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Self-Counsel Press - Gillian Eades Telford

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120 pages

English

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Choose the right home to provide comfort and care
Make an informed choice for yourself or someone you love
Research shows that the most common questions asked when choosing a nursing home are “Where is the facility located?” and “How much does it cost?” Seldom are any other questions taken into consideration. Yet, for a major life decision, careful research should be undertaken to ensure that you find the best possible care and the most enjoyable environment for yourself or your loved one. Making the Right Move was written both for seniors considering moving to a care facility or for anyone who is considering housing options for someone he or she loves. This book takes you step-by-step through the process of evaluating different facilities and their staff. The author uses real-life examples she has gathered from her own experiences as a registered nurse to explain what goes on behind the scenes at nursing home and similar facilities. Packed with checklists of questions to ask and forms for evaluating the answers, Making the Right Move: Housing Options for Seniors is a valuable and practical guide to staying focussed while making what can be difficult decisions. It examines issues including:
How to rate a nursing home
Supportive housing options with care components
Questions to ask the director of care
Finding elder-friendly environments
How to effectively deal with complaints and problems
Acknowledgments viii
Introduction: Making an Informed Choice ix
About This Book ix
Who This Book Is For x
Underlying Principles xii
Language xiii
Aging in place xiii
Definition of health xiv
Client centeredness xiv
Conclusion xiv
Part One: Choosing the Care That Is Right for You 1
Chapter 1: Aging Successfully 3
Making the Choice to Age Successfully 5
Dealing with the Physical Effects of Aging 6
How to enhance your physical well-being 7
Dealing with the Mental Effects of Aging 9
How to enhance your mental well-being 9
Dealing with the Spiritual Effects of Aging 10
How to enhance your spiritual well-being 11
Chapter 2: The Health Care System 13
The Health Care System in the United States 14
The Health Care System in Canada 15
Supportive Health Care Services 20
Case management services 20
In-home support homemaker services 21
Residential care services 22
Shared supportive living services 22
Adult day-care programs 23
Special support services 23
How to Get in Touch with Health Care Services 32
Chapter 3: Assessment Levels 34
Personal Care 35
iii
Intermediate Care Level 1 36
Intermediate Care Level 2 36
Intermediate Care Level 3 (Special Care) 37
Extended Care 39
Special Care 40
The Care Plan 40
Chapter 4: Options for Living Independently 48
Supportive Housing 51
Retirement Villages or Communities 53
Congregate or Subsidized Senior Housing 54
Abbeyfield Housing 55
Home Sharing 57
Granny Flats/Accessory Dwelling Units (ADUs) 58
Smart Houses 58
Program of All-Inclusive Care for the Elderly (PACE) 59
Chapter 5: Supportive Housing Options with Care 60
Family Care/Adult Family Homes 61
Personal Care/Board and Group Homes 61
Assisted Living Facilities/Intermediate Care Homes 63
Skilled Nursing Facilities (US) 64
Special/Dementia Care Unit 64
Extended Care Facilities 66
Specialized Facilities 67
Subacute Care Facilities 67
Private Hospitals 68
Hospice 68
Multilevel Care Facilities/Continuing Care
Retirement Communities (CCRCs) 69
Part Two: Finding the Home That Is Right for You 71
Chapter 6: Getting Quality Care 73
Client-Centered Care 73
Elder-Friendly Environments 76
Accreditation in the United States 79
Accreditation in Canada 81
iv Making the Right Move: Housing Options for Seniors
Chapter 7: Who Will Be Caring for You 83
Administrator 83
Director of Care 84
Registered Nurses 84
Nurse Practitioners 85
Clinical Nurse Specialist 85
Resident Care Aides 86
Dietician 86
Cook 86
Maintenance Director 87
Receptionist 87
Physician 88
Pharmacist 88
Social Worker 88
Recreation Therapist 88
Other Staff 89
Chapter 8: Choosing a Nursing Home 95
How to Use the Questionnaires 96
Location 97
Outdoor Environment 98
Indoor Environment: The Facility 99
Indoor Environment: Individual Rooms 101
Care Aspects 102
Special Care Aspects 105
Questionnaire 1: Choosing a Nursing Home 107
How to Score 118
Chapter 9: How to Rate the Care 119
Accessibility, Type, and Cost of Rooms 119
External Environment 120
Internal Environment: Care Components 121
Meals 121
Physical care 122
Emotional care 123
Services, equipment, and programs 125
Policies 125
Procedures 128
Contents v
Staff policies 131
Questionnaire 2: Rating the Care 133
How to Score 151
Staff Ratios 151
How to Score and Rate the Questionnaires 151
Questionnaire 3: Staff Ratios 152
Chapter 10: How to Be Admitted to a Nursing Home 162
Determining Eligibility 163
Getting on the Wait List 164
Being Admitted 164
Making the Move 165
Settling In 166
Chapter 11: Legal Matters and Decisions 167
Who Will Make Decisions for You If You
Become Incapacitated? 168
Power of Attorney 169
Advance Directives for Health Care 169
Wills 170
Chapter 12: Making Complaints and Dealing with Abuse 172
How to Complain in a Nursing Home 176
Dealing with Elder Abuse 178
Physical abuse 179
Financial abuse 179
Psychological and emotional abuse 179
Sexual abuse 180
Medication abuse 181
Violation of civil and human rights 181
Use of Restraints in Nursing Homes 184
Least-Restraint Policy 185
Choices and Risk 186
Table 1: A Quick Guide to Levels of Care 41
Appendix: Resources 187

Sujets

Elderly care

Informations

Publié par	Self-Counsel Press
Date de parution	15 avril 2012
Nombre de lectures	0
EAN13	9781770407947
Langue	English

Informations légales : prix de location à la page 0,0025€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

Extrait

MAKING THE RIGHT MOVE:
Housing Options for Seniors
Gillian Eades Telford, RN , BSN , LTCAC, MES
Self-Counsel Press
(a division of)
International Self-Counsel Press Ltd.
USA Canada

Copyright © 2012

International Self-Counsel Press
All rights reserved.
Introduction: Making an Informed Choice

Today’s elders are more concerned than ever about the quality of care in nursing homes. Health Canada studies show that more than 80 percent of elders consider the availability of chronic, extended care, or nursing home beds for those who need them to be “very important.” Unfortunately, many people are forced to make the decision to move to a nursing home when they are in a crisis or are sick and cannot bear to cope any longer in their present setting. At times like these, moving becomes imperative, and a decision made quickly may be uninformed.

About This Book
Making the Right Move is designed to help you make good, informed choices about your health and the places where you will live. It will encourage and empower you to consider your options before you are in a crisis so that you are aware of all the factors that can affect this important decision.
Choosing a nursing home for yourself or a loved one is a major life decision. After all, you have decided to move after a lifetime of independent living where you have managed to cope on your own — often with increasing physical and mental chronic conditions. You now realize that you need some help with your day-to-day activities.
But having to leave your family home does not mean that you have not successfully aged. All it means is that you now need a little help. Part One of this book discusses how to cope with the physical, mental, and spiritual aspects of aging. It then explains how the health care system works in the United States and Canada and helps you determine what level of care you may need. Part One also introduces you to the many housing options that are available to elders, from congregate living to 24-hour specialized nursing care. Remember, a nursing home is only one example of supportive housing available to you.
Part Two is designed to help you choose a facility that will provide you with quality care suitable to your needs. Using questionnaires that allow you to assess and compare facilities, this section of the book examines the components of quality care and considers what to do when you feel you are not receiving the appropriate level of care.
As you visit potential facilities and work through the questionnaires, keep in mind that the place you choose will be your new home — and it should feel that way. You should feel comfortable both with the level of care you are receiving and with your surroundings. Choosing a new home can be stressful. You may feel pressures from your children, your friends, even the staff of the facilities you are visiting. Take your time and choose the solution that is best for you.

Who This Book Is For
Making the Right Move is written for the elder who is considering his or her own future care. However, in many cases, children, spouses, or other relatives either assist in making this choice or are forced to make an independent decision themselves, usually because of a crisis. This book will provide assistance and guidance to both families and elders, giving them specific questions to probe their health care system and helping them to make the best choice to everyone’s satisfaction.
Many elders who have partners are concerned about what will happen when one of them requires additional care. Although most nursing homes have accommodation for at least one couple, usually each elder in the couple has very different needs. For example, one spouse may need special nursing care at odd times of the day and night, and that may disturb his or her roommate. Unfortunately, nursing homes are not very adaptable to this kind of situation in their physical environment or in providing the different levels of care, although they are improving.
More and more multilevel homes are being built that allow couples to be housed in the same complex, if not in the same room or building. The most frequent scenario for couples is that one spouse will enter a nursing home while the other visits daily for long periods. The visiting spouse, or caregiver, still plays an important role as he or she does the extra little things that make life more comfortable for his or her spouse. One of the downsides to this arrangement, however, is that when couples are living as a pair, their pension may be adequate. But when separated, the pension does not cover two places of accommodation. This problem can motivate couples into incredible coping arrangements.
By 2010, 60 percent of people over age 50 will have a surviving parent, compared with only 16 percent in 1960. One of the fears of many elders is that their children will abandon them forever, placing them in a nursing home to die alone and uncared for. This fear along with failing health can make some elders cantankerous. They use all their resources, mental whiles, and emotional blackmail to try to persuade their families that they can live independently.
This emotional turmoil and underlying fear translates into guilt for their families. The process of deciding to place a family member in a nursing home is not easy, especially for the chief caregiver. The caregivers may feel a sense of failure and guilt that they cannot cope any longer. They may also experience a sense of loss because, in many cases, caring for that person has given their lives purpose and meaning. This is especially true of spouses. Many spouses will exhaust themselves to the point of illness rather than enlist formal help.
While families generally share the care of their beloved elders, the majority of the care giving usually falls on one person, most often the daughter or the daughter-in-law. The chief caregiver is the one who will bear the brunt of the emotional warfare that goes on before the decision is made to change housing arrangements.
To ease that tension, try to find out what the elder in your life wants in terms of living arrangements. If his or her expectations are not practical or realistic, then you may need to explain as gently as possible how difficult it is to spend quality time with him or her when you are also having to act as caregiver. Health care professionals advocate the concept of aging in place (see later in this chapter), but it is not possible if the family cannot accommodate the elder. The best plans work when an elder makes a decision in concert with his or her family.
By using this book as a reference to ensure you have made the best choice, you can help allay some of the guilt and frustration of placing someone you love in a nursing home, knowing you have done your best in their best interests.

Underlying Principles
This book is the result of my 25 years of practical experience in the field of elder care. As a gerontologist and previous director of care of a nursing home, I have worked with countless people to help them choose nursing homes and other supportive housing for themselves, their spouses, or their parents.
I have based my discussion on four major premises that are interwoven throughout the book, each of which is described in the following sections.

Language
The first premise is that language used to name people denotes values. The term “elders” refers to people over the age of 65, although the majority of elders in nursing homes are over the age of 85. I have used this term because it denotes an aura of respect and wisdom. It is the term used by aboriginal people for older adults, who are revered in their communities.
It is imperative that we show respect for elders. Infirmity and frailty are not reasons to treat people any differently from anyone else. Respect can be shown by the way people address each other, by the choices clients are given as well as in the general planning of all activities and the set-up of the environment.
Another term frequently used in the book is “client.” I have used this term instead of “consumer,” “patient,” “resident,” or “individual” because it connotes power. A client has the respect of service providers, and nursing homes provide a service of care as well as housing.

Aging in place
The second premise is that aging in place is a positive concept. When you age in place, you live in the same community (although not necessarily in the same residence) until you die. Most elders prefer to live and die at home, where they are surrounded by familiarity. In fact, 90 percent of today’s elders live independently in their community (i.e., in an apartment, condominium, townhouse, duplex, or free-standing house). They are able to do most things for themselves, although some care is provided by family members or friends (informal help) or paid home care workers (formal help).
Other elders may choose to live in a nursing home or other facility such as Abbeyfield housing or congregate care. If that facility is in a community with which they are familiar, they will also be aging in place.

Definition of health
The third premise is that a broad definition of health is being used. According to the World Health Organization, “health is the extent to which an individual or group is able, on one hand, to realize aspirations and safety needs; and on the other hand, to change or cope with the environment. Health is therefore seen as a resource for everyday living, not the object of living; it is a positive concept emphasizing social and personal resources as well as physical capacity.” In other words, he