Beware, they’re warehousing our loved ones and rolling in the money!

Excuse me for a moment while I step up on my soap box.

Let me start by stating a couple of facts:

1. The population of the United States is getting older, our largest generation of the last century (Baby Boomers) are now in their 60’s and 70’s and many are starting to need nursing care.

2. It is very expensive to stay in any type of nursing or assisted living facility.  In the United States the average monthly cost for assisted living is $3,550.  This price varies state to state from just under $1,000 to up to $10,000 – PER MONTH!

OK, so here comes the ranting madwoman on a soapbox.  In the United States there is very little regulation regarding how many caregivers (nurses and CNA’s) are required per resident!  Some states have no rules regarding caregiver to resident ratios and in states that do have regulations the ratios are unrealistic and woefully inadequate.

Residents in nursing homes and assisted living facilities cannot receive the basic care they need in a timely manner because the staff are overworked, understaffed and often have insufficient supplies.

Imagine your loved one is in a nursing home, due to age they are now incontinent, they are weak and unstable on their feet so cannot get up to do anything for themselves, basically they rely on someone else for even the most basic of care needs … this can describe the vast majority of people living in nursing and assisted living.

Now, imagine you are a caregiver, C.N.A. or nurse working in your loved one’s facility.  You entered your profession because you care about people, want to help them and have a heart for the elderly.  You want to not only be able to meet the physical needs of your charges but also help to enrich their lives.  You recognize them as human beings who still mean something in the scheme of life.  You love being able to look someone in the eye and be able to communicate to them that they matter to you.  When you show up for work you are expected to provide care for as many people your employer can legally assign to you, and in many states that is unlimited.  You aren’t in this for the money either as most caregivers are paid minimum wage or possibly a bit over but not much.

A large majority of seniors in nursing homes and assisted living facilities are incontinent and wear adult diapers.  Many are obese should require two caregivers to be involved in any care to prevent the possibility of the senior taking a fall or injury of the caregiver.  Most require assistance in dressing, eating, bathing, and many other activities of daily living that we perform for ourselves without much thought.

Sleeping a solid 8 hours during the night is also something that rarely happens with residents, many nap during the day and aren’t tired at night or just don’t sleep more than a couple of hours.  Most get woken during the night on a regular basis by caregivers needing to do personal care such as changing adult diapers, showering, vital sign checks, and for giving medications.

Here is a scenario that is all too likely to be true and happening near you:

Mr. Smith’s family has placed him in a nursing home after he started having problems falling at home and being confused about his medications.  His family looked at many places in their hometown so they could visit often and finally chose a facility that was fairly new, with beautiful, comfortable decor and wonderful programs and amenities.  The rooms seem spacious, Mr. Smith will have his own room and will be able to have some of his own furniture and belongings there.  While the price per month makes his family shudder, they have just sold Mr. Smith’s home and the profits should cover the cost for a few years.

So, Mr. Smith is now in his new “home” and must rely on the staff to assist him with all of his personal care and proper dosing of his medications.  This is where the difficulty starts, depending on the number of residents, the level of care needed, state regulations and the time of day Mr. Smith may have to compete with anywhere from 10 to 20 to even 50 or more other residents to get the help he needs from the caregiver assigned to his room.

Mr. Smith needs to go to the bathroom, he dutifully presses the call button to summon his caregiver to assist him to the bathroom and he waits.  Five minutes pass and he’s feeling very uncomfortable with his full bladder.  Ten minutes pass and he’s contemplating trying to get to the bathroom by himself.  Fifteen minutes pass and he’s now trying to stand up.  Twenty minutes pass, he stood up briefly, fell on the floor when he lost his balance and to add insult to injury lost control of his bladder when he fell.  He is now lying on the floor, potentially hurt and in a puddle of his own urine. Finally, twenty-five minutes after he pressed his call button, his caregiver enters his room.

His caregiver wasn’t slacking off, didn’t ignore the call light because they didn’t care, quite simply they were in the middle of assisting another resident and couldn’t get away.  They also very likely had several other residents that had hit their call button prior to Mr. Smith.  It is actually quite common for caregivers in a facility to forgo their breaks during a shift in order to care for their charges, they are that dedicated!

In the end what happens is residents don’t get the care they need in a timely fashion which can lead to falls, injuries, sores developing from sitting in their own waste, infections and premature deaths.  They don’t receive the personal and social interaction to remain alert or feel like a human being and begin to fade away into themselves and/or become depressed.

Caregivers see this happening, they know what’s going on and that their level of care is substandard because of the incredible workload heaped upon them by their employers, they feel like they’ve failed, they’re tired, they’re injured, they’re depressed and they burn out.  I can’t tell you the number of caregivers I’ve spoken to who are frustrated by the overwhelming number of residents they are required to care for and the limited time and resources available to provide adequate care.  There are hundreds of forums out there for C.N.A’s with huge threads on frustrations over the under-staffing at their facility.

There needs to be a huge outcry from this country regarding resident to caregiver ratios in nursing and assisted living facilities!  This is not just a situation where a worker is being pushed to produce more for an employer.  This is Grandma, Grandpa, Mom, Dad, Aunt, Uncle being put in danger, so that some corporation can have higher profits.  This is putting caregivers in danger so some CEO can claim a larger bonus.  This is about human beings, residents and caregivers, being dehumanized into a number on a spreadsheet column.

I hope I’ve opened your eyes, I hope I can reach people and do my part to affect a change.  Our loved ones deserve it!

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“This is where I had a purpose” – Capt. Montgomery Scott

I have an honest confession for all of you.  I am a sci-fi geek.  I was raised watching the original Star Trek with my dad.  I enjoyed all the characters from the original series, but one in particular was my favorite.  The hard-working miracle worker, Chief Engineer Montgomery Scott (Scotty).  There was something special about him that made me smile.

Many years later when they started The Next Generation I saw they did an homage to the original series by bringing in some of the original cast for guest appearances.  Of those, my favorite was an episode entitled “Relics”.

The crew of the new Enterprise find a crashed Federation ship and go in to investigate.  There they discover that the transporter has been jerry-rigged as a type of life boat for the only survivor, Captain Scott, Retired.

Scotty shows his usual enthusiasm for anything related to engineering and steps in to help Lt. LaForge.  Unfortunately, 75 years have elapsed since the last time Scotty has worked on a warp engine and Scotty isn’t able to be the miracle-worker in engineering.

A dejected Scotty finds himself in the holodeck with a bottle of alien whiskey asking to be shown the bridge of the original Enterprise.

He is soon joined by Captain Picard and as they speak Scotty expresses what he’s feeling.

Scotty: “I don’t belong on your ship.  I belong on this one. (Meaning the holographic ship they’re on) This was my home.  This is where I had a purpose.  But it’s not real.  It’s just a computer generated fantasy. (sighs)  And I’m just an old man who’s trying to hide in it.  Computer, shut this bloody thing off.  It’s time I acted my age.”

He leaves with Picard looking at Scotty with compassion in his eyes.

Later Picard asks LaForge about some data that they needed to acquire from Scotty’s crashed ship.  Picard suggests that Scotty would be helpful in obtaining the information and asks LaForge to personally assist with this task as well.  Picard makes his request with this statement:

“Look, this is not an order.  It’s a request and one that you must feel perfectly free to decline.  You see, one of the most important things in a persons’ life is to feel useful.  Now, Mr. Scott is a Starfleet Officer and I would like him to feel useful again.”

I won’t post any spoilers for those who’ve not seen this but now want to. The upshot is by LaForge engaging Scotty in an area where he’s useful and taking some time to allow himself to be mentored by a more experienced engineer they both gain and grow from the experience.  In the end Scotty is able to show he still deserves the title of ‘Miracle-Worker’.

This episode of Star Trek: The Next Generation demonstrated one of the things I always appreciated about this and the original Star Trek.  The way they took on real life issues in the fantasy world of space travel.

We all need to feel useful.  We all need to feel like our lives have meaning.  We all need a purpose to give us a reason to get up in the morning.

As our loved ones get older and are no longer able to be as independent as they were it is easy for them to become depressed.  We need to acknowledge the impact they’ve made in our lives and in the world.  We need to let them know they still have a purpose in our lives and the world.  Even sharing their stories and things they’ve learned through experience will enrich the community around them.

Engage with the seniors in your family.  Encourage them in the ways they still make a difference and have a purpose.  Tell them how much their presence in your life enriches it.

Change their statement of “This is where I HAD a purpose.” to “This is where I HAVE a purpose”

As an interesting side note, James Doohan who played Scotty, died just over a decade after this episode was filmed.  He died from Alzheimer’s disease.

Caregiver dilemma: I’m scared of doing it wrong

Becoming a caregiver for someone you love can be a wonderful, but terrifying experience.  If you approach the experience with a deep love for your family member and the determination to make sure they are safe, loved and fulfilled as a human being should be then you will be wonderful as a caregiver!integrity

My most terrifying moment as a caregiver was the day we brought Dad back home.  He’d arrived via medical transportation and shortly afterwards I was alone with him for the first time.  I stood there scared beyond everything.

I was completely responsible for Dad’s health and well-being.  I had completed the coursework, testing and clinical experience required by my state to do this work.  I even had the little piece of paper to prove it!

But as I stood by Dad’s bedside that fateful afternoon I was nearly paralyzed with fear.  I was scared that I would do something wrong.  I was worried that I would cause him unnecessary harm with my ineptitude.

I took a deep breath.  I exhaled.  I did it a few more times – just to make sure I could.  I decided to start with the basics of caregiving.

I took Dad’s hand, told him that I was going to do my best for him and that I may have a bit of a learning curve.  I let him know that everything was going to be ok.  I spent several minutes talking to him, holding his hand and comforting him.

In comforting Dad I found that I was also comforted.  In telling him everything would be ok I felt that it would be ok.

I began to relax.  The fear that had frozen me dissipated and I was able to begin providing the personal care Dad needed.

There were times I made some mistakes, those mistakes didn’t make his condition worse.  The mistakes were a part of my learning curve and I did learn from them.  I used these lessons to provide even better care for Dad.

In the end I knew I had done everything I could to honor my father.  I had given him the care he needed.  I had ensured that his final days, weeks and months had been spent surrounded by love.  I do not regret forcing myself through my paralyzing fear – I would do it a thousand times over.

Dementia’s Impact on Fall Risks

The National Council on Aging has many resources to help adults build a foundation for longevity and prevent falls.  Currently, 1 in 3 adults 65+ falls each year.  Fall risks are usually the product of a combination between physical condition and environment; however, individuals with dementia are actually 4-5 times more likely to experience falls than older people without the disease.  There are many different types of brain disease that cause a wide range of physical and mental complications.  Here are a few common ways that dementia increases the risk of a  fall and what to watch for in a loved one with dementia:

Disorientation:  A large part of our stability involves awareness of surroundings, judging distances, knowing where we are and what we can expect from our environment.  When individuals with dementia become disoriented not only can they lose their ability to judge an environment properly, their increase anxiety puts them at greater risk.

Changes in gait and mobility:  As parts of the brain that coordinate our fine and gross motor skills are impacted by dementia, the way we walk and move changes dramatically.  Some types of dementia such as Parkinson’s can have a greater impact on ambulation and coordinating movement.  These changes may occur slowly over time and often a fall will alert family to the extent of the changes.

Changes in vision, hearing, and balance:  Our senses naturally decline with age; however for those with a dementia, the parts of the brain that coordinate our hearing, vision, and balance can be greatly impacted very quickly.  Any one of these senses contributes to our stability as we make our way through our homes and communities.

No memory of present condition/ mobility limits:  The different types of dementia are often associated with a range of difficult behaviors.  These may include yelling, unfiltered speech, repeating questions, refusal of care, etc.  Wandering is quite common in those with dementia as well as a desire to return home for those in a memory care facility.  This behavior uniquely impacts the risk of a fall as individuals can be so focused on getting where they are going that they are not able to take precautions in moving safely.  Increased agitation can compound this situation as well.

Dehydration:  As we age, we naturally feel less thirsty.  This can put seniors at risk for dehydration and range of other complications such as urinary tract infections.  For those with dementia who are not able to remember their needs, this is particularly an issue.  Dizziness or lightheadedness and headache from dehydration can greatly increase the risk of a fall in addition to these other complications.

Difficulty problem solving and adapting to new environments:  Many times families will rely on professional facilities to provide nursing and day-to-day care for a loved one with dementia, especially during the mid to end stages of the disease.  Adapting to these new environments would be difficult for anyone, but especially for those with dementia.  Confusion and an inability to problem solve can increase the risk of a fall as individuals with dementia lose their sense of what is safe or not safe to do in a particular environment.

Hallucinations/ delusions:  Some types of dementia can cause individuals to have hallucinations or delusions.  These types of experiences can erroneously heighten their sense of danger and cause them to behave rashly.   The increased anxiety and false sense of reality can increase the risk of a fall.

Lack of judgement/ inhibition:  The frontal lobe of the brain is the command center, filter and brake pedal for our actions.  It is the rational voice that says, you probably shouldn’t say that or do that action.  When dementia impacts this part of the brain, those filters and brake pedals deteriorate and no longer inhibit individuals with the disease.  This changed judgement and fading access to memory can greatly increase the risk of a fall as the individual may no longer be able to appropriately judge the limits of their environment and body.

If you are a caregiver providing or coordinating care for a loved one with dementia, we understand how complex and emotionally challenging the responsibility can be.  Our well-being has many components.  In fact, our lives are surrounded by a complex web of needs and desires.  When a loved one is diagnosed with a type of dementia, it is common for a spouse or adult children to become the hub of care, managing several categories of needs.  Professional Care Managers are pivotal in assisting families at the hub to simplify, coordinate, and proactively guide the care of a love one.

Side note from the blogger:  This is an article I found from a publication put out for seniors in my community.  The publication is produced by our sheriff’s office and is called S.A.L.T. (Seniors and Law Enforcement Together) Times.  The only notation as to it’s original source is Sound Options.  I would like to give proper credit to the original writer of this article, if anyone can help me find the author I will make sure they’re given credit where credit is due.

 

Nothing’s better than comfort food

There’s something special about sitting down to a hearty soup when the weather’s cold and blustery outside.  I honestly think it provides comfort to the soul, peace to the heart and when it’s also healthy, serenity for the mind.

This beef barley soup hits on all three counts, and since you can pop the ingredients into your slow cooker to simmer all day it also provides a stress free dinner!

Beef Barley Soup

slowcookerbeefbarleysoupheader

Oh where is my …

Have you ever gone to leave the house and searched forever to find your car keys?  Yup!  Happens to all of us, we place something in a specific place and then later when we go to find it we cannot find it.

Normally, for most of us this happens on occasion but for someone with dementia this may be an everyday occurrence, possibly multiple times a day.  When we go to help a family member with dementia in their home it is often to help them find these missing items, which are often right out in the open or in the most obscure location imaginable.

Sometimes when our loved one with dementia misplaces something they will start accusing people of stealing from them.  Family members or complete strangers are all potential suspects and these accusations can be emotionally very painful.  As painful as it may be to have your loved one accuse you of stealing from them may be it is important to keep in mind that it isn’t really THEM making the accusation, it is the DISEASE.

Dementia destroys the brain and especially in the beginning it destroys not only memory but also the ability for rational thought and logic.  So when they can’t find something they want (memory problem) and they know they didn’t do anything with it (again memory problem) then it is obvious that someone stole it even if no one has been in their home (logic problem) and if you happen to come into their field of vision or thought then you are the guilty party (rational thought problem).  This is all symptoms of the disease, the same as a rash is a symptom of an allergic reaction.

The best thing you can do during these times is to reassure your loved one that you will help them find whatever they are looking for, and don’t blame them for anything.  You will need a lot of patience, love, understanding and patience. (Yes, I did put patience twice.)

Check in often, I will post more about patience and loving while caring for a family member with dementia.

Shocking and unbelievable

I must admit that social media came into my life at a time where I had already learned some understanding of what should and should not be publicly shared.  I also had learned from a young age to follow the golden rule.

So, when I read about the idea of nursing home caregivers posting pictures to social media showing seniors in their care in deplorable conditions or being abused I was beside myself in outrage.  This level of cruelty and depravity cannot be understood or explained away.

Sadly, it is also a symptom of the nursing home industrial complex we have here in the United States.   In a country where the monthly costs of such care can run as much as $10,000 and there are little to no regulations as to caregiver to resident ratios it is unsurprising that those caregivers who really care about the seniors in their care burnout and quit the field entirely.  This leaves behind those who could care less about those in their charge allowing such heinous acts to be committed.

While corporate big-wigs reap huge salaries, overworked and understaffed the caregivers can barely make a living wage.  They often do not have the supplies on hand to provide proper care (gloves, cleaning supplies, adult briefs to mention a few).

Imagine the pain in the heart of a good, caring caregiver who has to show up to work day after day knowing they will never be able to interact with their charges as the human beings they are.  That they will never be able to adequately provide even the minimal amount of daily care because they are stretched so thin among all their charges.  While doing your job you will be barely earning enough to keep yourself housed and fed with your heart being torn out with each moment of heartbreaking toil there is little wonder that they burn out.

The regulations regarding the posting of demeaning photos on social media by caregivers are sadly necessary at this time, but I feel that it would be a better use of Congress’ time to search out what is causing the climate of unfeeling caregivers to propagate.  Perhaps requiring higher staffing levels and allowing the resident to caregiver ratios be based upon resident needs rather than straight numbers will allow the good caregivers to wish to remain in the industry and weed out the bad apples in the bunch.

Here is an article in NPR regarding the posting of demeaning photos on social media:

Exploitation on social media is a form of abuse