5 Dangerous Eldercare MythsWritten by Phyllis Staff, Ph.D.
Myths associated with selecting quality nursing home care suggest quick and easy ways to identify quality care. In fact, relying on these myths can lead to disastrous results. I have identified a few of most common myths in hopes of helping you avoid some of problems commonly found in many nursing homes. 1. The Smell Test You've heard it repeatedly: "The best way to determine quality of care a nursing home provides is to be alert to bad odors when you visit home." It seldom, if ever, works. Why? Nursing home administrators have heard very same advice. As a result, they are particularly sensitive to unpleasant odors in any area that might receive visitors. Almost all will do their best to remove offensive odors as quickly as possible, even when it means avoiding their primary responsibility to their residents. 2. The Personal Recommendation Recently, I heard a guest on a radio talk show state that very best way to find great nursing home care is to get recommendations from a friend. Like other myths, there is a grain of truth here, but you must check whether your friend has had extensive interactions with nursing home recommended. Often that is not case. Last weekend I dealt with an emergency call from Jim, a friend who had placed his mother in a nursing home recommended by a friend. Although she was recuperating from a stroke, no nurse or aide checked on her condition for more than 14 hours. Jim discovered her in morning with many cuts and bruises, her bedsheets soaked in blood. He was astonished that anyone would recommend such a poor care facility. "My friend said her grandmother was in this particular nursing home," he reported. "So, I thought it would be good care." "How often does your friend visit her grandmother?" I asked him. "I didn't think to ask," he responded. "And did you check latest survey for that nursing home?" "No," he answered. "I thought a personal recommendation was all I needed." Jim's mother is now back in an area hospital. No one knows yet how much damage this experience caused to her recovery. 3. You Get What You Pay For Nowhere is this statement less applicable than in nursing home care. In fact, I'd replace it with another shibboleth -- "Buyer Beware." Our own research, encompassing more than 6000 nursing homes and more than 100 assisted living facilities shows no relationship between cost and quality of care. You may find quality care in an expensive facility, or you may not! Similarly, fact that a facility is low-cost does not indicate whether you'll get poor, average, or quality care. You have to do your homework. Relying on price as sole indicator of quality care can lead to disastrous results.
| | Five Ways to Manage Difficult EldersWritten by Phyllis Staff, Ph.D.
'You are old, Father William', young man said, 'And your hair has become very white; And yet you incessantly stand on your head -- Do you think, at your age, it is right?' Lewis Carroll (1865) My grandmother was original matriarch. When she barked "frog," only acceptable response was "how high?" She was hard to deal with in her last days, surprising no one. Not being brightest penny in family bag, I reacted emotionally to her complaints, judgments, and demands. Rather than leave immediately, I stood my ground, trying to defend my relatives and myself from her relentless attacks. As a result, we were not speaking when she died. Had I understood what I was facing, had I tried to put myself in her shoes, our story could have had a better ending. In hopes that your story will have a more satisfying ending, I offer a few of tricks for dealing with difficult elders I've learned since then. 1) Make a plan BEFORE a crisis The best way to deal with difficult parents is to avoid as many problems as possible by planning how you will handle them before they arise. Pick a time when ALL family members can meet in person or on a conference call to discuss what you will do when a family member needs help. Take focus off elderly Family members by fully including them in planning and making certain they have a role to play. Be sure to take notes! Share them with all family members to verify your family agreements. In difficult situations, you might want to ask family members to sign and return a copy of any agreement. Here are a few of issues you may want to address: Physical Location How will you help a family member when they live in another town? Can you be an effective long-distance caregiver, and, if so, how? If not, who will move, and when should that move happen? Roles Who will be responsible for what? Will you share expenses equally, or will you balance money versus time contributions? What will happen when there are disagreements? How will you handle changes in individual circumstances? How will you react to threats to health and safety? Differentiate preferences and requirements. If it's more than a preference that family members not live together, get it out on table before a crisis erupts. Document Planning Where will you store important documents such as Wills, Power of attorney, Insurance policies, and Deeds of trust. Who will have access to these documents? And under what circumstances? 2) Stretch your patience muscle Remember your excitement when you crossed threshold of adulthood? When you first got a driver's license? When you got your first job? When you found your first apartment and could decorate it all on your own? Then think about how you would feel if you had to give up adult privileges, one by one. What you're feeling now may closely approximate feelings of your difficult parent. But your elder's feelings cannot be imagined away. Your difficult parent may fear ˇBecoming invisible; ˇSeeing themselves as useless or stupid; ˇLosing their friends; ˇLosing physical abilities; ˇBecoming dependent. By imagining yourself in their place, you may react more sympathetically and suitably. 3) Forget "Parenting Your Parent" One of least helpful ideas in our current culture is notion that as your parents age, you become their parent. Stuff and Nonsense! You are NOT your parent's parent, nor will you ever be. Your role may be friend, confidant, caregiver, and supporter, but when you take role of parent, you diminish your elder by reducing them to position of child. No wonder they react negatively. Wouldn't you?
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