Health & Wellness
App-licable to retirees
Some of us have owned smartphones for quite some time now. Others have finally joined the 21st century, just recently retiring their Motorola flip phone. (Love you Honey!)
Sure, the latest and greatest phones are used to make calls – oddly enough not as frequently as we send texts – but they can also help us through our day-to-day schedules. Jonah Bromwich, New York Times columnist, provides retirees with information on apps we might find quite useful. Read the rest of this entry »
Renaissance – Baby Boomer style
Abby Ellin, New York Times, writes about the late-life renaissances that many Baby Boomers experience when they re-decide what they want to be when they grow up.
When we were younger, many of us drifted into college studies and post-college careers that may or may not have been our first choice but at least paid the bills. As we near retirement, or even years before retirement, we wonder, “Is this all there is?” And when we wonder like that, we get dissatisfied, and when we get dissatisfied – if we’re gutsy – we’ll do what it takes to become satisfied. If we don’t attain our desired level of satisfaction, we’ll languish: lose vitality, grow weak, and become feeble. My oh my, is that what you want? Read the rest of this entry »
Neurological hell
NFL players are choosing early retirement. Is the future of football under scrutiny?
http://wapo.st/1xvFq9p
I LOVE football. Actually, I love the Seattle Seahawks, but I cringe each time a player gets pummeled in the head.
The above Washington Post article suggests American football may some day fall away as a sport, similar to what happened to boxing. Many years ago, I remember boxing being the sport that people gathered around their televisions to watch, whether at home or in the bars. I can understand why nowadays most of us would rather not watch two people bash each other in the head; a head with virtually no protection in the boxing ring. But even with all the sophisticated helmet and body gear covering football players on the field, players are still sustaining concussions that could sooner or later place them in neurological hell. Read the rest of this entry »
My Heroines: International Women’s Day
International Women’s Day: My Heroines. My heroines may look different from those posted in the attached article, and they certainly will look different from those you may consider as your heroines. That’s a very good thing because we all have different takes on the subject but the outcome is the same: heroines we admire that made a difference in their world, and in ours.
My mother: Patricia Constance Conroy Desonier was born in 1917 and died in 1994. Mom was a fair disciplinarian to us three kids and a fabulous confidant as an adult. To lose her when I was forty years old was a devastating loss for me. My biggest disappointment is that she didn’t live long enough to meet my current husband, an extraordinary man whom I met – almost exactly to the date – two years after mom died. Words to describe my mother (in addition to the above): talented musician, seamstress, faithful and supportive wife, involved parent, community activist, volunteer extraordinaire. Read the rest of this entry »
Requiem for the status quo
Allow me to reintroduce myself:
My name is Irene. I am the author of the upcoming novel Requiem for the status quo.
Some of you know me as a family member, friend, or casual acquaintance. Others are familiar with me as the author of this blog, a writer who has posted hundreds of articles over the past several years. Still others know me because of my professional connections as a volunteer advocate for vulnerable adults living in long-term care (LTC) facilities, or because of my years as an Alzheimer’s Association support group facilitator.
I’m here to announce that in addition to being the family member/friend/acquaintance/volunteer/co-employee of the past and present, I am also the novelist who has something to say.
“Oh my gosh Irene, I didn’t realize your book was already published!”
It’s not, but I’m actively pursuing agent representation by contacting several agents per day until I no longer need to.
“Why should people be interested in your book?”
Because I have an engaging way of writing about Alzheimer’s disease – a disease that will affect each and every one of you because until a cure or vaccine is developed to eradicate it, this disease is here to stay. Whether a person’s diagnosis falls into the actual Alzheimer’s category, or into one of several other dementia such as: vascular, lewy body, frontal temporal, Parkinson’s, or dementia resultant from a traumatic brain injury (TBI), there’s no escaping its effect on the unpaid caregiver (that’s you and me) and the person being cared for (spouse, partner, mother, father, brother or sister).
And here’s a fact of which some of you may not be aware: Alzheimer’s is not just an older person’s disease; an increasing number of people are being diagnosed well-before the age of 60.
“Say it isn’t so, Irene.”
I can’t do that. What I can do, however, is tell you a wee bit about my book: Read the rest of this entry »
A loved one’s move into memory care
An Alzheimer’s Love Story: The First Day of the Rest of My Life.
I 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. Read the rest of this entry »
Respect the crabby old lady
When 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. Read the rest of this entry »
When being a control freak is a very good thing
Think of a very uncomfortable subject that you don’t like to talk or even think about.
By any chance was that subject death?
If it is, you’re not alone. Given the option of getting a root canal or talking about our eventual demise, many would leap into the dental chair. Why? What’s so yucky about death? It’s an inevitable outcome of our life experience here on earth. To my knowledge, no one has successfully hidden from the grim reaper when it came knocking at their door. So what’s the big deal? I’ll tell you what’s the big deal.
Entering the arena of vulnerability
Now that my novel is finished, I decided to re-post an article I wrote about daring greatly. Everything we do requires a certain amount of risk: walking across the street, going on a 1st date, changing careers. But if we don’t take a calculated risk, we’ll never see the inside of the arena; we’ll never know what we missed.
I hope you enjoy reading this article that served to remind me that as I start to look for agent representation for my first novel, I should do so with the confidence that my vulnerability will one day pay off.
It’s not the critic who counts; it’s not the man who points out how the strong man stumbles; or where the doer of deeds could have done them better.
(Photo credit: Wikipedia)
The credit goes to the man who is actually in the arena, whose face is marred with dust and sweat and blood, who strives valiantly and who errs and fails, and is sometimes victorious. But when he fails, at least he does so daring greatly.
The above is an abbreviated quote from Theodore Roosevelt’s speech, Citizenship in a Republic a/k/a The Man in the Arena, delivered at the Sorbonne in Paris, France, on April 23, 1910.
Brené Brown, PhD, paraphrased the above when appearing on Oprah Winfrey’s show, Super Soul Sunday. I admit – I’m addicted to the types of shows that challenge the way I think, and/or that validate the way I think. This particular show that…
View original post 415 more words
A Super Bowl loss is not a matter of life or death
It may feel like that, but it’s really not. Win, Lose or Draw, it’s (only) a Game – Not a Matter of Life or Death – by Dietrich Gruen (Hospice Chaplain).
Dietrich Gruen, the author of the attached article, is a Green Bay Packers fan. My team, the Seattle Seahawks, beat his team in the game he references in his attached article. When I’m on the receiving end of a victory, I’m always cognizant of the fact that when I’m celebrating a win, there are those who are bemoaning a loss.
Well, let me tell you, the football field is a great equalizer, as was evident yesterday when the Seahawks lost the Super Bowl to the New England Patriots. It was a devastating loss, but it was not life-changing.
Sure, it may change some aspects of some of the Seattle team members’ lives, but it won’t alter what is truly valuable: life itself. With several hours separation between Seattle’s shocking loss and now, I’m able to re-categorize that loss as a speed bump. Read the rest of this entry »
Caregiving and the Super Bowl
This is NOT an article about football. Anyone who has a loved one for whom they provide care – whether hands-on or peripheral – knows all too well how unpredictable life can be with that 24/7 responsibility. We’d all like to think that special occasions and events are immune from medical emergencies and other disasters, but all too often that is not the case.
Welcome to the life of a caregiver.
I honestly didn’t think I had another football article in me but the unfortunate circumstances in my best friend’s life have proven otherwise. Read the rest of this entry »
Why I Volunteer For Research, Part II
This 2nd part in Ann Hedreen’s series about being an Alzheimer’s research subject will both make you cringe – ugh, lumbar puncture – and will make you proud to know that someone such as Ms. Hedreen exists in this oftentimes self-centered world in which we live. As someone whose father died from Alzheimer’s complications, I am most appreciative of her efforts. Although monetary donations are greatly needed, for me I find it far easier to open my wallet than to offer my spine for research. Not only did Ann offer her spine, she did it more than once.
by Ann Hedreen
Continued from last week…
Although being a control subject in Alzheimer’s research studies involves plenty of memory tests, there are neurological tests too. I was tickled with feathers, tapped on the elbows and knees, peered at with a penlight in my eyes. And there were psychological questions: On a scale of one to ten, do you usually feel life is worth living?
I was weighed and measured. I gave blood. I peed in a cup. My family tree was drawn, with special attention to anything that might be relevant: Grandma Cere’s Parkinson’s disease; Great Aunt Eine’s Alzheimer’s disease, which started in her seventies. I was approved for a lumbar puncture, more commonly known as a spinal tap, and a week later, I came back and curled up in a ball while two tablespoons of fluid were extracted from my spine with a long quivery needle: two…
View original post 477 more words
Throw a victory party, not a pity party, for yourself
Start the new year by celebrating your successes | Health | The Seattle Times. Dr. Tony Hacker’s article in the January 18, 2015 Seattle Times newspaper mirrors my thoughts: celebrate even the smallest of victories in your life.
Some of us feel our lives should be characterized by humility rather than pride. Sounds admirable but can lead to self-deprecation and result in drawing more attention to ourselves than not. One of the ways in which we practice this brand of humility is by being critical of ourselves when we don’t measure up to our great expectations. “…(I)f we set our standards too high we never feel that what we do is good enough.” What an unfair bar we set for ourselves. Read the rest of this entry »
Why I Volunteer for Research, Part I
In this particular instance, the thought of being a human guinea pig feels very, very comforting. Being able to help find a cure for Alzheimer’s that goes beyond monetary contributions sets up a legacy for many as a result of Ms. Hedreen’s extraordinary efforts. Ann Hedreen’s book is available on Amazon and at most retailers.
by Ann Hedreen
Here are two of the many things that scare me: having to change a tire all by myself (because I’ve never done it) and camping in bear country (because I have). Here are two of the few things that don’t scare me: taking pop quizzes and getting poked with needles. These slim categories of fearlessness make me a natural volunteer for Alzheimer’s research.
My mother grew up in Montana and nothing much scared her. She not only changed tires, she put chains on tires by herself, tying them together with shoelaces if they didn’t fit right, lying under the car in a snow storm. As for camping, after a twenty-year hiatus, she decided to try it again—solo, with four children in tow. We didn’t see any bears. The worst thing that happened was that we forgot spoons for our cereal. The best thing was being with Mom…
View original post 468 more words
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.
It’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. Read the rest of this entry »
Caring for our elders
9 Reasons why it‘s important to care for our elders – by Sai Santosh K.
The attached article from the Kindness Blog immediately caught my attention. Please take the time to click on the above link to discover nine easy ways to help an elder in your community. Whether that person is a family member, or a perfect stranger, the basic truth remains the same. As an advocate for the elderly I can’t help but encourage all of us to practice respect for those older than ourselves. Read the rest of this entry »
Welcome to the year 2015!
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:
Read the rest of this entry »
Do you believe in magic?
My December 29, 2012 Horoscope:
Today is a 7. Now’s perfect to start a new writing project; no need to wait until next year. Put down your thoughts without worrying about form, one word at a time.
Prior to 12/29/2012 I would have stood by my belief that Horoscopes are merely faulty predictions by faulty people provided to those of us who are humored by such baseless declarations of personalized present and future outcomes.
But that personalized declaration for Irene on a day in late December 2012 was right on the money.
The backstory: During the summer of 2012 I made the decision to write a novel that focuses on the lives of caregivers of loved ones with Alzheimer’s and other dementia. The focus would be split with equal attention spent on the person with the disease. My book’s mission: to put a personal face on those every day people (that’s you and me) thrust onto the memory-removing disease journey. Once I made the decision to write a book, I set January 1, 2013 as the start date for my project.
That start date was moved up based on the extremely accurate Horoscope (see above) for this wannabe author whose birthday fell under the sign of the bull: Taurus.
I obeyed the directive and sat at my computer that very day and managed to write page after page of content. Wow! I’m writing a novel! It was quite exhilarating being able to spew page after page of fictional story line based on experiences I had with my father, my sister-in-law, and the many people with whom I became acquainted during my years of work with vulnerable adults.
I finished the “final” version of my manuscript earlier this month and set the timeline for next steps: starting January 1, 2015 I will actively seek representation for my novel. Oddly enough, that seems to jive with today’s Horoscope (2 years after the first timely Horoscope) if you force a few of the jigsaw puzzle pieces to fit what’s currently going on in my life.
My December 29, 2014 Horoscope:
Today is a 6. Hide away somewhere peaceful and you can get some productive thinking in. Inspire intuitive leaps. Creative work pays well now. Don’t squander an enticing opportunity. Meditate on it, and your choice comes to you. Nurture your physical health with exercise, good food and rest.
I guess I may as well get to it based on previous personal declarations that brought me to this stage of my writing career. Seriously, why wait when I can do it now?
If you’re interested in how this all pans out for me, I hope you’ll Follow my blog for updates. If you’re already a Follower, stay tuned for more predictions and/or fabulous outcomes.
My wish for you: joy in good measure
It’s always a pleasure putting my thoughts and words out there to those who follow me and to those who, by happenstance, land on my site. Either way, I’m grateful for your attention.
Some of you are anticipating a joyous Holiday experience.
Others are biding their time wishing the season would quickly pass them by, especially now that they are constantly bombarded by good vibes that they believe have no chance of alighting on them.
If joy is your portion this season, please share your delight with those who are lacking – either directly, or through your projected good wishes and thoughts. I strongly believe that positive energy has a way of catching up with those depleted souls in need of a boost.
Sometimes our light goes out but is blown into flame by another human being. – Albert Schweitzer
I have some light to spare, do you?
Welcoming light from a neighbor’s living room
Have you ever struggled to fall asleep or stay asleep? At some point during that struggle, did you say to yourself (yourself being the only person awake at the time) Screw it! I may as well get out of bed and start my day.
There are far too many of those late night and early morning day-starters for me to recount in this article – the most recent being Monday, December 22nd when my day started at 3:30 a.m. My “best” record occurred a few years ago when I never managed to fall asleep so in that instance my day started the previous day. Read the rest of this entry »
Viral construction cranes or vibrant human activity?
Guest: As Seattle grows, will the community and character stay? | Opinion | The Seattle Times. by Taso G. Lagos
Here we go again: I’ve linked another article about neighbors and community. I’m not making this stuff up, folks; I’m not the only person out there who appears to be hyper-focused on neighborly kinship. When I posted my article, The importance of good neighbors, I had been experiencing a comforting sense of neighborliness resultant from how attentive my neighbors have been to me after a recent household accident in which I injured my back and right hip. Their outpouring of support wasn’t surprising to me at all – my neighbors are what I consider super neighbors – but their support clicked with me in such a way that I had to boast about them; so I did. Read the rest of this entry »
Positive community activism
Seattle Profile – Volunteering and Civic Life in America.
The Seattle Times newspaper posted an article touting Seattle’s stellar volunteer rate for 2013:
34% of Seattle area residents volunteer ranking Seattle 4th among the 51 largest volunteer locations. After researching that article, I found the attached report detailing my area’s community service activities. You can locate your State and city in the report to discern the degree of your community’s civic life.
This report shines a light on content that I recently provided in two articles posted to this blog: Restless in retirement? You don’t have to be, and The importance of good neighbors.
38.7 percent of Washington State’s Baby Boomer population volunteered in 2013, ranking my state’s volunteering Baby Boomers 6th out of 51. See? You’ll be in good company when you turn your retirement restlessness into service for others.
64.9 percent of Washington State residents participate in “informal volunteer activities” defined as doing favors for neighbors. Wow, that’s a lot of people getting to know their neighbors and “having their backs.”
You don’t have to give up all of your free time to help others.
I’ve heard people say time and again that they can’t spare another 40 hours a week to become a volunteer. Who asked you to?
There are countless volunteer opportunities that only require a couple hours a week. My best friend volunteers as a companion to a disabled person who needs transportation assistance to shop and/or to attend doctor appointments. A fellow Bar Method exerciser volunteers once a week at a local food bank to provide much needed sustenance to those in her community. Wow, such a small commitment of time that provides a service for which others cannot do without.
Thank about it: if you spent two or three less hours a week watching television, or two or three less hours working on home projects, or two or three less hours sitting at the computer (point taken), you’ll still have oodles of free time left after spending a fraction of your week focused on someone else.
Wow, when put that way, volunteering sure sounds easy, doesn’t it? And here’s a resource that will help direct you to volunteering and other worthwhile community involvement: Sixty and Me.
(All images courtesy of Pixabay)
The importance of good neighbors
I love the fact that my husband and I have a wonderfully supportive group of neighbors in my rural Redmond, Washington location. The houses in my neighborhood are quite spread out, but within the three adjacent houses to ours reside extraordinary people who, if asked, would certainly give the shirt off their backs.
We watch out for each other. If one of us hasn’t been visible for awhile, we check to make sure all is well on the other side of the fence.
If one of us grows an over abundance of flowers in the spring and summer, we e-mail each other and invite one and all to come over to pick them so as to liven up their own homes.
When a medical issue comes up of which we become aware, there’s always an offer of transportation, or meals, or “what do you need?” extended from the four households.
I think there’s far too much seclusion in society where we fail to even know by appearance who our neighbors are. Forget even being aware of their names or their family situation; we don’t even know what they look like. It’s no wonder we read news stories where a neighbor was found deceased in their house days or weeks after the fact because no one noticed they hadn’t been visible as of late. Isn’t that a horrible statement about society, that someone could pass from this life without anyone noticing?
My neighbors and I are lucky; we care about each other and because we care about each other we watch out for each other. We’re not “besties” – we don’t get together for backyard BBQs and dinners every weekend – but we’re tuned into each other because we realize the importance of community in a world where some day, that may be the only thing upon which we can rely.
If you make New Years resolutions, how about committing yourself to meeting two or three of your neighbors before the end of 2015. I mean, how hard could that be? If you’re in a multi-unit building, start up a conversation with the person picking up their mail, or instead of feeling awkward during that elevator ride to your respective floors, strike up a conversation that may expand your immediate community from “me, myself, and I” to “you and me.”
The phrase, “I’ve got your back” is a motto that we should follow. Among other things, it means:
- I’m going to watch out for you and be a second set of eyes for you;
- I will look out for your best interests;
- I will stick up for you.
I don’t know about you, but it feels pretty darn good knowing that someone else cares enough to do that for me.
Fine tune your “boogie” for your later years
Please Santa, let me be the smiling lady that gets up and dances.
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.
A doctor’s time vs a patient’s time: which is more valuable?
You call the clinic to make an appointment: “Your appointment is at 11:30 a.m. but you need to check in early at 11:15.” I always obey and I always arrive at least 15 minutes early.
Yesterday I was ushered into the exam room a wee bit early, 11:20 a.m., but I didn’t mind waiting in that room for the start of my 11:30 appointment. At 11:35 I heard my doctor enter the room next to mine and greet her patient. “Huh,” I said to no one in particular.
She concluded that appointment at 11:50, then I heard her make two consecutive telephone calls in the “Staff Only” portion of the area. “Huh!” I said again, this time with emphasis.
At 11:55, she started yet another call. I slapped my knee, and because I was in my street clothes, I walked out of the exam room, entered the “Staff Only” area and stood in front of her. She concluded her call and walked with me into the exam room. “Sorry, I had to make a few calls.”
“I’m just wondering, do the schedulers overbook the appointments? My appointment was for a half hour ago.”
I honestly don’t think doctors are aware of the appointment times, they merely walk down the hallway going to the next room in the chronological order in which the medical assistant places the files. My doctor apologized and stated she was not aware that she was so far behind. She explained that some patients need a little more talking-time so she tries to accommodate their need.
And I get that, because sometimes I need a bit more talking-time, just as I did yesterday. So what can be done?
There seems to be only one solution over which I have control.
From now on, I will not arrive 15 minutes early for my appointment. Even if my doctor runs late, at least I won’t be spending as much time at the front-end of the appointment as I will no doubt spend at the middle and back-end of it.
Long-term care residents’ rights: Part 6
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.
Legal loopholes, doggie-style
Integrity, n.1 the quality of having strong moral principles; 2 the state of being whole;Concise Oxford English Dictionary, 11th Edition, 2004
Integrity, n. the quality of being honest and fair; the state of being complete or whole; Merriam Webster
I respect the law and I respect the attorneys with whom I have worked and/or done business. What I don’t respect, however, is when ridiculous legal loopholes exist, and those legal loopholes are taken advantage of to the detriment of others.
Here’s my story. I was attacked by two dogs while walking in my neighborhood on May 7, 2014. While the dogs were in active attack mode – barking and chomping at my feet while I concurrently screamed at the dogs to leave me alone – the owner of the dog, whom I could hear but not see on their property, never came out to discover what the ruckus was all about. Then one of the dogs bit me, and shortly thereafter, both dogs retreated back to their property. I yelled to the owner, whom I still couldn’t see, “Your dog just bit me!” To which she replied, “Sorry.”
I chose not to approach the offending dogs’ house to confront the owner because quite frankly, I was afraid the dogs would consider me an even greater threat than when I was on the opposite side of the street from their house. Instead, because I was still able to walk, I hiked the remainder of the way to my house, cleaned my wounds, and headed to a hospital emergency room. After being treated, I returned home and filed an online complaint with my county’s animal control division.
The dog owner hired an attorney to fight the vicious dog charge and the inherent requirement to keep the dog contained at all times when outside. The attorney postponed the appeal hearing three times. The most recent hearing date was to be November 17, 2014. I planned on attending the hearing, even though I had submitted the following to the appeals court: 1) online official complaint with photographs of my injury; 2) my supplemental statement augmenting the county’s complaint form; 3) ER medical records documenting my treatment; 4) a receipt from the hospital where I sought treatment for my portion of the visit, $50.
The legal loophole was created the day after the incident. An animal control officer interviewed me at home and the dog owner at her home. Immediately after the latter, the officer gave the dog owner a 2-page handwritten citation summarizing the incident and detailing the infractions: 1) two unlicensed dogs; 2) two dogs at large; 3)two dogs without up-to-date rabies vaccinations; and 4) having a vicious dog on the premises. Biting a human being = vicious dog. When the investigating officer returned to the county animal shelter, he inputted all applicable information electronically into the shelter’s database. The written citation which was personally handed to the dog owner who signed the citation as proof that she had received it, did not specify which of the dogs bit me; the electronic citation did. That discrepancy voided the credibility of the animal control citation process.
I’m kidding, right?
A settlement was reached between the dog owner’s attorney and the county animal control agency stating that the dog containment order was rescinded and the vicious dog designation was removed. The attorney would agree to all the citation fees – totaling $850 – if animal control would give the dogs/dog owner a clean record in the matter. Animal control agreed. Keep in mind, part of that $850 was a $500 vicious dog citation. The dogs were vicious, there’s no question about that. The fact that the attorney agreed to let his clients pay all the fees speaks to that, as well as the fact that the dogs’ behavior satisfied the legal requirement to meet the definition of vicious.
The owners were penalized, why should I still care?
Because the only penalty they received was monetary. My neighbors and I did not benefit at all from the dissolution of the matter. The vicious dogs are not required to be contained on their property and there will be no vicious dog record of this incident should they ever get cited again. If the vicious dog designation had been honored, the repeat offender fee would jump to $1,000 just for the vicious dog designation.
This doggie-style loophole is a pain in the rear.
Long-term care residents’ rights: Part 5
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.
Long-term care residents’ rights: Part 4
Welcome to Part 4 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. Today’s topic addresses substandard and neglectful care. Let’s look at this scenario:
Take the pressure off Mom
My mother was the quintessential social butterfly but not in the way one might imagine. Her social involvement didn’t include tennis or golf, nor did it center on being seen at extravagant galas around the city. My mother, Joan Young, socialized with the homeless, the hungry, and the vulnerable. Mom was a volunteer extraordinaire whose monthly calendar was filled with opportunities in which she would donate her time, her resources, and her compassion.
One of her most time-consuming, but most gratifying volunteer venues, was as an activity assistant at Shady Rest Nursing and Rehab Center. That same venue is now her permanent home where she’s lived the past month and a half since a massive stroke robbed her of the ability to speak or move her limbs. We think she understands what we say to her because oftentimes she’ll get a twinkle in her eye that appears to relay some sort of connection with us. The experts say she most likely still recognizes us, but even if that is not the case, I hope the presence of smiling, happy visitors go far towards improving her quality of life.
The last few days, however, mom was withdrawn, and more often than not, she slept through my visit. Because I live within close proximity of the Shady Rest, I visit her almost daily. Dad and his wife live another state over, so although they were on speaking terms prior to mom’s stroke, speaking to anyone isn’t really mom’s strong suit right now. I don’t mind carrying the torch for mom; she’d do the same for me.
After four days of a significant reduction in alertness, I talked to the head floor nurse to discuss mom’s change in condition. She assured me that one can expect sudden changes in levels of cognition after the assault that was placed on her body as a result of the stroke. The nurse told me to toss my cares aside and trust the Shady Rest staff with mom’s care. “She’s in good hands, Robin. There’s no need for you to worry. If there is ever anything that needs medical attention, be assured we’ll take care of her.”
But they didn’t. Three days later, I noticed a fetid smell as soon as I entered her room. At first I thought that perhaps mom had gone Number 2 in her adult diapers but when I lifted up the sheet that covered her body, I saw she wasn’t wearing any. But oh my God, the smell was even worse. I looked behind me to see if anyone was looking, and seeing that the coast was clear, I gently rolled my mother’s body away from me and discovered the source of the stench: an oozing, red and green sore about the size of a quarter on her left buttocks. I couldn’t help myself; I ran into the bathroom and threw up the lunch I had eaten prior to arriving.
Then I pushed the Call Button which is supposed to summon a health worker post-haste – or so I was told when mom first moved in. Three minutes ticked by: no response. I pushed the button again, this time walking to the doorway of mom’s room to look up and down the hallway for signs of incoming staff members. Not a soul in sight.
I left my mother’s room in search of a staff person and landed in front of the nurses’ station. I pounded on the counter, “Hello! I’m Robin, Joan Young’s daughter. I called you twice from my mom’s room.” That’s when I heard, for the first time, a sound that in the past always seemed to be an indeterminate background noise: the persistent dinging of Call Button tones from various rooms on the floor. A quick glance up and down the hallway also showed lights blinking above numerous rooms that coincided with each ding.
I pounded the counter again and pointed at the LPN sitting at a computer. “You, follow me.”
“Miss Robin, I’m finishing up a report, I can’t leave my desk right now.”
I tossed all protocol to the side, walked behind the counter, pulled the computer mouse out of her hand, jerked her chair back and tilted it forward. “Come with me, now.”
That seemed to work but I didn’t take any chances. I held her hand and pulled her down the hallway into my mother’s room. “Do you smell that?” And then I pulled down the sheet on my mother’s bed, gently rolled her away from us and added, “Do you see that?”
“Oh my, Mrs. Young has a bed sore.”
“Ya’ think? This sore didn’t just materialize in the past three hours ya know. It’s been festering.”
“You could be right.”
“No, I am right. I want you to summon the head of nursing and I want you to summon her now. Tell her to meet me in my mom’s room, ASAP.” The LPN didn’t move, so I pushed her out the door. “Go!”
*****
The bed sore – or decubitus – had yet to go bone deep. Had that been the case, mom would most likely not have recovered from the infection. As it was, her health never returned to its previous state, even with the excellent care she receives at a different nursing home, thirty miles away from where I live. Sunnyside Nursing Home wasn’t as fancy as the other place, but obviously, looks can be very deceiving. What my mom saw as an activity assistant volunteer was far different from what she experienced as a patient. When we chose Shady Rest as her new home, we did so without the benefit of readily available resources that would have provided red flags as to the quality of care provided. We figured, “Heck, mom loved volunteering at Shady Rest, why look any further?”
Shame on us.
Joan Young was the victim of willful inaction that caused a potentially fatal injury to her person. Joan’s inability to verbalize or express her pain and discomfort, other than the withdrawal and malaise eventually recognized by her daughter, put Joan at even greater risk of serious health decline resultant from the unattended bedsore. Facilities must assure that a resident’s body is routinely turned to different and varied sitting and lying positions in an effort to prevent such bedsores. In addition to bedsore prevention, if Joan had been diligently cared for – for example, if her ongoing bathing and care plan had been strictly followed – any skin abnormalities would have been immediately noted and attended to and infection could have been avoided.
42 CFR 483.25 Quality of care. Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care …
(c) Pressure sores. Based on the comprehensive assessment of a resident, the facility must ensure that –
(1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable; and
(2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing. See also Washington State law RCW 74.34.
Some of you readers might be thinking, Well, if her daughter had been more attentive, she would have noticed the sore earlier or Why didn’t she say something about her mother’s malaise right away instead of waiting several days? Being an armchair quarterback is a very easy position to play. The very unfortunate – yet somewhat understandable – attitude of some family members and/or patients is: This is a licensed facility staffed by medical professionals; who am I to question their ability to take care of my mother? The answer to that is obvious: even when a family member moves into a long-term care setting, you must continue to exercise your role as family advocate. I understand the relief one feels of trusting ones care to a staff of professionals, but the unfortunate truth is sometimes that trust is misplaced.
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 5 of this series will deal with a resident’s right to make choices about their own medical treatment. Part 5 will be posted on Friday morning, November 21.
Long-term care residents’ rights: Part 3
Welcome to Part 3 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. Today’s topic speaks of the practice of illegal discharge from a LTC residential setting.
Adios, Mr. Reilly
“What do you mean I have a week to move my father? For what reason?”
Raymond Ortiz, the Easy Breezy Group Home owner, situated himself in the plush chair in which he was sitting, opened up the manila folder that was on the desk in front of him, put on his reading glasses, scanned the piece of paper inside, and then closed the folder. “I know this seems to be coming out of the blue, but the staff and I have decided that your father just doesn’t fit in with the rest of the residents. They, and us, would be happier if Harold wasn’t living here.”
I couldn’t believe what I was hearing; dad had lived at this group home for three months without a complaint from anyone, and now this? “What specifically has he done – or not done – that renders him an unsuitable resident? What do those notes in my dad’s file specify as the reason?”
“You see, it’s not as simple as that. Your father hasn’t complied with the way the other residents live, and let’s not forget, they were here before him.”
I was having a hard time controlling my temper. Through gritted teeth I said, “Specifics, please.”
“For one, he wakes up earlier than the other five residents – sometimes as early as 6 am – and in the evening, he insists on staying up well past 10 pm. His early morning schedule disturbs those who are sleeping, as does his late night schedule. I’m sure you can understand that sleep is a very important aspect of our residents’ healthcare and when that is jeopardized because of just one of our residents, we have to take measures to accommodate the majority.”
“Wait a minute, you mean to tell me that the other residents’ schedules are more important than my father’s? That’s utterly ridiculous. Tell me, is my father doing jumping jacks in the middle of the living room with the stereo blaring while everyone is asleep?”
“Now you’re being silly.”
“No, Mr. Ortiz, now I’m getting angry. If dad isn’t making a ruckus, why the concern? My father has always been an early riser – moving in here shouldn’t require that he change that feature of his life; same goes for staying up later than the others. His end-of-day routine has always involved sitting down with a good book and reading – sometimes for hours on end. What’s so disruptive about that?”
“Two things, really. He flushes the toilet, which of course makes noise, and the resident on the other side of the bathroom hears the flush and his sleep is disturbed. Also, the evening caregiver has evening chores to do and afterwards, lays down on the couch to be rested up for the next day’s activities. He can’t sleep while your father is still awake.”
I closed my eyes and tried to compose myself. “Look, when my dad moved in, you made a point of telling us that Easy Breezy is his home, just as if he owned the place, just as if he’d lived here all his life. Kind of like, ‘Mi casa es su casa’ and I took you at your word. Nothing you’ve said today jives with that sentiment, and I’m quite sure that nothing you’ve mentioned is grounds for throwing him to the curb. First of all, I know you have to give written notice and it has to be given with more notice than you’ve given me, and I’m damn certain your flimsy reasons won’t stand up to legal scrutiny once I’ve looked into this.”
“Now Ms. Reilly, no need to get all huffy about this. That’s just the way it is; majority rules.”
I stood up, slung my purse over my shoulder and said, “We’ll see about that Mr. Ortiz. I’ll be back.”
As Ms. Reilly surmised, any notice of discharge must be made in writing and must be provided at least 30-days from the date of discharge from the facility (said requirements stated at length in 42 CFR 483.12.) Federal and State governments make it very difficult for administrators/owners to move a resident out of their property. As stated in the CFR below, there must be a very valid reason, e.g., health and safety of individuals are in jeopardy, and certainly that is not the case in the scenario above.
42 CFR 483.12 Admission, transfer and discharge rights.
(2) Transfer and discharge requirements. The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless –
(i) The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility;
(ii) The transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility;
(iii) The safety of individuals in the facility is endangered;
(iv) The health of individuals in the facility would otherwise be endangered; See also Washington State law 70.129.110
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 4 of this series will deal with abuse and neglect of residents in LTC facilities. Part 4 will be posted on Wednesday morning, November 19.
Living: the ultimate team sport 