Quality of Life
Teamwork: playing nice together
As a child, do you remember being admonished to “play nice together” with your siblings or friends? Or perhaps you’re a grandparent who has encouraged your grandchildren to behave better with others by using that same phrase. I like it, and I think playing nice together needs to be a part of our daily life strategy. Read the rest of this entry »
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 »
A Friday good feeling
My husband and I purchase our wine at grocery stores where we can earn Fuel Points. We also purchase our wine 6 bottles at a time so we can get a 10% discount on our wine.
Today I purchased gas at a local Shell station and received a 60 cents per gallon discount for a $1.99 per gallon price. That’s the first time I’ve purchased gas under $2.00 in quite some time. (The going rate locally is between $2.59 and $2.79.)
It’s great finding a way in which to save money that is both pleasurable and profitable.
And that’s my Friday good feeling.
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…
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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 »
I’ll write what I damn well please
Where has freedom of the press, and freedom of speech gone?
Must we concern ourselves with offending every element of society – friendly or adverse – with the words we choose to express ourselves? to express our views? Whether political or religious views; whether mundane topics such as fashion or dining; are we supposed to produce euphemistic journalism so as to avoid ruffling the feathers of another person’s beliefs or opinions?
That’s not my plan.
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 »
As relationships move online, neighbors become more vital
Lately, it seems everywhere I look I read articles about the importance of neighborhood connections. In the past few days I wrote two articles specifically addressing that concept: The importance of good neighbors, and Positive community activism.
The attached article above, written by Froma Harrop, compares today’s community with that which existed in the movie It’s a wonderful life, an annual Holiday classic. George Bailey’s bank customers and neighbors were people with whom he had a connection, “of varying incomes, education, and ethnicity. Each of them was an individual, not just a useful provider of a good or service.” Ms. Harrop goes on to say that the middle ring of society – as existed in George Bailey’s life – has been weakened over the years. Her article outlines her belief that social media and e-commerce are responsible for that societal change.
Here’s an article excerpt that further explains the phenomenon:
Marc Dunkelman writes of the fading town-based model of society in his book, “The Vanishing Neighbor: The Transformation of American Community.” The middle ring, he says, was “where communities of people with different skills and interests, disparate concerns and values, collaborated with their neighbors in the pursuit of the common good.”
Those middle relationships are what bind us together.
That’s what I want, and thankfully, that is what I have with the households in my neighborhood where that connection exists. Eva and Ian across the street, Irma and Larry next door to the south, Simone and Gareth, our New Zealand next-door neighbors to the north, and Patty and Bob just around the corner, all represent my middle ring of people who collaborate for the common good.
If you live on the outside of that ring, I encourage you to make your way into the center, and bring your other neighbors with you.
(all images courtesy of Pixabay)
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.
Restless in retirement? You don’t have to be.
A guy who made city’s unused toilet paper a precious gift | Local News | The Seattle Times.
Those of us working the 9 to 5 work day drudgery can’t imagine having any difficulty filling our days with whatever the heck we want to do once once we’ve walked off our career path and onto the retirement treadmill. To be sure, the first several months – perhaps even the first couple years – we’ll readily manage the forty free hours a week now available to us post-employment.
But what about the point in time when we wake up in the morning, complete our morning rituals, sit in our easy chair and find ourselves thinking, “Now what?” Those of us who barely have enough time in the day to organize our thoughts can’t imagine ever being restless, but chances are, each and every one of us will be well-acquainted with that feeling at some point in our retirement future.
So what’s a person to do? Go back to the grind just so we have something to do that removes the boredom from our lives? Hell no. What we can do, however, is take on a project that satisfies our need to be useful and productive, but also satisfies the needs of those hidden citizens in our community whose needs far outweigh their means.
That’s what Leon Delong did when he got restless. He became aware of a pattern of waste that was going on in office buildings all over the city of Seattle: at night, janitorial crews replaced partial rolls of toilet paper with full rolls so that the nether regions of the next day’s workforce would have plenty of the stuff to take care of their toileting needs. Perfectly good partial rolls went unused – and worse – were thrown away. Thanks to the Toilet Paper Guy, however, these perfectly usable rolls were donated to food banks all over the greater Seattle area.
When you read the above, did you think, Big deal, it’s just toilet paper; it’s not like the food bank customers were offered a filet mignon to take home to their families. Hold onto that thought for a moment and think back to an incident where you scrambled for some sort of “cleaning implement” to finalize your stay on the commode. As the above article’s writer, Danny Westneat, stated, “I know it’s just TP. But as someone who once substituted coffee filters in an emergency, I can attest: It’s like gold when you don’t have it.”
When you become restless in your retirement years, who will you become?
- The Perfectly Usable But Discarded Produce Lady?
- The Overstocked Slightly Irregular Chartreuse & Hot Pink Striped Bedsheets Guy?
- The Unsellable Dented Canned Good Lady?
- The Super-sized Box of Costco Bandaids Person?
- The You Fill in the Blank Guy?
The possibilities are endless because there is no shortage of need in your community. Visit a food bank or homeless shelter and ask them what is their greatest need; the product that is most in demand. Then go about defining a way to meet that need. Come on, you have all the time in the world to do so and still have plenty of time to enjoy your own leisurely retirement activities.
“So take it from the Toilet Paper Guy. Life is like a toilet-paper roll. What you do with what you’ve got left is up to you.”
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.
Long-term care residents’ rights: Part 2
I hope you have already had a chance to look at Part 1 of this series on LTC residents’ rights. Today’s topic focuses on one aspect of the admission process that oftentimes slips through the cracks unnoticed.
The case of the missing Kindle Fire
“Housekeeping!”
That’s my cue to vacate the apartment and let a staff member clean my place. I turned off my Kindle Fire, placed it next to my reading chair, and opened the door. “I’m so glad you’re here. I love having a clean apartment and always look forward to my weekly cleaning.”
“You are Mrs. Ruth Milliken?”
“Yes, that’s me. Are you new on staff at Fairview Manor?”
“Yes, I am Carolina, I start this week. May I come in and clean?”
“Certainly, I’m heading to lunch so take your time.”
********
It was so nice being able to take advantage of the good weather by having lunch on the patio for a change. I’m going to read a bit and then maybe take a nap; all that sunshine made me a bit sleepy. I unlocked my apartment door, made myself a cup of tea, and returned to my reading chair.
“Oops! I’d swear I left my Kindle right here on the table next to my chair.” I stood up and lifted the seat cushion, thinking perhaps that it slipped between the cushion and chair frame without my knowing it.
“Now this is silly, I know I placed it on the side table.” Just the same, I looked throughout my apartment to make sure I wasn’t mistaken. A sudden realization hit me, “That new housekeeper, she must have stolen it.”
I made my way to the Administrator’s office to report the mishap. “Jason, may I come in?”
“Certainly Mrs. Milliken, have a seat, how can I help you?”
I sat on the edge of one of the visitor chairs and relayed my suspicions about my missing Kindle. “So you see, I’m certain it must have been your new housekeeper, Carolina. She was the only one who had access to my apartment while I was at lunch.”
“Are you sure you’re not mistaken? Was your door locked when you returned from lunch?”
“Yes, it was; at least the housekeeper locked up after herself.”
Jason got up from his desk, retrieved a folder from the large file cabinet behind him, and returned to his desk. “I’m truly sorry you’ve misplaced your IPad.”
“It was a Kindle – the latest Kindle Fire and it was a gift from my daughter-in-law.”
“Okay – Kindle.” He opened the folder and thumbed through a few pages and folded back one of them. “If you’ll look right here, you’ll see that you signed a Waiver of Liability when you moved into Fairview Manor.” He turned the folder towards me so I could read it. “This is your signature, isn’t it?”
“Well, yes, that’s my signature, but you can’t be saying that you’re penalizing me for signing that document. I signed lots of documents that day, fully trusting that everything you placed before me was on the up and up. Let me read that thing.” I glanced through the wording and couldn’t believe what I was reading: Fairview Manor and its parent company, Senior Housing Corporation, accepts no liability for items lost, stolen, or otherwise misplaced.
I looked up at Jason who was comfortably reclining in his executive desk chair. “This is utterly ridiculous; if I had understood what you were asking me to sign, I would have never signed this piece of paper.”
“If you hadn’t, we would have had no recourse but to refuse your admission into our community.”
“But that housekeeper stole my property. You have a thief on staff here.”
“I assure you, every employee hired at Fairview Manor goes through a criminal background check – otherwise they can’t work here.”
“Did Carolina’s background check come back clean?”
“Her State background check came back but not the Federal. She has a clean slate in Oregon, I’m sure the Federal check will come back clean as well.”
I am absolutely stunned; I know the implications. “So she could have committed a crime in another state – which would show up on the Federal database but not the State one – and you let her work here without first knowing if she was cleared?”
Jason had the audacity to shake his head and chuckle. “I assure you, in all my years working in the industry, there’s never been an employee who didn’t pass with flying colors. I’m not worried about Carolina.”
I stood up and addressed the Administrator. “I can’t believe I’ll never see my Kindle again. You can’t possibly think that’s fair, Jason.”
“My hands are tied, fair or not.”
All employees working with vulnerable adults are not permitted to work in a facility without a completed criminal background check.
42 CFR 483.13
(c) Staff treatment of residents. The facility must develop and implement written policies and procedures that prohibit mistreatment, neglect, and abuse of residents and misappropriation of resident property.
(1) The facility must
(i) Not use verbal, mental, sexual, or physical abuse, corporal punishment, or involuntary seclusion;
(ii) Not employ individuals who have been
(A) Found guilty of abusing, neglecting, or mistreating residents by a court of law; or
(B) Have had a finding entered into the State nurse aide registry concerning abuse, neglect, mistreatment of residents or misappropriation of their property; and
(iii) Report any knowledge it has of actions by a court of law against an employee which would indicate unfitness for service as a nurse aide of other facility staff to the State nurse aide registry or licensing authorities.
(2) The facility must ensure that all alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source, and misappropriation of resident property are reported immediately to the administrator of the facility and to other officials in accordance with State law through established procedures. See also Washington State law RCW 70.129.130
The admission process into a long-term care facility is stressful on residents and their family members. What they fail to realize is that the resident agreement they sign, and all other sub-documents of that agreement, are legal documents: some of them binding, others not. As such, it is a very good idea to read them ahead of time and even have them reviewed by an attorney or legal advocacy group. Most states do not permit Waivers of Liability to be a part of the LTC admission process. Administrators, however, oftentimes succeed in slipping that document into the ream of documents residents must sign. The good news is that such waivers are not enforceable; the bad news is that residents assume that because they signed a Waiver of Liability, they have no recourse when their personal belongings are stolen by staff and/or other residents.
Washington State law RCW 70.129.105 Waiver of liability and resident rights limited. No long-term care facility or nursing facility licensed under RCW 18.51 shall require or request residents to sign waivers of potential liability for losses of personal property or injury, or to sign waivers of residents’ rights set forth in this chapter or in the applicable licensing or certification laws.
Since the Waiver of Liability is not enforceable, the flip side of that is that the facility is liable and should either replace Mrs. Milliken’s Kindle Fire or provide the funds for her to purchase a new one.
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 3 of this series will deal with the discharge/eviction of a resident from a long-term care facility. Part 3 will be posted on Friday morning, November 14.
2014: The year of no ideas a/k/a red states vs blue states
2014: The year of no ideas | Opinion | The Seattle Times.
Syndicated columnist, Leonard Pitts Jr. did it again: he wrote about issues that most of us are very concerned about and at least for this one reader/writer, he spoke for me. The above article addresses the precise way that I feel – and that many others feel – about red versus blue. Here’s a few quotes from the article that you should take the time to read in its entirety.
First a quote from President Obama, a quote that he premiered ten years ago and reiterated after the recent mid-term elections:
“I continue to believe,” said President Obama, “we are simply more than a collection of red and blue states. We are the United States.”
Now a few paragraphs from Mr. Pitts’ article addressing that statement:
“People for whom everything is about politics tend to forget that most of us do not see the world that way. Red or blue, left or right, most Americans simply want a government that works, that gets things done, and a nation that stands for something, that means something in the world beyond just a parcel of land where a bunch of people live. This is why Obama’s words electrified 10 years ago; they seemed to connect people to ideals larger than their own lives.
“And it is why the same words seem flatter than left-out cola 10 years later, the hope of larger ideals having been sequestered, government shutdowned, PAC’d and gridlocked down into a sobering realization of how truly small American politics can be.
“Cowardice squared off against cynicism Tuesday [2014 election day] and cynicism won. But there is something wrong when those are the only options on the ballot.
“We are supposed to be united states, the president says. But there are too many days lately when a sentiment that once grounded and ennobled feels fanciful and unlikely.”
And now my statement:
Whether we’re talking about State/local government or Federal – year after year, too many employees of each have failed to do their job. These employees don’t work behind desks in the hallowed walls of government; they square off on the football field where at least two opposing sides refuse to give an inch for fear that the opponents’ goals might be reached.
And I might add, goals that could very well benefit the American citizenry, but are turned down simply because the other team proposed them.
Doesn’t that seem shameful to you?
Long-term care residents’ rights: Part 1
Since Baby Boomers and their family members face the possibility of arranging long-term care (LTC) housing for a loved one, or will be on the receiving end of long-term care, I am providing information related to what one can and should expect while living in a LTC setting. This will be a multi-part series wherein I provide a real-life scenario, and the Code of Federal Regulations (CFR) citation applicable to that scenario. Since I live in Washington State, I will also provide the applicable State statute, and I encourage those living in other states to do an internet search for “long-term care residents’ rights in your state” in order to locate your local laws. All scenarios assume that the resident in question is cognitively able to make his or her own decisions.
My kids aren’t the boss of me!
I’m so excited, my soaps are about to start and I have the whole afternoon to myself. I’m looking forward to seeing how they’re going to get rid of Sami. She’s been on Days of our Lives since she was a young teenager; that’s a long time in soap opera years. I’ll just wheel into my bedroom, get my knitting basket, and set myself up in front of the television.
All right, now I’m ready; it’s time to tune in!
There’s a knock at the door, drat, right when my first soap is about to start. “Come in!” Oh no, it’s that perky activity person. When they interviewed candidates for her job they must have had a perkiness contest as one of the criteria for hiring. I’ll see if I can get rid of her real quick-like. “Hello, Ruby, what can I do for you today?”
“What can you do for me? Don’t be silly, it’s what I can do for you that matters, Mrs. Tanaka. We’re showing a movie in the main living room that I’m sure you’ll like. It’s called, 101 Dalmatians, won’t that be great?”
A movie about dogs instead of my soap operas? Not going to happen. “That’s okay, Ruby, I’m happy just watching my TV shows. Maybe some other time.” Now I’ve gone and done it, Ruby looks baffled, not sure how to change the course of her task.
“Mrs. Tanaka, I was told to wheel you to the living room for the movie and not take ‘no’ for an answer.” She pulled a piece of paper out of her smock’s deep pocket and showed it to me. “Look right here. It says, ‘The family has requested that their mother not spend an inordinate amount of time in her room and that she attend at least four activities per week.’ It’s already Thursday and you haven’t even been to one event this week. We have to make up for lost time.” She bent over my wheelchair, unlocked the brake and positioned herself behind it.
“But I don’t want to see the movie, I want to watch television. I love my soap operas and today’s the last day Sami is going to be on Days. Please, I don’t care what my children have requested, I’d really rather stay in my apartment.”
Ruby leaned over, picked up my yarn and needles, and placed them in my knitting bag on the floor. “Come on, I’m sure you’ll like it once you get there.” Pushing with all her might, Ruby escorted me out of my room, thus bringing an end to all my plans for the afternoon. Those children of mine have no right meddling into my private life. “Ruby, whose opinion matters most: the person who lives at this assisted living facility, or those who don’t? This isn’t fair; don’t I have rights?”
Mrs. Tanaka was coerced to go somewhere she didn’t want to go; because she was confined to a wheelchair, her ability to stand her ground by refusing to attend an activity was compromised. Additionally, although this resident can get around her apartment in her wheelchair, wheeling herself long distances is very problematic for her; as a result, once in the living room she would require assistance to return to her room, rendering her a captive audience.
42 CFR 483.10 The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. A facility must protect and promote the rights of each resident, including each of the following rights:
(a) Exercise of rights.
(1) The resident has the right to exercise his or her rights as a resident of the United States.
(2) The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights. See also, Washington State law: RCW 70.129.140
Mrs. Tanaka has the right to make choices that are important to her. She wanted to watch television – not attend a kids’ movie. Regardless of what her adult children want, Mrs. Tanaka’s rights trump theirs.
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.
(b) Self-determination and participation. The resident has the right to:
(1) Choose activities, schedules, and health care consistent with his or her interests, assessments, and plans of care;
(2) Interact with members of the community both inside and outside the facility; and
(3) Make choices about aspects of his or her life in the facility that are significant to the resident. See also Washington State law RCW 70.129.140
Note: there are even more legal citations applicable to the above scenario; a quick search of 42 CFR 483 on the internet provides all laws relating to long-term care residents rights. 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 2 of this series will deal with the illegal practice of requiring residents to sign a Waiver of Liability prior to being admitted to a facility.
Your aimless life
‘Purpose in life’ can help reduce medical costs, study says | Nation & World | The Seattle Times.
Think of how you feel with the title of this article: Your aimless life. Now discern how you feel with the statement, Purpose in life. There’s no comparison, right? If the word aimless made you feel lost or empty, there’s a reason. The Oxford English Dictionary, 11th Edition, 2004, provides the following definition of aimless: adj. without purpose or direction. Not much can go right with that way of living.
In contrast, let’s look at the definition of purpose from the same dictionary: n. the reason for which something is done or for which something exists.
One can conclude therefore, that a person without purpose has no reason to live. That’s downright depressing, but that’s the point.
The above article from a recent Seattle Times issue highlights the benefit of reduced medical costs when a person successfully defines their purpose in life. Instead of focusing on reduced medical costs, however, I’d like to look at the less tangible – but more important – benefit of being in good health as a result of living a purposeful life. It’s amazing to me that just living and carrying out ones life with intention equates to being healthier than if one lived without any meaningful direction.
When a person enters retirement there is an initial exhilaration in not having to go through the drudgery of an 8 to 5 work day. Quite frankly, it would feel darn good not having to do anything you don’t want to do. Eventually, however, you might feel like you’re just drifting through that time of your life. You need to have a reason to get up in the morning that surpasses the joy of lingering over the morning paper and sipping a cup of coffee.
Don’t get me wrong; I’m not saying that you’re supposed to line up a new job, hang up your retirement sweatsuit, and return to the employment drudgery from which you escaped. I’d never promote that idea but I will stand by my belief that unless you have direction, you’re not going to be as happy – and as healthy – as you can be. Purpose and direction will mean something different for each of you.
Fulfilling long ignored house projects that will assure you and yours a safe and comfortable place to live for years to come? Fabulous.
Try your hand at growing your own vegetables and sharing with your neighbors or a local food bank? Delicious.
Volunteering for an organization that aligns with your world beliefs? Go for it.
Become a freelance writer ? Sharpen your pencil and get started.
What matters is not what gives you purpose, rather, that you put feet to that purpose. If it satisfies your life and gives you an added reason to get up in the morning, you’ve received the benefit that a purposeful life can provide.
It’s really as easy as that. You have many years ahead of you, make them count for you and make them count for others.
And here’s something to consider, from the book The One Thing by Gary Keller:
Purpose may sound heavy, but it doesn’t have to be. Think of it as simply the ONE Thing you want your life to be about more than any other … Pick a direction, start marching down that path, and see how you like it. Time brings clarity, and if you find you don’t like it, you can always change your mind. It’s your life.
Don’t throw in the towel: you’re not done yet
Encore Entrepreneurs: How Five Late Bloomers Turned Big Ideas into Sweet Success.
The attached article from Parade Magazine is a fabulous example of how a person can recreate their life – regardless of ones age, circumstances, or lot in life.
If you’re seeking a new direction in your life – or perhaps are in the process of recreating yourself – I’ve found that it’s easier to know which direction you should go if you’re already in motion. The world may have been created in a week, or zillions of weeks; either way, a lot of energy went into that creation and the world-in-process was not a stagnant one. As for you – you are never too old to try something new – as long as you’re willing.
Trial and error approach. I constantly look for ways to improve myself (a task that will always keep me busy) in an effort to increase my influence on the community around me. But if I wait around for some sort of change to occur, I’m going about it in the wrong way and believe me, I’ve experienced enough trial and error to write a book on the subject. The trial and error approach can work, however, if in doing so we discover what doesn’t work for us in our attempts to find what does.
Living or playing to your strengths. My life’s direction was greatly influenced by Marcus Buckingham, one of the world’s greatest authorities on employee productivity. He suggests that to make your greatest contribution, it’s best to play to your strengths most of the time. I have taken to heart Mr. Buckingham’s strong caution against veering off ones strengths path. After all, when I’m creating a new me, why would I choose to do the lame-o, same-o with all of its inherent dissatisfaction? That’s like doing the same thing over and over again, expecting different results. That has never worked for me, how about you? In addition to playing to my strengths, I try to play to my passions. As a person who’s not getting any younger, it makes sense that going forward I should avoid activities that drag me down and weaken me. Instead, I should run to those activities for which I am most impassioned and inspired.
Find your niche and go for it. I know what I like to do and what I’m good at so I try to consciously remain open to opportunities that directly relate to those strengths. I thoroughly enjoy working with an older population of adults but I know what part of that experience I’m able to do, and what I’m not able to do. In 2013, I retired from my work as a volunteer certified Long-Term Care (LTC) Ombudsman – an advocate for the rights of vulnerable adults. As an Ombudsman, however, I knew my limits on “clinical atmosphere” so during my ombudsman career, any involvement with the older population excluded my participation in a nursing home or hospital environment. Throw me in the midst of adults living in assisted living or dementia residential settings, however, and I will make new friends and earn the trust of everyone with whom I come in contact. Add to that, with my enjoyment and effectiveness as a public speaker, I used that strength to provide talks to professional care staff, and to residents & their family members, on what it means to protect the rights of seniors who are not able to protect themselves.
Recognizing an open door when you see one. We are constantly bombarded by information whether through social media, radio and television programs, or even mini-publications such as Parade Magazine. As we wade through all of that input, it’s helpful to be alert to what that input might be trying to tell us. Sometimes the information brings to light an opportunity that will utilize both our skills and our passions for the benefit of others. But I’ve discovered that not every door that opens is the right door. I have to be extremely careful when considering a particular opportunity, because sometimes I’ve sensed an open door through which I’ve thought I should walk, only to find that it was the wrong door for me. If I don’t look before I leap, e.g., research the project, consider all of its requirements, measure whether or not I’m able to fully commit, I won’t be doing myself, or those connected with the project, any favors. It is worth my time to weigh all options; to write a list of Pros and Cons; to ask trusted individuals for their opinion and then make an informed decision. If this new opportunity that I’ve carefully considered allows me to play to my strengths and my passions, everyone benefits and there are few, if any, casualties along the way.
What about you?
Each of you has a talent or a skill-set that can be used long after you’ve officially “retired” from the workforce. Think about it: you spent years as an employee or business owner using that talent – why put it to rest? Finding new ways to utilize your life’s work is good for you; it brings a fresh outlook on what you’re still able to accomplish, and equally as important, might prove beneficial to others as you stretch your wings in your efforts to make the most of your talents.
Human nature: it’s under our control
Several years ago I took a class with the ominous sounding title, Death and Dying. That was a topic with which I was very comfortable so I signed up for it and enjoyed it immensely. There were many things offered relating to wisdom gained as we age and how best to live before we die, but the following advice was the best of all:
Cherokee wisdom – Two Wolves
An old Cherokee chief was teaching his grandson about life… “A fight is going on inside me,” he said to the boy, “it is a terrible fight, and it is between two wolves.”
“One is EVIL: he is fear, anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.”
“The other is GOOD: he is joy, peace, love, hope, sharing, serenity, humility, kindness, benevolence, friendship, empathy, generosity, truth, compassion, and faith.”
“This same fight is going on inside you, and inside every other person, too,” he added.
The grandson thought about it for a while and then asked, “Grandfather, which wolf will win?”
The old chief simply replied, “The one you feed.”
Author unknown
What we say without words
How many of you have been hurt by something someone said to you without words?
To get you started, I’ll provide a couple personal examples:
Growing up, I was always taller than most kids my age; with my height, came big feet. Although I’m now in my early 60s, I still remember how it felt at approximately thirteen years of age when, while standing in line at a movie theater, an adult looked me up and down and then focused on my feet. She turned to her companion, nudged her, laughed, and held her hands apart, as though measuring the size of my feet. How do you think a gangly self-conscious young teenager felt about that situation?
As a manager for an assisted living/dementia care facility, I wore many hats – especially since the executive director of the facility was extremely ineffective as that building’s director. One day I found myself rushed beyond all measure and needed to get in touch with the Health & Wellness Nurse whom I knew was in the secured dementia wing of the building. I entered that wing at full-bore, with single-purposed intent, ignoring the dazed residents I passed in the hall, leaving a wake of distressed residents behind me. One of those residents somehow caught up with me and grabbed my arm, “What’s going on? Is there an emergency? Do we need to evacuate? Will you help us?” Shame on me. Without a word, I caused aggravation in someone who was the unfortunate recipient of my careless behavior.
How many of you have spoken volumes to someone without saying a word? Did you speak love, patience and comfort, or intolerance, annoyance, and anxiety?
Which would you prefer to receive?
Which would you prefer to offer?
Living: the ultimate team sport 