I had a blog on MySpace that I do not use anymore. But I had really good info on Alzheimer's...so here it goes.
3/20/09
This is a helpful link when someone is in the hospital and are on social security
Medicare Info
This is a helpful link on seeing if someone qualifies for Medi-Cal and what is covered.
Nursing Homes
I have also learned that if you want to utilize Veterans benefits for your medical issues, go to a VA hospital to get treated not a regular hospital. The VA told my daughter that if she had brought me there then the VA would have been able to cover a lot of this and help me into a VA facility once I was out of the hospital. But VA facilities are like Kaiser....you either love it or hate it. If someone is able to live independently and they are a vet.....APPLY FOR A VA HOME LIKE YOUNTVILLE!!!!! GET ON THE WAITING LIST. It is a continuous care campus so once your there you are taken care of till you die. But if you are diagnosed with dementia or alzheimers it is almost impossible to get in.
Medicare Info
This is a helpful link on seeing if someone qualifies for Medi-Cal and what is covered.
Nursing Homes
I have also learned that if you want to utilize Veterans benefits for your medical issues, go to a VA hospital to get treated not a regular hospital. The VA told my daughter that if she had brought me there then the VA would have been able to cover a lot of this and help me into a VA facility once I was out of the hospital. But VA facilities are like Kaiser....you either love it or hate it. If someone is able to live independently and they are a vet.....APPLY FOR A VA HOME LIKE YOUNTVILLE!!!!! GET ON THE WAITING LIST. It is a continuous care campus so once your there you are taken care of till you die. But if you are diagnosed with dementia or alzheimers it is almost impossible to get in.
3/20/09
***Written in my Father's voice and my view***
So I am in this hospital staring at the white walls and the holes in the ceiling. Because I have this infection, Vancomycin-Resistant Enterococci (VRE), the nursing home wont take me back....its not like they helped the situation when I was there. I have had this stupid catheter since January and when I got to the home we were suppose to work on getting off it. But that didn't happen and now I am stuck here with the infection. Based on medi-cal rules however, after 7 days I could lose my spot at the home. So now we have to go through the whole process again of finding me a good home.
Back in January I had a heart attack and I wasn't given more than a week to live. When I arrived at the CCC unit (where people die within a week) the doctor there said the other was wrong and I could live a few more months if not 6. So now my daughter was given 4 hours on a Sunday to find a home. Yeah right!!! So after many stalling tactics through Medicare, she found me a great home near her and one that her and her mother felt would be good to me. This was after going to about 50 nursing homes. So now if I lose my spot there they have to go through all those again. My daughter cried in most of them because of how bad the facilities were.
How come our society throws away our elderly? Put them in a home that is not suitable for even an animal? I served our country, I served as a civil servant for CA and I paid my taxes and social security. So why is it that my daughter has to suffer this burden? Why do I have to settle for the first home that says we will take him....I would if my daughter and ex wife didn't check them all out before saying ok.
Its just not fair how we treat the elderly and sick. I am incontinent and very weak...so someone else has to clean me....they didn't stay on top of that and I now have this infection....so why do I have to get booted?
Fathers out there....take care of this shit before you get old....don't put your kids through what I have put my daughter through....its not fair. But she does it because she loves me. No questions asked.
3/24/09
***Written in my Father's voice and my view***
Back in January I had a heart attack and I wasn't given more than a week to live. When I arrived at the CCC unit (where people die within a week) the doctor there said the other was wrong and I could live a few more months if not 6. So now my daughter was given 4 hours on a Sunday to find a home. Yeah right!!! So after many stalling tactics through Medicare, she found me a great home near her and one that her and her mother felt would be good to me. This was after going to about 50 nursing homes. So now if I lose my spot there they have to go through all those again. My daughter cried in most of them because of how bad the facilities were.
How come our society throws away our elderly? Put them in a home that is not suitable for even an animal? I served our country, I served as a civil servant for CA and I paid my taxes and social security. So why is it that my daughter has to suffer this burden? Why do I have to settle for the first home that says we will take him....I would if my daughter and ex wife didn't check them all out before saying ok.
Its just not fair how we treat the elderly and sick. I am incontinent and very weak...so someone else has to clean me....they didn't stay on top of that and I now have this infection....so why do I have to get booted?
Fathers out there....take care of this shit before you get old....don't put your kids through what I have put my daughter through....its not fair. But she does it because she loves me. No questions asked.
3/24/09
***Written in my Father's voice and my view***
So as of Sunday, my current nursing home said that if the VRE is colonized...then they would take me back...soooo, hospital did a retest just for them and it was colonized. Something to do with my body accepting the bacteria so then it wouldnt be contagious. Come Monday they told the hospital..."nope not taking him".
Que in my daughter....Hospital called my daughter and told her the news. They advised her to call the State Public Health Dept. She did and they told her that since there was a 7-day bed hold (filled out when I was first admitted to home) that they have to return me to the next available bed. If they refuse she can call Public Health back and file a Refusal of ReAdmittance Hearing request.
She called the Director of Nursing (DON) at the home and she was down right mean. Told her what the Public Health person said and she still said no. So then my daughter called the hospital and told them what was going on. In the mean time she would go and look at homes that said they would take me. My daughter is fighting for the current home because it is so close she can see me all the time and the farther it is the harder it is for her to be there.
My daughter then went to look at the other homes and they had mis-information. They had the old info and said they wouldnt take him. So she called hospital and said "send the right info....duh". While that was going on...my ex wife called and talked to the DON and she was kiss ass.....it must be the comment my daughter made about filing a complaint. The DON said she would try to rearrange beds so that I could come home. Then get back to her.
Today....DON is out sick...so is the Admissions Director...no call from Hospital and I am still laying in a hospital bed.
What would of happened if my family wasnt willing to do all this running around, where would I of ended up...the only real advocates for elders is their own family.
Que in my daughter....Hospital called my daughter and told her the news. They advised her to call the State Public Health Dept. She did and they told her that since there was a 7-day bed hold (filled out when I was first admitted to home) that they have to return me to the next available bed. If they refuse she can call Public Health back and file a Refusal of ReAdmittance Hearing request.
She called the Director of Nursing (DON) at the home and she was down right mean. Told her what the Public Health person said and she still said no. So then my daughter called the hospital and told them what was going on. In the mean time she would go and look at homes that said they would take me. My daughter is fighting for the current home because it is so close she can see me all the time and the farther it is the harder it is for her to be there.
My daughter then went to look at the other homes and they had mis-information. They had the old info and said they wouldnt take him. So she called hospital and said "send the right info....duh". While that was going on...my ex wife called and talked to the DON and she was kiss ass.....it must be the comment my daughter made about filing a complaint. The DON said she would try to rearrange beds so that I could come home. Then get back to her.
Today....DON is out sick...so is the Admissions Director...no call from Hospital and I am still laying in a hospital bed.
What would of happened if my family wasnt willing to do all this running around, where would I of ended up...the only real advocates for elders is their own family.
March 26, 2009 - Thursday
***Written in my Father's voice and my view***
 | So after all is said and done...one home has said I can come stay there and it isnt the one I was in before. My VRE is colonized so I dont know why there is a big issue other than politics. I should be arriving in my new home tomorrow and moving up from a 3 bed room to a 2 bed room. Yes with my state benefits (Medi-Cal) the usual is 3 beds to a room. But I have lucked out and they have a 2 bed room for me. So my daughter is going to check it out and see if it is to her standards...she had been doing this for a while. It is the same distance as before so she will get to see me as often as before which was almost every day. My mood has spunkied up and I am feisty. I am ready to blow this pie hole. Hope the food is better over there. So I will let you know when I land in my new pad. By the way, I am getting emails from women...some really hot. They want to go out with me....obviously they arent taking the time to get to know me because if they read my profile, they would know that I wouldnt even know what a date was anymore. Thanks, Bill |
March 27, 2009 - Friday
| Hi, its D, the Daughter. There is no simple way to start this blog, other than saying....the process sucks ass. What I have learned from doing this twice.... 1. Dont have high expectations...you will walk out of that home crying. I did about 20 times. 2. If it is private pay situation, call ahead and discuss price. Dont waste your time going, doing the tour, falling in love with it and then they slam down this outragous price. See #1. 3. Make a list of the basic needs/questions of your loved one. Like does he/she need someone to feed them, falling prevention, how often are showers and can I request more, how do they prevent dehydration. 4. Look at all the hallways and see how many residents are up and out of bed walking around or hanging out in their wheelchairs. If there is a good amout out consider that good. The nurses aren't just shoving them into be to get rid of them. Plus the longer a dementia/alz patient is up the more they should sleep at night with the sundowners. 5. Does the room meet the basic needs of the resident, is it clean? cords and peeled wall paper as well are not good signs. 6. Think about their personality and what they were like before the illness. My father is a simple man who didnt need much. I went to a home that I would say was too posh fo rhim...too frilly. I went with a simple clean home. 7. Did the staff take the time to talk to you...were they impatient? If they are impatient with you, think how they would be with your loved one. 8. Do their laundry. It makes you go at least 2 times a week and it shows a presence at the home. Plus you can prevent spread of illness like Scapes. Also you shouldnt lose any clothes. 9. Before committing to a place, google them. There are tons of review sites that will give you an idea of their violations. Now you wont find a home that is perfect. So look at what kind of violations and the less abuse the better of course. 10. With Dementia/Alz, how do they secure the facility? How do they prevent wandering? These should jog some more questions for you. But dont say yes to the first one. When I had to look, I saw about 20 homes. I got so good at judging them that I knew the moment I walked it. It doesnt have to smell like urine..there are plenty of places that prevent that. Lastly, know that you can only do what is within your power. This country doesnt provide for their elderly like we think our loved ones deserve. As their loved one, we are the only voice they have. D |
March 31, 2009 - Tuesday
| This site gives star ratings on the homes. Nursing Homes April 6, 2009 - Monday ***Written in my Father's voice and my view***
April 9, 2009 - Thursday ***Written in my Father's voice and my view***
April 25, 2009 - Saturday
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April 25, 2009 - Saturday
| Alzheimer's, Validation Therapy and the CareGiver  I ran across this article while "fishing" on the Internet. This tried-and-true technique can be used when you are at "wits" end when dealing with difficult behavior. The article contains examples that should help you develop your own frame of reference, techniques when dealing with difficutl situations on a daily basis. It should be particularly useful in helping you understand that the often bizarre behaviors evidenced by your Alzheimer's loved one are not uncommon and can be dealt with effectively. This article is worthwhile reading and is worth "salting away" for future reference. Nursing Homes, June, 2000 by Mark Warner DESIGNS for Validation Therapy Mark Warner This tried-and-true technique can be supported in the Alzheimer's environment As each member of the group sat in the circle hoping the balloon would gently drift their way, Roxanne burst from her chair in a fit of rage, shouting "There'll be no ball-playing in my house!" Furious at the insolence of the players who ignored her commands, Roxanne forcefully attacked a staff member, who tried to comfort her by explaining that she was not in her house, but merely with her friends playing a game. Roxanne didn't buy that and swung wildly, hitting the staff member squarely in the chest. Fearing that I, too, might fall victim to the same fate, I cautiously approached Roxanne. I put my arm around her shoulder and supported her in her cause that there should be no ball-playing in her house. "This is terrible," I said. "You're right, they should not be throwing that ball in your house, should they?" "No, they shouldn't," bellowed Roxanne, showing only the slightest relief that someone saw her point of view. "But you know, Roxanne, the only way they will stop throwing that ball is if we write down the rules for them. I think it's the only way they'll listen." Roxanne was buying this approach, so I suggested, "Let's go into that room over there and write down all the rules for them, okay?" Much to my relief, Roxanne agreed, and hand-in-hand we went into the room to write down the "rules." "Okay," I began, "Rule Number One is 'No ball-playing in the house,' right?" "That's right," agreed Roxanne. "So what will Rule Number Two be," I asked, and then offered, "How about, 'No running in the house'?" "That's right," said Roxanne, "my grandchildren are not allowed to run in my house." "Roxanne, you've got grandchildren," I said, raising the tone of my voice with delight. "Oh, yes, my little gran'boy is six years old, and he is as smart as they come." Roxanne was on a roll now, and the upset caused earlier by the balloon toss in the next room might as well have been miles away. Fifteen minutes later, when the game was over, Roxanne and I emerged from the room, both of us just as happy as we could be, the "rules" left on the table and the incident long forgotten. The technique used here is called Validation Therapy. It assumes that no matter what illusion the person with Alzheimer's disease (AD) is living, she is right, and nothing you can say or do will convince her otherwise. Naomi Feil is the acknowledged expert on validation therapy and wrote the book The Validation Breakthrough. The basic concept is that you have to buy into the resident's illusion and convincingly play along with it, there by validating it. Eventually you'll see opportunities to mold the tale--and the resident's behavior--into something that is acceptable and no longer upsetting. "What has this got to do with design," you ask? Everything, in fact. Understanding Alzheimer's disease and the many creative ways to deal with it are as much a challenge of designing an environment as of caregiving within it. Angie is always complaining about the stranger in the bathroom. She won't use the toilet while "the other lady" is in there. She says that the bathroom is occupied, not realizing it is her own reflection that she sees. Do you explain that she is seeing herself in a mirror? No. You go along with her. How about, "I'm sorry, Angie, let me see what's taking that lady so long." You go into the bathroom and somehow cover the mirror. One family confronted by this situation told their mother that the mirror was dirty and needed to be cleaned. They sprayed it with a powdered deodorant, creating a haze that obscured any reflection. "Mom, she's out of there now," her daughter said. "I wonder what took her so long. Let me know if you need anything. I'll be right here waiting for you." Caregiver 1: "Deborah won't eat anything. She just sits at the table and stares at the food. She loves gardening, though; we spend hours every day weeding and pruning the vegetables in our garden." A golden opportunity awaits us here. Figure it out. Deborah loves gardening, but won't eat. "So we tried something a little different. Though the tomatoes were days from ripening, I went to the grocery store and picked out some beautiful red ones. Instead of putting them on the table in front of her, I pretended to come in from the garden, tomatoes in hand. As Deborah Looked at the tomatoes, I told her, 'They came from our garden and don't they Look delicious?"' Granted, such ploys are not always so successful, but many are. Sharing the bounty of the garden, enjoying the fruits of your labor that you grew together, can somehow trigger pleasant, guiding thoughts and behaviors when all else fails. Perhaps it stirs up memories from long ago, or maybe it's just the thrill of eating your own garden vegetables. Regardless, it adds a new dimension to life that might very well conquer the ravages of the disease and perhaps bring new purpose to those waist-high gardens many facilities are installing these days. Taking validation to the next step often involves anticipating the problem and creating the illusion. Validation, also referred to as deceptive therapy, white lies and fiblets, means creating a story--in the best interest of the person who is "confused." "Dad, who's president? Do you remember his name?" "Of course l do, it's Roosevelt!" If your family member believes it is the 1930s, so be it. As he regresses in time, so do his memories of values, experiences and people. What was important then becomes important now! Given residents' belief that they are living when Roosevelt was president, what would the world have been like back then? What would the good experiences and environmental features have been? How can we recreate the familiar feelings of that period in a convincing and subtle way? For example, those were the days when they hung the clothes on a line in the back yard. Isn't that the kind of good and secure feeling we would want to recreate--possibly by merely providing a clothesline? Others might be enjoying the time when they were raising their families. What better way to indulge them than by allowing them to once again care for their spouse or children by hanging "their" clothes out to dry? Or, perhaps they have less comforting memories. Caregiver 2: "Mom collects everything--rubber bands, paper clips paper...everything! And she stores them everywhere. You can hardly walk in her room, there is so much stuff in there!" Perhaps Mom is reliving times when the country was at war, when every little scrap was valuable in the war effort, or the Great Depression, when times were so tough that you had to keep everything, when nothing that might be useful was thrown out. Environmental validation then might mean providing easy-to-see drawers, trunks or cabinets to store these important items. How were evenings spent in the good ol' days (before TV, let's say)? Many families spent hours sitting on the porch, watching people go by, talking to neighbors, etc. Why not create a porch, complete with rockers and swing gliders? Locate it carefully and safely, but within view of interesting activities (maybe a playground where children play). Make sure it is secure for those who might try to leave or climb over the railing; it should also be far enough from strangers outside who might be perceived as intruding into their space. Perhaps a screened porch would do the trick. One should also beware of environmental miscues. "Bruce, why aren't you eating?" "I didn't bring my wallet and can't pay for the meal." Although Bruce is living in an assisted living facility and doesn't have to pay for his meal, he doesn't realize that. As far as he is concerned, this large, beautiful dining room is a restaurant, and the more he eats, the bigger the bill. Perhaps if we had divided the room into smaller, more homelike dining rooms and spared the expense of the huge chandelier, Bruce would feel more comfortable with his home-cooked meal. Don't forget that little environmental touches can mean a lot. Caregiver 3: "My mother refused to take a bath. For years, soaking in a warm tub of water had been the highlight of her day. But now, for some reason, she feared the tub and everything it represented. Eventually she confided in me, relating a childhood story about a little girl who got sucked down the bathtub drain. She recalled that tale and, like that little girl, she was afraid that she too might fall victim to that terrible fate. The solution: We put a mat over the drain. Her fear suddenly disappeared." In a daycare center, angry and impatient residents wait for their rides to take them home. Each time the door opens, one, two or even three of them race to it and powerfully attempt to get into the van, which has actually arrived to transport someone else. Staff members intervene, often unsuccessfully, overcome by the strength and determination of people with a very important cause (the van is there for them). If we, as facility planners and designers, can anticipate this kind of behavior, we can plan door placement to eliminate visibility of the van outside, thus avoiding this upsetting and potentially volatile situation. There are design solutions for problems like these, if problems are simply acknowledged and thought about ahead of time. Although the stories I've recounted are all too familiar to healthcare professionals, they are often "Greek" to design professionals. Nevertheless, it is a design credo: To design for any client, you have to understand the client. Why should those who have Alzheimer's disease be treated any differently? We are only in the earliest days of learning how to design for dementia. Hopefully, there will soon be a cure for these devastating diseases, making an article such as this a moot exercise. But until then, we must continue to delve into our creative minds, take chances and discover what works and what doesn't for this population. Nursing home/assisted living managers should help designers understand how people with dementia perceive and interpret their worlds. Only when equipped with this knowledge can we designers begin to address these problems with the tools that we have available to us. Mark Warner, AIA, is the author of The Complete Guide to Alzheimer's Proofing Your Home, the first book in the Homes That Care series on age related conditions and creating homes for those suffering from them. His firm, Ageless Design, Inc., offers consultation and assistance in the design of environments for seniors. For more information, call (561) 745-0210, visit the Web site at www.agelessdesign.com or e-mail ewarner@agelessdesign.com. May 6, 2009 - Wednesday
May 14, 2009 - Thursday
May 15, 2009 - Friday
May 22, 2009 - Friday
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