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Holding Family Meetings About Senior Care

Meetings can be very useful when a family is faced with a tough decision, like whether to move a parent to assisted living. They provide a chance for relatives to come together, pool their knowledge, and discuss various options and strategies. It can be tough even to make the decision to hold such a meeting. The most important family members may not all live close together, so location is a challenge. People’s schedules are packed and some may be reluctant to add one more thing to the calendar. Sometimes it’s assumed that other relatives don’t want to get together. However, it never hurts to ask. Due to the serious nature of the decision, people may be more inclined to be cooperative. And if their lives are heavily affected by caring for mom or dad, they will be interested in solutions that will improve the situation. It is important to include the affected senior, even if it means overcoming challenges presented by physical or mental disability or resistance to facing the need for care. There are several reasons why you may feel this is inappropriate, but making sure your loved one is included in the process is vital to making any solution work. They deserve the respect of knowing that they have say in decisions affecting their life, and you can’t find a solution for them unless you have their own opinion on what their needs are. You may be surprised to learn how they see the issue. This does not mean that the solution mom or dad would choose on their own is necessarily the best one and that they have final say, but you do need to take into account their concerns. Consider including any paid caregivers or others who provide household services. The cleaning lady who comes in on Fridays may have noticed something you haven’t. Also consider bringing in the senior’s friends and neighbors. A social worker or for families where religion is important, a spiritual advisor, may also be helpful. Try to plan the meeting at a time when it’s easier for far-flung family to travel, perhaps during the holidays. When planning the agenda, make sure everyone will get a chance to speak so that they can make their case for what is important to them, and be sure to devote significant time to what the senior has to say themselves. Have everyone in the group review the agenda in advance. Also choose people to take on different tasks: someone who can be a neutral facilitator, someone to take notes, someone to keep time. Plan to hold the meeting in a place that will comfortable and have food and beverages available. Try to choose somewhere that allows a layout where everyone can make eye contact with one another. Tension exists in any family, even those where the members are close and get along well. It’s a normal part of life. Bringing everyone together at once will cause these problems to rise to the surface. Keep conflict to a minimum by focusing everyone on finding solutions for the future, not on rehashing past grief. Remind everyone that there will be no perfect solution and there will have to be compromise in some form. You won’t be able to fix everything then and there. The point is to gather perspectives and come up with practical answers. When you’ve finished the meeting, send the notes to people who were interested but unable to attend, and follow up on whatever course of action was agreed upon. Even if you decide that assisted living is not the right choice now, in time your parent is very likely to need help. Make plans to have them visit facilities you are considering and prepare for an eventual move. It never hurts to have alternate solutions available for when they might be needed. The one thing you can always count on is change.
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The Challenge of Eating Well for Seniors

One of the hardest things for seniors living on their own is having meals that are both nutritious and enjoyable. Cooking for one person is tough enough when you’re young and energetic, but when everyday tasks are more difficult and you move more slowly, it’s that much more difficult. Some seniors can’t get out to the grocery store to even get food to begin with. Especially when it comes to men and others who may not have done much cooking earlier in their lives, making your own meals can seem like an impossible task. In these situations, seniors tend to go for what’s quick and easy, not what would be the most ideal choice from a health standpoint. In addition, seniors living by themselves eat alone much of the time. Having dinner with only the TV for company can be pretty lonely. Even if the senior lives with family, how often in busy homes with kids does everyone come together to share a meal? Despite the living situation the end result may be the same: a microwave dinner in front of the evening news while children stay late to deal with work responsibilities and grandchildren attend basketball practice or reherse for the school play. This scenario may make the senior feel even more cast aside. To be fair, some seniors are still excellent cooks and can fend for themselves. But the chances are good that sooner or later, food will become an issue. When it does, it can contribute to making a senior’s delicate health even worse. Poor nuturition makes people more likely to get sick, can exacerbate conditions like Alzheimer’s and dementia, and can lead to depression. Those who are concerned about their older loved ones should not wait for the senior to ask for help, as sometimes they will fear the loss of their independence and hide problems. Watch for clues like excessive weight loss or a refrigerator with barren shelves or expired food. Consider whether getting to the grocery store is a challenge: does the senior have trouble getting outside his or her home? You also may want to ask if he or she is having problems with swallowing or chewing or if they’re experiencing a loss of appetite. This is one area in which assisted living can make a big difference in a senior’s life. Assisted living residents do not have to worry about cooking for themselves. They get to have regular mealtimes within a community and experience the comfort of gathering together with people they know. A good assisted living facility will make sure the senior gets the proper diet for his or her specific health issues. We all feel happier when eating well and enjoying good company. Attention to this area can be a huge boost in a senior’s quality of life.
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Choosing Assisted Living for Those with Alzheimer’s or Dementia

Some assisted living facilities are specially equipped to work with dementia and Alzheimer’s patients. This means that the environment is designed to be friendlier to residents with these conditions and that staff has been trained to meet their specific needs. How do you know if a facility that claims to specialize in these conditions is really right for your loved one? The only way is to visit. You’ll want to start by looking at our checklist of things to consider when visiting an assisted living facility, but you should also be alert for how the facility performs in each of the following categories. Environment Alzheimer’s and dementia patients are aided by routine and can easily become over-stimulated. The environment should be calm and peaceful, and the daily schedule should be consistent. Another sign that the facility is friendly to Alzheimer’s and dementia patients is cues that enable them to get around and complete tasks on their own, such as personal mementos that make it easy to identify a resident’s room and color-coded guides to common areas. Safety Facilities that cater to Alzheimer’s and dementia patients should have motion detectors or other monitoring systems to alert staff when there might be a problem, such as a resident wandering off. There should be systems in place to insure residents get the right medicine at the right time. Also pay attention to how disruptive behavior and outbursts are handled. The staff should not be using physical restraints or sedation. Staffing First and foremost, the staff should have the compassion to make your loved one feel comfortable. Ask about their training and experience, and consider how many staff members work each shift. Make sure there is adequate staff on weekends and holidays. The facility should also seem to be a pleasant place to both live and work. What does management do to prevent staff burnout? If staff turnover is high, this can be disorienting to residents. Quality of Care How much information does the staff request about your loved one, and is that information then used to design a detailed care plan? Are they taking comfort and psychological well-being into account in addition to health and safety? How many of the residents have dementia or Alzheimer’s? Ask what the staff does differently for these patients. Policies One of the most important things to note is how the facility handles the progression of the disease. How is it decided when additional care is necessary, and to what extent is family involved? Find out what happens when a resident needs to go to the hospital. Will his or her place in the community be reserved, and what are the fees in this situation? In general, what additional costs does the facility charge for care of dementia or Alzheimer’s patients? Watching for how a facility performs on the above categories can help you find a place that is truly suited to your loved one’s needs, and not just marketing a specialization that they don’t really have. Your loved one deserves quality care.
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Evaluating an Assisted Living Facility

Your selection of an assisted living facility should involve both tours of the places you are considering and extensive conversations with those running the facility. Comparing different facilities to one another can seem overwhelming. Use the checklist of questions below to help you notice important details that can reveal the true quality of a facility and aid you in the selection process. Note that if you are evaluating assisted living facilities on behalf of a loved one, you should try to involve them in the process and get as much of a sense of their desires as possible. He or she is the one who will actually be living in the facility, and his or her comfort, happiness, and satisfaction is the most important outcome. In General
  • What is your gut feeling about the assisted living facility both at the beginning and end of your visit?
  • Do the current residents seem happy and satisfied?
  • If you are able to talk with residents or their families about their experience, what do they say?
  • What do you learn when you research reviews and other information about the facility online?
Environment
  • Is the facility clean and free of odors?
  • Is the temperature appropriate?
  • Does the environment feel attractive and comfortable?
  • How many units are in the facility?
  • Does the assisted living facility offer private or shared rooms, or a mix?
  • What common areas are available?
  • Will any features of the community pose a problem for your condition?
  • Are the rooms large enough to meet your needs comfortably?
  • What are residents allowed to bring with them when they move in?
  • What are residents allowed or not allowed to do within their own rooms?
Nature and Quality of Care and Services
  • Does each resident have a written care plan? How often is it reviewed and revised?
  • Who is involved when assessing the resident’s needs? How much say does the resident have?
  • How does the assisted living facility adapt as the resident’s needs change?
  • What services does the facility offer and how often are they provided?
  • Is staff available to assist the residents 24 hour per day?
  • Are special care units available, for example for dementia patients?
  • How often are meals served, what times, and where?
  • How much variety is there in the menu?
  • Does the kitchen accommodate special needs and requests?
Safety
  • Is the facility well lit and does it have clear signage?
  • Are there call buttons in the rooms?
  • Are there safety locks on the windows and doors?
  • Are there handrails in the bathrooms and elsewhere in the facility?
  • Is the carpet firm to assist with walking, and are there non-slip materials on the floor?
  • Is there an emergency generator or another plan in place for power outages?
  • What do the assisted living facility’s fire safety and security systems consist of?
  • What is the plan if a resident wanders off?
  • What is the plan for a resident’s medical emergency?
  • What is the hiring process for new employees? Is there a background check?
  • What are the policies about elder abuse and neglect?
Community
  • Would you or your loved one get along with the assisted living facility’s current residents?
  • How does the staff treat you?
  • How does the staff interact with the current residents? Do they seem to have a good relationship with them and know their names?
  • How do staff members treat each other?
  • Are residents chatting with one another during meals?
  • What organized activities are on the schedule? What activities do you notice taking place? Are they well-attended?
  • Are residents encouraged to attend activities?
  • How much interaction do residents have with the outside community?
Fees and Policies
  • Are you allowed to examine a contract? Does it clearly lay out all services, fees, and policies?
  • How much is the entrance fee and security deposit? Is the deposit refundable?
  • What is the monthly fee?
  • Is long-term care insurance accepted?
  • How does the assisted living facility bill for services?
  • What is the policy on late payments?
  • How are rate increases handled?
  • What if the resident runs out of money?
  • What are the rules for when residents must leave the facility? What are the most common reasons why residents leave?
  • How are refunds and transfers handled?
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