Archive for month: February, 2013

Ten Things You Need To Know About Assisted Living *

25 Feb
February 25, 2013

 

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* The author has spent the last ten years as an assisted living facility resident

1. Before you sign the contract, check the Exclusionary Clause. This is the “We can throw you out if ” . . .list. It can include incontinence, dementia, and dying.

2. If you use a wheelchair, know that the overwhelming majority of assisted living facilities are not wheelchair accessible.

3. The primary objective is to make a profit. Everything else is secondary.  **I’m going to revise this one after reading a letter from my friend, Sue Anagnostou of ACHCA, who correctly pointed out that profitability is not a liability, but rather an asset. What I should have said is that the problem of profiteering becomes a problem when it’s done at the expense of personal care attendants making a living wage.

4. Ask for a copy of the Activities Schedule. The greater the number of interactive activities, the better.

5. As a general rule of thumb, not-for-profit and religious facilities often provide the best care. Here’s another way to think of it: the number of phone calls necessary to reach a decision-maker, is an accurate barometer of how responsive staff and administrators are likely to be.

6. Find out how many employees are on the 11 pm – 7 am shift. These are the hours most falls occur.

7. Does the facility have a Resident’s Council?

8. Do residents have access to mental health professionals? Ambient Despair — the hopelessness many residents feel due to higher-than-normal rates of disability, depression, dementia and death — can spread like a virus in communities without mental health support.

9. How much emphasis is put on physical fitness? Believe it or not, this is usually a good indicator of how much the facility is truly invested in a resident’s quality of life.

10.How “self-energized” are the residents? Residents who are active and community oriented, always do better than those who stay in their rooms all day. What programs does your prospective facility has to encourage “purposeful living?”

AETATIS

20 Feb
February 20, 2013

 

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AETATIS ( I-E-ta-tis. Latin “Changing Age”)

Currently, about 15-20% of Americans who need assistance with their Activities of Daily Living (ADL) are residents of an Institutional Aging Community (IAC).

The vast majority of people need assistance, however, (80-85%) live at home, either by themselves or with their families. And unlike IAC’s where, assistance is provided by a paid staff of personal aides, employed by the facility; in the community, it’s the family, friends, and neighbors who provide the care and assistance.

Personally, I favor a community environment: if set-up, operated and administered with wisdom and compassion, they can be places of healing, equilibrium and purpose.

My sister and her husband cared for my mother after she suffered a stroke for more than ten years. She had a beautiful apartment in my sister’s home and for the first nine years it worked out very nicely. But my sister works from her home and her husband’s job takes him out of the house, so most of the time my mother was alone. Like I said, for the first nine years it worked out nicely. In the tenth year however, the lack of human contact pushed my mother into an acute psychotic break. At that time we had to make a decision, and we chose to place my mother into a skilled nursing facility, owned and operated by the State of Pennsylvania. I assure you this was not a decision we took lightly, as my mother at first was determined not to go into the skilled nursing facility. As time went on however, the pain she suffered emotionally and psychologically from being alone made her rethink her options. Finally, after a couple of months in the skilled nursing facility she began to interact with the other residents and her depression and anxiety were considerably diminished.

The goal of any IAC should be to provide residents with an opportunity to grow emotionally, psychologically and spiritually. In other words, to find purpose. But “should be” and reality are often miles apart. Today, many families drop off an aging relative into what they see as a warehouse–to let God sort it out. One of the predictable indicators of this way of thinking is how the facility treats not only the residents, but the staff as well.

This has been my experience for the last ten years of my life in IAC: the staff and residents are usually treated with either indifference and disdain or respect and generosity. It’s not hard to understand this relationship if one observes the interaction between staff and residents. In the facility where the staff is treated with respect and paid a living wage, this has a ripple affect on the way personal care attendants treat residents they provide care for. In the end it’s a simple equation. If the staff is paid a living wage and treated with respect by the owner(s) that same staff, is likely to treat the residents in exactly the same fashion.

Aetatis believes at the present level of care provided by both PCA’s and CNA’s is insufficient for the needs of most residents. Today, a critical shortage of nurses and geriatric physicians have created a need for a more highly trained and proficient personal care attendant. Aetatis is a community that offers either both ADL compromised individuals and families the opportunity to live in a supportive environment, and a comprehensive educational component–a program designed to “retool” personal care assistants in a clinical setting. At the end of the academic semester, the students receive certification for their training. Unlike the residential community, the students are also entitled to free room and board and childcare – a function of the care they provide on their clinical rotations n the AETATIS community.

Who pays for all this? We do, by using on-site care, and economy of scale, Medicare and Medicaid expenditures per person for long term care services are significantly lower than national averages per household.

Additionally the students are virtually guaranteed good paying jobs in their communities.

Copyright © Martin Bayne 2013

 

 

 

 

TENURE

09 Feb
February 9, 2013

 

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Next week marks my 3,652 day as an assisted living resident – my ten-year anniversary as a member of America’s Institutional Aging Community.

Statistically, only 1 in 25,000 residents over 55 survives that long. And when you  factor into this equation my Young-Onset Parkinson’s, Congestive Heart Failure and two Pulmonary Embolisms, the odds become astronomical. (My first order of business upon waking every morning  is to acknowledge, with gratitude and astonishment,  that I actually woke up!)

Yet, here I am, after 63 years, still inhaling and exhaling. Still setting my quality-of-life indicator at its highest setting — indicating that despite ravaging tremors, excruciating pain and a failing heart that often makes me fight for each breath, I not only refuse to lay down and die — I  still squeeze what joy and inspiration I can from these ten-trillion cells called Martin Bayne.

And how do I continue to put one foot in front of the other in this often-disappointing and painful journey I call my life? In a word: purpose.

Purpose is the magic elixir that trumps pain, transcends any notion of limitation and opens our minds and hearts to possibility.

It is also the single most accurate predictor of joy and fulfillment in an aging population.

Which brings me to the reason I wrote this post — to share my anniversary with you in a format of “incremental victories.”   To openly share the ten-faceted jewel of knowledge and wisdom I’ve been given in exchange for all the pain and tremors.  Guard it well.

 

1. With stillness, we lay the foundation. 

When the mind settles, we become clear.

 

2. With courage, we move forward-despite our fear.

An authentic warrior recognizes fear as an ally.

 

3. With forgiveness, we discover true freedom.

One-hundred-years from now, what difference will it make?

 

4. With insight, we accept the change of life’s seasons.

We come, we go.  Can you remember the face you had before you were born?

 

5. With gratitude, we honor our elders.

Who determines who is “young” and who is “old?” Why, you, of course.

 

6. With tenderness, we turn the stream of compassion within.

She who has herself as playmate, coach and advisor, is a fortunate woman.

 

7. With faith, we learn surrender.

Give your heart away completely. It will always find its way home, bearing gifts.

 

8. With mindfulness, we do just this thing, now.

Life in the past and future — the cruelest prison of all.

 

9. With generosity, we make ourselves available to serve.

When duality drops away, who is serving and who is being served?

 

10. With purpose, we acknowledge our mission.

Purpose is our map; determination the vehicle.

 

Copyright 2013 Martin Bayne