Archive for Guides
Common Sense Caregiving by Gary Joseph LeBlanc: A must read for anyone caring for a loved one with Alzheimer’s
A columnist and book dealer from Spring Hill Florida Gary Joseph LeBlanc offers a personal and down to earth account of his experience caring for his father who suffered from Alzheimer’s disease. This common sense account of is a must read for anyone caring for a loved one with Alzheimer’s disease. Written as a completion of sixty-five articles from his column, LeBlanc gives an encouraging and enlightening guide for anyone navigating the turbulent waters of caring for a loved one with Alzheimer’s disease.
Top Five Questions to Ask an Assisted Living Facility (#5)
Over the past week, we’ve looked at the questions one should consider when researching an assisted living facility for a loved one. Today, we finish our five-part series with Question number five: What if it doesn’t work out?
“A second move is emotionally trying on the family and the resident, particularly if the resident has Alzheimer’s Disease. They may be facing behavioral problems down the road,” said Andrea Donovan, Senior Housing Placement Consultant and founder of Andrea Donovan Senior Living Advisors. “Will the community be able to accommodate the resident’s change in level of care, or will it involve a move to another community? Not all nursing homes are equipped to handle the later stages of the disease, particularly if a person develops unacceptable behaviors.” Donovan recalled one situation where she had placed a client with Alzheimer’s in an Assisted Living Facility with a “memory unit,” only to have to move them to a facility with a specific Alzheimer’s special care unit, which requires more specific training to become licensed, after the resident began slapping other residents.
Mitch Feigenberg once faced a situation that many adult children run into: what to do when one parent needs more extensive care than their spouse? One way to handle this would be choosing a facility that allows residents to transition between different levels of care while staying in the same building or on the same campus.
Feigenberg’s father, who was afflicted with dementia, needed to transition into assisted living at a time when his mother felt she could stay at home. “My mom moved into independent living in the same facility out of her sense of duty as a wife,” Feigenberg said. “The question, in our case, was more about what my wife, sister and I thought would be in his and their best interest. Knowing that the facility had all levels of care (independent, assisted, memory care, skilled nursing) reduced our stress level about the inevitable transitions that were to come.”
When touring a facility, make sure to meet with the person who would be helping you through any possible future transitions, advises Dr. Robert F. Bornstein, Professor of Psychology at the Derner Institute of Advanced Psychological Studies at Adelphi University and co-author of When Someone You Love Needs Nursing Home, Assisted Living, or In-Home Care: The Complete Guide. “They should be able to explain the process, the steps involved, which skilled care facilities (nursing homes) they work with most frequently, and what sorts of problems they encounter during transitions,” he explained. “Then you may want to speak with representatives of the nursing homes which work most closely with the facility, and ask about their experience as residents transition to them.”
What do you think? Are there other questions that should be considered when choosing an assisted living facility? If you or a loved one have already moved, do you look back and wish you had asked other questions? Let us know in the comments!
Top Five Questions to Ask an Assisted Living Facility (#4)
All this week we are taking a look at what the five essential questions to ask when evaluating an assisted living facility are. Today, we address question number four:
What is the culture like?
Of all the responses we received when asking what the most important questions were, the most common response was FOOD! Your parents have been cooking for themselves for decades, and have their own tastes and thoughts on how things should be prepared. Oftentimes, the food made at ALFs is mass-produced, with many dietary concerns in mind (low salt and low sugar content are the most common features – and bring on the largest number of complaints). Ask the facility for a copy of a recent weekly or monthly menu. Is there much variety? Are there more than one option at every meal? If the resident decides they don’t want to eat that night’s fare, is there a kitchenette in their apartment or on their floor that they can use instead? Sometimes, facilities will keep a dress code for their cafeteria – does your mother prefer the comfort of a nightgown to a skirt and blouse?
In the other homes your parents’ have chosen throughout the years, they probably only considered how their own family would interact within its walls. Now, however, they will have new housemates. During your visit, does it seem like the other residents interact with each other friendly and frequently, or are they all holed up in their rooms? Which environment would your parent be more likely to prefer? Of course, friendly staffers are always an advantage. Do they make an effort to chat with the residents about their day, or is it strictly business?
Top Five Questions to Ask an Assisted Living Facility (#3)
All this week we are taking a look at what the five essential questions to ask when evaluating an assisted living facility are. Today, we address question number three: Who is really going to be living here?
“Adult children must keep in mind that they are moving their parent into this setting, not themselves,” said Janice Williams, Vice President of Matrix Home Care and a licensed Assisted Living Administrator. “Therefore when looking at the facility, an adult child must think — would my parent like the dining room, common areas and the activity calendar?”
When evaluating the activity calendar, Williams encourages the adult children to keep in mind that it will be the parents living in that apartment and participating in community activities. Your loved one may be leaving the facility on fewer occasions as time goes on, so having activities there that fit into how they normally spend their time will make the transition easier. “If your mother is an avid library person, and you find out that there’s no library facility in the building, that’s not going to work,” says Williams.
While there may be no facility that fits perfectly into your loved one’s personality type, it is important to find the best match possible. Carol White, author of Live Your Road Trip Dream and President of Carol White Marketing Maven and RLI Press President, experienced this when she was placing her own mother, who quickly became frustrated with her facility. White explained the frustration was not because the facility was a poor fit, but simply stemmed from her loss of independence. She projected that frustration onto the facility itself. “She is in the finest facility in the entire state – this place has won all kinds of awards and is gorgeous. Our ex-governor lives there. The staff is caring and compassionate. It is my Mother that is the problem.
“It is a big change, and if your parent is fighting change, fighting getting old, etc., it may be that nothing will make them happy,” said White. “Sometimes it is us who has to adjust our attitudes, not the parent.”
Top Five Questions to Ask an Assisted Living Facility (#2)
All this week we are taking a look at what the five essential questions to ask when evaluating an assisted living facility are. Today, we address question number two: What services does the facility offer?
The services your loved one will need at a facility vary depending on their level of current ability, as well as how quickly they might need more help as their abilities weaken.
“Level of care needs is determined by how well an individual can carry out his or her Activities of Daily Living (ADLs); the more help they need with ADLs, the higher the level of care required,” said Robert F. Bornstein, PhD, Professor of Psychology at the Derner Institute of Advanced Psychological Studies at Adelphi University and co-author of When Someone You Love Needs Nursing Home, Assisted Living, or In-Home Care: The Complete Guide. The easiest way to evaluate what the future resident might need is to look at what you, as the adult child, are already providing. Does your mother take her medication at the prescribed times and dosages, or do you need to call and remind her? Is your father able to shower on his own, or do you go to his house every other day to help him? “Once a person can no longer carry out basic ADLs, they may require skilled nursing, nursing home, care,” said Bornstein, so be sure to factor in the possibility of a higher level of care depending on how quickly your loved one’s ability is deteriorating.
Top Five Questions to Ask an Assisted Living Facility (#1)
Everyone knows what they need when searching for a new home. Three bedrooms, two bathrooms, a two-car garage, good schools, and proximity to work might have been your parents’ main criteria when they chose homes in the past. When the time comes to move into an assisted living facility, the search is often nothing like they’ve ever experienced before, since many more factors need to be taken into account.
For many, this may be the first time their children are involved in their parents’ living situation decision – and it is not a decision that will affect simply where they sleep every night. When choosing a facility, one must remember that the resident will most likely be spending a greater percentage of time within those walls than they would have in their previous home, depending on how mobile they are and will be in the future. So now more than ever, it is crucial to pick a new home that will consistently be a good fit.
We’ve put together the five most essential things to ask about an assisted living facility to help you make your decision. Every day this week, we will post another question, along with suggestions from experts and fellow caregivers. Today we present you with question number one: What are the numbers, and how do they relate to your decision?
Discussing End of Life Care (Part 1)
Erin had been caring for her aging mother for the past four years as her body slowly succumbed to cancer. She had read every book and article she could find to teach her what to do throughout the various stages of care. As she stood face to face with an intensive care unit doctor, who wanted to know at what point they switch from attempts to prolong her mother’s life to giving her only palliative care to make her comfortable as she neared her final days, she became unsure of what to do. Over the past months, the exhaustion from battling the illness had gotten extreme; her mother was only awake for about an hour a day – and barely cognizant of her surroundings for that hour. Erin could not remember the last time she had gotten out of bed. Erin was faced with a tough decision… “If only I had talked to my mother about what she would have wanted,” Erin thought, recalling so many times over the past years where they had pretended that an end would never come. Instead of trying to enjoy every moment left in her mother’s life, she is spending it instead worrying whether her decision is really the one that her mother would be comfortable with.
Although Erin’s story is fictional, it is a reality for many caregivers – a situation that could be avoided with one conversation. While discussing end of life care may sound like a daunting encounter, it does not always need to be.
Before having the conversation, it helps to become familiar with what the different options are, and what is legally recognized in each state. This way, the adult child can be more confident in the information they are bringing to their parents, which will help comfort them and allow there to be fewer “what if’s” that may prevent the parents from opting to make a decision.
As We Age: The Five Senses
By Nicole M. Farmer, MD
The five senses work together to help us find our way through the world. Ironically as we move throughout life, the five senses change as almost as much as we age. Ask any person approaching fifty and they can tell you at least a few minor changes they may have noted while trying to focus on objects more while driving or while trying to concentrate harder on words said from across the room.
As common as the complaints are about how the senses change with age, the reasons behind the changes and the total impact on the lives of older people are less known to most people.
In this article we will look into the changes that occur with each of the five senses: hearing, vision, touch, taste, and smell.
Hearing
One of the most important senses is hearing. It is thought to be the only sense that can invoke other senses. Not only does our ability to hear affect our ability to appreciate wonderful things in life, such as a favorite song, once our hearing is impaired there may also be balance issues that ensue. Thus making understanding how and when to recognize hearing loss changes all the more important.
Over one-third of those over 65 and half of those over 85 have some hearing loss. The ability to have sharp, clear hearing may start to decline at the age of 50. Age related hearing loss is caused presbycusis.
Loss of hearing can lead to social isolation and depression. Changes with hearing can also cause falls because hearing contributes to balance.
Unfortunately, hearing is often under diagnosed and undertreated. This may be because assessment of hearing and hearing aids has not been covered under Medicare or most other health plans. Another potential reason for under diagnosis is that hearing loss occurs gradually and we may be unaware of subtle changes. One way to help determine if you or a family member is starting to experience age related hearing changes is the whisper test- done by whispering in the ears. Other signs to look for are frustration with talking to family members, problems understanding conversations in noisy rooms, difficulty watching television. With presbycusis, consonants become a major problem in conversation. The subtle sounds made by the letters z,s,f,p,g,t are difficult to understand for someone with hearing loss. An important note to remember is that when raising your voice, consonant sounds become harder to hear. So speaking louder makes it harder for those with hearing loss to actually understand.
While hearing loss from presbycusis is helped by hearing aids, sometimes hearing changes are from problems due to the ability to conduct sound through the ear. For example, impacted ear wax is common in the elderly due to increased water loss and can cause severe hearing impairment. Ironically, those with hearing aids may experience an increased amount of impacted ear wax.
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Mindful Caregiving Thought Tools for Resilience (Part 2)
Conserve Your Energy
By Holly Whittelsey Whiteside
Notice that the stiffest tree is most easily cracked, while the bamboo or willow survives by bending with the wind. – Bruce Lee
This series of articles will teach you ways to strengthen your resilience by building an internal toolkit that will last you for the rest of your life.
Article #1, Utilizing Your Emotions, introduced tools for managing self-talk and learning from anger. This article, Conserve Your Energy, offers approaches for gaining control over troubling issues.
Future articles will include:
- Build Well-being (Clearing Your Calendar, Practicing Self-care, & Adjusting Boundaries)
- Design Survival Strategies (Managing Obstacles, Knowing Thyself)
- Build A Support Team (Utilizing Family & Community, and How to Ask for Help)
Conserve Your Energy: Fine-tuning Your Commitments, and Choosing Your Battles
What you resist persists – Carl Jung
All struggles have one thing in common — they arise from some form of resistance. When our lives (or people) don’t measure up, we find ourselves in an emotional traffic jam somewhere between frustration and anger. It pays to look a bit closer at what is really happening.
In ordinary times, society encourages us to be on-guard, defend our rights, and complain about the state of things. When there are no outer battles to wage, we wage inner ones. But caregiving is no ordinary time. Energy conservation takes on a whole new meaning. When you know the source of your discontent, you can take care in the way that you address it. Feelings of being bound up, or are about to do battle, can arise from a host of causes which can include false assumptions, unexamined expectations, conflicting commitments, and childhood triggers. Understanding the root cause will allow you to address upsets appropriately and effectively.
Fine-tuning Your Commitments
Commitments source your energy and drive your life. They’re personal. A commitment is a driving principle, something you are unwilling to compromise that is fueled by a deeply held value. Behind every one of your upsets is a strong commitment to something. For instance, if you are upset with a doctor, it may be out of a commitment to your loved one’s safety, or a commitment to feeling supported by the medical community. Acting blindly on unarticulated commitments makes you far less effective. Identifying your root commitment in a situation lets you align the way you speak so as to achieve your desired result. But what about when you’re incapable of action?