Have you felt like a number instead of a person at your HMO or heath provider? What happened? Frustration? What about vulnerable seniors who may or may not have an advocate at their doctor and hospital appointments? If sane adults can’t advocate for themselves, how can a senior with dementia?
A few weeks ago, I went to my HMO (Kaiser) for a simple endoscopy procedure. It was a 5-minute procedure that required me to be under anesthesia in a twilight state. Anesthesia has not always been my friend. So I came armed with all my previous anesthesia experiences (the good and the bad). The doctor was informed of my concern through the nurse. The doctor acknowledged my concern (relief on my part) and said she would give me the same twilight anesthesia as a recent colonoscopy. I agreed to this, because it had been a good anesthesia experience for me.
Well, I awoke after the procedure to a nightmare of nausea and another bad anesthesia experience. A week later, my husband compared the anesthesia of the colonoscopy with the anesthesia of the endoscopy. Low and behold, they had given me 25 extra milligrams of Demerol for my endoscopy. That was not what I agreed to with my doctor. Why would they give me more than necessary? Was it because I was on a conveyor belt of medical procedures for that day? When I shared this experience with others, a couple of friends shared more stories.
A coworker was given anesthesia during a colonoscopy and felt them begin the procedure. The medical team jumped when she said that she was still awake. Then they gave her so much anesthesia that it took her three weeks to recover.
Another friend was given 50 mg of a steroid, when it should have been a 10 mg dose. The doctor continued to overdose my friend for three months. My friend is still feeling the affects of being overmedicated. It was determined my friend never needed the steroid in the first place but they have to slowly wean him off the steroid. It takes months to do this.
My own mother-in-law was given psychotropic medications in the emergency room. Amy had to lie on a gurney for three days because there was no room for her in the psych ward. She has still not recovered from what they did to her. Psychotropic medications do not mix well with dementia.
My mom with dementia went to the hospital for abdominal pain. They wanted to do an exploratory surgery. We (my family) said no to the surgery because our mom has dementia. The doctor understood, because my mom could lose more of her memory going under anesthesia. He did not convey our wishes (no exploratory surgery) to his team. When I went to visit my mom at lunchtime, she was not in her room. It turned out they were prepping her for surgery. My husband and I raced to that floor of the hospital to stop them. We got there in the nick of time. The doctor profusely apologized. Really?? The POA says no surgery and the HMO is going to do it anyway? Ridiculous! It turned out she had a urinary track infection and lived another five years.
How do we protect ourselves? How can caregivers protect and advocate for seniors?
Diane Masson has worked in senior housing for 18 years and is the regional marketing director for two debt-free Continuing Care Retirement Communities in Southern CA (Freedom Village in Lake Forest and The Village in Hemet). Her first book “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is being utilized by senior housing professionals across the country. Her new book is an all-encompassing answer guide for seniors called, “Your Senior Housing Options,” designed to help seniors navigate choices quickly. Learn more tips at: Tips2Seniors.com
Amy cleaned her plate!
Can you ever trust a retirement or assisted living community to take care of your mom better than yourself or a family member? Long distance relationships are never easy. Add dementia and hearing loss to the story and long distance communication with a senior parent is impossible.
The only way you really know if your mom or dad is okay is to have eyes on them for yourself. My husband just went 1000 miles by plane, two hours by car and a 20-minute ferry ride to visit his mom, Amy. One year ago, she was hospitalized after her husband had a heart attack. After the trauma of her husband (who was her caregiver for five years) being hospitalized, she eloped and the police had to bring her home. Amy is now in her third licensed assisted living community.
How do you evaluate the care of your senior parent? What should you be looking for or asking about on a one-day long-distant visit?
First, how does mom look? Is her hair washed? Are her clothes clean? Do the other residents look well cared for? The answer to all of these for my mother-in-law was good and yes!
Can she feed herself and how much can she consume? Always stay for at least one meal. My mother-in-law ate three plates of food over four hours by herself and asked for dessert. A year ago, she never wanted to eat, so this was a huge improvement.
Does she know your name? Can she hear? How does she communicate with the caregivers? My mother-in-law introduced my husband (her son) by his full name to a caregiver and said, “This is my number one son.” It was difficult for my husband to communicate with his mom in the dining room, it had too many distractions and was too loud. One-on-one, she could communicate and hear better. Plus, the caregivers actually bent down to talk to her – very nice!
What is mobility like? Is it better or worse? Invite them for a walk to determine the current status quo. The memory care layout can be shaped like a square inside. So they can walk all the way around the square without going outside. Amy and my husband walked it 25 times. She always used her walker and this was a huge improvement.
Observe the activities or it’s even better to become engaged with your dementia parent. Unfortunately not one activity happened at the memory care community on Saturday. One activity was scheduled and it never took place.
Watch the caregivers’ treatment and management of the other residents. This better be good or you need to move your parent ASAP. Amy’s caregivers were super. They treated all the residents well and managed an entire room full of dementia residents simultaneously.
Here was the report card for Amy and the memory care community.
- Cleanliness of all residents: B+
- Taste of food: B+
- Communication with mom: C (The severity of her hearing loss is dictating this score.)
- Caregivers interacting with residents: B+
- Activities offered: D+ (They did offer to paint her nails or it would have been an F.)
- Building layout and community spaces: A
Some of you may want a care conference to meet the key staff like the administrator and the nurse. You can learn exactly what types of care they are providing and details about medication management. We had one of those a few weeks ago, so my husband wanted to spend all his limited time with his mom.
You have to see mom or dad for yourself. Please have one local relative with eyes on your senior. We are so lucky that my sister-in-law does a super job with this. Her regular visits have improved Amy’s mind, attitude and appetite.
Good luck with your long distant visit and hopefully these tips will help you.
If you have a long distant parent, please share your experience in the comment section.
Diane Masson is a senior living expert who has authored two 5-star rated books. Her new book is an all-encompassing answer guide for seniors called, “Your Senior Housing Options,” designed to help seniors navigate choices quickly. The second book was written for senior living professionals called, “Senior Housing Marketing – How To Increase Your Occupancy and Stay Full.” Learn more tips at: Tips2Seniors.com
Do they prefer tea or coffee?
Last week the Tips2Seniors blog discussed: “Seniors in Denial, Relying on Friends and Family.” Every single one of us knows a senior who is struggling in their home. Some seniors silently suffer and others have a whole network of support from family and friends.
Ultimately when a loved one or neighbor tries to have “The Talk” with the senior it can have five typical results:
- Denial: “I am not ready yet. I am just fine living in my own home.”
- Shutting down: “I don’t want to discuss this.”
- Anger: “Why are you questioning my ability to be independent? Leave me alone.”
- Confusion: “Don’t you want to come see me everyday? I don’t understand.”
- Acceptance: “I understand that I have become a burden. Maybe it’s time to look at what my senior housing options could be. Will you help me look?”
In my 17-year senior housing career, sons, daughters and spouses have asked me the same question, how do I have “The Talk.”
Here are my 7 Tips to have “The Talk.”
- Set the stage for “The Talk”. You know if it is better to have “The Talk” in public or private with your senior.
- Public talk: Take them out to eat in a public location (so they can’t yell at you or they can’t escape into their bedroom).
- Private talk: Buy or make your seniors their favorite cookies. Serve the favorite cookies with their special coffee or tea at their dining room table.
- Tell your senior how much you love them.
- Then share your concerns, be very factual. Such as:
- You have fallen twice.
- You missed your medications three times this week.
- I come over here every day to help you.
- Explain your fears in loving detail. Every day when I call you my heart stops till you answer the phone on the third ring. I can’t handle the stress. It is making me sick with worry. I can’t keep this up. If something happens to me, you will be in jeopardy. (It is okay to cry and show your emotions. This is very emotional.)
- Recommend a solution to explore senior housing options together. I know you don’t want to move but it will be healthier for you and healthier for me. Let’s do this together.
- There is a book that can teach us how to find a great retirement community versus a mediocre one. Here’s the book, it is called, “Your Senior Housing Options.”
Depending on your senior, read it to them or you each read it on your own. Use the tips and advice in the book to find the best senior housing arrangement.
- Schedule a luncheon tour at a local retirement community that you have vetted with the tips from the book, “Your Senior Housing Options.”
If this article struck a cord with you, please share it on social media to help a friend or neighbor going through a struggle with a senior.
Give the gift of knowledge: “Your Senior Housing Options,” is an easy read with illustrations. It walks seniors and their adult children through the costs and pitfalls of navigating senior housing and includes the “7 Deadly Sins of Searching for Senior Housing Options.”
News Flash: Diane Masson’s interview on Generation Bold Radio broadcasted on Sunday, December 6th on the BizTalkRadio Network syndicated to 33 stations across the country.
Diane Masson is a senior living expert who has authored two 5-star rated books sold through Amazon. Her new book is an all-encompassing answer guide for seniors called, “Your Senior Housing Options,” designed to help seniors navigate choices quickly. The second book was written for senior living professionals called, “Senior Housing Marketing – How To Increase Your Occupancy and Stay Full.” Reach out to her through her website: Tips2Seniors.com and read the weekly blog.
You know who they once were better than anyone! Be the best advocate you can be!
Here are some tough statements that family members can hear at an Alzheimer’s or dementia care conference for their loved one (who might be residing in assisted living, memory care or skilled nursing care):
- She can’t direct her own care…
- Is regularly disoriented…
- Needs full help with bathing and dressing…
- She can become frustrated…
- Can be resistant to care…
- Does not always remember to use her walker…
It can proceed into an in-depth conversation about the ability of your loved one’s communication:
- She is not very verbal…
- She has improved in the last four months from not speaking at all (because she was still coming off of the psychotropic medications) to being a little more verbal.
- The staff has to use phrases or questions that are seven words or less to create less confusion for her.
- The staffs’ goal is to elicit a “yes” or “no” response, so she can make choices.
Then a group discussion can proceed about who she can still recognize and if she can still call anyone by name (this is tough one):
- Does she recognize you?
- She thinks her daughter is her sister.
How much food is or is not consumed?
Our family has experienced witnessing continual weight loss of my mother-in-law for 10 months. She is eating 50% of her food, but can pop out of her chair and start wandering sporadically while dining. She walks almost continually. The staff have problem solved this by feeding her in the country kitchen instead of the dining room to increase her food intake.
What should you ask in a care conference? Don’t be intimidated; no one knows your loved one better than you. Be his or her advocate to the best of your ability.
- Find out exactly what medication they take and why. Sometimes they were given a medication like a psychotropic in the hospital and no one is paying attention to the fact it is not necessary anymore.
- How much exercise or movement do they experience? Staying mobile is important.
- Inquire about live entertainment. Your loved one may be refusing to go to live entertainment and you know they love music. The only reason they may be refusing is because they can’t HEAR the caregiver asking them to go. Maybe the caregiver needs to speak up or…
- Ask about music therapy. It can be very affective for dementia and Alzheimer’s. If they tried it once and it was refused, try again. Every day is a new day. Seniors with dementia (such as my mom) can be more receptive and oriented in the morning.
- How much food do they eat? Maybe they are not eating because they have lost teeth (this happened to my mom)? Food adjustments can be made.
Is there anyone else out there dealing with a parent who has dementia? It is not easy. What tips can you share?
Diane Masson advocated for her mom who had dementia for nine years and her mother-in-law currently lives in a memory care community. Diane writes a Tips2Seniors blog every week and published a book to take the guess work out selecting senior housing before, during or after a health care crisis, “Your Senior Housing Options.” She has worked in senior housing for 17 years and her first book, “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is helping senior housing professionals on a nationwide basis.
Residents and staff from Freedom Village in Lake Forest walking for Alzheimer’s!
If enough of us keep walking and raising funds for Alzheimer’s we will eventually find a cure for this detrimental disease that affects so many seniors including my mother-in-law.
Almost $110,000 was raised by 741 walkers at the Laguna Niguel Alzheimer’s Walk on October 24, 2015. It was my first time raising awareness for Alzheimer’s in California. I was part of team Freedom Village (a Continuing Care Retirement Community in Lake Forest) who came in seventh for fundraising.
My mom had dementia for nine years and died in April. I watched the disease rob her of the ability to communicate. Her last and final roommate in skilled nursing was a wonderful woman who is still battling Alzheimer’s. I rode the bus to and from the Alzheimer’s walk with her husband. He shared the struggle of trying to keep his wife independent as long as possible. He had alarms on the doors to wake him if she tried to wander off in the night. Eventually, those alarms where not enough to contain her at night. He had to find her a safer home.
This brilliant husband took his wife one day a week to Silverado memory care to participate in activities. After several months he increased it to two times a week. She was so comfortable there that she would walk in and immediately be engaged with a staff person and walk to an activity. Then the decision was finally made to make it a permanent move. This time the community recommended that he not return for one week, so that his wife could adjust. She did adapt. In her three years at the community, she never asked once to go home.
At the walk, I learned that Alzheimer’s affects more women than men. It was a beautiful experience to walk side-by-side with other people that have been touched by this mind-altering disease. People carried blue flowers if they had Alzheimer’s. I carried a purple flower because my mom died from dementia. Other colors of flowers that people carried signified being a caregiver or financial supporter of Alzheimer’s.
All the Freedom Village residents and staff had a blast. Imagine what we can do next year in group participation and fund raising. We will build on our momentum and team enthusiasm from our first annual walk for Alzheimer’s.
How have you raised awareness for Alzheimer’s? Let’s keep this conversation going on social media to find a cure soon.
#Walk2EndALZ #freedomvillagelakeforest #silverado
Diane Masson is a sought after author, blogger, speaker and regional marketing director. She is very passionate about advocating for seniors on a nationwide basis and educating them about their future choices. She just published a book to help seniors take the guess work out of selecting senior housing options or staying home. It is called, “Your Senior Housing Options.” Her other book has been popular with senior housing professionals on a nationwide basis. It is called, “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full.” You can contact her through her website at tips2seniors.com.
First, plan ahead and know that every senior has a 66% chance of needing assisted living or skilled nursing in the future.
Second, do not rely on the verbal promises of senior housing sales people. Read the agreement for services or contract. If a senior does not understand it, they should ask a savvy friend or hire an attorney to help them. The majority of retirement counselors are honest and passionate about serving seniors. A few will say “anything” to get a senior to move in immediately.
How do you know if a retirement community will really take care of you or not in your future? Here are some important questions to ask EVERY senior housing community BEFORE you move from your home:
What happens when a senior needs a higher level of care like assisted living or skilled nursing?
- Will the senior be asked to leave the retirement community?
- Do they offer a higher level of care on the same campus? How much does that cost per month?
- Does an outside company bring caregivers into the senior’s apartment home to provide care? What is the hourly cost? What is that company’s reputation?
What happens if a senior falls in the middle of the night?
- Is there an emergency call system? Who responds to it? Are they medically trained?
- What happens if a senior falls and he or she can’t hit the emergency button? Will they will be found in a timely fashion?
- Is there a daily check in system?
What happens if a senior outlives their resources?
- Will they kick you out? A senior provider kicked out a senior in Houston a week ago.
- Is there a Good Samaritan Fund or Foundation to help a senior so that he or she won’t get kicked out? Is there a limit of how many seniors can be utilizing the fund at any one time?
- Or is there just a flat guarantee of care in writing that a senior will never be kicked out unless they divest their own funds on purpose by giving gifts to their children?
What else should a senior ask in order to make a good move?
These are just some of the intelligent questions that seniors should ask a senior housing provider. Other tips and advice can be found in Diane Masson’s new book, “Your Senior Housing Options.” She has recently been interviewed for TV, radio and newspaper features. Diane Masson has worked in all types of senior housing in her 17-year career. Her first book, “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is being utilized by senior housing professionals around the world.