..Fridays at the nursing home were very popular. Regular music groups would come by at the week’s end to play old favorites for the residents, always filling the room with cheer. My dad, who had dementia caused by failed surgery, loved the live music but also responded well to CDs of his favorites from the big band era. I know that his quality of life during his last ten years would have been diminished without music to help override the effects of dementia.
If ever there’s a group of people who suffer deeply from unearned guilt it’s caregivers. Whether you’re the parent of a vulnerable adult, an adult child of aging parents or the spouse of a vulnerable adult, you are bound to have your “if only” times where you are sucked into the quicksand of guilt. The reality is that most things you could have done differently wouldn’t have made a huge difference overall. Even if another approach would have made a difference, you can’t go back. Staying mired in guilt is counterproductive for you as well as your care receiver.
Bedsores, or pressure ulcers as the professionals generally call these injuries, are a serious concern for caregivers in long-term care settings, employees in hospitals and of course, to family caregivers. People who are bedridden or spend significant time in bed or a chair and cannot shift positions on their own can be at risk. While a small, irritated area of skin does not sound like a huge concern to the average person, this minor annoyance can quickly develop into a major health problem for a person who is vulnerable.
Dear Carol: My dad has vascular dementia which is thought to be caused by a series of mini-strokes. He lives in the memory unit of a fine nursing home. Dad needs a certain amount of nursing care and is at risk for frequent falls, but I believe that some of his depressed state could be relieved if he felt that had a purpose. Probably the same is true for several other residents. The staff is kind and devoted and I believe that they want the best for their residents, but choices for activities are limited. Do you have any ideas about how Dad and other higher functioning people could take part in life with more than visiting the zoo and playing bingo? Gary
People often ask what to look for when choosing an assisted living facility or a nursing home for a loved one. There are grading sites such as the Medicare Nursing Home Guide, found on Medicare.gov, and I suggest you use them. However, there are many things that go into good care that can’t be measured on a chart. In order to see the heart of a facility, you need to spend some time there. Observe routines and pay attention to the atmosphere. What is your gut feeling about the place?
Dear Carol: My mother is in a nursing home and has been on and off of hospice care twice, since improvement in her health has disqualified her for the program each time. This should be good news, but with or without hospice she is still very ill with lung disease. She also suffers from the effects of past chemotherapy and her mind is increasingly foggy. She says she wants to join Dad, who died years ago. This back and forth business is tearing me apart and, to be honest, it’s wearing me out to a point that I can hardly function. I need a vacation, but I’d never forgive myself if she died and I wasn’t there. I sometimes wish she could just die now, as she wishes, and get it over with. How do I get over the guilt of having these terrible thoughts? EMB
Photo credit:Westminster-Canterbury on Chesapeake Bay
Nearly all of us involved with dementia care know that the use of anti-psychotics has had terrible effects on many of our loved ones. My dad's story is one that I won't go into here, but let it suffice to say that I know what these drugs can do. That's one reason that the "Birdsong Initiative" fascinates me.
The 24-week study was conducted among residents of the Hoy Nursing Care Center by the non-profit life plan community Westminster-Canterbury on Chesapeake Bay in conjunction with Eastern Virginia Medical School and Virginia Wesleyan College. During the study, 31 Hoy Center residents whose dementia makes it difficult to participate in social activities used computers to regularly access enriching content customized to their personal interests and cognitive ability. The touchscreen technology is designed to be easy for seniors and offers Skype, social networking and a spectrum of content. It was developed by Colorado-based It’s Never 2 Late and is referred to as iN2L.
Hospice care is palliative care, but palliative care is not hospice. The difference between these two types of care is something that I have found difficult to clarify myself let alone explain to others. However, this care is a fundamental part of treating any chronic or terminal illness.
With that in mind, I contacted Kimberly Angelia Curseen, M.D., Associate Professor of Internal Medicine at Emory School of Medicine and Director of Outpatient Supportive/Palliative Care Clinic Emory Healthcare. Dr. Curseen has a passion for palliative care and was happy to clarify this important type of medical care that seems to pass under the radar.
Twenty-five years ago, my aunt and uncle moved from the Washington, D.C. area to be with my family here on the Great Plains. One of the few complaints that I heard from my aunt about the move was that when she went to their new bank, the tellers called her by her first name. To someone of her generation, a younger person should have been calling her “Mrs. Kelly.” Yes, she understood their intent and she now lived in a more open, friendlier community than before, but she felt that first names lacked dignity. Additionally, while she was obviously aging, her mind was quick and her memory accurate. All she wanted was a little respect.
Dear Carol: With reluctance, I’m looking for a good nursing home for my wife who has had multiple sclerosis for decades. I’ve cared for her all along but my own body is breaking down. I’ve checked Medicare’s Nursing Home Compare and that’s helpful. However, I feel that is too removed from the everyday life of most nursing homes. Some care homes look good in ratings and but in reality they seem lifeless and institutional. One that I like the feel of doesn’t have the highest rating, though the rating isn’t low. What are the best tools for choosing? Mike