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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

Memories of a Shopping Trip …or Not — When Alzheimer’s steals memories

05/072 Comments

Alzheimer’s Steals Memories

After Mom went to live at the “Group-Home” with 9 other folks who had dementia,  we continued our shopping trips as often as possible.

Shopping trips had become a tradition that Mom never remembered afterwards but we certainly enjoyed at the time. We laughed and talked and shared childhood memories; some hers, some mine. Either way, They were always new and fresh because Mom had no memory of our recent times together. I think she still remembered when I had my tonsils removed at two years old, which was 50+ years ago, and that was about as recent as her memory could get.

Our trips away from the “Group Home” generally depended on her mood. Mom took several medications, both for physical ailments and agitation induced by the affects of Alzheimers. Sometimes she felt really good and other days she dipped into sadness and depression.

On one particularly “good” day, we set off for a morning of shopping and an afternoon lunch at McDonald’s so Mom could watch the children in the “play area.” Mom’s all time favorite thing to do. On this day we’d had an exceptionally good time. Mom’s mood was jubilant and we’d laughed and chatted till our sides hurt. By the time we headed back to the Group-Home we were giggly, happy, laughing, and arguing over who got the bathroom first after our arrival.

We had been gone for more hours than usual and the last store we visited had no restroom. Now, I could only hope we both had dry pants by the time we pulled into the Mom’s driveway.

“I’m going first, Mom,” I teased feigning a serious tone, as I swung the car door open.

“Not if I beat you,” Mom grinned as mischievously as any child playing games–  We sounded more like children than Mom and daughter, both pushing the elderly category.

We laughed as we filled our arms with shopping bags, boxed Donuts, and an over-sized, Puppy with  mournful eyes that Mom could not resist. And thankfully, Mom made no attempt to out-run me as we headed toward her room.

In Mom’s suite we piled our goodies in a tall heap like icing atop her freshly-made bed.

“I beat you,” I squealed as I pushed into the bathroom first and closed the door behind me. It could not have been a sweeter day.  Mom had been free of depression or sadness for the entire day.

With relief, I washed my hands and swung the bathroom door open wide into Mom’s bright and cheery bedroom.

Mom stood facing the dresser with her back to me but her eyes staring at my reflection through the mirror from behind her. She spun around quickly with a frightened look on her face.

“What’s wrong,” I asked. Thinking surely she wouldn’t think a stranger would be entering through her bathroom. “Mom, it’s me.”

“You scared me,” she said as the dark shadow melted away and her lips finally parted in a smile. “Oh my gosh,” she said. “You scared me to death. When did you get here?”

Then she pointed to all the packages, and added, “What is all this stuff? Why did you bring me so much stuff today? I didn’t even know you were coming.  Is it my birthday?”

I felt like crying,   “No,” I said instead. “I just went shopping this morning and found a few things I thought you might like.” My smile was strained, and I felt little joy.

Inside, I wanted to cry. All the fun we’d had, all the good memories we’d shared,  such a pleasant day, a sweet memory for me but already forgotten for Mom. In her limited recollections–it never happened at all.

Sometimes great happiness can also bring deep sadness. But I still remember that day and all the fun we had. And I also remember that Mom was right there beside me, feeling and knowing the same pleasures. Now, I’m grateful for all those days we shared while we could.

No matter how deep into dementia our loved one may be, we can make many sweet memories to savor for a lifetime.

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Filed Under: Memories, MIDDLE STAGE Tagged With: Alzheimer's Steals Memories, cognitive decline, group-home

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