New Term for Senior Care: A Wonderful Concept

As I walk this life journey, I give thanks for the directions I move into and through bringing enlightenment and possibilities to others.

Here's a site I've found about a way of life for Seniors I didn't know about and as with so much in life, depends on "stumbling over". It's about "The Green House Project"

It's wonderful to discover there's someone else out there who's been able to use their time, talent and has the finances to positively provide for Seniors who deserve and need to be valued and honored for all the days of their lives and for what they have given to all of us.

Click though and check out this amazing concept and movement:

Move Over Nursing Homes....There's Something Different  

YOU CAN HAVE A POSITIVE INFLUENCE. Speak up. Speak out. Tell your friends and family about what you read. The good and the not so good. 

Start the Serving Our Seniors Movement by speaking out, writing, spreading the word.

The concept of the Shahbaz -- someone who actually, truly cares about their life's work; caring for Seniors.  Read this interesting story about the Legend of Shahbaz:

The Green House Project:  Proven Tools, Resources & Partnerships
  The Legend of Schabaz   Adapted from What Are Old People For? How Elders Will Save the World by William H. Thomas, M.D. Reprinted by permission of VanderWyk & Burnham, Acton Mass. Copyright 2004 by William H. Thomas.

LEFT BEHIND: Loss of Talent, Ability and Mentoring

Baby Boomers Unite!  Let’s demand, as we did when we started the “revolution” more rights, more inclusions and more recognition as we go forward into needing the support of society.

What has happened to us? We were so vocal about issues and causes. 

We still raise our voices and many of us are actively involved in change, but as a whole, our voices are much quieter and raised more singularly than when we were in our teens and twenties.

There are, of course, exceptions and their aging faces and graying hair are visible (ladies tend to cover that feature more than men although those products have greatly grown in popularity with the "graying" of America) and seen even on LinkedIn.

What's needed is to ensure that when our bodies become more limited through the passage of time, when we are more limited to where we can go and even where we can live, society doesn't see this as "the end" and treat us as though we barely exist.

Long ago we realized people can work from home, they can commute across time and place and work far into decades that were previously considered "mandated retirement".

The tools we have and the opportunities we're given result in what we can and will do.

It's no different for the aging and the aged than it is for our youth.

I admit, I wasn't a picketer and didn't carry signs or write messages and distribute them when I was younger (that came along much later in life). I was more of a conformist working behind the scenes for change in society.

Let's get our communities and the Senior Centers and Senior Organizations to recognize our talents, abilities and contributions still viable and vital to society and to ensure this message is delivered and distributed to all ages and stages of life.

Let's "reactivate" and find our voices and raise them for our brothers and sisters, some of whom are our age and others who are from the generations before us. 

We have precious abilities only time can teach and experience can "hone" -- yes, we're like a great tool and like that tool, keeping us "sharp" and "in repair" benefits our habitat, our surroundings, life itself.

LET'S NOT GO QUIETLY INTO THE NIGHT.

This means:  Please realize many of us are NOT INTO Bingo, board games or puzzles. If you're going to offer computer technology, recognize there are many of us far ahead of the "beginner" or even "familiar and interested in learning more" stages. 

We want to learn specific programs to create and to stimulate; our brains need the exercise and expansion and not to just duplicate what we've known and done for years on end or have no interest in learning or participating in.

We need mind stimulation. We are, after all, the first largest demongraphic group where college education became "the norm" for a large percentage of high school graduates. 

Our generation was in high school when man landed on the moon. We had parents who were scientists and teachers and other professionals who steered us on paths involving science, math, engineering, business. And even if they only graduated from eighth grade, they had open minds, loved to learn and were our examples of dedication and perseverance.

We Did Overcome -- to some degree:

We were told men were wanted in various positions but it was our generation that fought and won and got that high heeled foot and body into the doors -- sometimes later than others -- of major corporations and into the C Suite.

The Pill changed our lives. Our focuses on growing ourselves as well as our families and supporting our husband and his job changed society as a whole. And he didn't have to worry about so many mouths to feed as his father before him; but then he didn't need those hands, either, to work the land or help to feed the family.

We were born into a world of "separate but equal" and we opened the doors and windows for future generations to walk through and see through.

WAKE UP AMERICA:  You wait for us to come to you. You offer us centers with “activities” ranging from Bingo to cards and maybe some “dancing” – which for many of us is a turn away because we lost our spouse and don’t feel like joining the “stag line” as we did in our teens waiting and hoping for someone to ask us to dance.

You plan all activities during the day as though we have nothing to do with our time and that’s the only time we can or will attend. And, what about weekends?

I guess you see "other groups" as occupying our time: church, grandchildren and family, educational opportunities through a myriad of places: library, local colleges and even on line. All obtainable by reaching out, taking that first step and, quite honestly, wanting to stay within a basic "safety zone".

And then there are those of us like so many I've met in these last few weeks who are "still working" because where we worked and for whom we worked didn't provide a pension, didn't have "retirement programs" or who have found life circumstances of medical or other debt from the huge economic challenges we've faced every decade since the 1970's have eaten away and basically destroyed "our golden years".

What's puzzling is how we manage to compete, to stand resolute and to continue to make our own way when:

• You “put us out to pasture” long before we’re ready and long before we want.
• You categorize us as not being capable of learning, adjusting, being tech saavy; we can run rings around you given the exposure and the disposable income of those younger and we do when we have those abilities.

Why? Because we have the experience, a higher level of judgment and a knowledge beyond many, those of us who have successfully weathered storms and made decisions others face and “hope and pray” no one will realize they are making a decision based on trial and error.

CHARACTERIZATION.  Focus on the weaknesses and that's what you see. 

Yes, there are those in the 50+ range -- that's the range "Senior" organizations like AARP and OASIS start at, or the 60+ which encompasses the State Run Senior Centers, who are vibrant, active, many still working full time jobs and even more in part time and highly responsible volunteer positions. There are those with limitations -- but not always the limitations the most vocal in our society want us to believe and see a specific, and only one specific, way.

LIMITATIONS.  Society starts culling around the age of 40 now. 

What's concerning is my daughter's generation, the Millennials, are having such difficulty getting jobs that by the time they're just getting to be "ripe" and "seasoned" in the outside world, it will be their time to be "put out to pasture".

Guess we should be glad we're in the United States and not in Spain where the outlook for the Millenial generation is even bleaker at 55% of the population of this age group unemployed.

SCARY!  If the young are unemployed and underemployed what does this say for the future and for the "next" generation coming up the ladder?

The Whole Person Needs Primary Care

When someone you care for or about has medical challenges, you wish there was more you could do.

We visit, call, write and often feel our hands are tied as we wait.

Some of us serve as direct caregivers and walk alongside wondering where we're headed and when we'll get there. The same questions we always ask when we embark on a journey and don't know the distance or the path.

The closer the person is to us, the more challenging our vigil is.

What's needed is insight and overview from more than a "medical" perspective. Training, experience and knowledge can provide insight and possibilities but it's the individual that will determine the outcome.

What's missing or what's not seen is often where the person is and how to come alongside.

Medications and treatments are aids; finding ways to bring quality of life to illness is as important as bringing quality of life to everyday life only with adjustments.

Understand that this time is special. It will not come again in the same way. 

To be beside this person is a gift only you can provide.

Vigilance is part of keeping vigil. 
Watching the person and watching all that surrounds them.

There can be some who come alongside, who proport to bring assistance, relief, comfort bringing instead their own needs and wants above all else.

Remember, too, the person you serve is there beneath the challenge, inside the difficulties and wanting out as much as you want them to be.

Measure the road ahead with a ruler and the road traveled with a yardstick.

Weigh the hour in ounces and the days shared in tons.

Simply be there. Simply let them know you are there. 

Listen to what others say with kindness but listen to the person who's being talked about through their life and their time with you.

Lives aren't written in stone until they become epitaphs. Change can always happen.

See the flicker of light in deepest darkness;know tomorrow will surely follow today.

Above all, know the person who you keep vigil over values what you do.

The Numbers Game: Facility Approved Dr’s Have Captive Audience

How many Dr’s does your loved one’s facility have listed as “approved” to practice inside their location?  

What's the population, the average occupancy and usage of this number of doctors per month and per year?

Facilities must retain records; should know which Dr sees what patient. If using the computer at minimal functioning ability this information should be easy to access.

How many Dr’s are currently accepting “new” patients in case your loved one decides they or their representative are not satisfied with the medical care being provided?

We wanted to change. We couldn't get a “current” list; the Director of the Facility didn't have one and neither did the Nurse Administrator, the only RN required by the State of Missouri. 

It took three weeks. Why? Good question. First we were given a “couple” of names: one no longer worked for the facility and one was not taking new patients. Next “offering” produced two names not accepting new patients. Finally received ONE NAME possible; new Dr accepted by facility.

Do you have the full information on the Doctor who attends you as resident/the person you’re responsible for in a Long Term Care Facility?

Is this information available in the room of the resident posted on the back of the bathroom door or some other “safe” but visible place for those needing to know? At the Nurse’s Station or on the computer?

And, above all, have you checked to make sure your resident’s records are current? When we once checked ours, the facility had “failed” to update and still listed the old Dr on Mom’s personal record.

Yes, it is important to “follow behind” and ask for an updated printout of the main sheet of your loved one’s general file, the one they send with the resident when they leave for an outside Dr apt or ER or other medical appointment/transfer.

Do you have a complete list of all Dr’s currently accepting new patients at your/your loved one’s facility?

A list dated and including name, type of Dr (MD or DO), specialization(s), office(s) location, name of practice, office telephone number, exchange number, emergency number.

You should not be dependent on a facility to provide this information or make it available to you or your representative when you can “meet with” or “get through to” the person or persons with the “authority” to distribute this information. This was the case in Mom’s facility. And it changed. We never knew who did what, who was responsible for what and who to ask for what. 

Another entry; another time. Understanding the “politics” and “titles” at Long Term Care/Nursing Faciliites.

Critically Important Take Aways from this blog entry:

You are giving up rights currently held by individuals outside of Senior Long Term Care/Nursing Facilities TO CHOOSE YOUR OWN DOCTOR when you do not have this information. You should not have to ask for this information; it should be readily available to all residents and their representatives. See below re computer accessibility.

This is, in my belief, against the rights of people with disabilities to treat them differently from others, to NOT provide the ways and means for those who cannot be transferred or for personal/medical reasons are incapable of being transferred, to a Doctor outside of a Long Term Care/Nursing Facility -- current and accurate contact information on an individual basis, placed directly in the hands and at the immediate reference of residents and their representatives for all medical personnel, Dr’s, approved to practice at a facility.

SOAPBOX TIME:  Let’s have it put online! The list of Doctors affiliated with each LTC/Nursing Home facilitiy.

TRANSPARENCY. SUNSHINE LAW. AVAILABLE TO ALL CONSIDERING A FACILITY.

Shouldn’t you have the ability to check out the Dr’s practicing at a facility as easily as you can check out a Dr “on the outside” through the many on site resources to see their medical records, malpractice suits, etc. etc.?

You and your loved one are making a substantial financial and time commitment. You’re entrusting your LIFE to their medical personnel, their Dr’s. Even if you have an outside Dr, you may still “employ” the facility Dr.

AND THAT’S THE KEY, dear blog readers, YOU ARE THE CONSUMER. You have rights!

CONCERNS YOU SHOULD BE VOICING TO YOUR DHSS AND LEGISLATORS:

• Long Term Care/Nursing Facilities have taken away the Dr/Patient relationship by coming between the two and relaying all requests and concerns without including the patient or the patient’s legal representative directly with the Doctor.

• Most facilities do not have scheduled days/dates/times for Dr’s to visit. They come when they want to. The facility isn’t on a system of “rounds” and they are not truly “on call”.

• Representatives of residents appointed or with Durable Power of Atty for Healthcare should have the ability to find out when the Dr will be visiting the resident. There should be appointments for the DHSS mandated visit interims (if there is such a thing; must check).

• Residents and their representatives deserve medical updates especially test results provided directly to them following receipt of results. If a second test is usual, this step should not be excluded and all responsible parties should be advised of this procedure when the first test is done and the results when the second test is completed and results received by the facility.

BTW, if your resident misses a Dr’s “visit” to the facility, they wait until the Dr “comes again”. How can this happen? If the resident isn’t “on the floor” the Dr may not include them in their “rounds”. They have no responsibility to ensure the resident is located to ensure they are seen “this time”. Unfortunately, this is now some diagnosis are not made, some minor problems become major issues.

My second son thought that a Dr on call at his Grandmother’s facility meant if she or a resident became very sick that Dr on call would make a personal visit to the facility. NO, meant he/she could be reached by telephone for consultation by the facility.

WE ARE IN THE COMPUTER AGE.

• Facilities have websites if they’re any type of business wanting to stay in business.
• There should be resident/representative specific information available on Permission Level pages

Facility Deaths Seldom Investigated

When a baby, for no apparent reason, dies in their crib, we mourn.

When a Senior dies in a facility, we simply say it was "their time" and go on.

How many autopsies are performed on Seniors who pass while living in a Long Term Care/Nursing Home facility?

As usual, another question and my fingers begin searching for an answer.

A question brought about thinking back to our not being told about several of Mom's falls, about the real extent of her injuries and about the real reason the fall happened.

Not being told about many of Mom's illnesses until they were so advanced and the "medical facility", the Long Term Care/Nursing Home, was unable through the services they "chose" to provide, could not control progress that was controllable and we had to once again, RUSH Mom via ambulance to the ER.

I see medical incompetence, negligence or abuse. 

But then, I'm just a family member.

And, because of the horrible journey we were forced to go through with Mom preceding her death and during her final journey, her final days.

Once again, what I find is not only shocking but information we never see unless we happen to "run across it" in our busy lives. 

Yet, every day we're entrusting our loved ones to facilities, signing contracts, making commitments. 

Many walk away totally entrusting the life and death of those we care deeply about to people who are continuously hiding inappropriate behaviors and actions.

Here's my resource of the day:  http://www.propublica.org/article/gone-without-a-case-suspicious-elder-deaths-rarely-investigated

"An array of systemic flaws has led to case after case being overlooked:

When treating physicians report that a death is natural, coroners and medical examiners almost never investigate. But doctors often get it wrong. 

In one 2008 study, nearly half the doctors surveyed failed to identify the correct cause of death for an elderly patient with a brain injury caused by a fall.

In most states, doctors can fill out a death certificate without ever seeing the body. 

That explains how a Pennsylvania physician said her 83-year-old patient had died of natural causes when, in fact, he'd been beaten to death by an aide. 

The doctor never saw the 16-inch bruise that covered the man's left side.

Autopsies of seniors have become increasingly rare even as the population age 65 or older has grown. 

Between 1972 and 2007, a government analysis found, the share of U.S. autopsies performed on seniors dropped from 37 percent to 17 percent."

So what difference does it make, cause of death?

Look back to Point #1 -- cause was brain injury from a fall.”

But elderly people fall all the time, right?

Not all elderly people and not all falls are inevitable.

However, a fall in a facility reported as a cause of death would lead to another State investigation and that would be a "double inconvenience".

It might also prevent the neglect provided by low staffing, inept training and poor supervision.

Point #2: "In most states, doctors can fill out a death certificate without ever seeing the body."

Makes sense, they prescribe medications by phone on request from LPN's and often these are medications with serious side effects that are NOT fully explained to the resident and/or the responsible representative.

Mom's Dr didn't see her as she lay dying. We called upset because Mom was not being given any food or water. 

The facility had seen Mom as "dying" so they simply didn't provide any and provided absolutely no consultation or advice to us as to how or what to do including taking a damp cloth and wetting her lips. NOTHING.  

The Dr didn’t bother to “drop by” just to check on one of her patients? THIS IS LONG TERM “CARE”?  MEDICAL CARE?

Two days we went through this. On the third day, she finally passed. We have no idea how long she had not had food or water and if this could possibly have been the "cause of death".

We do know she looked dehydrated and as though she'd lost considerable weight.

When you're "run through the wringer" as we had been for so long, you function as best you can. 

You try to think and reason and act at the highest level but you ENTRUSTED your loved one TO THIS MEDICAL FACILITY and surely they will act, will provide, will ensure medical services are provided.

Once again I feel guilt. Did I do the right thing? 

Was she actually dying? 

Or was it what we did, what we went through with her the way we did that brought about her life's end before its time? 

We mourn the child because of the life that never was. 

We mourn the Senior because of the life that ended in ways that should not have been.