caregivers from leading aging and disability experts, caregiver advocates and support organizations.

The event is designed as a day of shared wisdom for spousal, grandparent, veteran, adult children and long-distance caregivers, as well as anyone else seeking hands-on advice and support as they care for a loved one.

Limited number of complimentary caregiver tickets are available for the seminar, which runs 8:30am – 2:30pm. Registration includes a sit down luncheon and is available by calling (877) 829-2734 or by going online to Caregiver.com - For caregivers, about caregivers, by caregivers.
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Old 12-01-2014, 09:53 AM
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Answers and support for family caregivers...Elder Options, The Mid-Florida Agency on Aging, hosts the Villages Fearless Caregiver Conference at The Grand Oaks Resort and Museum on Thursday, December 11, 2014. Support, information and advice for family and professional caregivers from leading aging and disability experts, caregiver advocates and support organizations.

The event is designed as a day of shared wisdom for spousal, grandparent, veteran, adult children and long-distance caregivers, as well as anyone else seeking hands-on advice and support as they care for a loved one.

Limited number of complimentary caregiver tickets are available for the seminar, which runs 8:30am – 2:30pm. Registration includes a sit down luncheon and is available by calling (877) 829-2734 or by going online to Caregiver.com - For caregivers, about caregivers, by caregivers.
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