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Posts Tagged ‘care facilities’

Last week I was asked as a Caring.com senior expert to speak on NBC Miami Live show and talk to folks in South Florida about how to choose a senior care facility for your aging loved one. Sometimes no matter how much we want to keep our loved one in their own home, or with us, it’s jut not possible. Working caregivers, frequent falls, severe dementia or other round the clock care needs can make it impossible for your loved one to remain with family. If, or when that time comes, it helps to have a plan and to already know your area and what it has to offer for families.

Here is a link to Caring.com’s YouTube channel to view the NBC Miami Live interview:

http://www.youtube.com/user/caringcom#p/u/0/u_8LHy-Cjto

It’s such a big decision and you want to make sure your loved one adjusts and is safe and well cared for. Are there specific points to help guide you through the search? It’s so overwhelming I thought I’d just bring up three key points to help guide you.

3 Tips to Consider When Searching for a Senior Care Facility:

  • Look past the fancy “storefront” and notice how folks are being treated. More and more facilities are beginning to look like country clubs, and that’s great but real care is what you’re after. Look past the golf carts that whiz you in and out, look past the luscious garden-like entrance, past the swanky lobby and even ask to see something other than the staged guest room all decked out with new pictures on the wall and a great view of the courtyard. Ask to have lunch with the residents. Stroll to the community center or gathering room. See if you can go down the hall where your loved one might be placed and see who their neighbors will be.
  • Don’t just take the tour–branch off–ask the residents (and their family members) who live there. Ask the residents if they like the food, if they get their medications on time. Ask their family members if they’ve ever had a bed sore or have problems with any of the staff or other residents. Even if they say the right words, notice how they hesitate, get antsy, or look around as if they’ll be heard. If your loved one has dementia ask to see that ward. Make sure there are safety measures for them not wandering away, and also make sure they are spoken to in a firm but kind manner. Look in their faces and see if they have that hazy drug look. Notice if they’re dressed, if their rooms are tidy, and if there’s a smell of urine in the air.
  • Ask how concerns will be handled, and what you can do if you need to change care facilities. Face it, you’re going to have certain questions and concerns. You’re going to have to ask them if they’ll change something to accommodate your loved one’s needs–that’s just normal adjustments. Find out how that’s handled up front. Talk to not only the day staff, but the night and weekend staff. Ask how they do their background checks and if they’re updated. Ask how you handle serious issues and what happens if you choose to move your loved one to a different facility.

Don’t think that once you move them in that your job as a caregiver is over. It’s not. You’re their care advocate. Visit often and not at the same time. Be cordial with the staff, get to know them and genuinely care about them. Bring in a treat or send them a thank you card if they’ve done something thoughtful or helpful. People respond to positive reenforcement and caring for a (sometimes) cantankerous, sick person who isn’t always jolly is more than a job, it’s a calling. It’s to your benefit to reach out. People who are visited often receive better care, and besides, it’s just the right thing to do.

There’s so much more I could talk about, but this is enough for now. In the end, follow your gut instinct. Stay involved and do all you can to surround your aging loved one with good care–no matter where that might be.

~Carol O’Dell

Author of Mothering Mother, available on Kindle

Got a caregiving question: Send it to me, Carol O’Dell, Caring.com’s Family Advisor at Carol@caring.com

(NBC Miami Live interview is now on Caring.com’s YouTube channel (click on link below):

http://www.youtube.com/user/caringcom#p/u/0/u_8LHy-Cjto

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It’s not that most caregiving families want to, but there may come a time when your spouse’s or elder-parent’s care becomes more than you can physically or emotionally manage at home. Caregivers need to look past the initial bells and whistles of a care facility to make sure that your loved one is receiving the very best care at all hours of the day and night.

How to Choose a Care  Facility For a Loved One:

  • Plan early—don’t wait until it’s an emergency. The highest rated
    care homes usually have a waiting list.
  • Don’t pay for more than you need. Know that cost rises with care needs, so don’t pay for services your loved one doesn’t need–yet. Ask if they have a graduated care situation or whether your loved one will have to find another home if their care needs increase.
  • Consider smaller care facilities or even a group home. Bigger isn’t always better.
  • Don’t get razzle-dazzled by fancy entrances/amenities. Look past all that and notice how the staff interacts with their residents–are they caring, engaged, friendly, and prompt?
  • Visit several times/and several shifts before making your
    decision–and eat the food for yourself–and if you can, talk to a resident or family member of someone who’s already living there
  • Consider visiting with a friend or someone who is impartial and can notice things you don’t want to–or can’t see.
  • Ask other caregivers if they know about this facility and
    “what’s the word on the street?” Check out a care home rating site such as the ones listed at: http://www.consumerhealthratings.com/index.php?action=showSubCats&cat_id=268
  • Check online for more facility information and reviews–Caring.com lists care homes, facilities and hospices in your area–along with helpful checklists and other info to assist you http://www.caring.com/local
  • Does the facility offer family support services, such as caregiver support
    groups and family event days?
  • Discuss how client and family concerns are handled, what is the
    protocol for disputes? Also find out the procedure for how to move your loved one to another facility if that becomes a necessity.
  • Ask about turnover rate of employees and residents. If people are happy–they stay.
  •  Ask how they screen their employees and how often this is
    updated (know that some care facilities allow employees to have misdemeanors, etc. on their record)
  • Ask to view the ACA survey. It will list the facility’s records on everything from safety records, employee issues, MRSA and other infections, bed sores, accident/fall rates.
  • How is orientation handled and what efforts are made to
    integrate your loved one with the staff and other clients?
  • Find out if your spouse/parent’s doctors/hospital serve this
    care facility or if you will have to find all new doctors. (Many physicians or their assistants visit care homes, which can make it easier than your family member having to make a trip into the doctor’s office.
  • Consider location and how often you–and others–can visit.
  • Consider other location factors–should your loved one stay in their own community where they have friends, doctors, and religious support?
  • Never forget that you are your loved one’s care advocate. Stay involved, hang out, and continue to be aware of their physical, financial, and emotional needs.
  • Visit often and make sure it’s not a “to do” session. Caregiving can strip you of your most important role–to be the spouse, partner, daughter or son. Once your loved one settles in, then it’s time to make an effort to be their emotional support–brighten their day by wearing a smile, bringing small presents, taking them outside (if possible) or bringing them home for a few days around the holidays.

~Carol O’Dell

Author of Mothering Mother, available on Kindle

Other great care facility information can be found at:

http://www.caring.com/articles/caring-checklist-evaluating-an-assisted-living-facility

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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 you’ve ever had a bladder infection (the common name for UTIs), then you know how very painful they can be.

If you haven’t, let me describe one for you:

Many times, you don’t realize right off what’s wrong.

You’re edgier than normal. You feel “different down there,” but you’re not sure. Then, you get the frequent urinating thing. Every two minutes.

It begins to be painful, sometimes there’s nothing to urinate but you feel ike you have to. I mean you have to like someone’s holding your foot and you’ve got to jump off a cliff.

You start drinking water like crazy thinking you can dilute it. You hear cranberry juice or pills help, so you run out and buy some and chug down a quart.

No matter what else you think you have to accomplish, you can’t.

You can’t think straight. There are no other thoughts but those of pain. Your lower abdomen aches. You wet your pants, you can’t help it, and you cry as you’re doing it.

You’re in absolute agony, and if you had a gun and could drive yourself to the pharmacy, you would hold it up—for meds. For relief. I’m not kidding.

Even after you get the meds, it takes hours, if not days. You can run a fever. You snap at everybody, if you can even answer them. You find yourself running your fingers through your hair over and over. You avoid everyone.

This is a bladder infection.

The medical world acts like it isn’t a big deal, but I swear, if you had to live this way, and live with this undiagnosed, you might kill someone. They act like the second you get antibiotics it instantaneously goes away. But the overuse of antibiotics carry a consequence, according to the AMA.

Doctors and nurses pooh-pooh you if you’re young.

They think you’re amorous, having too much sex. Wink, wink. While that can be one cause, it’s not the only cause.

Women suffer greatly from UTIs (more than men, in general) in part due to their anatomy—a short urethra. Yeah, blame us.

But I know there are other reasons. Nerves, for one. I always get a bladder infection when something big is about to happen—buying a house, passing a big test. And yes, I’m amorous (and monogamous). That’s a good thing.

UTIs are also serious and can be life threatening if left untreated.

But what would a UTI be like if you couldn’t communicate?

If you had ALS or Alzheimer’s, or some other impairment that kept you from realizing exactly what was going on? What if you didn’t want to tell your daughter, or your nurse that you wet yourself again and again? Would you be shamed? Who wants to change multiple sheets or panties?

Urinary tract infections in the elderly are very, very common.

Particularly in women, and even more so for those who live in a care facility.

And they often go untreated.

Why?

Too many to care for, perhaps. The elder’s inability to describe what’s happening.

UTIs in the elderly or in people with Alzheimer’s can affect not only their health, but can also lead to significant behavioral changes. In fact, if your loved one’s behavior has changed recently, even if they’re male, you should consider the possibility that they could have a UTI.

Just as with me, agitation or nervousness is a big indicator.

The person is concentrating to deal with the pain—there’s nothing left for niceties. Check to see if they’re running a low grade fever, if they’ve soiled their underwear, if they’re more disoriented than usual.  

Elders with Alzheimer’s or Parkinson’s, or other neurological disorders may not remember to urinate—even their bodies and muscles begin to forget, to give off the proper signals, and this leads to a tract infection.

 

Those who have diabetes are also having a higher risk of a UTI because of changes in the immune system. Any disorder that suppresses the immune system raises the risk of a urinary infection.

 

If your male elder has an enlarged prostrate, that can impede urinary flow and cause an infection. So can a kidney stone.

 

People who are catheterized or have tubes placed into the bladder are more prone to urinary tract infection. (This is the highest group of all)

 

Caregivers, You Need to Know the Most Common Urinary Tract Infection Indications:

·       Frequent urination along with the feeling of having to urinate even though there may be very little urine to pass.

·       Nocturia: Need to urinate during the night.

·       Urethritis: Discomfort or pain at the urethral meatus or a burning sensation throughout the urethra with urination (dysuria).

·       Pain in the midline suprapubic region also known as flank pain and is also associated with kidney infections.

·       Pyuria: Pus in the urine or discharge from the urethra.

·       Hematuria: Blood in urine.

·       Pyrexia: Mild fever

·       Cloudy and foul-smelling urine

·       Increased confusion and associated falls are common for elderly patients with UTI.

·       Some urinary tract infections are asymptomatic and difficult to detect.

·       Protein found in the urine.

·        

Kidney Infection Indications:

*                All of the above symptoms plus:  

·       Emesis: Vomiting.

·        Back, side (flank) or groin pain.

·       Abdominal pain or pressure.

·       Shaking chills and high spiking fever.

·       Night sweats.

·       Extreme fatigue.

 

Testing for UTIs is usually a mid-flow urine test, and trust me, that can difficult in and of itself when dealing with an elder loved one.

The treatment for UTIs is antibiotics, but antibiotics have become overused and may not always be effective. Be sure to retest. Elderly individuals, both men and women, are more likely to harbor bacteria in their genitourinary system at any time, which means it just comes with old(er) age.

 

Care facilities are a medical necessity in many families lives for many reasons, but there is a higher incidence in care homes for UTIs. If you can care for your loved one at home for as long as possible and utilize the many community resources available to you—and keep your elder on a consistent routine, your elder is better off.

 

 

But I know how hard this is. I cared for my mother at home for the last three years of her life, and I do know there comes a time when you can’t do any more than you’ve already done.

 

By at least being aware of UTIs and how they present themselves, you can keep your loved one from suffering from this very painful and frustrating ailment.

 

Don’t let your elder suffer in silence.

 

~Carol D. O’Dell is the author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir

available on Amazon

www.mothering-mother.com

Family Advisor at www.Caring.com

Syndicated blog at www.OpentoHope.com

www.kunati.com Publisher

 

 

Helpful Websites:

Alzheimer’s TreatmentsLatest news on drugs and treatment- from the Alzheimer’s Association.www.alz.org/treat

Alzheimer’s StagesUnderstand The Stages Of Alzheimers See Our Alzheimer’s Stages Site.Understanding-AlzheimersDisease.com

Alzheimers Nutrition TipsStrategies for Managing Mealtime Family Caregiving Advice & CDswww.LightBridgeHealthcare.com

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