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You are here: Home / Archives for The Stages / LATE STAGE / Nursing Homes

Nursing Home or Group Home – Part II

07/143 Comments

Two Part Series – Choosing a Nursing Home or Group Home

Part II – Choosing a “Group Home” for Alzheimer’s – Dementia Patient

To find all the “Group Homes” in your area may require more than the yellow pages in the phone book, as I did for Nursing Homes. When I was searching for a Group Home for my Mom,  I also searched the internet, entering my own state and city. I called Elder Care facilities listed in the government pages of the phone book along with the Alzheimer’s Association Chapter in my community.

It may be an unusual source, but I learned of several “Group Homes” in my own neighborhood from my regular USPS Mail Man. He often chatted with my mom while she swept the front porch and he delivered our mail, then he asked about her when the mesquite pods stacked up after Mom moved to the Group Home. Mom is only a half mile from my house, but the mailman said I could have done much better. Surprisingly, he gave me addresses of 3 Group Homes within walking distance of my home. I hadn’t found a single one of these three Group Homes during my numerous searches through the phone books or internet.

Later, I learned that a one year waiting list is considered standard for any of these three Group Homes. Since they seldom solicit new residents, there existence goes under the radar. So check in your neighborhood; ask your mailman, milkman, neighborhood-watch person. The vacancies in a good Group Home go quickly.

What I liked about the Group Home versus the regular Nursing Home was the low population and high ratio of staff to resident. Counting Mom, there were only 9 residents, each with their own room and some with attached bath. The Manager (a registered nurse stayed at the facility all day.) Besides the manager, during the day there were 3 staff members that took care of patient needs only. 2 Staff members who worked in the kitchen, but also tended to patient needs between scheduled meal-times. There was one male staff member who tended the Landscape, Shop, Service area (Accepting shipments of medical equipment, oxygen, etc.). He was also an all-around handy-man. If we needed a nail in a wall for a brand new framed photo, or a heavy dresser moved from one place to another, we called him.

I loved the dynamics of this group. They were family to Mom, and to Me.

Though they each had assigned duties, they could swap tasks easily and often did.  The manager had managed Group Homes for many years before she purchased this Home. Soon after the purchase she re-modeled, adding her own specific requirements to every detail. I must admit, it was ideal. I feel very fortunate to have found this particular Group Home.

If you’re searching for a Group Home, many of the same questions you’d ask of a Nursing Home would also apply to a Group Home.

  1. Do they accept Alzheimer’s and Dementia patients?
  2. What are their fees?
  3. How many patients do they have at any given time, and how many staff members?
  4. Is there a physician available at all times, or easily reached by phone?
  5. Are there safety lock-down procedures for the Dementia patient who wanders?
  6. Do patients have full assistance with hygiene?
  7. Do they offer Day Care? What hours are visitors allowed?

 

As with a Nursing Home, a walk-through examination of a Group Home will give you a view of the residents and the dynamics of the home. Are patients freely walking around? Do they appear sedated or groggy?

At one point my Mom had to be sedated slightly due to crying spells and begging to “go home,” a fairly common occurrence for some Alzheimer’s patients when “home” represents their “childhood home” and their own Mother. After notifying Mom’s physician of her worsening depression, he wrote a prescription.

When I gave it to the manager, she objected that the dosage was too strong for Mom’s needs and would keep her sleeping all the time. The manager phoned the physician and had the dosage reduced and mother recovered from that spell of depression while she remained an active member of the Group Home family.I don’t believe I would have found such “individualized” treatment or concern in a conventional nursing home.

Activities of a Group Home:

These are just some of the activities that happened at Mom’s Group Home. It may give you some ideas about what to ask and what to look for in a nice, busy, and happy Group Home.

  • Since all the residents of the Group Home  where Mom stayed were female, it did offer some distinct benefits. A beautician visited once a month and if I wasn’t busy, I always visited at least part of this day for the sheer fun of it. The ladies giggled and laughed and took turns in the chair, getting new hair styles, colors, and perms. It was always a playful and enjoyable day for most, all but the bedridden, of these elderly women. Throughout the day they giggled like teenagers at a slumber party.
  • School children visited once a month and each spent time with their favorite resident.
  • A local band came every Thursday and took requests from the ladies, playing songs from their era as they sang along.
  • Their all-time favorite activity, though it did spur arguments, was to fold the linen while it was till warm from the dryer. When it was folding time, they all gathered in their assigned chairs in the large family room.  These women could hardly sit still until the laundry baskets arrived and the constant bickering began, “It’s my turn for wash rags today,” “Oh no, it’s my turn. It was your turn yesterday.” “No, I haven’t had washrags in a week. It’s my turn.” “I want bath towels. They’re warm!” and on it goes until the laundry arrives.
  • This Group Home had a wall-sized television in the family room but you seldom saw the patients in front of it unless it was the (quiet time) right before bedtime.
  • Each patient had an assigned recliner, which had a parking space for their wheelchair or rolling-walker right beside it. These women were enthusiastic about decorating their space; their chairs, their walkers, the bedroom doors. Name tags hung by colorful ribbons on each door, walker, wheelchair or recliner. Especially for the purpose of remembering names, sometimes their own, though most of the time names weren’t very important anyway. –I do remember one elderly Alzheimer’s Patient who told everyone who visited,  “I don’t really live here, I just come here for my vacations because it’s so much fun.” I thought that was quite appropriate.

I suppose my best description of the Group Home where my Mom spent the last 2 years of her life would be “Homey.” It was “homey” for Mom and for me. They loved my Mom and took good care of her.

Wherever you decide to call “home” for your loved one, I hope you have as wonderful an experience as I had with the Group Home I chose.

PART I of this SERIES can be found here —>Choosing a Nursing Home Part I 

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Filed Under: Common Questions, LATE STAGE, Nursing Homes Tagged With: Choosing-Nursing-Home, dementia, group-home

Nursing Home or Group Home How to choose

07/121 Comment

Two Part Series – Choosing a Nursing Home or Group Home

Part I Choosing a “Nursing Home” for Alzheimer’s or Dementia Patient

Choosing a nursing home is a difficult time for Caregiver and Patient alike. Usually, both parties hoped that it would not come to this point. Like everyone else, I intended to take care of my mom for as long as she lived. But family circumstances or the patient’s behavior can change so drastically that new arrangements sometimes need to be made immediately. There is no shame in admitting your choices may need adjusting along with these new circumstances or behaviors.

If you’re like I was, you have not done your “homework.” Since I was so determined to keep Mom with me, why would I have investigated nursing homes? Generally, I’m better organized than that but I had promised my mom I would never put her in a nursing home and, I had fully intended to keep that promise.

But in life—sometimes things happen that you can not control. Though it still saddens me today, I know that moving Mom to a Group Home was best for me and her. I only regret not being more prepared when the time came. Our move needed to be done quickly and I was very fortunate to find a kind and loving home for Mom that was only a few blocks from my home on such short notice.

Make your life less stressful. Do your homework about nursing homes before you need to make the move and if you never need to use the information, all the better.

A few Things you want to know

A quick scan of your local phone book will show listings for Nursing Homes and may show listings for Group Homes, though I’ve found the “Group Homes” easier to locate by ‘word of mouth’–

Spending a few minutes on the phone, can save you many hours later. It’s an easy way to get answers   you need to narrow the list of nursing homes that need a physical visit.  Make a list of questions you’d like to ask before you tackle your list of nursing homes. Below are a few question that I asked while searching for a place to  put my Mom—

  • Does the Nursing Home accept Alzheimer’s and Dementia Patients? – Your list of available homes can dwindle quickly with this first question. Not all nursing homes will accept Alzheimer’s and Dementia patients due to additional care needed and security issues to protect them from wandering, etc. I was surprised at the actual number of nursing homes that would not accept Alzheimer’s patients.
  • What is the fee difference if the home does accept Alzheimer’s and Dementia patients? – There is almost always added fees when accepting Alzheimer’s and Dementia patients- In our area it averaged an additional $1,000+ per month for an Alzheimer’s patient. The difference was more if the patient was incontinent.
  • How large is the Nursing Home, How many residents? What is the Staff to Patient ratio at each Nursing Home? Is a Physician available if needed for an emergency?
  • Are there scheduled activities for the residents in the Nursing Home besides watching television? Are they allowed outside, and is it secured with locked doors or gates while they are outside? An Alzheimers patient’s total well-being can deteriorate if they are left to sit in a wheel chair all day long without activities. Despite their illness, they still need love, kindness and things to do to keep them busy.
  • Are the residents assisted with their morning shower and other hygiene throughout the day? Are wheelchair-bound residents offered assistance from place to place? Most Alzheimer’s or Dementia patients no longer remember how to set the water so they can shower, or remember the need to change their clothes every day.
  • Does the home offer Adult Day Care and the cost? – You never know when you may have an emergency and need temporary day-care for your loved one or even a small respite for a weary caregiver for a couple days.
  • Can you stop by for an impromptu visit?—  If they invite you to drop in and visit, accept the offer and take your loved-one with you. It will give you a view to their interaction with other patients and residents of the Nursing Home. This was #1 on my list. If the nursing home only allowed visitors at designated hours–they were removed from my list of optional nursing homes.

When you go to visit the nursing homes that have passed your list from above, there is much information to be gleaned from this visit. You will be able to Meet the staff, see the residents and sniff the air. I had a friend who worked in a nursing home who said your nose is the best judge. If there are no putrid odors floating in the air, then the staff is doing their job. I don’t know how well this method works, but I can tell you, I caught myself sniffing the air at every home I visited.

A first-hand view of other residents can only be a plus. They may not all be smiling but you can certainly tell if they are generally happy and congenial. Or, on the other hand, it will certainly catch your attention if most residents appear hungry, or sleepy, or miserable, or crying. Watch for residents with wet clothes or dirty bibs. Some situations are obvious and you will see them.

More important to me was visitation. Besides living only a few blocks away, I wanted to see my Mom throughout the day; did she shower in the  morning, have lunch before 2:00 pm, get more exercise than pushing buttons on the remote control.  And though it sounds silly, I wanted to know if they liked her or if they saw her as a burden that came with a pay-check.

What are your requirements for a good Nursing Home?

I suggest you make a list now. Even if your loved one is still living with you, it is reassuring to know your list of requirements for any Nursing Home is available if you need it.

As stress builds for the caregiver, you may be interested in the Adult Day Care programs that some nursing homes support. Most offer their services at an hourly-rate for part-time residents. Some caregivers work regular jobs during the day and require their loved-one to stay in Adult Day Care during working hours only.

  • Ask about visiting patients/residents and any restrictions that apply?– I would not accept a home without fairly lax visiting hours. The Group Home where my Mom stayed only had slight preferences; no visitors during early morning hours (as showers were given and breakfast served) and no late evening visitors as the patients were calmed in preparation for bedtime. I restricted my visits to those hours, yet I saw patients and staff interact constantly during the day.

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Part II – Choosing a “Group Home” for Alzheimer’s – Dementia Patient

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Choosing a Nursing HomeMore infoFinding a Silver Home for the Golden YearsMore infoAlmost Like Home: A Family Guide to Navigating the Nursing Home MazeMore infoWhen Love Gets Tough, the Nursing Home DecisionMore info

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Filed Under: Common Questions, LATE STAGE, Medical, Nursing Homes Tagged With: Choosing a Nursing Home, group-home, Nursing Home

How long will someone with Alzheimer’s dementia Live?

06/0612 Comments

How long will someone with Alzheimer’s dementia live?

Being diagnosed with Alzheimer’s isn’t an immediate death sentence. People with Alzheimer’s can live for a long time.

The life span of someone with Alzheimer’s dementia is more affected by other medical conditions now and prior to being diagnosed with Alzheimer’s.

It also makes a difference if a person is living a busy, active lifestyle, as this tends to extend life.

 Trampoline DeskCycle  Cadence Treadmill

My Mom was in her late 70’s when diagnosed and lived till age 82. But, Alzheimer’s wasn’t the main cause of her death. Mom had heart disease before the Alzheimer’s diagnosis and eventually passed away from lung cancer, though she had never been a smoker.

–> It isn’t all conclusive that if we get Alzheimer’s, it will cause our death<–

Many major illnesses weaken the system so much that it is not unusual for co-morbidities to exist. I have COPD and it’s exactly the same. When our body is in a weakened condition, we are more likely to have other dire medical conditions.

So no, we aren’t able to tell how long someone will live with Alzheimer’s dementia.

Generally, it does appear that women live longer than men with Alzheimer’s, but that is true for the general population as well.

Women tend to live approx 6 years after they are diagnosed, but men usually live approx 4 years. That doesn’t mean they only live that long after Alzheimer’s disease begins but rather after they are diagnosed.

Many have had Alzheimer’s for 10-15 years or more before they actually received a diagnosis of Alzheimer’s or Dementia.

Looking back, I’m sure my mother had it for many years, even before her husband passed away. Yet, with his assistance when she could no longer function in a particular area, her incompetence wasn’t noted. As her children, we never noticed a distinct difference in her behavior until she lived alone.

During studies, American’s with Alzheimer’s survived about half as long as those of a similar age without Alzheimer’s. The older a person is when diagnosed, the shorter the life expectancy also.

My mom only lived about 3 years after being diagnosed but she was already in her late 70’s. And, she had shown symptoms for many many years which we had attributed simply to “old age.” She may have actually had Alzheimer’s for 10+ years.

So there are many variations and considerations to be studied before anyone could even guess at their life expectancy.

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Barry Petersen heard the diagnosis “Early Onset Alzheimer’s Disease” for his wife, but could scarcely believe it because they were in their prime and he was at the top of his career.

Barry says, “Imagine hearing these words: “She has Alzheimer’s.” Now imagine that “she” is vibrant, active, loving, healthy…and just 55.

Acclaimed CBS News reporter Barry Petersen, writes about hearing the unimaginable: what it meant, what it still means, what he did–and didn’t do–and how this beautiful love story needs to be read by the thousands of families who have already heard that same devastating diagnosis…

EARLY ONSET ALZHEIMER’S. Jan’s Story is a full, rich story of two people–and thousands like them–for whom “forever” suddenly and terrifyingly has an expiration date. Barry Petersen is a long-time, award-winning TV journalist who has covered wars, the devastating Asian tsunami, the historic confrontation at Tienanmen Square, the unspeakable deaths in Rwanda, and so much more…but was not even slightly prepared for what happened to his darling wife, Jan.

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 Go Jogging Drink Veggies Eat Veggies Exercise Outside or In Go Bowling Go Surfing Play Basketball Exercise More Live Longer

Filed Under: Common Questions, LATE STAGE, Nursing Homes Tagged With: 7th stage, death, dying, Exercise Live Long, life span

When to Move someone with dementia to nursing home?

05/2318 Comments

When to  move someone with dementia to nursing home

Moving the person with Alzheimer’s to a Nursing Home can be a difficult decision for the caregiver… especially if you’re a close relative.

Too often in life we are forced to do things we promised our parent or relative that we would never do. I was certain that Mom’s condition would never come to that, but a year into her late stage Alzheimers I found myself faced with the possibility that I could no longer care for her at home.  We began our search for a “good” nursing home. The thought was not a happy one, I dreaded it. I knew the search would be awful, thinking I’d never find one that met the criteria for my mother’s care.

Circumstances change almost daily for the person with Alzheimers, their families and their caregivers. Planning ahead is near impossible. In the beginning, Mom was so adamant that she would never live in a nursing that we contemplated purchasing a small motor home or travel trailer for our own back yard; a pretend home for Mom during the day while she retired to the main house each evening.

Our thought being that Mom would be satisfied knowing she had her own place at night and gladly return to our home at night. Before we could begin a search for a travel trailer or motor home, Mom’s condition worsened and she could not be left alone, even temporarily.

I had a home-based business, a supportive husband, and had been certain I could take care of Mom in my own home for as long as she needed care. I had two computers on a network and envisioned the two of us working side by side, me doing business and Mom playing solitaire. (That’s another story) What a spot of fantasy that turned out to be.

But there is no written progression for dementia, and the 7 step and stages have no designated width.  Each individual is different, different symptoms, different behaviors, and different time lapses between each.

Some behaviors related to Alzheimers have their own labels. Labels that only another caregiver could understand; “sundowners”, “shadowing”, “pack-rat”, “junk-mail”, “violence”, “want to go home.”  One caregiver may find a behavior particularly hard to endure, while another caregiver may be disturbed by a totally different behavior.

Not all Alzheimer’s patients become violent, but some do. And taking care of a violent patient is not a matter of endurance and stamina but of safety.

A loved one needs to be moved to a nursing home if they are continually violent.

Sometimes medical issues can cause this behavior; a urinary infection or other medical problem. But sometimes, it’s simply the dementia itself–changing brain waves and the person’s personality.

For the security of all, patient and caregiver alike, an Alzheimer’s dementia patient who becomes violent must be moved to a more secure living community, a setting that is safe and comfortable.

The patient has no idea what they’re doing and would be devastated if they understood the danger they had become to family and caregivers. But they can become dangerous. And a nursing home should be considered under those circumstances.

Later in Alzheimers stages they may need more medical treatment than the caregiver is able to provide.

Many Alzheimer’s patients yearn for “home,” the place of their youth that no longer exists. They’ll walk and walk and walk, if unprotected by open (unlocked) doors.

Much like a young child, they can be in grave danger of becoming lost or walking into traffic or accepting a ride from a dangerous passers-by. If you aren’t able to keep the patient in a well-protected, locked area, you may want to look for other living facilities.

It isn’t always a happy moment, but many of us simply aren’t able physically or emotionally to care for a loved one in our own home.

Whether it be financial, emotional, or simply in the best interest of our loved one– there is nothing wrong with searching for a safe and loving care-home to meet our loved one’s needs.

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Filed Under: Common Questions, LATE STAGE, Nursing Homes Tagged With: caregiver, dementia, home, Nursing Home, Shadowing, Sundowning, Violent

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