It Is important to plan for the what ifs when dementia is part of the equation. For my wife and me this was very important. One never knows when they or their loved-one might end up in the Emergency Room or in a hospital. Approximately one in three people living with dementia will be admitted to the ER or hospital every year. This establishes a basic tenet for the importance of being prepared for the what ifs. What if you or your loved-one ended up in the ER or hospital? What would you do if they told you at 4:00 PM one day that you or loved-one were being discharged? You would need to go to a Memory Care Center or a Long Term Care Community.
My life experiences have given me insights into the stage of life that I am now living. During my high school years, I worked at a men's clothing store and later during my high school years worked at a pharmacy. Later I worked at a funeral home in my hometown. My first year of pharmacy school, I did not have a place to live. The funeral director that I had been working for made arrangements for me to work at his friend's funeral home in Atlanta. I lived in the funeral home and made ambulance calls and death calls at night. In the daytime I went to pharmacy school. In my second quarter of pharmacy school, I moved into an apartment. In the afternoons and on the weekends, I would intern at a pharmacy in Decatur, Georgia. My second year of pharmacy, I transferred to the University of Georgia College of Pharmacy. Each weekend, I drove home to intern at a local pharmacy. It was here that I met my bride.
My pharmacy career consisted of retail, long term care, assisted living, terminal pain management, compounding, diabetes education, therapeutic shoes, therapeutic stockings, intravenous nutrition and other IV medications. For 15 years, I reviewed every patient's chart in the 750 nursing home beds that I serviced. My Mom had Alzheimer's and my Dad had vascular dementia. Nothing prepared me for my diagnosis of LBD. In the later years of my professional career, I was on the Executive Committee of the Georgia Pharmacy Association for five years. My fourth year, I was President. My fifth year, I was chairman of the Board of Directors. This gave me experiences of seeing what was taking place in the entire country in the arena of pharmacy.
These experiences prepared me for the what ifs of living with dementia. My wife and I have visited six Assisted Living and Memory Care Communities. We have ranked these largely on my life experiences, but also including my wife's feelings as well. It has been a TEAM effort. One community stood out to us. There is one that is a close second. This enables us to face the what ifs in an immediate situation of my needing to have additional care.
Before arriving to visit the community make sure you made an appointment. Tell them your reason for wanting to visit the community. Visiting the community does not mean that you or your loved-one is ready to live in the community. Even ask if you might have lunch with them that day. This will give you an idea of what type food service they have.
What are some things that we observed? First we looked at the physical setting of the community. Did it appear to be a safe environment? Then we looked at the appearance of the exterior from the parking lot to the front door. We looked at the back of the building. Does the building have a patio or area outside that is securely locked for you or your loved-one to go outside? Touring the entire interior of the building is essential.
We can gain knowledge from talking with the Administrator. What is his or her goals for the community? Does she actively watch what takes place within the community? What is her relationship with staff?
Setup a meeting with the Director of Nursing before your visit. Prepare questions that you would like to ask. Some questions that you might ask are as follows. Do they have different villages within the community? If so, what criteria is used for placement in one village versus another village? What type activities take place in each of the villages? What is the resident's
schedule? Do they have volunteers or staff who come in and interact with the residenta? Do they have volunteers or staff who come in and play games with the residents? Do they have volunteers or staff who come in and sing with the residents or play musical instruments for them? How much access does the community have to physicians, pharmacists or nurses? Is the resident permitted to go on trips? This is just a sampling. I am confident you will think of many more.
Lunch with the staff is important. You will be able to interact with them, and also see what type food they are serving. You will be able to observe the temperature of the food they are serving. Observe the dining hall while you are at the community. You will be able to see how the staff interacts with residents. How much assistance do they give them? Do they address food allergies, sensitivities and likes? Does the community have trained staff to provide food at odd hours?
Touring the facility, you will want to observe the cleanliness of the community. Talk with families that might be present. If it is a two story building, see if there is an elevator? What is the staff to resident ratio? What is the monthly cost? Are there possible additional costs that might be incurred under certain circumstances? What is their process with end of life? Are they able to provide pain management or other needs at the end of life?
Is there a game room? Is there a movie theater? Are the rooms private?
Do they have a hair salon? How many meals a day will be provided each day? How often are they given snacks and liquids throughout the day? How is your loved-one approached if they have an emotional outburst? How is it handled? Do they immediately call the physician and get some medication ordered, or do they look for ways to diffuse the situation? How will you be contacted if your loved one needs something? Do they have a NP or PA? I am confident that you will think of others.
Doing these things early can diminish the frustration and stress at a difficult time. Please private message me on Facebook with any other thoughts you might have. In a week or two, I will develop a document that can be used as a checklist with your visit. Also, I will provide for short notes.
Fight Like a Tiger --- Be LBD Strong
©July 3, 2016 Robert Bowles
Robert Bowles, Jr.