Grandma had a disabling stroke a couple of years ago. She now lives in a skilled care facility. She is in very bad shape and spends her days sitting in a wheelchair and requires full care. Poor Grandma! Grandma can't fed herself or carry on a conversation. She sees poorly, often is stuck in repeating a nonsensical phase for months at a time. So what's a family to do? Here are some things that we have learned through trial and error.
Visit as often as possible. Short and sweet is fine. Spend more time if you can.
Talk about past happy times. Tell your loved one about current happy times. Mention family names. You may get a word or two. Capitalize on that and tell them more about that person.
Tell sad news on a relevant, as needed basis. They may need to know that a loved one has died. However they do not need to be burdened with the troubles of world events or the messy details of a divorce. If a regular visitor hasn't been there for awhile do tell them that so and so has not visited because they are sick. I think Grandma is thinking and perhaps worrying about her family.
Listen to music together. Notice your loved ones' response... choose calming, soothing tones.
Enlarge photos to 8x10. Photos of the kids when they were with Grandma in her younger days may connect with the part of Grandma's life that is still with her. Past events generally stick in a stroke patients mind current events often do not. Talk about all the fun you had at the event in the photo. You may be rewarded with a smile of recognition.
Read the Bible to your loved one. Short encouraging passages will be good for both of you. Your family member may be thinking about their spiritual life.
Read poetry or short, simple, and happy stories to your family member.
Have a card shower. Send an e-mail out to family and friends to send Grandma a card with cheerful note or photo. Read the mail to your loved one... more than once.
Go for lunch. Patiently feed your loved one. Plan on spending some time doing this. Take this opportunity to chat with the staff at the table about your loved one. Tell them that your loved one is a big sports fan, what type of job they did, hobbies, pets, children or anything else that will make your loved one a real person to the staff. Remember the staff probably knows nothing about your family member. This will help the staff talk to your patient and also make the patient more than just someone to be cared for.
Take a treat. Check with the nurses before you offer this to your loved one. Grandma is not diabetic so she can have a milkshake. However, thickner is added to that she will not choke as the ice cream melts into liquid form. The staff should be happy to help you with getting this correct. Grandma loves this part of our visit.
Give Grandma a kiss and hug. Tell her you love her and appreciate all she did for you.
Take a box of chocolates to the staff. Show appreciation for their efforts on behalf of your loved one.
Be your loved ones advocate. Be respectful and specific if you see any problems. Go to the adminstrator of the facility if necessary. Follow through until you are satified with your loved one's care. Pick and choose your battles but your loved one deserves to be treated right.
Talk to the staff. A good staff will be working on your loved ones issues. After months and months of listening to Grandma tell us that there was " a bear-flier in her hair" one of the staff members goggled the phrase "bear-flier". To our amazement she found that a "bear-flier" was a type of fishing lure. With that little piece of information I asked Grandma if she had ever had a "bear-flier" stuck in her hair while fishing with her husband. She nodded her head "yes" and looked enormously relieved. I asked her if she had gone to the hospital to have it removed and again she nodded her head "yes". She finally got through to all of us! Kudos to the staff member for solving the mystery.
None of the family knew this story but Grandma wanted us to know. It was a great relief to all of us. She is still talking about the "bear flier" but at least we know what that's about now.
Grandma I love you!
Please share your ideas on ministering to your elderly loved ones.
Showing posts with label assisted living. Show all posts
Showing posts with label assisted living. Show all posts
Sunday, February 17, 2013
Thursday, February 3, 2011
How to choose a nursing home for your loved one...
Caring for a loved one at the end of their life is both privilege and responsibility. If you have been named the health care representative you will be choosing your loved one’s long term care facility. Your guiding principal should be the golden rule. Care for your loved one as you would want to be cared for. As health care representative you have been entrusted with your loved one’s life. This decision is often made quickly and with little guidance as to what to look for in a facility. I would like to offer some helpful suggestions.
1. Take some time. Know that you can request a 48 hour extension to pick a facility.
2. Look up all facilities that you are considering on the internet.
www.medicare.gov.
Go to resource locator
Then click on nursing homes
Google: (your state’s) Department of Aging and Disability.
Find the Consumer Information reports.
These two resources will help you get a general idea of what the facility care is like but it certainly does not give you the whole picture.
Quality of care should to be looked at carefully. Medication errors and actual harm dings are really bad.
3. Go visit several facilities. This will help you make a sound decision. Do not just pick the closest nursing home or the one that your neighbor said was good. Nursing care can be great one year and poor the next. If a key person leaves the job then nursing home can quickly go from good to bad. Breakfast time is a good time to visit because it is the hardest for the nursing staff. If they have their act together at breakfast they probably have their routine down pat. You should expect faces to be clean, beds made up, and patients alert by 9 or 10 a.m.
4. Find the survey. Read it carefully. Surveys have to be easily found by the public. You should not have to hunt or ask for the survey. Surveys are usually in the lobby area at the main entrance
Interpreting the survey...
Quality of care. A-D ratings are generally not a cause for concern.
G level or above are REALLY BAD.
Medication errors are BAD.
Actual harm errors are BAD.
5.Questions to ask…
How was your last survey? May I see it?
Observe the staff persons response. A well run facility will not be threatened by your questions.
What is your staff/patient ratio?
Different department should have different ratios. Departments where more care is needed should have a lower ratio.
What is your percentage of pressure sores this year?
Don’t look at the number look at the percentage. The percentage should be less than 5% unless they are specialists in healing bed sores.
6. Observations during your visit.
What is the general atmosphere?
Is the staff happy? What is the general attitude of the staff? Are they snotty and cold or warm and caring?
Is the facility dark and depressing or is it warm, cheerful, and homelike?
Is there a lot of odor? Spot odors may occur due to accidents but in general the whole place should smell clean and fresh.
Is the staff checked out? Someone should stop you and kindly inquire as to whom you would like to visit.
Is the staff working? or are they down the hall talking?
Are the patients being fed? Patients should not be staring at a plate of food. Meals should be brought when someone is available to feed them.
Are patients being encouraged to eat?
Are patients alert? Patients should be alert and not drugged or tied into a wheelchair.
Is the facility restraint free?
Bolsters, scoop mattress, and M bars are all good.
Beds should not have side rails.
Side rails are dangerous as people can become trapped in them.
Talk to a resident… what do they say?
7. Listen for these buzz words.
Eden Alternative
Person-centered care
Culture change
Research each of these philosophies.
While these things do not indicate the quality of care they do indicate that the nursing home is focused on patient choices. These will also give you some sense as to the nursing homes underlying philosophy of care.
Two more things you can do…
Ask for daily skilled service. (this will ensure that an R.N. will check on your loved one on a daily basis)
Ask for a lawyer name that specializes in Medicaid.
Remember to look at the big picture…
Any short term disruptions or inconveniences that you experience will be rewarded by the satisfaction that you did right by your loved one. You are their friend and advocate.
1. Take some time. Know that you can request a 48 hour extension to pick a facility.
2. Look up all facilities that you are considering on the internet.
www.medicare.gov.
Go to resource locator
Then click on nursing homes
Google: (your state’s) Department of Aging and Disability.
Find the Consumer Information reports.
These two resources will help you get a general idea of what the facility care is like but it certainly does not give you the whole picture.
Quality of care should to be looked at carefully. Medication errors and actual harm dings are really bad.
3. Go visit several facilities. This will help you make a sound decision. Do not just pick the closest nursing home or the one that your neighbor said was good. Nursing care can be great one year and poor the next. If a key person leaves the job then nursing home can quickly go from good to bad. Breakfast time is a good time to visit because it is the hardest for the nursing staff. If they have their act together at breakfast they probably have their routine down pat. You should expect faces to be clean, beds made up, and patients alert by 9 or 10 a.m.
4. Find the survey. Read it carefully. Surveys have to be easily found by the public. You should not have to hunt or ask for the survey. Surveys are usually in the lobby area at the main entrance
Interpreting the survey...
Quality of care. A-D ratings are generally not a cause for concern.
G level or above are REALLY BAD.
Medication errors are BAD.
Actual harm errors are BAD.
5.Questions to ask…
How was your last survey? May I see it?
Observe the staff persons response. A well run facility will not be threatened by your questions.
What is your staff/patient ratio?
Different department should have different ratios. Departments where more care is needed should have a lower ratio.
What is your percentage of pressure sores this year?
Don’t look at the number look at the percentage. The percentage should be less than 5% unless they are specialists in healing bed sores.
6. Observations during your visit.
What is the general atmosphere?
Is the staff happy? What is the general attitude of the staff? Are they snotty and cold or warm and caring?
Is the facility dark and depressing or is it warm, cheerful, and homelike?
Is there a lot of odor? Spot odors may occur due to accidents but in general the whole place should smell clean and fresh.
Is the staff checked out? Someone should stop you and kindly inquire as to whom you would like to visit.
Is the staff working? or are they down the hall talking?
Are the patients being fed? Patients should not be staring at a plate of food. Meals should be brought when someone is available to feed them.
Are patients being encouraged to eat?
Are patients alert? Patients should be alert and not drugged or tied into a wheelchair.
Is the facility restraint free?
Bolsters, scoop mattress, and M bars are all good.
Beds should not have side rails.
Side rails are dangerous as people can become trapped in them.
Talk to a resident… what do they say?
7. Listen for these buzz words.
Eden Alternative
Person-centered care
Culture change
Research each of these philosophies.
While these things do not indicate the quality of care they do indicate that the nursing home is focused on patient choices. These will also give you some sense as to the nursing homes underlying philosophy of care.
Two more things you can do…
Ask for daily skilled service. (this will ensure that an R.N. will check on your loved one on a daily basis)
Ask for a lawyer name that specializes in Medicaid.
Remember to look at the big picture…
Any short term disruptions or inconveniences that you experience will be rewarded by the satisfaction that you did right by your loved one. You are their friend and advocate.
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