Category Archives: Senior Housing

A loved one’s move into memory care

An Alzheimer’s Love Story: The First Day of the Rest of My Life.

Distraught manI hope you’ll watch the attached 4 minute video that chronicles a husband’s experience of moving his wife into a memory care facility.

This is not a decision that comes easily to anyone.

Think about it.  You’ve spent decades living with the love of your life.  Your days are structured around each other; the ebb and flow of all those hours are what you crave and enjoy.

You are faced with what will most certainly be an irreversible decision to leave your wife in the hands of others.  You feel guilty, regardless of how well-informed and appropriate the decision. Continue reading

Respect the crabby old lady

Angry personWhen I’m an old lady and end up in a care facility, I sincerely hope my personality and attitudes don’t relegate me to the category of “that crabby old lady in Room 210.”  Have you visited someone in a nursing home or hospital and had the distinct feeling that the patients were treated like numbers or medical cases?  You know what I mean: “the urinary tract infection in 4A” or “the decubitis in South 6.”  Wow, that’s a horrible thing to consider for myself: the history of all my years on this earth being characterized as a medical condition or an intolerable behavior resulting from that condition.

What about my history of being a pretty darn good mother/wife/business person/neighbor/community volunteer/friend?  Doesn’t that person still exist within the body occupying that bed?

Let’s all take the time to read this poem that depicts such a scene.  Gender-wise, this could be about a crabby old man as well. Continue reading

If Alzheimer’s disease isn’t a secret, then why are we whispering?

Alzheimers Research Funding Lags Other Diseases- Dementia – AARP.  The January/February 2015 AARP Bulletin focuses on the prevalence of Alzheimer’s disease in America.  The cover contains photos of fifteen celebrities who died from the disease.  Some of those spotlighted may surprise you because their cause of death was not broadcast to the media.

What a shame.

Quiet 2It’s a shame that the stigma attached to the disease still manages to relegate Alzheimer’s to the closet.  Cancer used to be that closeted disease – so much so that many years ago people shied away from even mentioning the word, preferring to call it “The Big C.”  Before Alzheimer’s disease, cancer was the whispered disease but now the populous embraces each and every body part afflicted, even those considered of a private nature: breast, ovary, prostate, rectum. Continue reading

Welcome to the year 2015!

2015 New Years

If you’re like me, you’re wondering how another year has slipped by so quickly.  I’m sure there were a few of the 52 weeks that seemed to slog by, but all in all we can now look back and marvel at what we accomplished, or what others accomplished in our stead, during the past 365 days.

An accomplishment with which I’m happy is having authored this blog for the past three and a half years.  I’ve provided this blog for you, but I’ve also provided it for me because I truly enjoy having the opportunity to share my experiences and my viewpoints; I hope in the process that I have encouraged, helped, and entertained you.  From the start of Baby Boomers and More in 2011 to the end of 2014, I posted 520 articles.  I’d be a very happy blogger if the quality of those articles surpassed the quantity because if I’m just talking into thin air without benefit to others, its hardly worth the space my blog occupies.

Here are links to the five most visited articles in the year 2014 based on WordPress statistics:
Continue reading

Fine tune your “boogie” for your later years

Please Santa, let me be the smiling lady that gets up and dances.

(photo courtesy of Pixabay)

(photo courtesy of Pixabay)

Are you preparing right now to never lose your boogie, no matter your age?  I am.  The attached article is a delightful story of how music affects the elderly – whether cognitively impaired or not.

The Alive Inside program proved how beneficial music therapy is to those whose world has diminished and whose communication and connection with others has been cut off.  Regardless of the music’s era, regardless of the generation listening to it, everyone can harken back to long-ago memories just by listening to familiar tunes that meant something to us then, and that mean something to us now.

Retaining ones essence and ones individuality goes far towards announcing to the world, “I’m still here; I’ve still got it; I’m still vital.”  As expressed in the article I’ve shared from a fellow blogger, I hope I will indeed be the smiling lady that gets up and dances, and I hope you’ll join me on the dance floor.

Long-term care residents’ rights: Part 6

Photo credit: Ian Merritt

Photo credit: Ian Merritt

Thank you for returning to this multi-part series on long-term care residents’ rights.  At the bottom of this article, you will find links to the previous five postings.  As this is the last in the series, I want to advise my readers that I have in no way covered every topic that could be covered in a series such as this one.  I have, however, covered complaint topics that quite commonly occur in long-term care settings.  In most complaint categories, more than one residents’ rights law has been violated.  For the most part, I have only mentioned one aspect of the law that addresses the rights violations.

Today’s topic covers the umbrella topic of dignity and quality of life.  Without exception, every rights violation is an infringement of a resident’s dignity and a detriment towards enhancing the quality of life residents should expect to experience.  The same holds true whether that resident lives in a “Champagne and Chandelier” facility or a “Generic Brand X” facility.  Regardless of how fancy, regardless of how bland, the same rights are afforded to all residents.  All situations listed in this six-part series assume a resident is cognitively capable of making his or her own decisions.

Breakfast in bed, pee on the side

I rolled over in bed thinking I might get a few additional minutes of sleep, but those potential minutes were rudely interrupted by the assault from the room’s overhead light, the hustle of someone rushing into my room, and the abrupt raising of the head of my electrically powered bed. I don’t know if you’ve ever tried to remain curled up on your side while half of your bed is put at a 90 degree angle, but trust me, it’s not possible and it’s not comfortable.

“Hey, Gloria, time for breakfast. Come on, open your eyes and sit up so I can give you your breakfast tray.”

I’ve lived in this nursing home for three months now and every time one of these care people talks to me, they call me by my first name, and in my eyes, that’s a sign of disrespect. “First of all, I’ll remind you that my name is Mrs. Lewis, and second of all, I absolutely cannot eat the morning meal prior to going to the bathroom. Please help me to the toilet and then I’ll have my breakfast.”

“No can do, Gloria, you’re just one of forty other patients I have to personally deliver meals to this morning. You should have thought of that earlier and asked one of us to take you to the toilet before we started delivering meals.”

“But I was asleep, and besides, I told the head nurse many times that I require toileting assistance and that I require it before my morning meal. How many other times must I make this request?”

“I don’t know, how many?”

I looked at this uncaring individual and pleaded with her. “Please won’t you take me to the potty? My bladder is ready to burst!”

“Look, I’m already running behind. Just go in your pants, that’s what your nighttime diaper is for any way. Sometime after your breakfast, someone will clean you up, but it won’t be me.  After I deliver all my trays, my shift is over.”

Imagine, if you can, not having the opportunity to use the bathroom after a full night’s sleep, and trying to enjoy a meal that is placed before you.  Then imagine not being able to hold it any longer and peeing yourself and sitting in it for who knows how long.  The above scenario is real.  A family member of mine experienced this exact scenario.  I also am acquainted with a gentleman who, after asking three times in a half hour period to be assisted to the restroom so he could evacuate his bowels, he was told “Go in your pants.  I don’t have time to help you right now.”  That neglect does not preserve a person’s dignity, nor does it promote quality of life.

42 CFR 483.15  Quality of life.  A facility must care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident’s quality of life.

(a)  Dignity.  The facility must promote care for residents in a manner and in an environment that maintains or enhances each resident’s dignity and respect in full recognition of his or her individuality.  See also Washington State law RCW 70.129.005 and RCW 70.129.140

What follows are a few other frequently occurring scenarios found in LTC residential settings:

Visitation policies: residents have the right to receive visitors of his/her choosing and a facility must not interfere with such access. There is no such thing as visiting hours, regardless of the LTC setting.  If an adult son’s work schedule is such that he can only visit before 8 a.m. or after 9 p.m., reasonable accommodation must be made to facilitate his visit.

Choices regarding schedules, clothing: regardless of LTC dining room and meal hours, a resident has the right to receive meals outside of those hours.  For example, if a resident is not an early-riser, he should still be able to acquire a suitable breakfast meal; this does not mean that he has full access to all that was offered prior to the “end” of breakfast hours, but he should still be able to eat breakfast items.  A peanut butter & jelly sandwich does not qualify as such – unless, of course, that’s his choice.  Unless a resident has turned over the responsibility of making daily clothing choices to a staff person, a resident must be given the opportunity to make clothing choices that are important to her.  Clothing choices promote individuality.  Each of you reading this article dress as you please; that shouldn’t change just because you move into an institutional setting.

Isolation & seclusion: punishment to a resident for perceived misbehavior in the form of prohibiting participation in dining room meals and/or activities of his choosing, is not appropriate and is a complete violation of a resident’s rights.  A better response to behavioral issues is to discern the cause of said issues, e.g., depression, medication anomalies, medical conditions such as a urinary tract infection (UTI).  Resolve the cause, and you resolve the effect.

Series links:  Part 1, the right to make choices that are important to the resident; Part 2, admission polices, waivers of liability; Part 3, eviction and discharge process; Part 4, substandard and neglectful care; Part 5, accepting or rejecting medical care.

If you or a loved one need assistance regarding LTC residents’ rights, contact your local LTC Ombudsman office which can be located at the National Long-Term Care Ombudsman Resource Center.

 

Long-term care residents’ rights: Part 5

Photo credit: Ian Merritt

Photo credit: Ian Merritt

Welcome to Part 5 of my series on long-term care (LTC) residents’ rights.  Part 1 focused on a resident’s right to make choices that are important to her.  In Part 2, I discussed the topic of LTC admission procedures, specifically, a Waiver of Liability document that is oftentimes included  in the admission packet.  Part 3 addressed eviction/discharge from a long-term care facility, and Part 4 addressed abuse and substandard care.  Today’s topic addresses a resident’s right to choose, or reject, prescribed medical care.

A pile of poo disguised as a hot dog

I guess when you don’t have a choice in the matter you gradually come around to liking life in the assisted living “community” as the staff at this facility like to call it. When I couldn’t get around my old place without the constant threat of falling in the neighborhood or falling asleep at the wheel of my 1994 Mercury Sable, I took my son’s advice as gospel, and let him move me five miles from my lady friends, and ten miles from the Baptist church I had attended for God knows how long.

Now, my only option is to attend an ecumenical service in the activity room each Sunday – it more or less satisfies those who rely on some sort of ritual to get them through the following week – and I have a completely new set of lady friends with whom I eat every meal.

It must be baseball season; for lunch today, the dining room is decorated with red, white, and blue crepe paper and the centerpieces contain a miniature bat and ball placed “just so” surrounded by a pile of sticky Cracker Jacks that we’re told are not edible, but I try one anyway and add credibility to the admonishment by spitting it out into my napkin.

Lord have mercy, we even have a special lunch menu from which we can choose what apparently is considered food one would eat at sporting exhibitions: hot dogs, hamburgers, fries, all served with a gigantic phallic-looking dill pickle on the side. Now, don’t act so shocked.  The young people don’t think us older folk know what the intimate body parts are called and that we would never know what to do with them even if we did, but let me tell you, my group of lady friends have a laugh or two over things of a sexual nature. We’re not dead yet and most of our memories of such things are still intact.

The four of us ordered the chili dog special and got caught up on all the latest news since the previous time we saw each other. About ten minutes later, my meal was served, followed by everyone else’s, and the young server said, “Bon appetite!” But something was horribly wrong. Before the gal got too far away, I beckoned her back to the table. “Sweetie, what is this pile of dog-poop looking stuff on my plate?”

“That’s your chili dog.”

“My lady friends ordered the same thing I ordered and yet look at each of theirs: a hot dog is nestled into a bun, smothered by chili, cheddar cheese, and a few onions. My hot dog, on the other hand, looks like a pile of poo!”

The waitress addressed me, and therefore all the other ladies at the table.  “We have a Special Menu report the kitchen & wait staff are required to review before each meal. There was an entry for you stating that all your food must be pureed because you’ve been having difficulty swallowing. Evidently, when you went out to dinner with your son a couple days ago, you almost aspirated on a piece of flank steak.  Remember?   The Maitre d’ of that restaurant had to Heimlich you. You could have choked! You won’t choke on pureed food – or at least we hope you don’t – so that’s what you have to eat. Doctor’s orders.”

My lady friends looked embarrassed for me and pretended that this youngster wasn’t talking about my health issues in front of everyone within hearing range. But that’s not the only thing that’s bothering me right now: I want to eat a chili dog that looks like the rest of the chili dogs on the table so I decided to tell the server. “I’m sorry, remind me of your name, sweetie?”

“My name is Jessica.”

I picked up the plate of poo and shoved it towards her. “Jessica, please toss this mess in the trash and bring out a real chili dog, and while you’re at it, I want a hefty serving of French fries as well.”

“I can’t do that Mrs. Bellamy, I’ll get in trouble.”

“You’ll get in trouble if you don’t provide me with the food that I’ve requested. Please take this plate away from me, my arm is getting tired holding it up.”

The youngster took my plate and with the other hand, signaled her boss to join her in the kitchen – no doubt to report my aberrant behavior. My lady friends, however, applauded my assertive efforts, and offered me a bite of their dogs while I waited for mine to be served.

Mrs. Bellamy’s pureed diet was prescribed by her doctor; as such, it is now a part of her medical profile at the assisted living facility in which she lives.  Mrs. Bellamy chose to ignore her doctor’s orders – certainly her right whether she lived in her private home or this public facility.  Residents at LTC facilities have the right to refuse prescribed treatments such as restrictive diets, medications, or physical therapy to name a few.  As cognitively capable adults, they have the right to go against doctor’s orders, fully understanding the risks of not abiding by such orders.

42 CFR 483.10

(b) Notice of rights and services.

(1) The facility must inform the resident both orally and in writing in a language that the resident understands of his or her rights and rules and regulations governing resident conduct and responsibilities during the stay in the facility…

(3)  The resident has the right to be fully informed in language that he or she can understand, of his or her total health status, including but not limited to, his or her medical condition;

(4) The resident has the right to refuse treatment, to refuse to participate in experimental research, and to formulate an advance directive as specified in paragraph (8) of this section;  …

(d)  Free choice.  The resident has the right to –

(1)  Choose a personal attending physician;

(2) Be fully informed in advance about care and treatment and of any changes in that care or treatment that may affect the resident’s well-being; and

(3) Unless adjudged incompetent or otherwise found to be incapacitated under the laws of the State, participate in planning care and treatment or changes in care and treatment.  See also Washington State law RCW 74.42.040(3)

Additionally, Mrs. Bellamy’s medical condition should  not have been discussed in front of everyone within hearing distance: her lady friends, other residents seated adjacent to Mrs. Bellamy’s table.  The HIPAA Privacy Rule also applies in LTC settings.  Jessica, the server, violated Mrs. Bellamy’s right to privacy by talking about her medical condition.

If you or a loved one need assistance regarding LTC residents’ rights, contact your local LTC Ombudsman office which can be located at the National Long-Term Care Ombudsman Resource Center.

Part 6, the final installment of this series, will deal with dignity and quality of life.  Part 6 will be posted on Wednesday morning, November 26.