Thursday, January 27, 2011

Hunt for a New Home

I’m on the hunt for a new home for Robert.

Robert currently lives in a Residential Care for the Elderly in the Assisted Living portion of the facility. He has his own room with a television, mini-fridge and phone as well as his own bathroom (I’m jealous of his closet space!). Robert participates in all the activities at the facility with Bingo his absolute favorite. Whether it’s on the phone or while playing cards in the evening, our conversation about his day goes something like this:

“I played Bingo today and won a game.”

“Good job, hon! What did you win?”

“A Milky Way candy bar! They’re my favorite!”

He doesn’t eat these candy bars, though, he’s more like a Milky Way Candy Bar Hoarder -- his mini-fridge is filled with them (he’s lived at The Home for almost two years; wins at Bingo at least 4 times a week – you do the math). I’ve tried to take a couple (you know, just to make room) but he watches the supply like a hawk so I have to sneak them out. To make room. Like I said. Really.

Saturday, January 22, 2011

Caregiving of a Different Sort

The past few weeks, my caregiving has taken a different direction. Sure, I’m still working on finding Robert a new home and visiting him (just to have him beat me at cards again!) and taking him for a spiffy new haircut and some new (yeah, read: bigger) pajamas. But, I have also been taking care of my beloved cat, Tinkerbell.

Tinkerbell, at fifteen years old (probably closer to sixteen), is the Queen Bee of the house. She’s persnickety (I plan to be, too, when I’m ancient) and does not tolerate the dogs trying to wriggle their way to her food plate. She regally ignores the youngest cat trying to tackle her in the morning while she limps her way over to the food bowl. She has had her share of health problems over the years which we nursed her through (although, there wasn’t much we could do about the limp) but she maintained her perch on the couch and loved to gnaw on whose ever head was closest to her (she had a fascination with Grandma K.’s curly hair and the girls’ blonde locks!).

Tinkerbell came to us as a kitten via my boss’s son who found her roaming around their backyard, not far from the river. Rach has been an animal lover since she was tiny (I called her my little Dr. Doolittle) and we couldn’t turn away the cute little grey cat with the gorgeous green eyes. Rach immediately christened her Tinkerbell (hey, she was 6).

Once Rach and I added my husband and his kids to our family, Tinkerbell survived being put in the bathroom hamper by my 4 year old step-son (because he was a terror like that) and let the girls put her in a baby carriage to walk her (and our other cats) through our new neighborhood.
We have adopted a lot of animals through the years but they all are about the same age (old). We’re doing our best to keep everyone healthy but my friend jokes that we are running a senior care facility for animals (not far from the truth!).

A few weeks ago, Tinky got very sick, very quickly. We tried all kinds of medications (both traditional and herbal) and fed her using a dropper since she wouldn’t eat. She was so good she let me hold her like a baby while feeding her and only really fussed when I had to make her take a pill. I learned how to do an i/v to administer fluids so she would stay hydrated and we actually thought she might pull through. Unfortunately, she took a dramatic turn for the worse yesterday and died last night. We all feel fortunate that she didn’t suffer at the end but we miss our Queen terribly.

Caregiving doesn’t always have a happy ending but, I believe, the bonds forged while doing it make us better people and give comfort to those we care for. Whether it’s our relative, friend or treasured animal, they all deserve the best and the most that we have to give.

Written with much love to my precious Tinky.

Monday, January 17, 2011

It's Time to Tour

Using the methods described in previous posts, you’ve narrowed your search and are now ready to tour the potential homes! Based on your phone conversations, you have hopefully built somewhat of a rapport with the director of the homes. I recommend giving a courtesy call to the director to say that you are interested in touring. You can then set up a time to meet the director in person and get a formal tour. However, you are also welcome to visit the homes without giving any notice.

I recommend visiting more than once. The first visit can be just you (and a friend or family support person) because you may further narrow your list and the second visit can be with the loved one you need to place.

Take your checklist and list of questions (and answers you’ve already found out) with you (you didn’t really expect me to advise you to leave it at home, did you?).

You’ve done your homework so you know if there have been problems at the home. Remember that you are your loved one’s advocate so don’t be timid about asking how these problems have been resolved. If the director is not willing to discuss past problems and resolutions then this may not be the home for your loved one. Great communication with The Home is important at this stage and will be a pretty fair predictor of how well they communicate with you once your loved one is a resident there.

Tuesday, January 11, 2011

Always with the Checklists! Ways to Narrow the Search for the Perfect Home

Determining the type of facility your loved one is best suited for is just the first step in finding a Home. Several factors should be considered before choosing a Home but, thankfully, much of the research can be done before ever leaving your own home.

A few steps to get you started:

1. Create a checklist. You think I’m kidding? I find them so handy I have a checklist for my checklists! Create a list of facilities in the category needed by your loved one (RCFEs, SNFs, etc.) using resources such as internet searches, Dept. of Health & Human Services, organizations such as the California Advocates for Nursing Home Reform or the California Assisted Living Association. Each state differs with the type of resources available but I have found that once you start the search, you can quickly expand the information available by just asking a few questions when calling facilities (there’s help with that below) or by searching for key phrases related to assisted living.

If your loved one is being discharged from a hospital or SNF, the discharge coordinator can also be very helpful and provide you with possible options. However, these coordinators (for whatever reason) can also be completely unresponsive and out of touch with the needs of your loved one so keep your advocate hat on and be cautious about their recommendations.

Also, don't underestimate the power of personal referrals.  Many people have had to place someone in a facility at one time or another and these personal experiences and recommendations can be invaluable.  Ask around for recommendations.  It can't hurt. 

Update information on your nifty checklist (yes, I said nifty – a highly underutilized word in my opinion). Include the Home name, phone number, administrator or other contact person, address and website (if available).

Sunday, January 9, 2011

Finding a Care Facility for Your Loved One – Where to Start

Grappling with the decision of whether or not to place a parent, spouse or a sibling (less common, but my personal experience) in a care facility can be excruciating.

However, once the decision has been made and the guilt has been rationalized into a tiny little ball stored neatly in the pit of your stomach, finding the best home is critical.

I’ve been through the process twice with Robert and have to go through it again soon but hopefully, that will be it for a long while. I have tried to learn as much as I could while going through the process and I hope this information helps if you are ever in a similar situation.

The first step is to determine the level of care needed which will lead to the type of facility to search for. Assessing need is a critical step in finding a home which will be the best fit for your loved one.

Robert first needed a Skilled Nursing Facility, (“SNF” – go ahead and call it a “sniff” – those in the field will know what you’re talking about). Robert had a raging infection which required intravenous antibiotics and instead of leaving him in a hospital for six to eight weeks, we placed him in a SNF. At the time, this was a completely foreign area to me but the discharge coordinator at the hospital was an angel and helped me find a suitable SNF for Robert.

There are also (to name just a few other options) Residential Care Facilities for the Elderly (RCFEs), Intermediate Care Facilities (ICFs), and Board & Care Homes. Due to a variety of reasons, Robert currently lives in a RCFE but will most likely be moving to either an Intermediate Care Facility or a Board & Care facility.

Each facility has different levels of care. The information I provide here is geared toward California residents but other states should have similar information through their own Department of Health Services (or a related agency).

Tuesday, January 4, 2011

The Search for Rob's Home

Robert has lived in The Home for almost two years now. After realizing Robert needed to be placed in an Assisted Living facility, I searched for the perfect place for him. A place where he would be close to me, the staff would look out for him and he could participate in many activities, including church services which are so very important to him.

I researched what to look for in a facility when visiting, what questions to ask of the staff and was thrilled to even find a ready-made checklist! (I do love my checklists). I looked up code violations for the homes before visiting and crossed them off my list if the violations were excessive or severe.

I toured a few homes and decided against the home that had wheeled an incapacitated patient on a gurney into a lunch room corner, placed a tray of food on her stomach and walked away. The woman was clearly not aware of her surroundings nor was she even remotely capable of lifting a fork to her mouth. The facility director I was talking with walked right by her but made a point of calling other residents by name as they walked past us. If the residents hadn’t about fallen over from shock when she said hi to them, I would have believed she was being sincere. A tour of the room Robert would be in made me quickly exit with a, “thanks, I’ll call you” as the stench of stale urine was too overpowering to ignore.

This will not do.