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Archive for the ‘rehab’ Category

Most people, in fact 85% don’t want to go into a nursing home–that’s what they used to call them.

Many of our seniors cringe at the word and imagine long, dark halls, people screaming, sitting in soiled diapers, horrible food, and being abused. Thank goodness, this is not the norm–and there’s more vigilance to report elder abuse and substandard care today.

According to surveys done by AARP, most of us would prefer to Age in Place–meaning, stay in our homes  and augment care as needed–a mix of family caregiving, professional caregiving services, adult day cares, and other elder-care community based resources.

I highly recommend staying at home, including various elements of family caregiving, paid care, and community care–but I do know that there are times and circumstances when this just isn’t enough.

What Are the Different Kinds of Care Facilities–and Which One Is Right For my Loved One?

Contining Care or Graduated Care is when you buy into a community in which you can choose your living condition (small home or condo at first), and then “trade” it in when/if your care needs increase. Within one “complex” you might see homes or duplexes, condos or apartments, a building (care facility) that houses many units of care, and all these may be near a hospital or hospice facility. These are usually a large development and can offer meals, hired care workers, transportation, activities, and other amenities.

Assisted Living is similar and can be a part of graduated care. Assisted living can be houses/duplex, condos/care facility where the person has their own apartment but has access to additional help. There may be a place for meals, a van for transportation, and non-skilled care workers can be hired to do various needs and levels of care. Some assited living and care facilities are individually owned while others are a part of a larger corporation.

Care Facility or Skilled Nursing Care is considered a full-care facility and is what people think of when they say, “nursing home.” They can be a part of other facilities, such as the continuing care, or assisted living home, but they have the added component of a skilled nursing staff (RN’s–registered nurses) as well as non-skilled care, usually called CNA’s (Clinical Nurse’s Assistant). Care facilities are for people who have medical needs, have severe mobility issues (can’t walk, falls), and need supervision as well as medical care. They often have a staff of doctors and other care workers who will come to visit them, prescribe medications, and offer in-house treatments such as physical therapy.

Memory Disorder Facility or Center can be a part of an assisted living or care facility and focuses on the needs and care of people with neurological disorders such as brain injuries, advanced Parkinson’s or Lewy Body, Alzheimer’s and dementia.This facility has the feature of secured doors and exits so that people who tend to wander can’t leave. They specialize in dealing with the behavoiral, psychological and physical issues that come with neurological disorders. Since this is an area that overlaps, many of their clients need medical care/skilled nursing care/visiting doctors, etc.

Rehabilitation Facility is usually a short term facility that focuses on people recovering from surgeries, accidents, and for those who need various care treatments such as physical or occupational rehabilitation therapies. They are a “half way” facility people go to when they’re not quite ready to go home, or need more care than a graduated or assisted living facility offers. Most rehabilitation facilities are corporate owned and work closely with hospitals and doctors. 

How Do I Assess If My Loved One Should Go Into a Care Facility?

  1. They choose a graduated/continual care or assisted living on their own.
  2. They have no family nearby and no one can or will coordinate their care (don’t forget how helpful geriatric care managers can be in figuring out various stage of care and evaluating care facilities)
  3. They need full-time care, perhaps with needs of skilled nursing care as well–and this has become too much to manage for a loved one to deal with.
  4. Their dementia/Alzheimer’s has increased to a level to where they’re not manageable at home–violent, escapes, can’t be managed by one care helper–needs more supervision, medication, and physical control than the family/and caregivers can provide.
  5. Are at the late stages of various diseases/aren’t mobile/and the family can’t manage their care–perhaps hospice is involved and there are end of life and palliative care needs (pain management).
  6. You, the family caregiver simply can’t do it anymore–your own health or finances are falling apart and you’ve done all you can.

There are valid reasons for your loved one to enter a care facility.

You have not failed as a caregiver–nor are you “done” when your loved one enters a care center/facility.

Your loved one needs you more than ever to oversee their care and make sure they are safe, respected, and receiving all the care they need and deserve.

Also know that the first care facility may not be your last one–it may not be a good fit, you may have to change and try a different one. Also, as time goes on and their care increases, you may have to move them again.

Don’t forget that hospice and palliative care is still needed (and must be asked for) to supplement their care at the end of life.

You may also consider letting them come “home” to die.

You  have many options.

Helpful Links:

Great article:

newoldage.blogs.nytimes.com/2008/07/14/faced-with-caregiving-even-experts-struggle/  

~Carol O’Dell, Author of Mothering Mother–an Amazon Bestseller in Alzeimer’s and Aging Parents.

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If someone microchips their dog we think of them as acting loving and responsible.

Is that a good enough reason to put a microchip in a human? Isn’t that too “big brother-ish?”

We also put dogs to sleep, right? So maybe that’s not the best analogy.

As you can see, microchipping a human is controversial.

Why?

Some would argue it’s an invasion of privacy.

Others would argue it could be used by someone other than a family member or police.

Others say there are health concerns, such as cancer.

We insert pacemakers, steel rods and plates, silicone and collagen into our bodies, surely we can figure out how to make a tiny chip safe (enough) to give us some peace of mind.

What do you think?

You might feel different if you’ve ever lost your mom or dad. If they’ve ever snuck out of the house half dressed or not dressed at all. If they have Alzheimer’s and are not thinking clearly–insist they’re going to catch a taxi–my mother said that constantly even though I’m not sure she had ever ridden in a taxi in her life–and how in the world did she happen to remember that word but not her own daughter’s name?

Many, many, many night, I caught my mother trying to escape. We had several safety measure on the doors, and an alarm system that would beep if any doors or windows were opened, but still, I worried. She insisted she had to go preach, had to go to church, needed to go to the store and mostly….she needed to go home.

I was also worried because there was a river in our back yard and a 17 foot bluff/drop off. That didn’t seem to register to mother who was drawn more to the driveway and the street. We caught her in the bushes–a lot. And I was a vigilant caregiver. She was just slippery. I actually thanked God she had Parkinson’sto slow her down. Terrible thing to be thankful for, but as I see other moms with Alzheimer’s, and knowing my mother’s strength and fiestiness, I was grateful for any deterrent.

Why “chip?”

  • So they won’t get out and get hit by a car.
  • So they wont’ be kidnapped, raped, fall, wander in the woods.
  • So that so much time doesn’t lapse that they miss crucial medications.
  • So that if they take a car, bus, or train, you’ll know and won’t spend precious minutes, hours, or days in absolute panic and terror.

So yes, I would microchip. Give the benefits of the chip outweighs the risks.  I think. 

Let’s not confuse the issue here: most microchips simply hold information so that if/when the person is found, the information can be “read.” Most of these chips are not tracking devices. Technically, they’re called RFID–Radio Frequency Identification Device. 

One of the major controversies has to do with several studies that suggest that these implanted devices could cause subcutanous sarcomas — malignant tumors. This isn’t due to the radio frequency, it’s simply due to something foreign being under the skin (the tumors develop around the chip itself. Opponents argue that of the 10 million chipped pets, this isn’t a major issue, but it is something to think about.

So now, I’m back to wondering, would I?

The chip will only help “mom” out when someone (the police, etc) find her. If she’s stuck out in the woods tangled in briars, it won’t help?

I guess in my situation, I wouldn’t have been overly concerned about the cancer, considering her age and the greater risk of her getting lost–but I’d only do it it kept my mom safe and allowed us to find her quickly. I would want her found minutes, not days later.

One major microchip company that has recently been in the news is Verichip.

The chips about the size of a grain of rice and contains a 16-digit identification number which is scanned at a hospital. Once the number is placed in a database, it can provide crucial medical information.

This chip is now being tested in about 25 Alzheimer’s and elder/ill persons in Palm Beach,  and Del Ray Beach, Florida.

Here are some articles on microchips so you can decide for yourself:

http://abcnews.go.com/GMA/OnCall/story?id=3536539

http://gizmodo.com/gadgets/elder_tracking/rfid-microchips-implanted-into-alzheimers-patients-294731.php

http://www.time.com/time/health/article/0,8599,1672865,00.html

Memory disorder units use various types of wander protection for their residents. They have to. This is different than microchipping, but eventually, microchipping will be incorporated into this system. If you ever have to place your loved one somewhere due to Alzheimer’s, then you’ll need to know how they safeguard their residents. A building full of Alzheimer’s patients could spell disaster without a decisive protection plan. That’s why these units cost so much. You can expect to pay 4-6,000 dollars a month. (gasp)

One such system is Roam Alert, and here’s a diagram of how it works in a facility. Each resident must wear a non-removable band. While this may cause skin irritation and some patients obssess about it, it’s a necessary component.

 

 

Benefits to the wanderer:

  • Freedom to interact with other residents
  • Freedom to use facility’s resources
  • Safety from wandering into dangerous areas

 

To cognitive residents:

  • Freedom to mingle with all residents
  • Avoid “prison lock-down” image

 

To the facility:

  • first line of defense
  • Insurance coverage
  • Quick response to wandering

I’m not endorsing anything here, I’m just using these companies as examples of what’s out there. Most family caregivers are too busy doing the actual care–driving to the docs, cleaning up, meds, and food prep to have the time or energy to do all this research.

I can’t help but believe that this is all a matter of time until we track and chip our loved one’s who cannot make good judgements. We will have to reconcile our sense of moral obligation in regard to privacy issues with our moral obligation to keep them safe.

Will there be abuses? I’m sure. Just like all technology, it’s amoral and up to the user to be ethical. We can already track people by their cell phones, and as the numbers of Alzheimer’s patients swell, this will not only become big business, it’ll become a national concern.

If not the chip, how do we keep mom and dad (or our husbands and wives, sisters and brothers) safe?

I’m just asking because I truly don’t know the answer.

~Carol D. O’Dell

Author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir

available on Amazon

www.mothering-mother.com

 

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Are you stuck at home?

Stuck hours at a time in a hospital / care facility with a loved one?

Do you own a snap front house dress and wear it with socks and house shoes? (Guys…come on, fess  up.!)

Then you might need a caregiver re-invention!

It’s kind of like an intervention–you know, when your loved ones all get in your face and tell you your life has gone to pot and you need professional help….

If you’re not careful, you’ll lose yourself in the vortex of caregiving.

I know, been there–my mom had Parkinson’s and Alzheimer’s and lived with me (and my family) the last almost three years of her life. 

I had many, many days when I was too tired, lethargic, zombie like to do much of anything past cut pills, serve meals on trays and wash bed sheets.

But caregiving didn’t come in your life to drag you down. It also can provide incredible, unique opportunities.

If you’ve had to quit your job/work less hours/move or have your loved one move in with you, chances are you’re not going to be able to go back to your old life. Life has changed. You’ve changed.

The average caregivers spend 4.5 years caring full-time for a loved one–and 70% of all caregivers do it at home–and go it alone. Sad. Caregiving need not be that isolating.

You have to think creatively. Use adult day care while you can. Hire a sitter–a neighbor–someone you trust–while you can. There may come a day when you can’t. Even if you do have to put your loved one in a facility, you still have to check on them all hours of the day and night to make sure they’re receiving good care.

But…in the few snatch and grab minutes you have during the course of 24 hours a day–why not try something new?

  • start that memoir or write a poem–even a sappy one
  • buy a hummingbird feeder and take pictures of them–you don’t even have to go outside
  • buy some yarn, some knitting needles and a book
  • cook something you saw on the Food Channel
  • try an online college class
  • take up chess or soduku
  • try a home repair yourself–get a book from the library
  • buy a yoga DVD and do 5 minutes a day–build from there

Now, none of this is going to change the world, but it can brighten yours.

Before you go all snarky on me, grumble, complain you don’t have time–or energy for such malarky…give it a try.

No one’s watching.

Caregivers need a break and  no one’s going to give you a break until YOU give you a break.

I know it’s difficult to think about, but one day, your loved one will not be on this earth.

And you need to go on. You need to come out of caregiving a different person–with new skills and interests.

Caregiving happened for a reason, for many reasons–some of them good.

Reinvent yourself. You just might like the new you.

~Carol D. O”Dell

Author of Mothering-Mother: A Daughter’s Humorous and Heartbreaking Memoir

by Kunati Publishing

available on Amazon and in most bookstores

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