Regrets and Things I am Thankful For

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America. I love You, but also think much of the rest of the world does this one thing better.

Taking care of our elderly.

I have traveled a bit and one takeaway that I have brought home is the stark difference with how we handle aging vs. how much of the rest of the world handles it. When I graduated from college, the last thing I wanted to do was live near my parents.  I was seeking adventure and independence. I got it.  As a result, I never really got to experience an adult relationship with my parents.

Yes, I would visit them, but I would only see them about twice a year.  That is 33 years of only seeing them twice a year.  That, my friends amounts to only 66 visits in 33 years.  That is pitiful and starkly different from how families are structured in much of the rest of the world.

Families stay close.  Parents live (often) in the same town and in some cultures, even in the same house with their kids.  By keeping this family structure, it helps out both the young and the old.  The young people have support as they raise their own families.  And the older people get help as they age and require it.  And the relationship has an opportunity to mature over that time into a friendship, leaving behind the parent/child relationship they once had.

Because I was so stubbornly independent, I moved halfway across the country, where I had my own family. My husband and I raised our kids, essentially on our own, as we had no family nearby. My kids were cheated out of real meaningful relationships with their grandparents and vis-a-versa. And I was cheated out of valuable support in raising my kids.  I had a double whammy because my mom passed away before I was even married, so I didn’t have any “mom” advice either.

Now, 33 years later, I move my dad out to be closer to me so I can help care for him as he ages. He came out here too late to enjoy his grandkids as they have flown the nest. His own kids are much closer geographically than ever before but because he can no longer travel, his sons are only able to visit sporadically. So now you have my regrets.

But what about the things I am thankful for?

I have spent every single day for the last year and a half with my father, for hours a day. In that time, even with his communication and dementia difficulties, I have come to really appreciate him and to love him even more deeply. Despite all of his challenges (and he has many), he has maintained his sense of humor, his kindness and his “go with the flow” personality. I have learned about resiliance and about the importance of patience and cooperation. In short, I have gotten to know him and see him through my adult eyes, something I didn’t have the opportunity to do before.  And for that I am grateful.

I plan to do things differently in my own future. I will watch closely where my kids land.  And, when the time is right (and while I can still enjoy them and their families), I will move closer to them.

Because at the end of the day, nothing matters as much as family.

6 Tips for Living to 90 With Grace & Humor

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Dad will turn 90 tomorrow. As I reflect on a life well-lived, I can honestly say that the way to live to the ripe old age of 90 boils down to these personality attributes. This is what my dad has taught me and more importantly has reinforced for me in the last year when I have been his caregiver.

  1. Don’t worry until you need to worry
  2. Most things pass, so obsessing on something will only cause unnecessary angst.
  3. Be content with where you are in life and look for the positive things about your current situation.
  4. Be grateful
  5. Always find things to laugh about
  6. Even though you are frustrated with your declining abilities, there is always a way to find humor even in frustration.

A prime example of #6.  My dad’s declining language abilities often will mean that he creates made-up words in lieu of the word he is trying to find. What comes out of his mouth can be truly funny. One way to look at that is to be sad and frustrated with his circumstance. What I have found with my dad is that if I can keep my demeanor positive, he reflects that back to me. So one day I suggested we create a Paul Light “dictionary” for all his made-up words.  He loved that idea and laughed at the thought. So every time comes up with a new word, I remind him that it will be going into  the “dictionary.” He laughs every time. (#6 on the list)

Where he is living, at Daylesford Crossing,  is generally a very positive environment.  The staff has picked up on this positivity and reflects it back to him regularly.  As a result, despite his declining abilities, he remains happy and positive (#3 on the list).

Although his cognitive state continues to decline and he has good days and bad days, occasionally he reaches out to me and instigates a hug, or says “I love you” or thanks me. It is on those rare occasions that I know everything I am doing for him has been worthwhile (#4 on the list).

And finally, my dad’s mantra throughout his life has always been “This, too, shall pass” which has meant that he really isn’t a worrier and he doesn’t get caught up in something unpleasant that is happening in the moment because he knows it is temporary. I think this has meant a much less stressful life overall. (#1 and #2 on the list).

Lessons learned.

10 tips for thriving longer

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SEVENTY FIVE PERCENT

That’s a big number.  That is how much control we each have to determine who we will live out our lives.  Will be be mired in chronic illnesses?  Will we be the man or woman bungee jumping on their 90th birthday?  The person getting their Ph.D at 85?  It turns out we have a lot of say in how our story ends.

Here are 10 tips on how to control your own destiny.

  1. Use it or lose it. It’s true that the more sedentary you become, the less you will be able to do the things you love to do because your muscles will atrophy, your brain will become apathetic….you get the message.  What your Grandma told you is actually backed by scientific evidence.
  2. Keep moving. In a 2008 National Health Survey, they discovered that 36 percent of adults were considered inactive.That’s ALL ADULTS.  If you focused that on just older adults, I suspect the number would rise. Being sedentary increases your risk dramatically for all kinds of chronic illness from heart disease to osteoporosis to decreased cognition.  Trust me, after spending hours with my dad in an assisted living center, you DON’T want to sign up for any of these. Unfortunately our society has segmented physical activity for us.  Now it is relegated to “going to the gym” or “exercise class.” Instead, it should be worked into the very fabric of our lives, just as it was for our ancestors.
  3. Challenge your brain. This doesn’t necessarily  mean going back to school, although that would be great.  It just means challenging yourself to learn something or do something new each day.  Walk a different way to the store than you usually do. Read.Try your hand at learning a new language. An interesting study conducted in Minnesota on Nuns showed that when they performed autopsies on their brains after death, they found all the typical anatomical things associated with Alzheimers. However, none of the Nuns showed any symptoms because they continued to stay active physically and mentally throughout their lives, thereby stalling the onset of those symptoms. You can control your destiny.
  4. Stay Connected. Our ancestors learned that they were better together than they were alone.  We are not human unless we are with others. This is why solitary confinement is probably the most extreme torture method used. Several scientific studies have proven that when we feel a part of a community, our bodies, at the cellular level, show positive gains.
  5. Lower your Risks. Of course if you are prone to heart disease and diabetes, as I am, because my mother had both, it is important to actively lower those risks.  For me, that meant keeping my weight in order, making sure I get plenty of exercise and I try to eat clean.  All of this helps minimize my risk.  Know your risks and be the Captain of your own health.
  6. Never Act Your Age. If you expect to be old, you will act old.  Enough said.  You are the  maestro of your life. You decide whether you are old.  I suggest to you that you are never truly “old.”  You may have to face physical challenges at some point – we all will age at some point physically.  But just like you did when you were young, you find “work around” solutions to keep going.  You don’t just accept that your better days are behind you.  You just don’t.
  7. Wherever you are, be in the moment.  It is so important to get out in nature.  To get off the electronics.  To focus all of your attention on your spouse, your grandkids, your kids. In today’s life, technology has caused our brains to run 24/7 and it’s not a healthy thing.  You don’t have to meditate, although that is one way to force yourself to be in the moment.  But it is truly healthy for you to take a walk on a beautiful day;  look at the fall color; focus on the breeze. Be where you are. When your mind is on the next thing, you are creating stress.  And we all know, stress is a killer.
  8. Keep children in your life. There is something magical about the connection we all have to children, whether they are your own or others.  They view their world through a prism of constant learning.  We were once like that.  To be around children offers you the wonderful opportunity to teach them and to also learn from them.  This stimulates your brain, can be physically demanding (keeping you physically active) an is just plain fun!
  9. Find purpose. This cannot be understated.  We are wired to live purposefully. As Albert Schweitzer said “I don’t know what your destiny will be, but one thing I know: the only ones among you who will be really happy are those who have sough and found a way to serve.” Think about how you might serve others.  This is the element that ties it all together.  If you are serving others, you will find yourself a part of a community, you will find yourself mentally challenged, you will be fully engrossed in this activity, which means you will be “in the moment” and it will help reduce your overall risks for chronic illness. And you’ll be helping others!  A Win-Win!
  10. Laugh often. It has been scientifically proven that laughter lowers the stress hormone cortisol.You can actually laugh yourself to better health. A study conducted at Boston University on Centenarians found over a 15 year study of those 100+ that they were able to handle stress much better, and to show more resilience if they laughed often. Laughter usually happens when you are with someone, so that fulfills tip #4.

GET TO WORK ON YOUR OWN LIFE!

Live Longer. Live Better.

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We really are in control of our destiny.

Daylesford Crossing, where my dad lives, had a visiting author, Dr. Richard Landry, MPH,  come and speak this evening.  There were a couple of notable takeaways that I’d like to share from his presentation:

  1. In our country, we spend 3-4% on preventable healthcare and the rest on the treatment of chronic diseases
  2. According to The MacArthur Foundation study on successful aging, 70% of the physical difference and 50% of the intellectual difference between those who age successfully and those who age by experiencing a slow decline lived out with chronic illness were due to lifestyle choices…Those who lead sedentary lives, don’t take care of themselves mentally, spiritually or otherwise will live nearly HALF of their lives with chronic illnesses – most of which can be either forestalled or prevented simply by making different choices in our lives.
  3. If you want to live longer and die shorter, you must live your life like the fall foliage we all appreciate:  as we age, we grow more beautiful individually and collectively with all the other trees, we become a stunning display.  And when our time arrives, we die just as the leaves fall from the tree.

Physically speaking we have evolved from hunters and gatherers.  They used their bodies.  They moved ALL THE TIME. On average they walked between 15,000 and 23,000 steps a day.  They had to always be thinking, innovating to stay one step ahead of their environment which was full of predators.  They found that they were more effective working as a community rather than individually. And they had no formal schooling, so the younger folks learned from the older folks and the older folks were held in high regard and had a purpose for their entire lives. This is how we lived for a very very long time.  It is only since the industrial revolution that we have dramatically veered away from this lifestyle.

We have invented all sorts of things to keep us from moving – cars, escalators, moving sidewalks, TV, etc.  Our society has become extremely youth focused, therefore marginalizing  a huge segment of the older population. As we age, we tend to become more isolated as friends die off, move and spouses die. And we start to buy in to the belief that our prime has passed.  All of these attitudes and societal norms have contributed to a huge rise in chronic disease.  Couple this with the fact that science has us all living longer and you have a tsunami on our hands.

In my next blog post I will write about some of the ways you can stem this tide and, at any age, live your life the way it was meant to be lived.  Age is just a number.  It’s how you internalize that and the choices you make that has the biggest difference in how you will age.

Stay tuned.

I Am The Bridge

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I am heartbroken when I see the elderly, particularly those who have been stricken with Dementia, Alzheimers or other memory impairment, alone, day after day. At the beginning, family visits often. They want to make sure they visit while the person can “still remember who they are.”  Once they start losing that ability, the visits slow down and the often are far and few between. For many elders, they receive no visitors.

I can totally see how it can happen, however.   I visit my dad daily, often for 2-4 hours. Trust me, it isn’t always that fun.  I have many, many other ways I could spend my days. In my dad’s case, his language is impaired, so for much of the time we “converse” but I have no idea what he is trying to communicate to me. So I improvise. I nod my head A LOT. I tell him I will check on “it.” What is “it?”  It could be anything that I perceive he is worried about.  Even if I have no idea what he is worried about, I do whatever I can to make sure HE ISN’T WORRIED.

I make sure he gets outside every day the weather cooperates. I get him out of his wheelchair and walk with him to make sure he is getting enough exercise. But mostly I sit with him and talk to him. It’s silly, really because we often end up having parallel conversations.  I tell him about what is new in my life (and believe me there isn’t much from day to day) and then he responds back with a sentence that doesn’t relate to anything we were talking about. It’s an interesting phenomenon to experience, believe me.  The worst is when he asks me a direct question and because I have no idea what he is asking me, I have to make something up that responds to his question just a little bit.  But really, who knows what he is asking me?

I talk to him about his parents. We talk about trips he took – things that he still has a grasp on. The other day, he told me that his dad was a pig farmer…that he bought and sold pigs. That was the first I had heard that. I only knew my Grandpa as the owner of Light Furniture in Denver CO.  I will be checking on this factoid as I am intrigued to find out if this could possibly have been true.

When people stop visiting because they think their loved one no longer knows them, they think, “what’s the point?”

HERE’S THE POINT

We are the bridge.  It is our  job to help him remember his life, even as it slips farther and farther out of reach. My dad is still very much in there, despite his language difficulties and his inability to remember anything for more than 10 minutes.

So, the next time you say “What’s the point?” Remember that YOU ARE HIS BRIDGE. Pick up the phone and call.  Visit. It matters.

5 Techniques for Caring for a Dementia Patient

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I have been caring for my dad for about 4 years, 3 of which were remotely and the last one locally. Like everyone dealing with caring for a parent or other loved one, there is no advance cramming you can do to prepare for this job – you wake up one day and suddenly you need to be an expert in all things elder-care. It is the ONLY job that doesn’t come with a manual and there are few resources to help you other than learning on the job.

I thought it might be helpful to share some of the techniques I have developed and learned over this time period. These work with my dad, and I hope that they might be useful to you.  Unfortunately, there are over 70 different types of dementias so your loved one’s situation may be different from my fathers, but all dementias have many crossovers, so it’s worth trying some of these techniques.  You have nothing to lose.

  1. Pay attention. Be observant. To everything. I missed so many red flags when he was deteriorating.  I was so concerned with pushing him into assisted living that I stupidly was relying on him (someone who I now know had the early stages of dementia) to tell me when he was ready.  If you aren’t there, every day, then make sure a neighbor is watching out for signs.  Some of the early signs that I DID KNOW about didn’t register to me as signs.  Here they are:
    • Losing the ability to “work” the remote control on the TV; or conversely, saying that his/her TV is broken. Again.
    • Difficulty doing tasks that were, before, second nature.  In my case, my dad could send emails, was on facebook and was pretty “with it” for a guy in his mid-80s. The day I spent one full hour with him on the phone trying to instruct him how to open a browser window, should have been more than a red flag; it should have been a rocket blast. But it wasn’t.  Because I didn’t know anything about dementia.  I thought it was simply, short-term memory impairment.  It is so much more.
    • Impaired judgment.  One day, my dad decided to reheat a slice of leftover pizza. So he put the tin-foil-wrapped slice right on top of the burner and turned the burner on. Can you spell F-I-R-E? Again, didn’t register as a red flag.
    • Word finding difficulties.  This comes with aging for all of us.  It doesn’t necessarily mean dementia, but it is a possible pre-curser.  So if you see signs of this, be even MORE tuned in for other signs.
    • Forgetting doctor appointments or to take medicine. My dad even forgot that he brought his walker to lunch.  After lunch, he went crazy looking for it in his room because he had literally no recollection of it every leaving his apartment.
  2. When you enter the room where your loved one is sitting, make sure you are directly in front of them and have made eye contact.  First offer your hand (even if you plan to hug them next). By offering your hand, you give them time to process who you are. Processing slows down with Dementia.  Their vision narrows and eventually becomes binocular so don’t come at him from the side as you may startle them.  The instinct to shake hands will never leave them and by extending your hand to them, they will take yours instinctively.  Then tell them who you are, even if you think they should know you. And make sure to tell them your relationship.  “Hi Uncle Paul, it’s Bev, your niece.”
  3. Always tell them what you are about to do or where you are going (if you move them). Their world is very scary right now.  They want advance notice of any changes. The fewer changes you can make, the more comfortable they are.  If you never take them from the facility where they are living, they won’t care, as long as their routine isn’t disrupted.  For them, routine means safety.
  4. If you are a healthcare provider and want to take their blood pressure or re-bandage a wound, make sure to tell them what you are going to do and why and then, most importantly, ASK THEIR PERMISSION TO DO SO.  They have so little control left; they want to retain control over their body.
  5. Try to focus your activities on things they can still do.  Music is a wonderful activity as it is retained in a part of the brain that is unaffected by Dementia.  Dance together.  Do karaoke. Play name that tune. Play catch with a beach ball or a football, even from a seated position.  Hand eye coordination seems to stay in place and it can be fun!
I will continue with more techniques in future blog posts, so check back.  And if you haven’t subscribed, please sign up so you’ll get the next blog post delivered to your email. And finally, if you have any techniques that have worked for you, PLEASE SHARE THEM WITH ME!  I am always learning on this job.

 

Trying to Out Run the Inevitable

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Lately, I have felt like I am trying to outrun a boulder rolling down the hill right towards me.  I am trying to outrun it, to keep just ahead of it, averting disaster.  This is the life of a caregiver, but it is particularly evident as time marches on.

In the past month, my father, who has a plethora of health issues, including Parkinsons, Dementia, Aphasia, cardiac problems, now has another couple more to add to his list: Bladder Cancer and another hip surgery because the last one didn’t heal properly. Yesterday I made the decision to go back in for corrective surgery to his hip in hopes that it alleviates the pain he has been in. Before I can take him into the hospital, though, I have to take him to the urologist so he can cauterize the tumor growing in his bladder.  We just found out that he had a tumor and since he isn’t a good candidate for surgery, we opted to cauterize it periodically to try to stay ahead of the cancer growth.  Once he goes in for his hip surgery and then on to rehab, Medicare’s rules don’t allow him to go outside for any doctor appointments, because once you leave skilled, they won’t let you back in without considering it a new episode (which would require another 3-night hospital stay). SO….to avoid that, we are going in to take care of the tumor and then HOPE that it won’t grow TOO FAST while he is receiving rehab because he won’t have another chance to see the urologist for 2 months.

We also have to get him in to see the Movement Disorder’s doc before he leaves for the hospital – he hasn’t been seen by him since last December.  Why? Because he unexpectedly fell and had to go in for hip surgery #1. Need to squeeze that in as well.

Hence the feeling of trying to out chase the boulder.

I am so angry about his hip.  Something to keep in mind if your loved one has to have hip surgery – particularly if they also have dementia.  Make sure you know ALL the details before you agree to anything.  I thought I had asked all the right questions.  When he fell last time, the doc said he would recommend the least invasive type of surgery, where they simply insert screws to help tighten up the fracture he had suffered (his was a non-displaced fracture).  I asked if the rehab would be easier because it was kind of laborious when he had his other hip done, although the outcome was excellent.  He said it usually was.

The VERY IMPORTANT PIECE OF INFORMATION HE DIDN’T SHARE WITH ME WAS that this type of surgery requires an individual to maintain a 50% weight bearing status for SIX WEEKS.  

Had he told me that, I would have told him that this won’t work with someone like my dad, who cannot remember anything.  As a result, the rehab was a disaster.  He was forced to be bedridden for 4 weeks (which is terrible for someone with Parkinsons, where exercise is truly an elixir) and then two weeks later, Medicare discharged him for failure to make progress. Nice, eh?  If the doc had shared that tiny piece of information, we wouldn’t be where we are today, going in for his THIRD hip replacement surgery.  No one should have to go through this, particularly an almost 90-year man. So the moral of this story is make sure you ask about the weight bearing restrictions, or for that matter, find out if there are any restrictions post surgery.  Then make the decision based on what you think your loved one can handle.

 

 

 

The Roller Coaster Ride of Emotions a Caregiver Feels

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If you are a caregiver providing support and care for a parent or loved one, then this blog post will confirm what you are already feeling.  I want you to know that you are not alone. If you are a sibling or a relative who is across the country and only checking in from time to time on your parent or loved one, let me give you an inside look at differences in your experiences to those of the direct caregiver.

As you know, I am the primary caregiver for my dad, who has Parkinsons’ and Dementia. Every day that I visit him, and it is EVERY day, I am mourning him. From the time I moved him near me after he fell last summer and fractured his pelvis and, I believe, hit his head, he effectively passed away for me. The father whom I spend time with each day, is not the father  I knew. Although from time to time he pops back in to show himself, for the most part, we don’t have many meaningful exchanges.  His language is completely compromised and I spent most of my time being his advocate and making sure he is getting proper and appropriate care. And I make sure to show him daily that I love him and will protect him.

That said, I mourn for my dad every single day.  It is an ongoing, dragged out sense of loss.  Very different than one feels typically upon the passing of a loved one where the grief is overwhelming and complete.  For me, it is a daily experience.  When the time comes that he does pass away, for me, it will be a celebration.  It will be a sense of relief.  I know that no one, unless you have experienced what it is like to care for someone – on the front lines – you may not understand this.  But it is real.  Very real.

Dementia and the Art of Improv

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Improv?  Yes.  Now that I am extremely experienced in the world of Dementia, I have observed how important the skill of improv is to my interactions with my dad.  A bit of background first…my dad not only has Parkinson’s Dementia but also has Aphasia, which is simply that the language center of his brain has been impacted.  He can no longer communicate in a way that makes any sense.

For instance, this sentence may come out of his mouth “It was really  interesting today.  The thistle came out of a grain and was car.”  Or, “did you see the biddle up the nickel?” Most of the time, I have no idea what he is trying to say to me.  But he clearly thinks he is communicating something and would like a response to either keep the conversation going or to answer his question.

The technique I have used is very much improv at its core, which is based on the concept of “Yes, and?”  Most of the time I answer with “really! Tell me more!”  And that gets him to continue talking.  I feel as if I can get him to continue to talk to me that is a win.  He feels as if he is expressing himself and occasionally I can decipher what he actually means, through context, and we can have a meaningful exchange.  Some days are better than others.  In fact, one day recently, it was as if he had an awakening of sorts.  He was making connections he hadn’t in awhile, remembering facts from the previous day, which is next to impossible for him typically and was able to talk on the phone with relatives fairly easily, again not typical. It was short lived, however, as it usually is, and the next day I was back to using my improv skills.

I am so lucky that my father has a pleasant personality, still smiles and laughs at himself and the staff where he lives generally enjoy him.  That, unfortunately, isn’t typical with Dementia.  I am hopeful that his personality will carry him through this terrible disease and that he will be smiling and laughing until the end

It has been awhile. Lots has happened.

relievedI haven’t posted in awhile.  There is a reason.  After moving my dad back into Sunrise of Paoli around Thanksgiving, it was a great deal of work getting him back into a groove…to a sense of normalcy after spending two months in skilled nursing, in two different rehab facilities. Honestly, I wonder sometimes if he has any clue where “home” really is.

After about 3 months at Sunrise, with no further broken bones, I made the decision to move my dad to a facility down the road from Sunrise, called Daylesford Crossing. This is where I had wanted him to move initially, but because he was out in Iowa and couldn’t be evaluated in person….and because he was coming off of an pelvic fracture, he was a “two person assist,” meaning he needed two people to help him with just about everything. They rejected him.

The one positive thing to come out of his time at Sunrise was he had a chance to fully heal following his pelvic, then hip fracture. He is actually more ambulatory now than he was when he moved in back in August. I took a chance and re-applied to Daylesford Crossing….and he was accepted!

When I toured Daylesford Crossing (particularly now that I had the experience of knowing what assisted living in a memory care unit really was like), the difference was palpable.  The vibe was calmer, quieter.  The staff was infinitely better trained. They had a multitude of ongoing activities for the residents, both in the memory unit itself and within the building (which the residents from the memory unit participated along with everyone else). The atmosphere was vibrant, alive, filled with people having fun.  It smelled nice. I know that’s a silly thing to mention, but Sunrise always smelled a bit like urine. I attributed it to the fact that there were 26 residents, all wearing depends. You should know, however, that it doesn’t have to smell. If it smells, it’s because the staff isn’t doing their job.

The move went smoothly and my dad transitioned to his new home with very little issues. It is a great relief, for me, to have him living in a place where I can reliably expect the staff to take care of him.  I never had the confidence that that was the case at Sunrise.

The internal communication was abysmal. At Daylesford, they use the latest technology throughout the building, using iPhones for all staff, so people are easy to reach and messages get shared easily. You have no idea what a difference that makes to my confidence level.  At Sunrise, I would make a request to one person and they never shared that request with anyone else! There are three shifts of staff!  I ended up doing most of the work which they should have been doing…Making sure he had fresh batteries in his hearing aids, that he was wearing them daily, that he had a handkerchief in his pocket, that he got up to exercise daily…these sorts of things. I wasn’t asking for the moon, but it seemed to feel like I was.

I cannot over emphasize the importance of choosing a facility based on the following very important criteria:

  1. How is the internal communication?  Exactly how does it happen? Do they use pagers? iPhones?  Can you text someone? How often is email checked? What are their systems really like?
  2. Is the facility run well?  Do they review care plans regularly and adjust? My dad NEVER had his care plan reviewed despite his improving condition.
  3. If your loved one is in memory care, how much overlap do the residents have with folks who do not have dementia?  It is important that they feel they are a part of a larger community for entertainment, parties, etc. At Sunrise, it seemed as if the two units operated independently from one another. As a result, my dad was isolated even further.
  4. Look at the other residents who live in the memory unit.  Are they at a similar stage of dementia as your loved one?  DO NOT place your loved one in a community where they are the least impaired. They will quickly sink to the level of who is around them. Look for a community where they will have people who are at a similar stage of the disease.
  5. Look at the percentage of women vs. men.  In many of these communities the population leans towards female. Not an issue on the surface, but it becomes an issue when most of the activities revolve around doing one’s hair and nails and crafts.  My dad was never interested.  Make sure there are activities that your loved one might enjoy. Also – make sure that the activities are MODIFIED for those who have dementia. If you see the list of activities and they include crossword puzzles, bingo and more traditional games you might find in senior living centers, just know that these are not going to work with someone with dementia.  They have to be MODIFIED. This requires that the staff have REAL training in dementia.  At Daylesford, all staff are trained in the methods of Teepa Snow, a well-respected dementia expert.  Who does the staff training? What kind of training is it? Dig under the covers a bit.
  6. Look at the size of the bathroom.  Look at the shower.  Is there a lip on the shower that requires someone to step over?  Better to not have that. It can become an issues as they decline. The size of the bathroom is critical for someone who uses a walker or wheelchair.  My dad’s bathroom at Sunrise was so small that it was a real chore getting him in position to sit on the toilet because there was never enough room for the walker.
  7. Come several times to visit, at different times of the day. Are the staff interacting with the residents or talking amongst themselves. This was a real issue at Sunrise.  Most of the time, staff was sitting around a big table chatting with other staff, while the residents watched TV, which, as it turned out, was the main activity in the memory unit at Sunrise.  Even though they posted other activities, often those activities were never done. If you see a place with the TV on all the time, that is not a good sign. Do they have lots of music?  Music is something that can be enjoyed by everyone, even those in the latter stages of dementia.
  8. If you notice people are spending a lot of time in their rooms alone, this is not a good sign.  People with dementia cannot safely be left in their room alone for long periods.  They no longer understand what is safe and what is not.  Often they can be quite impulsive, in fact.
  9. Find out if there is a dedicated med-tech for the memory unit.  This is important as you want it to be easy to find this person if your loved one’s medicine is late in arriving.  Because one of my dad’s medicines needed to be given on time, I spent many hours wandering through the floors of Sunrise looking for the med-tech and because they did not have technology to reach the staff quickly, I was often given this response when I asked where the med-tech was: “Oh…she just went downstairs, I think.”  It was then up to me to find her to haul her back to give my dad his medicine, which I was paying them to do.

I hope this helps you as you evaluate facilities and that you can learn from my mistakes. I am so happy that I found a facility that is well-run, my dad seems happy and most of all, I believe he is finally being well cared for. If you have any questions for me about what to look for or if you are worried about what you are seeing, please feel free to post in the comment section.  I am happy to help guide you, if I can.

Ciao!