What to look for when placing a loved one for long term care?
When the time comes to place your loved one in a long-term care facility, the decision can be difficult and often overwhelming. Here are some questions you should ask at each facility you inspect in order to ensure quality care:
- Is the staff happy and involved with the residents?
- Is there a licensed nurse available to monitor resident care and staff oversight?
- What is the resident-to-direct care/caregiving staffing ratio?
- Do you see the residents restrained in wheelchairs, unattended and looking over-medicated?
- Are residents involved in activities designed to eliminate feelings of boredom, loneliness and helplessness?
- Does the facility have outdoor areas for socialization that are locked and accessible from the inside during the day?
- Does the facility have pets?
- Is the pricing structure a fixed rate or “tiered structure” with added unpredictable costs for increasing levels of care?
- What happens if my loved one’s physical condition or behavior deteriorates?
- What would be the circumstances or medical conditions under which I would be required to move him/her?
- Does the facility provide care to residents at all stages of dementia-from early stages through hospice?
- Does the facility have at least two staff members on duty to assist in transferring of non-ambulatory residents?
- How is the Living Environment? Is it familiar as a real home? Are there any unpleasant odors? Are there planned activities?
- Are the residents dressed and out of bed by 9 a.m.?
What is Dementia?
Dementia is an umbrella term used to describe the loss of cognitive or intellectual function. Many conditions can cause dementia. Dementia related depression, drug interactions, thyroid and other problems may be reversible if detected early. That’s one reason it’s important to obtain a professsional assessment, so that the actual cause can be identified and proper care provided. Several diseases also cause dementia, such as Parkinson’s, Alzheimer’s,Creutzfeldt-Jakob, Huntington’s and multi-infarct or vascular disease, caused by multiple strokes in the brain. What is Alzheimer’s?
Alzheimer’s disease is a progressive, degenerative disease that is characterised by the loss of function and death of nerve cells in several areas of the brain, that results in impaired memory, thinking and behavior. Alzheimer’s disease is the most common cause of dementia. It affects an estimated 4 million American adults.
What are the Warning Signs of Alzheimer’s?
The Alzheimer’s Association has developed a list of warning signs that include common symptoms of Alzheimer’s disease (some also apply to other dementias). Individuals who exhibit several of these syptoms should see a physician for a complete examination.
- Memory loss. One of the most common early warning signs of dementia is forgetting recently learned information. While it’s normal to forget appointments, names or telephone numbers, those with dementia will forget such things more often and not remember them later.
- Difficulty performing familiar tasks. People with dementia often find it hard to complete everyday tasks that are so familiar we usually do not think about how to do them. A person with Alzheimer’s may not know the steps for preparing a meal, using a household appliance or participating in a lifelong hobby.
- Problems with language. Everyone has trouble finding the right word sometimes, but a person with Alzheimer’s often forgets simple words or subtitutes unusual words, making his or her speech or writing hard to understand.
- Disorientation to time and place. It’s normal to forget the day of the week or where you’re going. But people with Alzheimer’s disease can become lost on their own street. They may forget where and how they got there, and may not know how to get back home.
- Poor or decreased judgement. No one has perfect judgement all the time. Those with Alzheimer’s may dress without regard to the weather, wearing several shirts on a warm day or very little clothing in cold weather. Those with dementia often show poor judgement about money, giving away large sums to telemarketers or paying for home repairs or products they don’t need.
- Problems with abstract thinking. Balancing a checkbook is a task that can be challenging for some. But a person with Alzheimer’s may forget what the numbers represent and what needs to be done with them.
- Misplacing things. Anyone can temporarilly misplace a wallet or key. A person with Alzheimer’s disease may put things in unusual places, like an iron in the freezer or a wristwatch in the sugar bowl.
- Changes in mood or behavior. Everyone can become sad or moody from time to time. Someone with Alzheimer’s disease can show rapid mood swings-from calm to tears to anger-for no apparent reason.
- Changes in personality. Personalities ordinarilly chanfe somewhat with age. But a person with Alzheimer’s can change dramatically, becoming extremely confused, suspicious, fearful or dependent on a family member.
- Loss of initiative. Its normal to tire of housework, business activities or social obligations at times. The person with Alzheimer’s diseae may become very passive, sitting in front of the television for hours, sleeping more than usual or not wanting to do usual activities.
What is Parkinson’s disease?
Parkinson’s disease (PD) is a degenerative neurological disorder of the brain related to a depletion of a neurotransmitter called dopamine. The average age of diagnosis is 60. The cause of PD is still under investigation, however there may be multiple factors including genetic predisposition and exposure to environmental toxins. Syptoms can include: Rigidity or stiffnesss of arms, legs or neck tremors, mostly in the hands (at rest), instability in posture or balance, slowness in movement. Secondary syptoms may include facial “masking”, depression, confusion, difficulties in speech or swallowing.
Protecting Caregivers Health
How do you know when it is time to seek help for the care of a loved one in order to maintain your own health?
A study of elderly spouse caregivers, aged 60 to 96; found that caregivers who experience mental and emotional strain have 63% higher risk of dying than non-caregivers.
Caregivers are often so concerned with care for their relatives needs, that they lose sight of their own well being.
Please use the caregiver self assessment questionaire below to help assess your need for help.
During the past week or so, I have…
- Had trouble keeping my mind on what I was doing.
- Felt that I couldn’t leave my relative alone.
- Had difficulty making decisions.
- Felt completely overwhelmed.
- Felt useless and unneeded.
- Felt lonely.
- Been upset that my relative has changed so much from his/her former self.
- Felt a loss of privacy and/or personal time.
- Been edgy and irritable.
- Had sleep disturbed because of caring for relative.
- Had a crying spell or spells.
Felt strained between work and family responsibilities.
- Had back pain.
- Felt ill (headaches, stomach problems or common cold).
- Been dissatisfied with the support my family has given me.
- Found that my relatives living situation to be inconvenient or a barrier to care.
- On a scale of 1 to 10, with 1 being “not stressed” to 10 being “extremely stressefull”, please rate your current level of stress.
- On a scale of 1 to 10, with 1 being “very healthy” to 10 being “extremely ill” please rate your current health compared to what it was this time last year.