Articles Posted in Real Life Story

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I just turned 55 on my last birthday. Although some people consider 55 as the official age of becoming a senior, I have never allowed my age to deter me from participating in my hobby of tap and jazz dancing. As a senior living advisor, (and a former, part-time children’s dance teacher of 13 years, hobby only) I am also pleased to see so many of the senior communities offering dance therapy classes to their residents. I have also taught tap and ballet on a voluntary basis in some of the assisted living communities that specialize in dementia care and several senior centers. I was made aware that several of the participants also had Parkinson’s disease.

Exercise that is performed several times a week can help to elevate a person’s immune system and make them feel better about themselves. That is because of the endorphins that are released. The exercise classes provide camaraderie while encouraging seniors to move all of their body parts. If a person moves their limbs, it increases hand to eye coordination, strengthens the core, and helps balance.

I approached the classes as I would have at any other basic level. I included combinations and repetition to Frank Sinatra and Bobby Darin songs. I found that most of my “students,” found ease in doing the tap warm ups, grape vines, and some jazz movements, even if they were confined to a wheel chair. Many of the participants said that their joints felt better, their overall movement improved, and most importantly their spirits had been lifted. After the class had finished, I always served them a snack and we’d talk for a while. Some of the residents with dementia would reminisce about where they used to go to dance with their spouses. One resident in particular spoke about a church in Evanston, Illinois that had a Scottish affiliation and offered Scottish dance lessons. She even went so far as to quote me the exact street address.The repetition of certain exercises helps people with Parkinson’s to concentrate on movements that have become difficult for them, such as doing two things at once. People who have suffered a stroke are able to express themselves by moving to the music even though they can’t talk. Sometimes peoples’ medications stop working for them and the classes give them relief from their symptoms.

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A recent, nationally publicized tragedy involving a woman with memory issues emphasizes the fact that a senior with dementia (even in the early stages) should never travel alone. The woman’s family was aware of the fact that she was having memory issues. Yet, they allowed her to fly from Barbados to Washington alone (flight time approximately four and one half hours) with a layover in Miami. The article states that the family was concerned about her memory issues and planned to have her checked once she arrived back in Washington. It seems to me that she should have been checked prior to doing any travelling. In addition, the woman had poor vision. She walked past an airline agent who was carrying an electronic sign with her name on it. He was to escort her to the baggage area where the daughter was waiting. Her physician would have advised against her travelling alone and the tragedy could have been prevented.

As a senior living advisor, I always tell my clients that a senior with dementia should never travel alone. Here are some other tips that I offer to ease the stress of travelling with a senior who has dementia:

:-Always stay with the person in the airport. Do not turn your back on him/her.

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I am often confronted with some interesting family dynamics when a family hires me to consult with them. At times, the children are willing to accept my advice without reservation. Sometimes, there is often one child who wants to prove that s/he can “do this on her/his own.” While there is usually one child who emerges as the spokesperson for the family, the choice of the right care should be the result of a family consensus and not the persuasive skills of a ringleader. Consensus should be coupled with careful comparison of cost and methods of payment, level of care needed, staffing considerations, location, and quality of care involved with all the senior living options. Please read the following “Real Life Story,” that exemplifies my point

Real Life Story

One of my clients who did not follow my initial advice contacted me last week. She was unhappy with the care that her Mother was receiving at an assisted living community that specializes in memory support.

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When I am hired by a family whose loved one has Alzheimer’s or some other form of dementia, my thoughts immediately turn to my Father. My Mother, who is a registered nurse, insisted upon caring for him at home until his medical conditions forced his transfer to a nursing home. He had been one of the charter physicians who helped open a major hospital in the 1960’s. Because of this fact, my Mother felt obligated to place him a nursing home that was owned by the hospital. It was centrally located for most of my family members, except for my husband and me. We would travel 25 miles every night after work so that I could visit him. The commute exhausted both of us. The poor care resulted in my Mother making a decision to move him to a nursing home that was closer to her, but even further away from us. The care and compassion that he received at the new nursing home was the difference between night and day. I just had to resign myself that I was going to see him less. As a senior living advisor, I always tell my clients that location is important but it shouldn’t be the sole factor in choosing a long term care community.

REAL LIFE STORY

My clients were an 82 year old woman and her children. Their Father was at home with two caregivers who took care of him in 12 hour shifts. He was diagnosed with Alzheimer’s disease. His behavior was becoming very difficult to the point where he was a two person assist. The family was in favor of placing him in a long term care community. There was one child who volunteered to move him into her home. Her intent was hire a number of caregivers to accommodate the two person assist.

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During the week, I was presenting my “Senior Living Myths Unmasked – Separating Fact From Fiction,” to a group of business owners. As a senior living advisor, I told them that I always make certain that a skilled nursing community is certified for Medicare and Medicaid and to understand any stipulations relating to both. The response from several members of the audience was “Do you mean some aren’t?” Therefore, I would like to share an unusual incident that encourages exercising due diligence in understanding your loved one’s terms of permanent admission.

For the past several weeks, I have been assisting a woman whose husband was at home with a 24 hour caregiver. This arrangement had been in place for a number of years and the cost was becoming prohibitive. As much as she wanted to keep the current arrangement in place, she needed to move him in enough time to afford placing him in a top notch skilled nursing community. There were enough assets to pay privately for a number of years. But like many seniors, he would need to file a Medicaid application once his funds were depleted.

When I sat down with the wife, she gave me some location parameters. I immediately came up with a suggestion for a community that I felt would be perfect for him. My client was pleased because her husband’s primary care physician happened to be the community’s Medical Director. Although she was elated with my suggestion, she wanted to look at other communities for the purpose of comparison. I went home and chose 2 other communities to present to her.

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The firestorm controversy regarding the refusal of a retirement community nurse to administer CPR to an 87 year old resident of its independent living section has been fueled, in part, by faulty media coverage. On the morning of March 4, 2013, I heard a reporter on a local news radio station in Chicago refer to the Glenwood Retirement Community in Bakersfield, California as a “nursing home,” which is a mistake. Many national news announcers made the same mistake. The more accurate terms would have been “senior retirement community” and “independent living.”

The distinctions do make a difference — not necessarily for the moral and ethical implications of the case (which are gravely serious and merit solemn discussion in a nation founded on life-affirming Judeo Christian values), but for the majority of Americans who might not understand the wide range of senior living options.

Glenwood Gardens is a community that offers independent living. The independent living unit where the decedent lived does not require any sort of licensing. Glenwood’s licensed assisted living units and nursing home are located on adjacent property. The independent living facility is not unlike a regular apartment building. Its residents are supposed be able to function with very little assistance except, perhaps, for some meal preparation and housekeeping help. Therefore, during the widely reported incident, the Glenwood nursing staff member was following business protocol when she called 911. Her choice not to administer CPR to the resident who later died is something that she will have to live with for the rest of her life.

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I remember when my 91 year old mother was admitted to the hospital after a mini-stroke (TIA), I was not caught off guard. She has had a history of having TIA for many years. As a senior living advisor, I have toured and evaluated over 400 senior living communities in the Chicago metropolitan area on the basis of cost and method of payment, level of care, staffing, quality of care, and other quality of life factors such as food and housekeeping. Therefore, I was prepared when it came time to choose a rehabilitation community for her. However, the institution of the 30 day readmission rules for Medicare recipients has made me more vigilant with watching as to whether she is admitted as an inpatient or under observation.*

The following story may not necessarily be directly related to the 30 day readmission rule, but it makes for some very interesting food for thought as you monitor your senior loved ones’ admissions, re-admissions, and discharges.

During a recent hospital stay, my husband was in a semi-private room because it was otherwise full. Due to the fact that he and his roommate were separated by nothing but a curtain, I overheard the situation involving his roommate’s admission. The man was a gentleman who was in his late seventies. He had been living at home, suffered a heart attack, and had broken his neck in some sort of fall or other incident. Most recently, he was placed in a senior community and was assigned to some rehabilitation. He was not cooperating with the therapists and was sent back to the hospital. His re-admission occurred at 1 A.M. Later that morning a social worker was in the room at 9 A.M. telling the gentleman that he was set for release that day. However, he was not able to go home alone; and, his daughter felt she was incapable of taking care of him.

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The prospects of alternative living options for people with dementia who are under the age of 65 are not plentiful. Although there are assisted living communities offering memory support for prospective residents under the age of 65, the pay source is strictly private. I have been faced with situations where the prospective resident has been in their early 50s and had severe Alzheimer’s disease. Unfortunately, the family lacked the funding to pay privately at an assisted living community. I had no other option except to assist the family with placing the individual in a nursing home that would accept Medicaid.

As a senior living advisor, I must persuade my customer’s to accept options that are less than optimal because there is nothing else available. In the following Real Life Story, I had the long term solution to my prospect’s problem, but the individual is still contemplating other arrangements.

REAL LIFE STORY My client’s sibling is only 51 and has early onset dementia. The individual was living alone in an apartment quite far away from the rest of the family. The person had worked at the same job for many years until it was apparent that the symptoms caused poor job performance. The person was dismissed from the job. The person had a monthly income of less than $900. The person also had a 90 pound dog that needed to be cared for. Yet, the individual could perform all of the activities of daily living. A recent neuropsychological report stated the person was capable of holding down a job with repetitious tasks. However, her sister was worried about her care on a long term basis and safety issues.

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I have been working with a lot of families who are not familiar with the differences between types of services that are provided at the independent living, assisted living, and nursing home care levels. The result is that they waste a lot of time touring communities that are inappropriate for their loved one. It is even worse when a loved one is placed in a community at the wrong level because it is cheap. I have seen instances where an admissions director often convinces an uneducated family that their loved one can survive at a level of care that is inadequate for their needs. Bear in mind, there are a lot of communities with low censuses and apartment/rooms that need to be filled. The bottom line is that if the senior cannot function at a level of care that is too low for them, s/he is the one who suffers!

A Real Life Story Continued From Chicago Senior Living Advisors Blog November 18, 2012

I had written a partial Real Life Story about this incident recently. Here is part two of the story. My client is an 86 year old woman. I am her Power of Attorney For Health Care. She has severe short term memory issues, is incapable of handling her finances and medications, and as of late needs standby help with her activities of daily living. Her former Power Of Attorney For Healthcare (who resigned from the position and resides out of state) placed her at the independent level because it was cheap. Independent living means the senior can function on their own, with some help with housekeeping and meal preparation. I was assigned to the position the day before she was supposed to move. She was already objecting to the move. It was too late and she really needed to be in an environment that had some semblance of supervision. In my opinion, she really needed to be in an assisted living community with a memory care unit. Memory care units provide structured activities, 24 hour supervision, and heavy cuing plus standby assistance with activities of daily living.

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Whether you are moving your loved one into a high end assisted living community or a nursing home that will eventually accept public aid, it is mostly a heartbreaking event that is stressful for the senior and their family. Because it is such an emotional event, you need to be careful with what you promise to your loved ones who are lucid. Please read the following Real Life Story and you will understand what I mean.

REAL LIFE STORY I was hired to coordinate the transfer of and elderly loved who had children in the south suburban Cook county area of Illinois and a child living out of state. They had filed an application at one the supportive living communities. They had experienced some communication problems with regard to the admission and asked me to step in and expedite the process.

I always do an assessment of every senior that I place. When I went to conduct the assessment, I found the senior was not appropriate for supportive living. Here is a quick review of the type of care the supportive living program provides:

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