Tag: assisted living

Being a Dementia Caregiver

Being a caregiver for a person with dementia does not mean we do all of the work all of the time. Caring for someone we love does not require us to do all the hands-on work. It does not mean we do it all without help.

Sometimes caring for a person with dementia involves hiring outside help.

Sometimes caring for a person with dementia involves having home health involved, including shower aides.

Sometimes caring for a person with dementia involves having them attend a day program.

Sometimes caring for a person with dementia involves placing them in a live-in community where staff do the day-to-day hands-on work, and we get to visit and love them without constantly feeling overwhelmed.

Sometimes caring for a person with dementia involves placing them in a locked facility or memory care for their safety and security. And for our peace of mind.

All the time caring for a person with dementia involves doing the best we can within our limits and based on their needs and disease progression.

I Thought I Was Okay

I thought I was okay. I thought I was handing it all.

I went to visit today. It would be a quick visit because she was napping.

I checked her snack and Ensure supplies. I went to check her bathroom supplies.

Then I saw it. A wheelchair.

A month ago she was walking. She was slow, but she was walking. She could walk without assistance.

Now she has a wheelchair.

I finished my business. I spoke to the staff. I left.

After I left the facility, I stopped for a burger at our favorite burger joint. I broke down in tears at the counter as I ordered. Thankfully the manager was at the register. She gets it. She lost her daddy to this disease.

I thought I was okay. I’m not.

Caring Staff

I wish you could see how the staff of her Assisted Living love and care for her!!!

Wednesday I went to refill her fridge before a big snow/ice storm hit. I walked in and saw her sitting in a wingback chair all wrapped in a soft, warm blanket. They’d pulled the chair right in front of the fireplace, where she could feel it’s warm and enjoy watching the flames.

“She said she was cold,” they told me. “And we know she loves to watch the fire. We didn’t want her to sit alone in her room.”

I love how the staff care for her and their other residents. I love how they love the thirty-something people in their care, how they care for each one and meet each one where they are.

I love how they tell the old cowboy every night about five o’clock, when he gets anxious, “Yep. We got them all in the corral. All the horses are in. You don’t need to worry. It’s chow time. We’ll help you let them out in the pasture tomorrow morning. Let’s go eat.”

I love how they help one care for her baby and how they patiently answer all of another’s questions over and over again.

I love seeing a young man, a med tech, treat every person with kindness, regardless of how ugly they may be acting at the moment.

I love how they patiently feed this one and dance with that one.

I love how Activities Director is able to get even the most reserved among them to join in the activities, crafts, and exercise class.

I love how the Director of Nursing knows who needs what and how the Med Tech Supervisor knows just what to say to calm and assure a new resident.

I love that the Executive Director can be found helping serve meals or talking with the people under his care rather than just working in his office away from staff and residents. I love how he treats his staff and residents with honor and respect.

And I love how the staff are kind and compassionate to their residents’ families.

I hate this disease. But I love the care she is receiving.

Choosing a Long Term Facility for Your Loved One

In the past two months I’ve been contacted by a number of folks who needed to “place momma next week!” They were looking for advice and help. (I’m always glad to help when I can and to share my knowledge!)

A few of these folks had been thrust into the situation because their family member had a sudden debilitating illness or accident. Others had been caring for the family member in their home for years but could no longer continue. I was able to get in touch with someone who could help them quickly.

Here’s my advice for those with elderly or infirm family members:

If you are caregiver for a parent or family member with dementia or serious chronic health issues, don’t wait until you need full time, residential care to start visiting area facilities. Don’t wait until your loved one needs urgent full time care to learn about care options and the rights of residents of long term care facilities. Start now. Learn everything you can so you are able to make the best decisions for placement when needed.

Three years ago I visited every Independent Living (IL), Assisted Living(AL) and Memory Care (MC) facility in town. I also visited many facilities near E’s brother, so I could compare state to state and learn as much as I could (and in case I decided living near him was best for her.) It wasn’t until ten months later that she moved to Texas, to an Assisted Living near me.

I took tours. I made notes. I asked questions. I spoke to staff and residents. (At one facility the tour guide knocked on a door to show me a particular room layout. The lady who lived there was thrilled to have a visitor! I ended up sitting and chatting with her for more than an hour as she showed me the beautiful furniture her late husband had made and told me about him and their children. The staff member started to apologize, but I told her I was fine. She had a meeting which she went to the meeting while I stayed and chatted. No, I did not place E there. I believe spending time with that sweet woman was the purpose of my tour.)

When I could, I had a friend go with me on the tours. Linda had experience with Alzheimer’s and placing family in long term care facilities. She went with me on my first three tours. Her perspective was so helpful! She often just asked me what I thought of this or had I considered that or did I notice that thing. I’m so grateful to her.

Find a friend or professional to help you as you tour facilities. (More on professionals later.)

At each facility I was given a brochure. I made notes on the material as we toured. I took pictures of rooms. If needed, I asked to sit for a moment to write things down.

I created a spreadsheet and added information after each visit:
Facility Name
Address
Type of Facility – IL, AL, MC
Number of Residents
Type of Room – Private or Semi-private
Private Shower – some facilities have toilet and sink in rooms but showers are in the hallway and shared by residents.
Room Type – each facility has names for the styles of rooms. I made note of what rooms were available.
Size of Room – square footage
One room or two – E’s room had a bedroom area and a living room. Her first placement had one large room with no separation.
Cost per Month Rent
Cost per Month Additional Services – E needs Medication Management, Assistance Dressing (Cueing only. Hands-on would be more) and Escort to Activities)
Do They Accept Medicaid? – rarely does and Assisted Living accept Medicaid. It’s good to know if yours does.
General Impressions.

I learned how the types of facilities differed. I learned terms like “Age in place” and “Secured facility”. (Secured facilities are usually Assisted Livings that accept residents who are “Elopement Risks” and may have many residents who suffer from advance dementia, but they differ from Memory Care.)

I read books about Eldercare and dementia. “The 36 Hour Day” and “Dementia with Grace” are the two I learned most from.

I joined caregiver support groups on Facebook. I wanted to understand caregiving so I’d know what to look for in a long-term care facility.

I researched the rights of long-term care facility residents and their families. I learned what an ombudsman was.

I asked lots of questions!

And I prayed.

On hiring a professional….

When I first became Guardian for E, I hired a Care Manager. She was an expert on facilities in that area. She met with both of us (E and me) and asked lots of questions not only about E’s card needs but about her likes and dislikes. Then she put together a list of places she thought would be a good fit. She answered lots of my questions over the next few weeks. And she visited E weekly for months (a huge help to me since I was eleven hours away.)

A friend of mine owns Senior Living Transitions in Wichita Falls. Her services are free to the families. She is paid by the facility once a placement happens (similar to an employment agency). She knows the area facilities and staffs because she visits often. She volunteers for things like Bingo where she sees the residents and staff interacting. I recommend finding a service like SLT in your area. And, yes, the Senior Living Transitions team has worked with families as far as eighteen months in advance of when their loved one was actually placed in a long term care facility. They are willing to work with you to help you the best possible solution and the right timing for placement.

Yes, national agencies can help you find a place for mom. But they may not have a person in your area, in which case they will look online and give you information from facility websites.

Having someone experienced and knowledge in your area is priceless!

Flowers

I can’t go in to see E; all long-term care facilities are on lockdown. Only medically necessary visits allowed.

I can’t visit her, but I can brighten her day.

A local grocer had large bunches of flowers for $5. They were half price 3-7 pm on Friday. I bought six bunches.

A friend and I gathered a few dozen small vases. We washed them in hot, soapy water.

Then we took everything to E’s assisted living.

Tomorrow they are going to let 2-3 residents at a time come to the dining room to make a floral arrangement. The arrangements will be taken to the residents who never leave their rooms. Some arrangements will be placed around the common areas.

Next week I’ll try to find more small vases. And I’ll get more flowers.

Please note: I called the Activities Director first to get permission. Staff met me at the door to get supplies since I cannot enter the facility.

Caregivers/staff plan to collect the vases once the flowers die. They will wash the vases in the kitchen dishwasher then reuse them.

Vegetarian Is More Than “No Meat”

Vegetarian does not just mean “take away the meat.” It seems the cook at the Assisted Living did not understand this…or didn’t care.

A sweet woman named Bobbie lives at the same Assisted Living my mom lives. They are great friends. They work puzzles and attend church together. They eat together. They can be seen gabbing about life together.

Bobbie is a vegetarian and an amputee. She’s been having trouble with her leg. Sores developed where her prosthetic grips. Her wounds had gotten so bad she could not wear her prosthetic. She’s been in a wheel chair for three or four months. She gets around and has a wonderful attitude, but being in a wheelchair restricts her activity.

Many times I’ve stayed at the AL when I visited my mom. I would do puzzles and eat meals with these ladies.

I noticed a few months ago Bobbie wasn’t eating much. Or to be more precise, she wasn’t being served much. When beef stroganoff was served, for example, the staff simply removed the meat and gave her a bowl of plain noodles. Another night chicken with cheesy potatoes and beets were on the menu. Bobbie was served beets. Just beets. It seemed that the kitchen staff were simply taking away all meat and dairy products from meals to make them vegetarian. They were not substituting appropriate foods. No protein. No fiber. Sometimes no veggies.

Last July, on advice from my lawyers, I hired a care advocate. Deb visits my mom weekly and helps her when I am not in town. I learned Deb also works with Bobbie. I called Deb to tell her what I’d seen and expressed my concern about what Bobbie was being served. She thanked me for my concern but said she could not discuss Bobbie with me due to privacy protections.

A few days later I received a cryptic note. “That issue we discussed…We are ON IT! Thank you!”

Yesterday I received another note from Deb. With permission from the guardian Deb told me Bobbie has been going to wound care for a year with minimal improvement until the past month or so. Suddenly she is making great strides and her wounds are improving at a face pace!

Yes, protein matters! Getting proper nutrition matters! Vegetarian does not simply mean “no meat.”

Because I noticed what she was being served and spoke up to someone who could do something about it, this beautiful woman is healing. Her care advocate had a meeting with the Assisted Living staff to discuss proper meal plans. The staff implemented the plan. And Bobbie is now being served nutritious vegetarian meals. Her body is responding. She is getting better!

I am grateful to have played a very small part in making a difference in her life.

Not All Who Wander Need Memory Care

I thought I’d share a sweet thing that happened yesterday.

A man named John lives at the Assisted Living where my mom lives. He always wears khaki pants and a golf shirt with tennis shoes. He has lovely grey hair that’s always groomed nicely. He also has dementia. I’d been told he is moving soon to a smaller group home. The AL says John has started to “wander” a bit, and they were saying he has to go to memory care. I’m not sure that what he’s doing is wandering, neither is his family. They don’t believe he is an “elopement risk.”

John likes to walk up and down the sidewalk outside. His family thinks it because it’s springtime and the weather is beautiful! The sidewalk is sunny and warm. It’s the only place to enjoy the sun! The garden spot the AL wants him to go when he goes outside is all shade. John has never left the sidewalk directly in front of the Assisted Living.

I’m glad his family has decided to move him to a group home with a sunny backyard instead of to a more restrictive memory care unit.

Back to yesterday…

John was walking on the sidewalk. Back and forth. Enjoying the sunshine and greeting everyone who arrived. He waved goodbye to everyone who left and wished them a nice day.

I knew a staff member was going to come tell him he had to go back inside. They are sometimes not very patient with him.

John always smiles at me when I arrive. He’s very sweet. He pointed out the flowers blooming along the sidewalk. The “Garden Area” in back has no flowers. Just a concrete porch with patio furniture. All in the shade. (Can you see why he’d rather be out front on the sidewalk? Sunshine. Warmth. Flowers. And people to greet.)

I wanted to gently get him back inside before staff made him go in.

I spoke with him about the flowers and walked with him a bit. Up and down the sidewalk. Back and forth we walked. In the warm sunshine. Then I showed him pictures of my wildflowers. As you know, it’s hard to see pictures on a cellphone in the sunshine. He tried to see them. Then he said, “let’s go inside where I can see the pictures.”

Mission accomplished.

Here are some of the pictures I showed John. I have a couple dozen pictures on my phone. We stood inside and looked at pictures. Then he wanted me to show them to other residents and staff. He is very social.

I will miss seeing him when I pull up today. He moved to a more appropriate and less restrictive placement yesterday afternoon. I wish him well.

Dear Musician Friends

Dear Musician friends,

I’ve heard many of you play. I’ve been to your performances. You are very talented.

You must practice often. I know you do. Sometimes you practice for an hour or more each day. Sometimes you practice alone, sometimes with a few other musicians.

Have you considered spending time one day each month playing at an assisted living? Maybe one day each month your practice time could be spent performing for a small audience of older people. Maybe you could play for those who cannot come to your performances. Older folks who love music but don’t get out much any more.

There are hundreds of seniors living in these communities even in a small town like Wichita Falls. Thousands in cities like Denver, Atlanta, Chicago, or Dallas.

The staff of these communities welcome folks to come and play or sing. Most facilities have lovely pianos waiting to be played. Or you can bring your cello, flute, guitar, violin, etc. You could simply sit and play for whomever listens. Soft music. Hymns. Broadway hits. Or oldies they know and may sing along.

Call Brookdale, Elmcroft, Rolling Meadows, Royal Estates, Presbyterian Manor, House of Hope, Texoma Christian Care Center, or Arbor House. Google “Assisted Living near me” to find facilities in your community. Ask to speak to their Executive Director or Activities Director.

Explain that you are a musician and would like to come play for an hour. Nothing fancy. Just you and your instrument. Or maybe you and a few friends and your instruments. Have a list of dates and times you are available. (2:00 or 3:00 in the afternoon is a great time as it rarely interferes with meals and other activities.)

Some have weekly hymn singings or music happy hour. Others schedule performances when volunteers are available. Are you willing to be available?

These people love musicians. They love music. They love art. And they love visitors.

Thank you for sharing your music.

Sincerely,

Someone whose loved one lives in an Assisted Living and who loves music

#careforwidowsandorphans
#notjustduringholidays
#musicallyear

A Lovely Day

Today was a lovely day. I’m visiting my loved one at the assisted living. I’ve been here since Thursday. I stay in a guest room on site, so I get to do life with Marie. (That’s not her real name to protect her privacy. All names have been changed.)

I had lunch and dinner with Marie. We laughed and talked. I showed her videos and pictures of my kids whom she adores. We cleaned out her fridge and made a shopping list for our Target run tomorrow.

I’m here to see her, but I have gotten to know and care for her friends and fellow residents.

Right after breakfast we participated in BFit exercise, a class led by a resident for all abilities. Many do the exercises in their wheelchairs. It’s fun to laugh and encourage each other as we get stronger.

I got Melanie to smile this morning. She’s been sad lately; she remembered recently that her daughter died. She sits in her wheelchair in the same spot all day. I got her to plot a heist of Fig Newtons from building three. Building two didn’t have any. She loved the plotting. She was to be my lookout and create a diversion by squealing as if she saw a mouse. We practiced a few times, much to the humor of everyone else in the living room. She didn’t follow through; she never leaves building two. But she smiled. A lot. And she kept smiling right through dinner! (And building two got fig newtons this afternoon. Win win!)

We (Marie and me along with a few other residents) helped decorate for Christmas in building three. They all live in building two, so it was a chore to get them to go with me. (it’s across the driveway) But they had a lovely time.

Marie and her friend Betty did most of the work. They are great at decorating. They did all the Christmas decorations in building two, so they were asked to help in building three. They let me tag along.

Jim, a former prosecutor, helped us decorate. It was a great break for the staff. He has dementia and asks questions all. the. time. Like every few minutes. The same question over and over. He’s charming and kind and dresses so sharply! He simply doesn’t remember things. I sat on the floor and handed him ornaments to put on the tree. Not one question for more than 45 minutes. Lots of smiles though. And the tree looked beautiful.

Jamie sleeps most of the day. In an arm chair in the living room with her feet propped on her wheelchair. She has a lovely voice; I’ve heard it during BFit morning exercise class. She sings “Bicycle Built For Two” when do bicycles and “I’m In the Army Now” when we march. She’s tiny, half bald, and missing most of her teeth but has a strong alto voice. I sat next to her this afternoon. I began singing Christmas carols quietly. She sang with me. For quite a while. We had a wonderful time! (I continued to sing quietly so others could hear her lovely voice.)

We watched Mr. Holland’s Opus after dinner last night. I bring movies and try to get residents to watch with Marie and me.

Debbie is new. She gets lost often. She went with us upstairs to watch the movie. They all loved it! Debbie was talking about it this morning. She had so much fun she went with us to decorate. I walked with her when she went to the restroom and back then back to her room so she wouldn’t get lost. I had to help her more than a few times and reminded her this is her home now, so she doesn’t need to find a ride home. She started to hangout with some of the other ladies by afternoon. They are becoming friends which will make her stay here much more pleasant. She and I sat in the living room chatting for an hour after everyone had gone to their room tonight. she told me about her nieces and nephews. She’s delightful!

By taking Jim and Debbie with us to decorate, the staff did not have to help either of them for more than two hours. They thanked me. I did it because I like these people.

I am falling in love with these seniors. ♥️

Oh! And we got to face time with my grandkids! Marie loved seeing them.

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