5 May 2007
Dear Mary,
I would like to share a bit of humor with your readers. My mother suffered a heart attack and was hospitalized for a few days. She has mild dementia and is particularly confused at night so the staff had to be watchful that she did not hurt herself by climbing out of bed. One day I visited and she asked me where she would be sleeping that night. I told her she would be sleeping in the same hospital bed she was in now. Mother seriously replied, “Oh, thank God. Last night I had to sleep in the beauty parlor”. I told the nurse what she said and she explained that Mom was determined to get out of bed so they put her in a geri-chair and moved her into the hall for close observation. As you know, a geri-chair is a vinyl recliner on wheels and apparently the feel of it and the activity in the hall with all the bright lights made her think she was sleeping in a beauty parlor. I couldn’t stop laughing.
Dear Reader,
Thank you for the laugh of the day. I always say, humor in caregiving is a must. Keep laughing.
Dear Mary,
I am trying to find the appropriate facility for my father. There are a few in my area but the one most recommended is an hour away. I want him to have the best care, but also be close enough to visit. He has dementia and I am told he needs specialized care. How do I find the right one?
Dear Reader,
Ideally you will want to find a facility that satisfies both your father’s need for care and your desire for proximity. However, you may have to sacrifice convenience in order to adequately meet his needs.
It is important to know what level of care your father actually requires, that of assisted living or nursing home. You can find this out by calling the Department of Aging and Disabilities (410-222-4464) and requesting a free AERS (Adult Evaluation and Review Service) assessment. Once you know, speak to someone in the Housing Department for information about assisted living facilities, or talk to an Ombudsman if nursing home placement is needed.
To compare nursing homes, go to the website www.medicare.gov. The Center for Medicare and Medicaid Services also offers an online PDF publication called Guide to Choosing a Nursing Home that is very helpful ( www.feddesk.com/freehandbooks/1216-4.pdf). However, nothing replaces a personal visit and the use of your five senses. Pay attention to smells: a strong odor of urine may indicate that residents are not being toileted frequently enough. Listen for call bells and notice how quickly they are answered if the resident’s need is met. Watch how staff relates to the residents and what kind of attitude they have. Observe for meaningful activities, how meals are presented, and how residents who need to be fed are managed. Ask how they assess for and implement person-centered-care and how they deal with behaviors. For example, what would they do if your father insists on going home or resists bathing? A good facility will know how to handle these issues without sedating him or calling you to come and get him.
It is important to understand that facility living will not be home as you or your father know it. If you choose one a distance away, call frequently and visit as often as you need to. Initially, though, the home may ask you not to visit for a week or two to allow your father to settle into a routine. As you learn to let go and trust the staff your calls and visits will become less frequent and stressful. Letting go will be the hardest thing to do, but knowing he is safe and cared for is what matters most.
Mary C. Fridley RN, BC
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