Monday, September 27, 2010

Eldercare Tips: Finding a Great Adult Family Home

Adult family homes, also called group homes, recently took a hit in the press with Seattle Times' "Seniors for Sale." The five-part investigative report released in February and Sept. 4 and 5 uncovered widespread abuse and neglect in this ill-regulated and rapidly growing industry. My previous post examined the findings.

What does this mean for you if your aging parent needs care, and you want a small, homelike setting? Excellent adult family homes do exist, provided you do your homework.

Some ideas:

1. Once you find your desired location, do an Internet search to find several addresses. Or ask friends or associates for referrals. Drive by each home and look closely. Is the home in good repair? Is the grass mowed? Little things count.

2. Visit each home several times, at least one announced. Try to arrive at mealtime to observe the quality and quantity of the food. Are staff and residents enjoying one another? Or do residents seem stressed? Does the home look and smell clean and fresh? What about activities? Music? Look at the entire home, staff and program in the light of your parent's needs.

3. Ask the owner, manager or other representative to show you the most recent state inspection report. If you need help interpreting it, ask a friend in the medical field.

4. Call the Long Term Ombudsman in your area to see if any complaints have been filed recently against the home. Ombudsmen work to resolve problems of individual residents and to work on the local, state and national levels to improve care.

5. Contact the Better Business Bureau to check out the home's record.

6. If these steps sound like too much work, consider contacting an eldercare referral agency or a geriatric care manager. Both can be of help in locating a good fit.

Do you have personal experience with a good group home or a bad one?

Monday, September 20, 2010

Eldercare Tip: With Adult Family Homes, It's 'Buyer Beware'

Choosing an adult family home, or group home, for your aging parent can be dicey. Nationwide, this 20-year-old phenomenon is touted as cheaper and more homelike than a nursing home. But better?

That depends. Clean and comfortable, a well-run adult family home is staffed with consistent caregivers who love and understand the elderly. In such an atmosphere, music, nutritious meals and activities will fill your parent's day.

Finding such a place requires diligence. State regulators can't keep up with the pace of this rapidly growing industry, making it easy for ill-trained, money-grabbing owners to exploit the elderly and their families.

So says The Seattle Times. Last week it published the fourth and fifth segment of the investigative series "Seniors for Sale," a critical examination of adult family homes in Washington State. Earlier segments ran in January.

In reviewing years of state records, the reporter, Michael Berens, noted that of the 11,200 residents living in the state's 2,843 homes, thousands have been exploited financially or harmed by unqualified caregivers. He reported accounts of victims imprisoned in their beds at night, strapped to their chairs during the day or left without proper medical treatment for weeks.

In scores of cases, the report continued, owners collected monthly payments while playing the miser. They eliminated meals, turned off heat or left residents in soaked clothing for days.

The abuse and neglect mentioned above, as awful as it is, doesn't tell the whole story. Earlier this year I met an 80-something man named Paul at Northshore Senior Center. He lives in one of three adult family homes in the Shoreline, Washington, area, owned by Laura Cirves, RN. They're called For Senior's Sake.

Once a week Paul goes dancing at the senior center, thanks to transportation provided by the adult family home. Other times he and the other residents go out to lunch and attend baseball games. They receive manicures and permanents. Live musicians perform weekly.

Laura's homes are licensed for residents with dementia and mental health issues. Despite their medical diagnoses, the residents get every chance at life possible.

"My mission is to increase the quality of the lives in my care," Laura says.

The next post will give some guidelines in choosing an adult family home.

Sunday, September 12, 2010

Eldercare Dilemma: Grandpa Tells the Same Stories Over and Over

Does your aging parent lapse into stories at the drop of a hat? And does he or she repeat the same ones again and again, in great detail?

Grandpa Jake certainly does. When he tells of receiving his first pony, a Shetland named Bill, on his fourth birthday, he travels back in time. From that day on, Jake and his pony were inseparable. "A silly name for a horse," Jack recalls. "Lightening would have been better."

Jake has told this--and other stories--so many times that his family is not only bored; they're worried. Do repeated stories signal dementia? Or an unnatural drawing inward that is unhealthy?

Not so, says David Solie, author of "How to Say It To Seniors." He contends repeated stories are a vehicle for completing a key developmental task: the building of a legacy.

At the end of life, people want to be remembered for their time on earth and cherished by future generations, Solie says. They review the happenings of their lives and consider how those events figure into the way they want to be remembered.

That's where the repeated stories come in. And the detailed rendering of the events, Solie says. More important than the facts are the underlying values--building bricks of their legacy.

In Grandpa Jake's story, the thrill of receiving his horse may have explained his value of gratitude--both as a child during the Depression, and during the rest of his life. A lifelong love of animals may have caused Jack to repeat the horse story again and again. As the story is repeated, other life values may surface, evident to him and his family.

Bottom line: When our aging parents repeat stories, they are in the process of creating a legacy. We need to listen respectfully not just for the facts but for possible themes.

"Tell a similar story from your own life," Solie also suggests.

Connection is everything.

Does a senior in your life tell the same stories again and again?

Sunday, September 5, 2010

Eldercare Jargon Translated Here

Eldercare jargon is alive and well on Planet Earth--unfortunately. Senior Care Professionals often sprinkle their conversations with words which carry no meaning to you and me.

An elderly woman commented recently on the brochure I sent her about retirement living: "I have one question. I'm not sure what 'congregate living' means. Does it have to do with religion?"

Oops! I thought to myself. The word "congregate" is a little like the word "congregation." But that's not what I had in mind. In my brochure I'd committed the unpardonable sin of slipping into eldercare jargon without thinking. After owning my misdeed, I translated: Congregate living is retirement living offering meals, housekeeping, transportation and activities.

Here are other examples of eldercare jargon you may hear as you care for your elderly parent.

ALC--After 14 years working in this field, I heard this recently from a professional. "I often give talks in ALC's on veterans' benefits." When I asked the meaning of an ALC, she said, "ALC is an assisted living community." Really!

Interdisciplinary Assessment--It's a nursing home term. During the first 14 days of residency in a nursing home, all departments come together to report on the new resident's needs and determine how those will be met.

Transfer--This has two meanings. The first obvious meaning refers to an elderly person moving from one care setting to another, such as from an assisted living community to a nursing home. Transfer also refers to the process of getting up from a sitting or reclining position. If your parent is a two-person transfer, he needs two other people to help him get up.

Respite--In a broad sense, this word means "rest," usually for a caregiver. This usually takes the form of bringing their loved one to a care setting temporarily, so the caregiver can take a break.

Discharge--No, this doesn't refer to bodily fluids. It has to do with leaving a care setting, such as being discharged from a hospital, a rehab center or a nursing home. Sometimes discharge happens because the person needs more care; sometimes because the person's health has improved.

Spenddown--This occurs when your parent's limited funds are paying for health care and will soon run out. Yet he or she is not yet eligible for Medicaid. Each state has rules about how funds can be spent during this spenddown period.

Have you encountered other examples of eldercare jargon? Please share.
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