Autumn View Gardens in St. Louis will be hosting a lecture on Caregiving on 7/22/10 from 6:30pm to 8:30pm.

Autumn View Gardens in St. Louis will be hosting a lecture on Caregiving on 7/22/10 from 6:30pm to 8:30pm.

Autumn View Gardens is a beautiful assisted-living community located on Schuetz Road in Creve Coeur, a suburb of St. Louis, MO. They have a total of 90 private apartments, including companion suites, with a choice among six apartment styles. All apartments feature private bedrooms, kitchenettes, individual thermostats, large closets, and balconies or patios. Apartments range from 300 to 600 square feet.

Have a kind and respectful day.

Long Term Care Ombudsman of St. Louis will be hosting a presentation on empowering Caregivers to Make Better Decisions on July 22, 2010

Long Term Care Ombudsman of St. Louis will be hosting a presentation on empowering Caregivers to Make Better Decisions on July 22, 2010 from 10am to 12pm.

The Long Term Care Ombudsman Program of Saint Louis (LTCOP), a United Way agency, is part of a nationwide program which began in 1971 in response to public outcry over abuse and neglect in long-term nursing home facilities. Since its inception there are now over 500 Ombudsman Programs across the United States. LTCOP is the area’s most comprehensive resource that serves residents of licensed long-term care nursing homes and their families.

The St. Louis Long-Term Care Ombudsman Program is comprised of professional and specially trained staff and volunteer ombudsman who are assigned to long term care nursing home facilities weekly, getting to know residents and providing advocacy, support, and education about their rights. When requested, ombudsmen act as a voice for resident treatment and care. Ombudsmen can help mediate resolution of grievances and disputes, make referrals and monitor the referrals to see that the problems are resolved. Ombudsman listen to nursing home residents concerns and complaints and work to educate residents about their rights while working with families and facility staff in resolving care and treatment plan issues.

Their mission is “To preserve the quality of life for long-term care residents by empowering residents and their families through education, advocacy and support.”

Have a kind and respectful day.

Putting The Human Back Into Nursing Homes

KindEthics Newsletter November 30, 2009
Sign up on the lower right side of KindEthics.com

Quote:

The great secret that all old people share is that you really haven’t changed in seventy or eighty years. Your body changes, but you don’t change at all. And that, of course, causes great confusion. Doris Lessing

Putting The Human Back Into Nursing Homes:

One day when I was visiting my aunt at the skilled nursing facility, the woman that shared her room was complaining to the nurses aide that she was tired and she wanted to put on her nightgown and go to bed. The aide told her that she couldn’t go to bed, because it wasn’t allowed until after dinner. I remember at the time thinking how strange this was. Why couldn’t this woman go to bed? If she was tired, why couldn’t she take a nap? My dad took naps, I take naps and lots of other people take naps. I realize looking back that what this woman wanted/needed didn’t fit in with the schedule of the nursing staff or the institution. When did the needs of the staff become more important than the needs of the resident? When did the nursing home staff become the boss of the resident? When did the residents lose their right to having their basic needs and decision making power taken away from them?

(This bothers me a lot as I am writing this. I can imagine the day when I am living in a long term care facility and someone won’t let me nap. I love to nap and can’t imagine that this would be taken away from me just because I am old. But it isn’t just about the nap, this is about our human need to be listened to and to be respected while we receive the care we need.)

I have been reading The Erosion of Autonomy in Long-Term Care written by Charles W. Lidz, Lynn Fischer and Robert M. Arnold. This book takes a look at the history of long term care facilities and where we are today. As you can tell by the title, the right of the patient to be heard in these facilities is slipping away.

The authors write that what once was a home-based environment to serve the needy in our small communities, has morphed into a hospital-like institution where the rules dominate the humanity. The residents who “behave” and are “compliant” are good and those who want something that isn’t on today’s schedule are “bad”.

This makes me wonder if the people we store in nursing homes are as impaired when they get admitted or if the institution itself, takes away their voice and their interest in life. (I know I just said store in nursing homes. Perhaps that is too harsh a word, but have you visited a nursing facility lately? Have you seen what kind of life these people are living? If you haven’t, I would suggest that you visit your local care facility.) Another concern I have is the growing number of people being abandoned by their families in nursing homes. There are laws against abandoning your pet, but we allow people to be disposed of and forgotten in these institutions. Something has to change and it has to change soon.

Now I am not saying that people are being mistreated in care facilities, (of course a few are and that is why we have ombudsman to protect them), but what I am saying is that it is no kind of life for the residents at most of these places. But this doesn’t mean it can’t be improved and that some people know how to get it right. I recently talked with a woman who raved about the place where her mom was staying. Her mom had been admitted to one facility and when it became evident that it wasn’t a good place, she took the time to find a better place for her mother. Advocacy and effort matter when it comes to our loved ones.

So, here are some organizations that are helping to get it right.

The Pioneer Network http://www.pioneernetwork.net/
The GreenHouseProject Homes http://www.ncbcapitalimpact.org/default.aspx?id=148
The Eden Alternative http://www.edenalt.org/
National Consumer Voice for Quality Long Term Care http://nccnhr.org/

There are four states receiving financial incentives from Medicare to change the culture of nursing homes. Arizona, Mississippi, New York and Wisconsin. If these incentives work, then these programs will be spread to other states.

The Nursing Reform Act is also working to promote and mandate the changing of nursing facilities from institutions into a more home-like environment. Where people can live without hearing bells and alarms going off or being told when they are tired. Where people can get up when they want to, eat when they are hungry and be treated as an individual. You can download information about the Nursing Home Reform Act at http://www.resource4nursinghomeabuse.com/images/pdf/nursing_home_reform_act.pdf

I think if I was granted one wish, this is what I would wish for. That long term care facilities could become home-like and that people wouldn’t be abandoned in them. I don’t have the answers but I do know that others do. If you are interested in being part of the change, volunteer at your local nursing home. Connect with one of the organizations that are making a difference. And if you are a healthcare professional, make sure you visit the facilities you are recommending to your patients. Don’t take someone’s word for it that it is a nice place, go there yourself. See what is being served for dinner and sit and watch what is happening. You will be surprised by what you see.

Have a kind and respectful day.

Choosing a Nursing Home – A checklist

Visit Nursing Home Compare at www.medicare.gov/NHCompare for more information. This list can be found at http://www.medicare.gov/LongTermCare/Static/StepsOverview.asp

Name of Nursing Home:
Date of Visit:

Basic Information – Answer Yes or No

The nursing home is Medicare-certified.
The nursing home is Medicaid-certified.
The nursing home has the level of care you need (e.g. skilled, custodial), and a bed is available.
The nursing home has special services if needed in a separate unit (e.g. dementia, ventilator, or
rehabilitation), and a bed is available.
The nursing home is located close enough for friends and family to visit.

Resident Appearance

Residents are clean, appropriately dressed for the season or time of day, and well-groomed.

Nursing Home Living Spaces

The nursing home is free from overwhelming unpleasant odors.
The nursing home appears clean and well-kept.
The temperature in the nursing home is comfortable for residents.
The nursing home has good lighting.
Noise levels in the dining room and other common areas are comfortable.
Smoking isn’t allowed or may be restricted to certain areas of the nursing home.
Furnishings are sturdy, yet comfortable and attractive.

Staff

The relationship between the staff and the residents appears to be warm, polite,
and respectful.
All staff wear name tags.
Staff knock on the door before entering a resident’s room and refer to residents by name.
The nursing home offers a training and continuing education program for all staff.
The nursing home does background checks on all staff.
The guide on your tour knows the residents by name and is recognized by them.
There are licensed nursing staff 24 hours a day, including a Registered Nurse (RN) present at
least 8 hours per day, 7 days a week.
The same team of nurses and Certified Nursing Assistants (CNAs) work with the same resident
4 to 5 days per week.
CNAs work with a reasonable number of residents.
CNAs are involved in care planning meetings.
There is a full-time social worker on staff.
There is a licensed doctor on staff who is there daily and can be reached at all times.
The nursing home’s management team (including the Director of Nursing and the
Administrator) has worked together for at least 1 year.

Residents’ Rooms

Residents may have personal belongings and/or furniture in their rooms.
Each resident has storage space (closet and drawers) in his or her room.
Each resident has a window in his or her bedroom.
Residents have access to a personal telephone and television.
Residents have a choice of roommates.
Water pitchers can be reached by residents.
There are policies and procedures to protect residents’ possessions.
Hallway, Stairs, Lounges, and Bathrooms and Exits are clearly marked.
There are quiet areas where residents can visit with friends and family.
The nursing home has smoke detectors and sprinklers.
All common areas, resident rooms, and doorways are designed for wheelchair use.
There are handrails in the hallways and grab bars in the bathrooms.

Menus and Food

Residents have a choice of food items at each meal. (Ask if your favorite foods are served.)
Nutritious snacks are available upon request.
Staff help residents eat and drink at mealtimes if help is needed.

Activities

Residents, including those who are unable to leave their rooms, may choose to take part in a
variety of activities.
The nursing home has outdoor areas for resident use and staff help residents go outside.
The nursing home has an active volunteer program.

Safety and Care

The nursing home has an emergency evacuation plan and holds regular fire drills (bed-bound
residents included).
Residents get preventive care, like a yearly flu shot, to help keep them healthy.
Residents may still see their personal doctors.
The nursing home has an arrangement with a nearby hospital for emergencies.
Care plan meetings are held with residents and family members at times that are convenient
whenever possible.
The nursing home has corrected all deficiencies (failure to meet one or more Federal or state
requirements) on its last state inspection report.

This is just the beginning. Make sure you plan on visiting at different times of the day and night to make sure that this is the place you would want your loved one to live. And after the person moves in, make sure you keep visiting at random times so the staff knows you are watching out for your loved one.

Have a kind and respectful day.

“Changing your Nursing Home Culture and Environment.” Part 2 of Interview with Frances Shani Parker, author of “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes” on July 31st, 12pm PST.

Changing your Nursing Home Culture and Environment.” Part 2 of Interview with Frances Shani Parker, author of “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes” on July 31st, 12pm PST.

Call in to listen live at (347) 945-5152 or listen online at blogtalkradio.com/kindethics. To listen to Part 1: http://tinyurl.com/rdsf58

An award-winning writer, consultant, and former school principal, Frances shares insights and experiences about her years of hospice volunteering in Detroit nursing homes. Using stories, poems, and general information, she has written a groundbreaking book that is an inclusive and literal guide for becoming dead the right way. Topics include hospice, caregiving, dementia, death, bereavement, and strategies for improving eldercare and nursing homes. While universal perspectives are presented, the often missing views of people of color and residents in urban nursing homes are examined.

Frances’ background as an educator and her upbringing in New Orleans, LA add interesting layers to her problem solving in nursing homes and to her descriptive storytelling. She uses her writing and public speaking skills to advocate for senior citizens and promote conversations empowering others to have dignified death journeys. Her favorite anonymous quote is “If you think one person can’t make a difference, you haven’t been to bed with a mosquito.” Visit Frances in cyberspace at www.francesshaniparker.com and at her blog titled “Hospice and Nursing Homes http://hospiceandnursinghomes.blogspot.com

Video Poem: Reflections of a Hospice Volunteer (Hospice, Nursing Homes, Eldercare) 3:25 mins.

http://www.youtube.com/watch?v=LeBl5QtlPxg

Video Poem: “Pieces of Our Minds” (Dementia, Alzheimer’s Disease, Hospice, Nursing Homes) 2:24 mins.

http://www.youtube.com/watch?v=LgRoKDUEOUk

(Search under FrancesShaniParker on youtube.com.)

Have a kind and respectful day.

Ombudsman Program cut dramatically in California. With these cuts, you need to be more proactive about protecting your loved ones in nursing homes.

I don’t know if you know about a service that is provided free of charge to our nursing home residents. It is something called an ombudsman. (I have used the services of the Ventura County Ombudsman program when my aunt was in a nursing home.) The ombudsman is a specially trained person who protects the resident from being forced to sign something they don’t understand, protects them from elder abuse and protects them when they are receiving sub-standard care. I will be interviewing Molly Davies from the Los Angeles County Ombudsman Program, The WISE & Healthy Aging Long-Term Care Ombudsman Program, in August but I just wanted to let people in the Los Angeles area know about the effects of the budget cuts today. The office is down to 10 people who are protecting the 73,000 nursing home residents in Los Angeles County nursing homes. If you have a loved one in a nursing home in California, you need to be even more diligent about visiting and checking on your loved ones for the rest of this year. Hopefully, next years budget will better but for now, we all have to take on the role of the protector for our loved ones. Here is the statement from the Los Angeles County office.

Long-Term Care Ombudsman Program
Impact of the Governor’s Budget Reduction

The impact of the enacted 49% State budget cut to the local Long-Term Care Ombudsman Program (LTCOP) in California is devastating to the integrity of the services that are delivered and will negatively impact the residents that we serve. The WISE & Healthy Aging Long-Term Care Ombudsman Program is the sole contractor of Ombudsman Services in the City and the County of Los Angeles. The impact to this local program has been the loss of $1,109,783 in funding retroactive to July 1, 2008. In response we have eliminated 22 positions resulting in the reduction of staff from 32 to 10, and we have closed our Lancaster, Downtown LA, Burbank, and San Dimas regional offices. All remaining staff received a reduction in salary.

The following are conservative projected estimates of the reduction of our capability to deliver service to residents in long-term care.

Over 12,000 unannounced visits to nursing homes and board and care or assisted living facilities will not be conducted during this fiscal year, and every year thereafter.

Over 11,500 cases, including allegations of abuse and neglect will not be investigated during this fiscal year, and every year thereafter.

The LTCOP in California has three currently unfunded mandates that include the investigation of elder and dependant adult abuse investigations that occur in long-term care settings; the witnessing of advance health care directives for residents in skilled nursing facilities; and responding to the 24-hour State Ombudsman after-hours crisis line. Although these are unfunded mandates, we have managed to take on these tasks with out further compensation from the State of California, but may not be able to sustain these activities without restoration of our funding.

In the last fiscal year the WISE & Healthy Aging Ombudsman Program responded to 2,086 abuse complaints. Many elder abuse cases are identified during unannounced visits conducted by Ombudsmen, which will decrease proportionally with these enacted budget cuts.

The WISE & Healthy Aging Long-Term Care Ombudsman Program is the largest in the nation providing service to more than 1,816 facilities that have the capacity to care for 73,486 residents. The Ombudsman Program advocates for the rights of residents in long-term care facilities, and for many residents we are the only outside support they receive. The impact of these cuts effectively silences the voices of our most vulnerable constituents, residents in long-term care.

You may want to support the pending legislation AB 394 (Feuer and Jones) Protecting Vulnerable Seniors from Abuse and Neglect by Restoring Ombudsman Funding
AB 392 would use penalties paid by substandard nursing homes to help restore monitoring and advocacy by ombudsman programs. It is fitting that the penalty funds be used to support the ombudsman programs given their critical role in protecting residents’ health and safety.
Current law allows the penalty funds to be appropriated for ombudsman services. AB 392 would require that at least half of the penalty funds be allocated to local ombudsman programs each year in accordance with an existing formula.
Support AB 392 is co-sponsored by CANHR and the following organizations: AARP, Bet Tzedek Legal Services, California Alliance for Retired Americans, California Association of Area Agencies on Aging, California Senior Legislature, California Commission on Aging, Catholic Charities of California, Congress of California Seniors, and Ombudsman & HICAP Services of Northern California. Additionally, it is supported by local ombudsman programs and many other consumer organizations.

You may want to write or call your state senators.

Want More Information?
Use www.leginfo.ca.gov to find contact information for your Senator • and Assembly Member
and to keep track of AB 392’s progress.
• Visit CANHR’s website (www.canhr.org) for updates on all of CANHR’s legislation and to find
out how to become a CANHR Advocate.
• Call CANHR @ (800) 474-1116.

Have a kind and respectful day.

On Monday, May 11th at 2PM PST, blogtalkradio.com/kindethics, I will be interviewing Frances Shani Parker, author of “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

On Monday, May 11th at 2PM PST, blogtalkradio.com/kindethics, I will be interviewing Frances Shani Parker, author of “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

She is an award-winning writer, consultant, and former school principal, Frances shares insights and experiences about her years of hospice volunteering in Detroit nursing homes. Using stories, poems, and general information, she has written a groundbreaking book that is an inclusive and literal guide for becoming dead the right way. Topics include hospice, caregiving, dementia, death, bereavement, and strategies for improving eldercare and nursing homes. While universal perspectives are presented, the often missing views of people of color and residents in urban nursing homes are examined.

Frances’ background as an educator and her upbringing in New Orleans, LA add interesting layers to her problem solving in nursing homes and to her descriptive storytelling. She uses her writing and public speaking skills to advocate for senior citizens and promote conversations empowering others to have dignified death journeys. Her favorite anonymous quote is “If you think one person can’t make a difference, you haven’t been to bed with a mosquito.” Visit Frances in cyberspace at www.francesshaniparker.com and at her blog titled “Hospice and Nursing Homes Blog.”

She welcomes your questions and calls. You can call in to listen or to ask questions at (347) 945-5152.

Have a kind and respectful day.