Health & Wellness

Retirement communities: the good and the bad.

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In the April 2012 issue of the AARP Bulletin, two articles caught my eye.  The first article, “To be a Bride Again at 100” (attached is the video link) celebrates the marriage of Dana Jackson, 100 years old, to her groom, 87 year old Bill Stauss.  This is a love story between two residents of a nursing home in Bowling Green, Kentucky.  This nursing home celebrated their love, and their death-do-us-part vows, in such a lovely way.  The management and staff of the nursing home exhibited a wonderful sense of community and support of Dana and Bill.  Whether they realized it or not, the staff at the Rosewood Health Care Center helped the newlyweds exercise their rights as long-term care residents.

The second article in the Bulletin’s column, What an Outrage, “Barred from a fine dining restaurant,”  shines a spotlight on a Virginia retirement community that not only did not exhibit a sense of community and support, but they quite literally violated the rights of a husband and wife living there.  When the husband’s care needs required him to switch to the skilled nursing care portion of the retirement community, while his wife remained in the independent living portion of the community, their meals together were abruptly stopped.  The wife could continue to dine in the fine-dining restaurant of the retirement community, but her husband was barred from doing so.  He and the other sixteen nursing care and assisted living residents were required to eat in their own separate dining room.

Harbor’s Edge retirement community had a couple non-fatal choking incidents involving three of its nursing care and assisted living residents in 2011 so a new rule was put in place segregating the more inform from the less infirm, even going so far as to ban the more infirm residents from attending events where food was served.  Keep in mind, residents in this retirement community make a sizable deposit to live there, to the tune of a half million dollars, PLUS a $5000 monthly fee.  I guess money doesn’t buy happiness but it sure should have bought these residents the right to eat where they pleased!

The outcome: the Virginia Department of Health was contacted and soon thereafter, the ban was lifted.  In Washington State, laws are in place to protect the residents of long-term care (LTC) facilities so that these residents can experience a dignified quality of life.  Vulnerable adult residents are guaranteed specific rights by law.  Revised Code of Washington )RCW) 70.129.020 Exercise of Rights, says in a nutshell that a resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility…The resident has a right to be free of interference, coercion, discrimination and reprisal from the facility in exercising his or her rights.  The remainder of RCW 70.129 further details all the civil & resident rights afforded vulnerable adults in the State of Washington.  If in your experience you suspect that someone’s long-term care resident rights are being violated, please contact the long-term care ombudsman program in your state by visiting the attached weblink for the National Long-Term Care Ombudsman Resource Center.

What great, and not so great, experiences have you had relative to long-term care residential living?  I would love to hear from you so we can celebrate the good, and expose the bad, for all of our benefit.

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Alzheimers Test, the Alzheimers Questionnaire Alzheimers Reading Room

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Alzheimers Test, the Alzheimers Questionnaire Alzheimers Reading Room.

No test for Alzheimer’s disease is fool proof and I would venture to say that ALL tests of this nature aren’t black & white.  There are many gray areas when attempting to discern the presence of Alzheimer’s or other dementia in its earlier stages but as is often said, knowledge is power and certainly some information and guidance is better than none.  I hope the article linked here will prove helpful to you.

What are YOUR Lack-Of-Customer-Service Pet Peeves?

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Here are just a couple of mine.

Today I experienced the inevitable straw that broke the camel’s back regarding poor customer service that inspired me to write this article which, I warn you, will be full of complaints and negative energy.

I’ll start off with the incident that inspired the diatribe you’re about to read:

The original Piggly Wiggly Store, Memphis, Ten...
The original Piggly Wiggly Store, Memphis, Tennessee. (Photo credit: Wikipedia)

Grocery check-out lines.  Purchased my weekly dose of grocery items today – a mere $225 worth.  From the start of the transaction to its bitter end, the checker didn’t utter one word.  No baggers were in sight so I started to bag my own groceries, even though there were two employees standing five feet from me at the self-checkout area with nothing to do other than to watch this Baby Boomer bag her own groceries.  (Bagging groceries by employees is still a common practice at most supermarkets in Washington State, including this one.)  The transaction ended with the checker putting a couple remaining items into a bag, handing the receipt to me, logging off his register, and walking away.  Mind you, all my grocery bags still remained on the checkstand counter, leaving me no option but to personally place them in my grocery cart.  I feel a letter to the manager forming in my brain – not the first letter I’ve written to grocery store managers.

A patient having his blood pressure taken by a...
I don't know why THIS guy is so happy! (Photo credit: Wikipedia)

Assembly line doctor visits.  I’m convinced that doctors are required to meet a certain patient quota per day – at least my doctor is.  The last few times I’ve visited her, she’s rushed me through the visit, even going so far as to do the following: 1) using a hand gesture to hurry me up – picture her hand going in horizontal circles in front of her while I’m trying to explain my reason for the visit; and 2) two weeks after major spine surgery this same doctor expressing her impatience by saying, “Hurry Irene, this appointment needs to end!”  Sorry to have messed up your day, doc! How callous of me for talking to you about my horrific and painful surgery experience!

A surgeon’s god-complex.  I just have to mention the aforementioned surgery experience.  A neurosurgeon operated on me a year ago to perform an anterior cervical spine disc replacement and vertebral fusion: a four hour surgery, one night in ICU, a full year of recovery.  At my two-month post-surgery appointment with this god-surgeon, I explained how difficult it had been going through such a drastic surgical experience.  His comment, and I quote, “It wasn’t that drastic of a surgery.”  Ahem.  My comment, and I quote, “It may have been the 5000th cervical spine surgery you’ve attended but it was my first!”  Imagine him minimizing my surgery, thereby dismissing my discomfort and recovery experience?!  Grrrrrr.

Before my blood pressure rises to unsafe levels – which would take a lot because my normal BP is 96/65 – I’ll stop right here to let you vent about YOUR frustrating lack-of-customer-service experiences.


Making Memory Books for People with Alzheimer’s Disease or Dementia.

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Making Memory Books for People with Alzheimer’s Disease or Dementia..

This post, from a wonderful Blog about caregiving, http://www.letstalkaboutfamily.wordpress.com provides an excellent idea.  It’s never too late to start this project for a loved one with Alzheimer’s or other dementia.

Long Term Care Insurance scares me.

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insurance, n. A thing providing protection against a possible eventuality.  Concise Oxford English Dictionary, 11th Edition; 2004.

Result of a serious automobile accident
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Auto insurance, home or renters insurance, and health insurance – we understand these policies and know that more likely than not the need for the aforementioned insurance policies will rear its ugly head in the near or distant future so we pay the premium for said policies, hoping we won’t need it, but sleeping better at night because we have it.

Why is purchasing long-term care insurance such a difficult step to take for me and my husband?

  1. Unquestionably, it’s expensive;
  2. Fearfully, companies who offer this product are going out of business left and right and may leave us holding an empty bag;
  3. Definitely, it’s a real difficult type of policy to understand; but
  4. Undeniably, the financial need for it can outweigh the cost of purchasing it.
New Orleans, 1942. Doctor at Marine Hospital p...
Image via Wikipedia

My husband and I have still not made an effort to look into it further.  Here are my two reasons based on family experience – both of which tend to contradict each other:

My father’s long-term care insurance policy.  My father had a long-term care insurance policy for which he paid premiums for at least 20 years – no small amount of money to be sure.  He was diagnosed with Alzheimer’s at the age of 84 and died five years later.  His care needs at the retirement facility in which he had lived for 13 years didn’t meet the insurance reimbursement threshold until his final month of life.  As with most policies, the insurance holder’s care needs must meet a defined level of care before the insurance company kicks in their assisted living care reimbursement payments.  When that happens, the insurance holder no longer pays any more premiums.  Twenty years of paying premiums for one month of reimbursement benefit.

My sister-in-law’s long-term care policy.  My brother and sister-in-law purchased their long-term care insurance policies when they were in their late fifties.  Less than a year later my sister-in-law was diagnosed with early-onset dementia and approximately two years later drew benefits from her policy.  A couple of years of paying premiums for what will be years of reimbursement benefit.  If that isn’t the good news/bad news of long-term care insurance I don’t know what is!

I have no excuse. I know the devastating costs of long-term care because in my past professional life I worked for a senior housing provider and they represented the Champagne & Chandelier variety of assisted living.  But even the generic assisted living providers charge high rental rates and as ones’ care needs increase, so do the care fees.  This isn’t avoidance behavior on my part and I’m not squeamish about the subject of health and ones’ eventual death.  I’m just finding it hard to take this leap into signing up for insurance, even though it holds the assurance of fending off the potential of total personal financial collapse without it.

How are you Baby Boomers dealing with this subject?  If you finally bit the bullet and purchased a policy – how did you finally take that leap of faith?

I AM NOT LOOKING TO BE BOMBARDED BY SELLERS OF INSURANCE AS A RESULT OF THIS BLOG ARTICLE SO PLEASE DON’T GO THERE.  But I welcome other constructive feedback for those of us on the brink of making this difficult decision.

Sufficient caregiver training: vulnerable adults deserve nothing less.

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Local and Federal governments have more red on their accounting ledgers than black.  Citizens balk against any raise in taxes, regardless of how infinitesimal the increase.  The same citizens demand more services from their government.  How does one get what they need without paying for it?

THEY DON’T.

I’m not a politician – and never will be.  I’m not a brilliant person nor do I fully understand all the nuances inherent in government bureaucracies.  About this one thing, however, I am absolutely certain: many valuable services that were initially set in place for those considered vulnerable in our society are still desperately needed for even a modicum of dignity and quality of life.  Did the needs suddenly disappear?  NO.  Did the vulnerable in our society somehow experience a miracle and are now fully capable of managing their lives on their own?  NO.  The needs are still there and the vulnerable in our society are being pushed to the wayside and are slipping through the cracks.  Do I like paying taxes?  NO.  I guess I’m wondering how to generate funds for needed programs without “robbing Peter to pay Paul.”  Taking from one program and sliding it over to a different program robs other needed services.  If ever there was a Catch-22, this is it.

Let’s look at caregiver training.  In Washington State, in the year 1996, caregivers were only required to pass First Aid training, CPR and HIV training, the Fundamentals of Caregiving training (22 hours), and had to successfully pass the State’s criminal background check.

In a Seattle Times article printed January 23, 2000, Push on for more caregiver training, the following statement begins the article:

With a first-aid card and some training about CPR and HIV, you can find yourself a challenging new job caring for the elderly and infirm, bathing them, feeding them, and fielding punches from them.  For this you can make about $7.50 an hour.  At McDonald’s, you can make more slinging burgers and fries.  It’s a wonder anyone cares for the elderly and infirm at all.

The year 2000.  For the third time in four years, the Washington State’s long-term-care ombudsman (who is independent of any government agency) pushed for more training for caregivers.  “The Legislature and the industry both need to step up and say this is an important key profession…People who take care of human beings are important people.”  State bill I-1029 passed which would increase the number of required training hours and implement specialty training for residents with special needs such as dementia, mental health, and developmental disabilities.    Implementation of this Bill’s provisions was delayed and set to go into effect March 1st, 2002.

Fast forward to February 2002.  Let’s look at another Seattle Times article, Caregiver-training issue causes split in state’s long-term-care community.  After the Bill from the year 2000 passed, the Department of Social and Health Services didn’t get the training curriculum revised in time for the March 1st, 2002 implementation so the State Legislature delayed the start-up of the new training requirements to September 1, 2002.  Private providers of long-term care – those not accepting Medicaid – would have to foot the bill to provide employee training, most certainly passing the costs along to their residents.  Long-term care facilities that accept Medicaid payments would rely on the State Medicaid program to provide the mandatory additional training and the State contended that the budget does not exist to provide the mandated training voted into law from initiative I-1029.  Time to go back to the drawing board.

Bear with me.  Fast forward to November 2008.  Let’s look again at another Seattle Times article, Voters back more caregiver training.  In 2008 a revised caregiver training Bill was passed requiring a training increase from 34 to 75 hours for new long-term care workers and required caregivers to undergo a Federal criminal background check.  This bill passed overwhelmingly.  It’s great that the citizens of my fair State decided that anyone taking care of the vulnerable should be held to a high standard.  Oops – in the same voting cycle, initiatives that would have imposed taxes on candy, soda pop, and other piecemeal purchases failed big time.  These miniscule, microscopic taxes would have saved vital services for the vulnerable and would have helped the State pay for the “mandated” new training.  No money – no increased training – no Federal background checks.

One more time.  Fast forward to November 2011.  Washington voters asked to boost caregiver training again, Seattle Times.  The Legislature delayed the implementation of the 2008 Bill because of budget cuts.  And during the voting cycle of 2011, a re-worked caregiver training initiative made it to the ballot once again as Initiative I-1163, right in the middle of an ever-increasing budget crisis, and the Washington State voters overwhelming approved it.  Implementation of the new training and background check requirements are set to start in 2012.  Lawmakers pushed implementation to 2014 but the good news is that the Legislature won’t be able to delay implementation of the new requirements without a two-thirds majority.  As of March 1, 2012 – the Washington State legislature has yet to finalize any enactment of the Bill protecting vulnerable adults; those that the voters of my state approved – and voted for – numerous times since the early 1990’s…stay tuned…

WHAT’S HAPPENING IN YOUR STATE?

HOW IS YOUR STATE PROTECTING YOUR VULNERABLE ADULT POPULATION?

Five Sources of Hope for the Deeply Forgetful, Dementia in the 21st Century

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Five Sources of Hope for the Deeply Forgetful, Dementia in the 21st Century.

I’ve found the Alzheimer’s Reading Room to be very helpful in my efforts to continually improve my understanding of Alzheimer’s and other dementia.  The good news?  Subscribing to the Reading Room is free!  I hope all benefit from this attached article about dementia in the 21st century.