Nursing Homes: Make the Best of it!
May 17, 2013
Care Conference: Just as every nursing home has an ombudsman assigned to them every nursing home in required to hold a series of care conferences that include you, your aging parent and an interdisciplinary team that should include a nurse, social worker, activities director, dietician and a member of the therapy team, if appropriate. You and your parent should receive an invitation to this conference. If this is not happening, ask to be invited and attend. This gives you an opportunity to have an entire team of professionals in front of you at one time and you can get some very valuable input.
Connect: Find the person in the nursing home that can help you. For us, it was the evening shift nurse. She seemed to know what she was doing was willing to share information and always followed through. Plus she did a heck of a job with my dad’s catheter care. There’s no guarantees but your social work would be your best bet in terms of finding your advocate and the person willing to help you the most. On the other hand, a nursing assistant may be the person to provide you with the most insight in to how your aging parent is getting along. Regardless of their title, I want you to find that person you feel you can trust and connect with.
Attitude: Don’t go in to this with a chip on your shoulder. It’s very common and oh so easy to project your fears and anxieties on to the nursing home staff. The saying “you can catch more bees with honey versus vinegar” could not be more true when it comes to working with the nursing home staff. In general, nursing home employees care a great deal for the residents they care for and you’re going to get a lot more help and understanding if you treat them well. This is not to say that you overlook poor care or live in fear of retribution but be respectful. They work hard and your attitude towards them can make make all the difference in the world. It’s human nature to gravitate towards those who appreciate us so try to keep a positive attitude!
Pick Your Battles: There will be plenty of things you can complain about in the nursing home so I advise you pick your battles wisely. What are your “line in the sand” issues? What are problems that you can live with? What are the deal breakers? For us, I wasn’t real thrilled about the overall environment and communication in our nursing home but the nursing staff did an amazing job at providing intermittent Foley catheter care without introducing infection. The lack of communication drove me nuts but at the end of the day the catheter care was far more important and I relied on the evening nurse to get the information I needed so I didn’t complain. Pick your battle wisely!
I don’t think anything can really prepare you for that moment when you have to admit your aging parent in to a nursing home but knowledge and a positive attitude can help ease the anxiety and make for a better nursing home experience. I know a lot of you have had this experience so please feel free to share any ideas or tips you may have that could help someone else make the best if it!
Nursing Homes: 5 Secrets to Finding the Right One!
May 15, 2013
Five Secrets to Finding the Right Nursing Home
Are you starting to think it’s time for your aging parent to move to a nursing home? The decision to transition your aging parent to a nursing home is the toughest one of all along your elder care journey. The impossible promises made, the uncertainty of what you’ll find and the horror stories you’ve heard can create overwhelming anxiety and apprehension. I’ve been on both sides of this decision: admitting my dad for a short term stay in a nursing home and having worked in admissions and social service in nursing homes. There are good ones out there you just have to know the secret to finding them…
I can spot a good {or bad} nursing home a mile away: this is what I look for…
Reputation: The first question I ask clients that are considering locating a nursing home for mom or dad is this: have you or someone you know and trust had any experience with a local nursing home? The best way to start your search is to go on reputation. If a facility has a reputation of providing excellent care over the years, this is the facility I would look at first. On the other hand, reputations wax and wane so do your due diligence before you make that leap and sign the paperwork but reputation is the place to start your search from!
Odor: I don’t care what anyone says: all nursing homes have a bit of an odor but some worse than others. There’s no way to avoid this when residents are incontinent of urine and feces. However, the odor should be isolated, not masked by perfumes and should not be ignored. If you smell odor throughout the building on your tour, I would think twice. If you smell an odor that is isolated or acknowledged by the admissions coordinator, I would consider it “par for the course”. The admissions coordinator may say something like “excuse me I’m going to check to see if someone needs freshening up” and then discretely get help for someone.
State Surveys: Reviewing the latest state survey {which should be easily available} is one way to start narrowing down your search but take them with a grain of salt. True Story: years ago I worked in a nursing home that was inspected by a state surveyor that had been terminated by the company that owned the facility. How unbiased do you think that person was? The state survey process is not related to care as much as how care is documented. Some companies are really good at this documentation and some are not. Review the survey and look for patterns: medicine errors, skin care and family complaints. Try to read between the lines and ask the facility if you have concerns regarding specific citations. See how open they are to discussing or avoiding the questions!
Staff: All nursing homes have staff turnover especially with certified nursing assistants. Cleaning feces off of frail older adults at minimum wage isn’t exactly a long term situation for most. What I want to know is how long has the current Director of Nursing been at the facility and ask to meet with him or her. The Administrator is important as well but believe me it’s the Director of Nursing that runs the show and oversees the care your parent will be receiving. Get a feel for the type of person they are: eye contact, open door policy, warm, friendly, are they asking questions about your mom or dad? Is staff dressed appropriately? Do they have rings in their noses or eye brows (I can’t tolerate this one)?
Look and Listen: As you walk down the hall listen and learn. Is staff being loud and offensive using words like honey and baby? Are there a lot of call lights on that are being ignored? Are you acknowledged with a hello and eye contact? Are residents yelling and being ignored? Are people making eye contact and acknowledging you? You should hear people being treated with respect and dignity. You should not hear staff gossiping and complaining about their workload. You should hear calmness in the tone of the staff, cheerful conversation and positive reinforcements: “you’re doing a great job today Warren” or “Mary I love your outfit, you look awesome today”.
No doubt, the nursing home decision will be the toughest you have to make along your elder care journey. It’s never an easy decision but there’s plenty you can do to find a decent facility that will provide competent loving care for your aging parent. Start here and if you have any questions leave them in a comment!
Nursing Homes: Volunteer and Make a Difference
May 14, 2013
You can make a difference in your community by becoming a nursing home volunteer. You might think that nursing homes are all gloom and doom but there are plenty of smiles, laughter and hugs to be had. Nursing homes are full of individuals that have lead long and eventful lives and they could use your support. You might even learn a thing or two…
As a volunteer you could provide any number of activities to stimulate the residents minds and provide comfort: bingo, manicures, poem readings, one on one conversation, letter writing or computer support. This list goes on and on but my favorite volunteers are those who bring in their children and pets. You can’t imagine the joy that children and pets can spread in the nursing home: it’s a touching and powerful moment to witness!
Five Things I Want You to Know About Volunteering in a Nursing Home!
Every nursing home has someone that is in charge of the volunteer coordinating. Your contact person will typically be the activities director. Some larger facilities may have a volunteer coordinator and some activity directors are referred to as the life enrichment coordinators. Either way all you have to do is call the facility and ask the receptionist who you would talk to about becoming a volunteer.
You can’t just walk in off the street and expect to get started. The nursing home will have an application and training process that you will have to complete. Don’t let this scare you off: anything worth doing is worth doing right and the nursing home is responsible for their residents. They want the right volunteers doing the right job for their residents and they have policies and procedures to follow…
When you say you are going to be there, be there. Don’t decide one day you’d rather have coffee with friends or hang out at the pool. The volunteer work you do in a nursing home is important to the residents and they depend on you to be there. Talk with the volunteer coordinator and understand the expectations. Before you decide to volunteer, consider the commitment it takes and act accordingly. Don’t be a flake…
Even though you won’t get paid you can use your volunteer experience on your resume and perhaps the activities director would even give you a reference. It’s also a great way to explore the possibility of working with older adults on a professional basis and may lead you to a career you never even thought of before. My very first experience with working with older adults was as a volunteer in a nursing home…
You will receive far more in the way of gratification and wisdom than you could ever imagine. There are many wise old souls living in nursing homes that still have plenty to give. All it takes is for someone to make that connection and reach out to them. You’ll develop friendships and you’ll feel good about yourself. You’ll leave that building every time knowing that today you made a difference in the life of a frail older adult…
If you are considering volunteering in your local nursing home and have questions, please ask them by leaving a comment. I may not know the specifics of your local community but I can get you headed in the right direction…
Aging Parents: Waiting for Apologies? Reflect on this…
April 21, 2013
Aging Parents: Let’s Talk About Guilt!
April 11, 2013
Let’s talk about guilt.
Guilt: feelings of culpability especially for imagined offenses or from a sense of inadequacy.
We all feel it from time to time. It can really paralyze children of aging parents and lead you to make decisions based in fear and toxic emotions not healthy ones. Those decisions can lead to resentment, which can lead to depression, which can lead you to ultimately not able to care for your aging parent in a healthy way.
Years ago I was facilitating a support group when an older woman who had been caring for her husband, who was suffering with Alzheimer’s disease, spoke. Mary (not her real name) had been caring for Dale (not his real name) for some time and it had been quite a struggle: eloping in the middle of the night, calls to the police, physical behavior etc…
The conversation went something like this…
Mary: I put Dale in a nursing home a couple of weeks ago and I’ve been dealing with this overwhelming sense of guilt. (tearful)
Me: Do you not feel it was the right choice?
Mary: Yes it was the right choice.
Me: Are you happy with the care he’s receiving?
Mary: Yes the people are wonderful and they are good to him.
Me: What do feel so guilty about?
Mary: How good I feel about it all!
Group: Laughter and hugs all around.
The moral of this story: be clear on what you feel guilty about. Dig deeper in to the emotion and understand that you have the right to feel this way. It would have been so easy for Mary to displace her guilt on to the staff at the nursing home or feel anger at her children for not providing more support.
I admire her courage for stating her truth and you can bet she made an impression on me and others at her support group. By clarifying what we feel guilty about we can then make room for the transition to occur, grief to unfold and the journey to continue…
Aging Parents: Crisis Mode
April 5, 2013
Aging Parents: Crisis Mode
Chances are the first time you’re asked to step in and help your aging parents it will be during a time of crisis. You may be setting in a hospital intensive care unit as you read this or your head may be spinning with bad news from your mom or dad’s physician. You may be making that frantic long distant trip by plane to be by their side; unsure of what you’ll find when you get there. I’ve been there both professionally and personally and I want you to know you are not alone and things will get better.
Tips for Managing
Don’t Panic: If it takes a state of denial or a quick call to your therapist or minister, don’t panic. Take a deep breath, focus on what’s in front of you and don’t get overwhelmed by the “what ifs”. You may be in a situation that is out of your control and it may take a few hours or days of simply putting one foot in front of the other before it all unfolds. Your mantra is “one step at a time”!
Manage What You Can: If you are just entering the world of elder care, you’re in for a big shock. Navigating the health care system is frustrating and at times you’ll feel like Alice in Wonderland falling down the rabbit hole. Manage what you can: call friends and family, identify your resources and support systems, confirm that the hospital has accurate personal information, keep notes in a journal. Manage what you can and know that it all unfolds in due time!
Educate Yourself: Don’t count on professionals to be transparent (more on this at another time). Whatever your situation, you want to make your decisions based in knowledge not fear. Ask questions, call local organizations (Area Agency on Aging or Alzheimer’s Association) and yes use the internet (with caution) to locate information. The information you discover now may come in handy down the road!
Be Aware of Emotions: Stepping in to your aging parent’s life during a crisis may trigger some emotional baggage for you. I don’t care how far you’ve moved or how much psychotherapy you’ve endured, your buttons are going to be pushed. You may feel like an angry teenager or helpless child. Acknowledge it, identify what you feel and save it for another day. Now is not the time to dredge up past grievances or issues. The next few days are going to be an emotional roller coaster; manage it!
Stay in the Moment: While it’s important to make decisions based on two steps down the road, it’s just as important to stay in the moment and not get caught up in the “what ifs”. This can create the type of anxiety that will paralyze you. Decisions are going to have to be made related to what’s happening now not two or three weeks from now. Managing your elder care crisis is a process that will unfold and stressing out over what may or may not happen is not going to help you or your aging parent. By staying in the moment, you focus on the important issues!
I hope these tips for managing your aging parent’s crisis have helped you in some way. I’ve been in your shoes and even with all of my experience and education it was still difficult. The fear, the anxiety and that overwhelming feeling of helplessness can really put you in a bad spot. Remember that everyone’s crisis is unique and unfolds differently; this too shall pass and you will survive.
If you have recommendations that could help others, please share them in a comment…
