Keeping the Peace Among Siblings

Our assisted living facility California makes it easy for family visits.Handling the needs of an aging parent is a task that requires teamwork, understanding, communication and cooperation among the senior’s grown children. The stress that comes with the situation can be overwhelming, making it difficult to get things done and work together. Conflict over many different issues—what kind of care is needed, who will do what, etc…—is common. But there are steps siblings can take to make this task easier. First, conduct a group meeting with all siblings and any other affected parties. The meeting will give the opportunity to lay out the issues at hand, brainstorm solutions, and establish individual roles for each person. Come to an agreement on an agenda in advance and remember to take notes. Keep focused on the aging parent’s needs and wants. Try to find the best possible avenue for obtaining these things and assign tasks to each caregiver. Be sure to establish roles among family members early in the process. These aren’t set in stone: it’s possible to redistribute roles later. It’s common for one sibling to become the primary caregiver. This can occur for many reasons, including living in an area close to mom or dad and having available time and resources. Unless siblings agree to this arrangement in advance, this can cause resentment, misunderstanding, and frustration. Not every caregiver is going to have an equal responsibility. Acknowledge individual strengths and weaknesses and assign duties accordingly. Discuss what each person is willing and capable of doing. Family crises can resurface old grudges and create resentments. Siblings can avoid this by setting up discussion rules. If possible, have regularly scheduled meetings with all caregivers, perhaps once a month or once a year, where everyone can discuss issues and concerns. Remember that working as a team is more productive and less hassle than working against each other. The aging parent and their needs are the primary focus, not settling family debates. If arguments continue to block progress, seek out information on elder mediators. Mediators are third-person professionals who can handle sensitive family debates on aging parents in a fair, honest way. It is essential to involve family members who appear to be in denial or unwilling to participate. Their assistance will help keep the amount of work from burdening the other caregivers and keep resentment at bay. The easiest way to get a family member involved is to ask them to do a specific task that is within their means. It is possible that this particular family member does not know how to help and is withdrawing because they aren’t sure what responsibilities they should take on. If there is no progress on persuading the family member to contribute, continue trying by sending e-mails or letters and making phone calls. Share medical records revealing the reality of the aging parent’s health and the list of tasks that need to be completed. If denial continues to be an issue, involve a third party. This could be a doctor, a family friend, or a mediator. Keep trying, if not for the benefit of an extra helping hand, then to involve this sibling in the limited time left with the aging parent. Managing the affairs of a dying parent is not an easy feat. To help things go smoothly and to keep family members on friendly terms, be proactive in maintaining the peace.  
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Is Your Assisted Living Facility Prepared for an Emergency?

Our Los Angeles assisted living facilities are ready for any emergency.

Photo used under Creative Commons from imarcc.

No matter where your loved one’s assisted living facility is located, there’s the chance of a natural disaster. Federal and state laws require that assisted living facilities have a comprehensive disaster plan in writing. Yet, you should not take it for granted that every facility will have an effective plan in place. When interviewing facilities, try to gain a clear understanding of their disaster plan and their capability to carry out that plan. First, ask the management if you can review the facility’s disaster plan yourself. If they seem reluctant to grant this request, that by itself is a red flag. You may not be an emergency preparedness expert, but start by using your basic knowledge and common sense to evaluate the plan. Is something obvious missing? Take yourself through a disaster scenario in your mind. Can you spot potential problems? Ideally, when reading through you’ll have the impression that they’ve thought of everything. Asking to see disaster plans at several different facilities will help you start to recognize which plans are better designed. Evaluate the comprehensiveness of the plan. Does it cover all reasonable possibilities? Any true potential threats should be addressed in this plan. For example: here in California we are not overly concerned about hurricanes, but you would definitely want an assisted living facility to have a plan for earthquakes. Some of the questions you should ask the facility manager or director are:  
  • Does the facility cover these plans with the residents and the staff on a frequent schedule? There should be regular reviews and drills that involve both the residents and the staff. What kind of emergency training do staff members have?
  •  Is someone who is well-versed in the plan and capable of leading staff in carrying it out on site at all times?  Is there a plan to increase staff during a disaster? The number of people necessary to support a facility on a day to day basis may be insufficient during an emergency situation.
  • Are there disaster kits on site? If so, what is included in these kits and how will they be distributed and used in the event of a disaster? A facility should have disaster kits on hand that provide each person with canned food and water for one week. The kit should also contain candles, matches, flashlights, batteries, and first aid and sanitation supplies.
  • Even during an emergency, residents need to continue following their care plans. Ask the facility about their ability to continue without interruption during a disaster. Care plans should be easily accessible.
  • How will essential medications be dispensed during and after a disaster? You will want to be sure your loved one can get their medication during disasters.
  • Is there a plan for how to notify family members in an emergency?
  • How often is the plan updated?
The websites for FEMA and The American Red Cross can provide you with more information about specific types of disasters and improve your ability to evaluate a facility’s preparedness.    
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Tips for Selling Your Home to Pay for Assisted Living

Board care for elderly may require selling a home.

Photo used under Creative Commons from Casey Serin.

When they decide to make the move to assisted living, for many seniors selling their home makes a lot of sense. They have likely accumulated a great deal of equity during their ownership, and now no longer need this residence since they’ll be living somewhere else. But selling a house in today’s market is often a challenge. Below are some tips on how to make this process easier, so that you can more quickly move on to a new stage of your life. Keep Tabs on Your Agent’s Work While you will probably hire a real estate agent to sell and show your home, it doesn’t mean this agent will necessarily do a good job. So after they’ve listed your home, go online and see if potential buyers can find it easily, going back to check again on a weekly basis. See what pictures have been posted and if you agree with the description of the home itself. Tell your agent to change it if you don’t. They work for you. Post a Love Letter on YouTube The video sharing site can work to your advantage when selling your home, as you may have lived in it for decades and can talk candidly about why it is such a great place. Have a family member video tape you or do it yourself and show your home from a very intimate perspective. This will be helpful to your real estate agent and to prospective buyers when they are trying to make a decision. Make Necessary Inside Fixes All those little maintenance issues will need to be fixed. New paint, appliance repairs, light switches – tackle the things you have been putting off for years because you can live with them. Your home needs to be in the best shape possible for buyers, much like a car needs to be perfectly clean and waxed before you sell it. These improvements can always be folded into the overall sales price – and may even raise the value of your home beyond their cost. Up the Curb Appeal First impressions go a long way. So just as repainting and doing small bits of maintenance around the house are helpful for the resale value, so is the exterior landscaping. Have a good yard crew come in and mow the lawn, plant a flower garden, and trim the trees so when that eager new family shows up to buy their first home, your place will charm them as much as any they have seen. Know the Right Price Learn what other homes similar to yours are selling for in your area and have a good idea of your property’s worth. Pricing a home too high will just waste time and money and add stress; however, pricing too low will just leave money on the table. Do your research with the help of a real estate agent and make sure you price your home in exactly the right range so that it will sell quickly, but not cheaply.  
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How to Tell If Your Parent Is Eating in Assisted Living

Our LA home for the aging ensures residents are healthy.

Photo used under Creative Commons from foodswings.

The best assisted living facilities provide nutritious meals that are designed to help older adults take in plenty of nutrients and calories. At Raya’s Paradise, we pride ourselves on our home-cooked food. However, even with delicious things to eat readily available, many people lose their appetite as they age or deal with chronic diseases. It’s a good idea to keep an eye on your parent and look for signs of skipped meals during your visits. The biggest thing to notice is whether your parent has lost weight, but this can be tricky to spot if your mother or father is already relatively thin. Keep an eye on the wrist and forearm area for signs of looser skin. Ask your parent about the fit of their dentures as well – embarrassment often prevents older adults from wanting to discuss their dentures with assisted living staff. Why is this an important detail? If your parent is dealing with sore gums or a loose fit, they may not eat as much as necessary. Issues with proper swallowing can also make it hard to eat enough every day, even with a healthy appetite. Some seniors suffer from strong coughing fits after each bite due to esophageal issues. Every now and then, share a meal with your parent to get a sense of how easy or difficult it is for them to chew and swallow their food. Some illnesses interfere with a patient’s desire to feed themselves. Many seniors struggling with dementia, depression, digestive issues or ongoing infections spend more time pushing their food around the plate than eating it. Each person has different nutritional needs depending on their age, health condition, level of physical activity, and digestion ability. An active senior with diabetes needs a different food plan than one who is bed-ridden resident with severe stomach problems. Ensure that your parent is seeing a dietician and that the facility is providing food that matches their needs. People who have to deal with a lot of pain when swallowing may need high-calorie foods to maximize the energy they get with each bite. If you notice an issue, bring it up with a staff member. The care team, perhaps with input from your parent’s doctor, can come up with a solution. Depending on the particular reason why your parent isn’t eating, there are many simple tricks and strategies the staff can use to make sure they get the nutrition they need. For example, someone with Alzheimer’s disease may need to be seated facing towards the wall rather than looking out over the rest of the room, where noise and activity may distract them. It may also help these patients if staff makes sure they’re seated next to the same companions at each meal, providing a dependable routine. Staff may also serve nutritional shakes to residents who have trouble eating, to make sure they’re taking in enough calories. The assisted living staff will also check on the eating habits of the residents, but you know your parent best. You may be able to notice subtle changes that are difficult for others to spot. These kind of observations, not just about eating but also about the state of your parent’s general well-being, can make the difference between good and excellent care. The more people watching out for them, the better off the resident will be.
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What is the Difference Between A Large Assisted Living Facility And A Smaller Board & Care Home?

Our assisted living facilities, Los Angeles feel like home. Raya’s Paradise was featured in the Beverly Hills Courier, November 9, 2102: Most people do not know the difference between a large assisted-living facility that may house 150 or more residents and a smaller board-and-care home. Larger facilities are usually for more active residents able to enjoy all the community activities offered; and for those who can manage getting to and from the building’s dining room and common areas on their own. These large facilities carry the same license as the smaller board- and-care homes. In California in the early 1970s, the residential care system was established to provide non-skilled nursing-based services to the elderly. These homes are referred to as “Board & Care” or “Residential Care Homes for the Elderly (RCFE’s).” The governing body is the State of California, Department of Social Services, Community Care Licensing. These homes are not allowed to provide medical services. They can, however, provide assistance with all activities of daily living (ADL’s). Board & care homes are smaller residential homes that afford a safe home-like atmosphere and comfortable and dignified care where residents can enjoy the living room, backyard, kitchen/dining services, homemade meals, personal attention and social interaction. For those elderly who suffer from dementia, the small residential home can be an ideal setting because of the consistency in staff and constant super vision. Residents adjust faster and often do better than in the larger Assisted Living Facilities. Such a place is Raya’s Paradise, a residential care facility with five locations in L.A. and West Hollywood with 6-11 residents each. “We make sure your loved one feels at home away from home,” says Moti Michael Gamburd, executive director. “Our caring staff—many of which have been with the company for more than 18 years—provides personalized attention to each individual,” says Gamburd adding that the caregiver to patient ratio is 1:3. While all are welcome at Raya’s Paradise, the company is known for its care of those with Alzheimer’s, other memory disorders and those who’ve suffered strokes. “We offer a new approach to dementia and Alzheimer’s care,” says Gamburd “Our environment is designed especially for our resident’s to thrive. “The activities they do together create opportunities to experience and feel accomplishment and satisfaction for completion of a job,” adds Gamburd. “This team approach gives the security of knowing there is always a helping hand ready when they need it.” The daily routine has residents up for showers in easily accessible bath- rooms, followed by breakfast and a morning activity. Since some of the homes are near parks there are visits for those want ing to go by foot or wheelchair. Afternoons often see musical entertainment, like an accordion player and all holidays and birthdays are celebrated. “We try to keep it as homey as possible,” Gamburd says. “There’s always something to do,” Gamburd adds, “like cards, puzzles, reminiscing, big band music or bingo.” More alert residents often help set the table or help with the home’s laundry to keep them engaged. For an RCFE to accept a resident with dementia it must have a “waiver” from Community Care Licensing, as the Raya’s facilities do. The waiver means a variance to a specific regulation based on a facility-wide need or circumstances which is not typically tied to a specific resident or staff person. Raya’s Paradise also has waivers to care for bedridden residents—”the building has to meet certain licensing criteria,” Gamburd reports. Gamburd advises those seeking a board-and care home for their loved one to ask questions: • If you are placing your loved one with dementia into an RCFE, you should be asking the administrator for a copy of their waiver for dementia care. This will give you peace of mind knowing that this RCFE has the proper staffing, wander guards or other means to keep residents from wandering; and knowledge of how to manage their residents with dementia. • Does this RCFE provide 24 hour “awake” staff? Falls usually occur in the evening; and it is important that staff is awake and ready to help residents get to and from the restroom at night. Many small board-and-care homes or RCFE’s, do not have a 24-hour awake staff. They may have a hus- band and wife who live in the home and are working 24/7. Working that many hours is a daunting job and it is important that staffing is “fresh” and that they are going home to rest before returning to work. Night staff should not be working somewhere else during the day and then coming to work at night at your RCFE. Raya’s homes have separate day and night staffs to provide compassionate, committed care. Raya’s also caters to those not yet ready to move with its CARE (Caring, Assisting, Respecting Elders) program that provides in-home caregivers. View or download the published article here: Beverly Hills Courier Full page 11-09-12
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Hospice Care: What to Expect

Board care for elderly can be done properly.Deciding to enter hospice care is never easy. Everyone involved in the decision may find themselves experiencing regret, sorrow, and confusion about what to expect. While issues of death and dying are always extremely difficult, knowing what to expect can help make the process a little more bearable. Most know hospice as a form of care for those who are suffering from terminal illness. It’s more than just medical care, however, as clergy and social workers may be part of the hospice team in addition to physicians and nurses. Hospice helps patients and their families come to terms with this difficult event. The main goal of hospice is to make the final days of a dying person’s life as painless and comfortable as possible, while helping to bring about a sense of resolution. One of the main qualifications in order to be eligible for hospice is that the individual must be expected to live for no longer than six months. In most cases, if the person requires additional time, their physician can extend their care. Hospice can be discontinued if the person receiving it begins to recover. One of the first steps in going about retaining hospice services is to consult with the loved one’s primary care physician. You can also contact a hospice group or a facility, such as Raya’s Paradise, that provides hospice care. Once a hospice team is assembled, all aspects of the patient’s care will be considered and a comprehensive plan will be developed. This would include the patient’s comfort level, finances, necessary medical care and medication, as well as religious beliefs. When determining whether hospice is appropriate, physicians will usually use the Karnofsky Performance scale. This is a set of criteria to help evaluate the patient’s general health in order to determine life expectancy. Common diseases that usually resolve in hospice include cancer and Alzheimer’s disease. Some may consider opting for hospice to be giving up. This couldn’t be further from the truth! In fact, it takes a very strong person to be willing to accept help and support when it’s needed. This is not a matter of giving up, but more of doing what’s necessary at that point in time. Furthermore, by choosing hospice, your loved one will receive increased comfort and support, leading to more fulfilling and meaningful final months of life. Discussing hospice is never easy. Nobody wants to be the first person to bring up the topic of death and dying. If you or someone you love is considering hospice, it’s important to realize that not saying anything could in fact delay hospice and cause unnecessary pain. Hospice is all about making the last stage of life as comfortable as possible. There’s no point in prolonging discomfort. Take a moment to begin the conversation now and you may help ease the suffering of a loved one.
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Making Memory Boxes for Seniors

Our Los Angeles assisted living features fun activities.For individuals experiencing memory loss due to conditions like Alzheimer’s disease, memory boxes can be a great way to help them recall their past, even if for a brief period of time. Memory boxes can be a collection of your loved one’s favorite objects from childhood or can even be items that capture the essence of a time. These projects can be a great way to reconnect with loved ones suffering from dementia when talking and other approaches don’t seem to have much of an effect. Memory boxes work by capitalizing on a person’s senses in order to help trigger memories from long ago. They’re filled with objects that the individual can touch, smell, and see, with the hope that the person will be brought back to the point in time that they experienced such sensations. Sometimes these objects can be the only way back to a forgotten memory. Setting up a memory box is easy. All you’ll need is a box of the size of your choosing and various items and objects that you’ll use to decorate it. This box is something that will carry meaning for you and your family member, and what’s inside of it will be more important than how the box itself looks. Now comes the fun part. Any objects that your parent or loved one once owned or used in the past are fair game. Perhaps there is a ring, necklace, or other piece of jewelry they frequently wore before moving to assisted living. Maybe you have old photos of them in their prime that will help them recall a particular time period. Even something as seemingly trivial as a piece of fabric could spur old memories to the surface, just from the touch or feel of the material. Once you have assembled the memory box, it is now time to present it. You’ll want the recipient to handle each object for some length of time, allowing their senses to respond. You can ask them to talk about the object, describe it, or simply free associate about any thoughts or feelings that the object brings up. If you are feeling at a loss for objects to put inside the memory box, don’t despair. Other relatives may be in possession of objects that have significance to your loved one. If not, you can easily find objects on your own. A great start would be to visit a local antique or hobby shop. Here, you will find many different items from past time periods that will help bring your loved one back to a time when they were younger. For example, memorabilia from World War II could spark a story about the family’s victory garden. There’s no set formula for putting together a memory box. Anything that carries meaning for your loved one should work just fine. This article has a few ideas if you’re stuck: How to Make a Memory Box.
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Downsizing to Prepare for a Move to Assisted Living

Board care for elderly takes prep time.

Photo used under Creative Commons from Bunches and Bits.

The transition to assisted living is a challenging time. One task that will need to be completed is deciding what to do with the valuables and property you have accumulated over a lifetime. Unfortunately, moving to assisted living usually means less space, and you’ll have to sort out which belongings you’ll keep and which you’ll discard. The process will inevitably become emotional as you relive the memories your current home holds, all the while knowing that things are now changing. Below are some tips to keep in mind when going through this monumental task. 1. Remind yourself that change is inevitable. As hard as it may be, change is something we need to face. But you do have options in choosing how you react to it, and this can make all the difference. Focusing on the sorrow you feel may leave you stuck in sadness. Encourage yourself to see the opportunities and benefits of this transition. Getting rid of items can feel liberating and rewarding. There is the potential to meet new friends among those you’ll be living with now.  And by moving to the care of assisted living you may be able to look forward to better health in the supportive environment it offers. 2. Begin as early as possible. Going through an entire home is no small task. While this is completely manageable spread out over the course of several weeks, trying to do this all in a few days or even a week can be highly stressful and overwhelming. 3. Break the task down into small steps. Just as waiting until the last minute could prove to make this process unbearable, trying to take on the entire task at once could make your head spin. Going room by room will make your life a whole lot easier. Take things one drawer or one closet at a time if you need to. 4. Consider how life is changing when evaluating items. A new home and lifestyle means new needs, and many things that seem useful or valuable now may just be a burden in your next home. Will this item require maintenance or care that you no longer want or are able to provide? Are there size considerations to be made? Will there be space for this belonging in the new place? Will you ever use it? There’s only so much room for possessions, so make sure the ones you do bring serve a purpose, even if that purpose is simply to bring you joy or comfort (i.e., a family picture). Figuring out what to do with these objects once you have begun downsizing can also become an issue. You have several options here, including donating to charity, selling them in a yard or estate sale, or giving them away to a family member or friend. Sometimes it can be very satisfying to give your belongings as gifts to those who will find them meaningful. Donating to charity can also be just as fulfilling. Whatever you do, don’t fall into the trap of letting your attachment to objects overrule practicality. In the end, what we really need are the simple things: family and companions with which to share old memories and make new ones. Working to enjoy life and savor the moment can make things seem less important.      
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How the Option of Assisted Living Developed

How board care for elderly developed.Today, seniors enjoy a wide range of options to choose from when it comes to finding a place to spend their later years. Things haven’t always been this way. In fact, not too long ago, assisted living wasn’t even an option. Prior to the advent of these facilities, older people could only choose between staying at home under the care of a family member or a hired caregiver, or going to a nursing home. Going to a nursing home was not something one wanted to do, as it often meant forfeiting basic rights, such as the right to privacy. Many times, residents were not permitted to have locks on their doors and would have to share bathrooms. The institutionalized setting and communal bathing and showering areas created an environment all too reminiscent of some of the facilities used to care for the mentally ill. To make matters worse, nursing homes were gaining a reputation for being places where the elderly were frequently mistreated, neglected or even abused. Dr. Keren Brown Wilson, whose own mother lived in a nursing home, made it her life’s work to develop alternative means to care for the elderly. She was integral in the inception of the first assisted living facility, which would serve as a model for such facilities all across the country. One of Dr. Wilson’s major priorities when developing the assisted living model was to restore the privacy and dignity that were missing in the institutionalized settings of nursing homes. In addition to this, Dr. Wilson made sure that these facilities were adequately staffed with round-the-clock supervision and a more individualized level of care with one-on-one support. This prototype for a new and innovative way to provide care for the elderly drew attention from many other organizations that then helped turn assisted living into a viable alternative for older adults looking to make the transition to a living situation that provided more support. The need for supportive living accommodations for seniors is greater than ever, and fortunately, there are a variety of desirable arrangements available. Today’s seniors can choose from different types of assisted living facilities depending on the specific care they need, their budget, and lifestyle choices. Their options, rather than demeaning them at the end of their lives, can help make these years a golden time to enjoy the sunset of their days with few worries.
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