Category Archives: Senior Housing

Dead Inside

What a horrible title for an article.

It’s also a horrible concept, don’t you think?

But many with dementia are dead inside without any means of engaging with others in meaningful conversation.  Heck, they might not even be able to talk to themselves: a practice I engage in quite frequently.

What an isolating state to be in: you’re there, but not there.

My daughter & I outside the Varsity Theatre, Seattle, after viewing the documentary.

My daughter & I outside the Varsity Theatre, Seattle, after viewing the documentary.

Fortunately, those with Alzheimer’s, dementia, or other cognitively restricting illnesses, have a chance to awaken their memories – and therefore their history – but not without the tools to do so.  Alive Inside, the 2014 Audience Award winner at the Sundance Film Festival, is a one and a quarter hour documentary film that touts the benefits of personalized music therapy for those who are living dead inside.

Dan Cohen, social worker, Founder and Executive Director of Music & Memory, started this awakening project several years ago.  Here is a description of the project, taken from the film’s website: “Music & Memory … promotes the use of digital music players with individualized playlists to improve the quality of life for elders, regardless of their cognitive or physical status … Dan has spent most of his career helping individuals and organizations leverage technology.  Music & Memory operates in hundreds of long term care homes across the U.S. and abroad.”

Watch the 2.15 minute trailer on the provided Alive Inside website to witness a few of the individual awakenings spotlighted in the film.

Even if the film is not scheduled to appear in your area, you are still able to help awaken the millions of people in the United States and abroad by your participation in Mr. Cohen’s project.  Whether it’s feet on the street or a click of a mouse to donate funds, each of you can become a part of these efforts.

Additionally, if you know someone, or are caring for someone with cognitive decline, put together a personalized database of music for that someone in a digital music storage device, then connect them to it with a set of headphones.  You might be able to  awaken that person with that simple effort on your part.

Downsizing our lives

Boomers need help dealing with their parents’ ‘stuff’ | Business & Technology | The Seattle Times.  The attached article by Sacramento Bee reporter, Claudia Buck, provides sage and practical advice for those who are downsizing a parent’s belongings when said parents move into a senior housing environment, and for those who are dispersing the parental belongings after their death.  Please read Ms. Buck’s article; it contains extremely useful information.

The following list gleaned from the article provides a few suggestions worth your consideration:

  • When you set out to eliminate stuff from a residence, don’t get rid of the memories in the process.  Once you’ve dispensed with the goods, you’ll never get them back again.  My mother died in her sleep – no one in the family expected it or prepared for it.  After the funeral event had passed and my brother and sister had returned to Washington and California, I remained to help my father with a massive downsize of his house.  There were obvious sentimental items that were boxed up for later, but for the most part, we stuffed large Hefty bags with items and placed them into two piles: donation-worthy, and garbage.  Not a bad idea, actually, but we didn’t pause long enough to properly discern what should have been kept.  With both parents now deceased, us three adult kids have far too few tactile sentimental items in our possession.
  • Creating a shadowbox of the most precious mementos.  Having read the attached article, I’ve decided to create a shadowbox of the few items remaining from my parents’ lives so I can reminisce at the sight of them.  One thing is for certain: containers full of sentimental nick nacks stacked in a closet do not honor a memory.
  • If you absolutely know that some of the nicer items will not be enjoyed by your household, give them away or donate them so others can.  Look at it this way, your and your parents’ legacies will live on in the lives of others.  Not a bad consolation if I do say so myself.
  • My family in the 70s. I no longer have the red dress I'm wearing, but I do have those earrings my mom is wearing.

    My family in the 70s. I no longer have that red dress but I do have those earrings my mom is wearing.

    If at all possible, prior to any parent’s death, document the items that are meaningful to each family member.  You’ll be glad you did.  Within three months of my mother’s death, my father moved into an independent living senior community taking with him the bare necessities of furniture and kitchen items, as well as the aforementioned sentimental items that he and I had boxed up earlier.  As he aged, he wisely decided that the next time each of us kids visited him, we would designate which items we would most like to inherit at his passing.  Dad documented our wishes, and when he died all I had to do was retrieve the list from his files and distribute that which us three kids were interested in.  Sure, conflicts can arise, but a little give and take go a long way towards preserving the value of each memory.

  • Speaking of taking steps in advance, what about you?  Do you have clothing you haven’t worn in more than a year and probably won’t wear in the years to come?  How about household items for which you have duplicates?  Is there any chance whatsoever that over the years you’ve acquired items that could be re-purposed, donated, or tossed?

I’d say with 100% confidence that you have belongings that you no longer use or need.

Donating to charity is very commendable because it’s always a good thing to provide for those who don’t have the means.

And just think of all the room you’ll gain in your closets once you’ve successfully downsized your life by adding to the lives of others.

June 21st: The Longest Day Alzheimer’s Style

The Longest Day.  The attached article by Author, Ann Hedreen, can be found linked above, and you can find additional well-written articles on her blog The Restless Nest.  Reader alert: Ms. Hedreen’s book, Her Beautiful Brain, will be released September of this year.

Sunset in RedmondWhat was your longest day like?

Was it long, because it was fun-filled and absolutely fabulous, or was it long because the day was crammed with the most difficult and stressful experiences of your life?

Caregivers: you are heroes to all who understand the job that you’ve taken on as carers for your loved ones.  You live the 36-hour day with all of its burdens and insurmountable challenges, while across the United States there’s much discussion – even controversy – over raising the minimum wage.  In contrast, there you are earning no wage but working harder than you’ve ever worked before.

Loved ones with Alzheimer’s or other dementia: your disease-controlled days might seem to have no beginning or end; you go about your day trying to fulfill its challenges while perhaps being at the stage in your disease where you are still able to feel the frustrations of not grasping the how-to of tasks that prior to your diagnosis required no complex thought processes on your part.

Those who have yet to be intimately involved in the above-mentioned roles: look around you – you won’t have to look far – and then on this year’s longest day, Saturday, June 21st, do what you can to help the co-worker or neighbor who desperately needs your help but doesn’t know how to ask for it, or is too ashamed to admit that they can’t do it all.

Jerry and his new rideWhen you offer help, please don’t leave it open-ended.  Instead of saying to your neighbor, “Hi yah, Joe.  Be sure to call me if you need anything,” be more specific so it’s easier for Joe to accept your offer, “Joe, when I get out my lawnmower this weekend, I’d love to swing by your place and take care of your lawn so you won’t have to.”  Or how about, “Yah know, we’re always making more food than we can eat at our house so we just freeze the leftovers for another time.  Can I come by later this week and give you a week’s worth of meals so you don’t have to concern yourself with what to fix for dinner?”

And then keep it up because your neighbor or co-worker’s life isn’t going to get any easier.  Keep offering tangible ways in which to provide assistance and you’ll go a long way towards making the longest day – which is every day in the life of a caregiver – a bit easier to tackle.

 

 

Delivering the best customer experience

Regardless of the industry you represent your goal must always be to deliver the best customer experience.

Bar Harbor Cruise ShipI have read and viewed many advertisements in which a company assures a future customer that their goal is to deliver the best customer service to each and every customer they serve.  This is a very commendable goal in my eyes – a goal that must be reached by every provider of products and/or services.  Whether I am a passenger on a multi-level cruise ship or a seaport’s rickety party boat;

Photo credit: www.definefishstudio.com

Photo credit: Rob Owen-Wahl

whether I dine at a casual eatery or a popular Michelin 3-star restaurant; whether I am a guest at a Residence Inn or a resident at a senior citizen housing community, you must provide me with the best customer experience you can muster.

A couple months ago, I commented on a LinkedIn article that discussed one particular goal that should be considered by long-term care (LTC) providers, e.g., senior housing, assisted living, and memory care owners and operators.  The particular goal stated in that article was to fill the buildings, attain high census, or as some industry leaders describe as putting “heads in the beds.”

Assisted living apartment. Photo credit: Vyolett

Assisted living apartment. Photo credit: Vyolett

My comment to this article centered on my work as a long-term care ombudsman (advocate for residents living in long-term care facilities).  I explained that when a new General Manager was hired for any of the facilities to which I was assigned, I made a point of meeting her or him to explain my role as a resident advocate and to get to know a bit about this new person who was now in charge of 50 to 100 or more residents.

I asked one particular newbie what he felt was the greatest challenge as the new General Manager for this particular independent/assisted living community.  “Fill up the apartments.”  I suggested that a more appropriate goal might be to retain the residents he already has.  I explained that retaining residents most likely means that he and his staff are doing the right thing in delivering the best care and customer service experience to each of his residents.

  • Retaining the residents he already has equates to fewer additional apartments to fill;
  • Retaining the residents he already has means satisfied residents who say great things about the building thereby attracting additional friends/acquaintances as future residents;
  • Family members of happy residents in LTC means happy adult children who will also spread the good news to others;
  • It stands to reason, therefore, that satisfied current residents are the best tool a manager can maintain in his marketing tool chest.
Dining room at my dad's memory care facility.

Dining room at my dad’s memory care facility.

I have retired from working in long-term care housing and from my advocacy work as a certified LTC ombudsman.  I know first hand the pressure that employees experience each and every month to report the right numbers to the corporate office.  The suits want the bottom line, baby, and if you can’t deliver the numbers they want and need, you’re outta there!  (Just like all the losing pitchers the Seattle Mariners have gone through in the past ten years or so.)

I’m not saying that the Suits are only concerned about profit, but I will say that perhaps their focus needs to center more on the delivery of exceptional care for those who are entrusting the Suits with the lives of mom, dad, spouse/significant other, or sibling.  Those family members want to be able to sleep at night knowing that their loved one is receiving the best care possible, the most nutritious meals known to man, and that their loved one is living in a safe environment staffed by employees who care.

All you have to to is deliver the best customer experience. Do that and the bottom line will take care of itself.

Alzheimer’s shifting personality

Little Did We Know.

The attached article from a blogger that I follow contains extraordinary prose on how dementia can fool, frustrate, and reward, all in one sitting.

Sundowner time

Sundowner time

Please take the time to read her accounting of how Alzheimer’s has encroached on her family.

Caregiving and The 36-Hour Day

A Caregiver’s Day.

Caring for a loved one is a full-time job, as one of my fellow bloggers clearly illustrates in the attached article.  Please read her article, especially if you’re not quite aware of how full the carer’s day can be.

My father died of Alzheimer's 10/13/2007. I'm on the left, then my hubby, then my brother.

My father died of Alzheimer’s 10/13/2007. I’m on the left, then my hubby, then my brother.

There’s a reason why the book, The 36-Hour Day (now in its 5th edition) is so popular with health professionals and family caregivers.  The subtitle for the book reads, A Family Guide to Caring for Persons with Alzheimer’s Disease, related Dementias, and Memory Loss.  As the former caregiver for my father who died from Alzheimer’s in 2007, I can verify that whether you are providing hands-on care or managerial long-distance care for a loved one, your job never ends.  A normal day is a relative term that changes with every day or hour – or as is sometimes the case – every minute.

My article, A normal day, caregiving style, throws a spotlight on how a patient’s and caregiver’s life changes once a diagnosis has been delivered.  The concept of normal is an ever-changing paradigm where the sand on the beach shifts so much, one can barely hold herself upright.

I celebrate all caregivers who manage this extraordinary task so well, and so devotedly.  You are a hero to many.

You are a hero to me.

Advocacy for long-term care residents

Alternate Title:  Give me a damn beer!

Lately I’ve read various blog posts mentioning that employees of long-term care (LTC) facilities are routinely disregarding the rights of their residents.  What’s that you say?  You didn’t know that when these older folks walked through the doors of a facility, thus giving up their cherished long-term independence, they actually gained rights that they never had before?  Here’s some information that will benefit you and your loved ones.  I’ll explain by way of providing a few examples:

  • Charlie moves his mother into a facility and the head of Health and Wellness strongly suggests that he not visit her for awhile so she can adjust to living in a different environment.

WRONG!  If mom wants her son to visit her, Charlie should ignore the “advice” of the H&W employee and visit mom as often, and as long, as he and his mom wishes.  Logic: What do you think benefits mom most?  The calming presence of her son who has been the only constant in her life, or the absence of any person or thing that would lessen the feeling of abandonment in a strange environment?

  • June, who is confined to a wheelchair, is forced to go to an activity by facility staff.  Apparently June’s family has asked staff members to make sure that June gets out of her room and socializes with other residents.  On this particular day June would rather stay in her apartment and watch game shows on television.

Who wins this argument?  June should because it’s her life, and neither staff, nor family, can force her to do anything.  Logic: Doesn’t someone who’s lived at least 7 or 8 decades have the right to make decisions that are important to her?  Yes – and that right is protected by law.  Legal implications: June is reliant on others to transport her to and from places, therefore when she’s taken to the activity room against her wishes, the law considers that action as physical restraint because she is “stuck” in the activity room and in her chair, and not able to physically move herself elsewhere on her own steam.  Additionally, the facility is guilty of coercion – forcing June to do something she doesn’t want to do.

  • George joins his buddies in the dining room for lunch and orders a chili dog and a Bud Lite.  When the meals for him and his buddies are served, George’s chili dog has been pureed and his beer has been substituted with a glass of iced tea.

Scc dining room & Don setting up ADilemma: The server tells George that his doctor ordered a pureed diet because George almost choked on a roll at a nearby restaurant and he risks aspirating on his food.  The server then tells George, and anyone within hearing distance, that his doctor also said George should not drink alcohol because of his diabetes.

Rights infractions: The server talked about a medical condition in front of his buddies by mentioning two medical conditions: George’s choking hazard and his diabetes.  That’s a violation of his privacy rights.  George is aware of the choking incident – and he is also aware that alcohol may not be such a good idea because of his diabetes – but he is making an informed decision to eat and drink what he wants, knowing all the risks involved.  Solution: Oftentimes facilities are worried about liability in these types of situations – very understandable.  To resolve such a concern, all that is needed is to conduct a “care conference” in which the health & wellness director, George, and perhaps his doctor by phone, discuss the risks inherent with George’s decisions.  They can easily discern that George has weighed the pros and cons and that although he acknowledges that doctor’s orders have been issued, George decides to disregard said orders.  Care conference notes should indicate the gist of the discussion; perhaps everyone in attendance signs their name agreeing that what is written in the notes accurately reflects the points covered in the discussion, and then everyone should be happy and no lawyers need to be involved.

I strongly suggest that you contact the long-term care ombudsman in your state should you have any inkling that your loved one’s rights are being neglected.  Visit the National Ombudsman Resource Center (NORC) and join with them to advocate for your loved one.  Everyone deserves to be treated with dignity, and certainly all of you would agree that all people should have a satisfying quality of life regardless of ones’ age and residential environment.

Final thought: put yourself in your loved one’s position … what would you want done on your behalf?

Submitted by Boomer98053, a retired Certified Long-Term Care Ombudsman.