On living in a retirement community

For years I’ve been writing about my efforts to get my parents and my in-laws into senior housing. As a senior care professional, I know how important independence is to seniors but I also know how much faster people fail when their movement slows, social interaction is reduced and nutrition start getting overlooked for the sake of convenience. So for our parents, I wanted them to gain from the benefit of living with others in an active senior environment. I wanted them out of the driver's seat, too, if the truth be told.

We’re lucky in that both parents could afford this option. We live in a community with lots of housing choices, too. My mom chose a faith-based non-profit community of cottages; my in-laws a large for-profit high-rise closer into the city center.

The choice didn’t come easy. My in-laws, in particular, resisted the decision for a very long time. My mother-in-law was determined to die in the house she had lived in for the past 50+ years, just like her own mother did.

And then last Saturday night she fell. Right away my father-in-law pulled the emergency cord. Within minutes someone had come in to help calm them both and call 911. When the ambulance came the staff greeted them and make sure everything went well during the transfer to the hospital.

By the time we met them at the hospital, everything was fine. My father-in-law exclaimed over and over how glad he was that they lived where people could come to help immediately. "We have buttons or cords in almost every room!" he kept exclaiming.

My mother-in-law? Her main worry was whether she’d miss the special Sunday Brunch the next morning.

Is retirement housing or assisted living an option for you or your loved ones? Whatever your answer, focus on quality of life. Focus on what will increase your loved ones’ interaction with others, what will increase their physical activity and what will help ensure that they get good nutrition and, if needed, medication assistance. Think about how their move will affect you, too. Will it free you to focus more on your relationship and enjoy your time together, or will it cause you to spend even more time doing chores and handling responsibilities?

At the end of the day, it’s not where we live – it’s a matter of living a life rich with joy and meaning. It is, in a nutshell, about making it to Sunday Brunch!

Assisted Living companies in bankruptcy: what can a family do?

Every day I see a new article on another assisted living company entering financial difficulties. Some are filing for bankruptcy; many are on the brink.

If you have a loved one in an assisted living community, what should you do? Many families are feeling anxious about their loved ones' care as major companies like Sunwest Management Inc., one of the largest retirement housing providers in the country, files for bankruptcy protection in one state after another.

I know, from my own days as an owner and operator, when money is tight it's hard to focus on care. It's very hard to think about training and energizing employees who may not even be with you next month - or next week.

You spend hours every day looking for areas where you can cut expenses without hurting the people in your care.

As Eric Carlson, the director of long-term care for the National Senior Citizens Law Center said in a recent Denver Post article, "When facilities are losing money, they're tempted to cut staffing below safe levels."

If my own mom were in an assisted living or retirement community that was on the verge of bankruptcy, here's what I'd be looking for:

1) Basic life necessities: Food, water and heating. Stop in from time to time during a meal. Don't call ahead; just drop by. When communities are cutting beyond the point of reason you'll see meal portions reduced, dining rooms understaffed, and food served warm (when it's supposed to be cold) or cold (when it's supposed to be warm). Believe it or not, many companies in trouble delay paying utilities until the last notice, causing risk of basic water, sewer and power. I've heard more than one property manager talk about paying the utility bill out of her own pocket just hours before the shut-off was scheduled; I've never heard of a community getting all the way to shut-off, though. To me, that's a testament to the dedication of most community managers - they'll do everything in their power, literally, to keep the residents well cared for.

2) Talk casually to your loved on about call-lights, if they have them. Ask how long it takes someone to arrive. If the community is cutting too deep into staffing response times will lengthen dramatically. Let your loved one know who else to call if no one is coming to assist in a timely manner (for example, when is it appropriate to directly dial 911; when should they call you so you can ensure care?)

3) Sit in the lounge, living room or lobby and simply observe staff. If the company is managing their financial difficulties appropriately the staff providing direct care to residents - including housekeepers, maintenance staff and caregivers - will continue to be cheerful and talkative while they work. They won't show noticeable stress and anxiety about their own jobs. You should observe polite conversation (instead of stressed frustration and anger); hopefully even laughter and hugs when appropriate.

4) Pay attention to cleanliness and maintenance. Deep cuts can result in a building with a feeling of grime instead of polish; a lack of routine maintenance will result in light bulbs dark and toilets that run without stopping. In a busy assisted living or retirement community it doesn't take long for these things to become noticeable.

5) Finally, watch your loved one for signs of stress or anxiety. If he or she stays on top of the news a little anxiety will be normal; more than a little may mean that staff members are sharing their own stress with your loved one. Nothing causes a compassionate resident more despair than hearing, over and over, the trials of the people who provide them with daily services and caring attention.

If my own mom were living in a community in trouble, these are the things I'd watch for. And I'd know, seeing one of more of these conditions appear, that it was time to look for another home for my mom, before the company's difficulties became my own.

Alzheimer’s Caregivers can keep loved one out of nursing home for extra year and a half with simple training

Here’s the opening sentence to a new report that sheds exciting light on help for individuals caring for people with Alzheimer’s or memory loss:

The findings are stunning: Offering simple training to people struggling to care for loved ones with Alzheimer's disease not only eases their burden ---- it even can keep patients out of nursing homes for an extra 1.5 years. (Source)

The challenges in implementing what seems to be a simple solution to save families thousands of dollars in nursing home expenses is a common one for all caregivers: time and access.

For family caregivers, having enough time to attend training classes, let alone support groups, often means making complex arrangements to get someone else to stay with their loved one or find somewhere to leave the person with the memory loss.

Attending classes is challenging, too. Many are not available in rural areas; travel and expenses make traditional classes simply out of reach for many families.

But for family caregivers, technology offers exciting new solutions. The internet offers a wealth of resources and information on nearly every disease.

Internet based caregiver training can provide exactly what the caregiver needs to learn, when it’s needed. It can be accessed from the comfort of home, too, helping families avoid the need to travel to classes or fit them into a busy schedule, not to mention finding a caregiver for their loved one while they’re away.

Are behaviors a challenge? Find out how to prevent behaviors from happening, or how to appropriately respond when they do happen.

Is your loved one losing weight or having difficulty eating? Is showering a constant struggle? Going to the doctor mission: impossible?

One of the major benefits of taking online classes is that learning can be on-demand. That means that the caregiver can access the training they need at the time they need it. It eliminates the experience of attending a series of classes and then finding yourself, months from now, thinking, “I know they covered that in the class, but I can’t remember exactly what they said to do…”

Caregivers across the nation are finding the internet a tool to get support, too. Email or internet forums can become a tool for beginning conversations, getting custom tips and advice, and, in general, feeling less alone in the caregiving challenges.

Many websites offer information; many forums allow caregivers to share their experiences and support other caregivers.

Some, like Caring forMom, offers online training and support, all in one location.

For caregivers of people with memory loss and Alzheimer’s disease – for all caregivers, actually – technology today offers much more than peace of mind. It can offer real savings in terms of money that would be spent on facility care. It can also offer families the chance to do what they really want to do: keep their loved one at home and continue to provide the care needed.

Senior Citizens: How we look and how we feel are two different things

Here's a video my brother sent me last week - it makes me smile as I can relate only too well. Point (besides fun): our bodies may be growing older but in our minds we're still young and sexy!

Point #2: your mom/dad thinks this way, too!

Family Caregiver’s Resolution

No matter what your year was like we get, by benefit of the modern calendar, to turn the page and start fresh in the new year.

As a family caregiver it may be hard to tell day from night, let alone pause to mark the passing of one year and the start of the next.

But here’s the challenge I’d like to make to every family caregiver for the year to come:

Find a way to make caregiving joyful.

“Ha,” you say. “Caregiving is a tough job. There’s little to be joyful in it.”

It is a tough job, no doubt about it.

My brother-in-law’s father, recovering from heart surgery, has become so ornery that none of his sons can stand to be around him. They still dutifully shop for his groceries and offer to drive him wherever he needs to go. When he couldn’t live alone, they arranged for an out-of-work nephew to stay with him for a few weeks. He’s their dad, and they have a responsibility to be involved in caregiving, no matter how challenging it is.

But I give them kudos for not trying to move dad in with one of them. Instead, they found a family member who needed the work and who, by his emotional distance, wasn’t so personally affected by dad’s behavior as the sons are.

Here’s what I encourage you to do in the year ahead:

FIRST: Remember the reason you’re involved in caregiving. It’s undoubtedly because of a relationship. You’re a son, a daughter, a spouse or a significant person in the life of the person you’re providing care to. You didn’t have to become a caregiver, so why did you step into that role in the first place?

SECOND: Imagine the “perfect world” scenario. Just finish the sentence, “In a perfect world…” In a perfect world, your loved one wouldn’t need care; he or she would be perfectly independent and healthy. But setting that aside, in a perfect world, what would your relationship as a caregiver look like?

“She’d say thank-you more often.”

“He’d actually laugh at my feeble attempts at a joke.”

“She’d recognize me and remember our happier times.”

Notice that each of these endings focus on what the person you’re caring for would do? None of them focus on things that YOU can do.

Let’s take it a step farther: what would YOUR actions be, in a perfect world?

“I’d come in with a smile every day, rested and relaxed.”

“I’d bring small gifts – fresh flowers, home-baked muffins or a new book or magazine, each time I visited.”

“I’d be happy to be providing care instead of feeling resentful and frustrated so much of the time.”

NEXT: Think about the steps you need to take to achieve those last statements – the ones about yourself.

“I’d come in with a smile every day, rested and relaxed.” – what would that take? Do you need to get a caregiver to relieve you every few days so you can take guilt-free breaks from caregiving? If so, what do you need to do to make that happen?

Actually, all of the statements that caregivers make above depend on one thing: getting a break.
That leads us to the FINAL step: Pursue the break you need, so that you can regain the quality of the relationship. Find a way to make the relationship you have with the person in your care once again joyful.

It won’t be easy. It might be expensive – in time, emotion or money. But make this your goal for the New Year, and see what amazing things you can accomplish.

Share your goals and resolutions.