by Tyra Phipps, Ed.D. (tyra.phipps@gmail.com)

Dag Hjalmar-Second Secretary-General of the UN

On June 21, 2015, Mr. Dave Berry wrote, “Your last post emphasized the issue I’m dealing with now:  The Reality of Aging.  This past week I competed in the Blair County Senior Olympics softball throw event in the 65-69 age group.  When I first decided to start training for this event last winter, I was recalling my halcyon college days, when I could throw a softball the length of a football field, to the amazement of my fellow gym class participants at Lycoming College.

At age 68, I fancied my arm strength still capable of throwing around 200 or so feet on the day of the competition.  Ha!  I threw 110 feet and the winning toss was 145 feet.  Bitter reality. 

I ran the Boston Marathon at 58.  Now, a decade later, a number of physical issues have humbled me.  My mind has been writing checks that my body can't cash.  The shock of aging is something for which we all must be prepared.  Wisdom is supposed to come with age, but to quote Clint Eastwood in Dirty Harry, ‘A man’s got to know his limitations.’  I’m getting to know mine.

I have no right to complain, in light of your (and your fellow residents') situation.  That’s for sure.  However, the shock of aging is something for which we all must be prepared.

Incompetence is everywhere.  Maybe those of us who are obsessive about conducting our lives expect too much from everyone else, but when oblivion to duty invades the ALF, disaster follows shortly.  There’s a big, dangerous difference between a store clerk who can't calculate the right amount of change to give you and a nursing aide who forgot a critical patient caution. Actions have consequences.”

Ms. Jan Bond also wrote on June 21, 2015.  She observed, “I also fear that my time of being fully mobile is coming to an end.  I have a myriad of medical issues, but I am lucky to have a wonderful man who would do anything for me.  I think we can only take care of each other in this world.  Those who are paid to assist in nursing homes, from what I’ve found, have no desire to be there.  They just need a paycheck.  There are a few exceptions to that I’m sure, but I haven’t met too many of them.”

A third response from Mr. David Cravey came in on June 30, 2015.  He disclosed, “Another topic that my friend, Dean and I have been discussing, is the proper medication in the facilities memory units.  If his mother is given enough medicine to keep her calm, she is in a lethargic state and not communicating with her son or daughter.  When they try to dial the dosage back, she becomes agitated and fights with imaginary strangers at night often winding up in the ER at 3:00 a.m.  It gives my friend a lot of guilt.  Pray that we don't live to reach this stage of life.  I do not want to place this guilt upon my children.”  Mr. Cravey is a trained hospice worker and has been working in long-term care for more than twenty years.

Mr. Steven Hatcher recently published the book, Safe in the Storm:  The Grace of God In the Midst of Cancer.  He was interviewed on the NPR program, Growing Bolder which aired on July 12, 2015.  This young, accomplished attorney, found himself diagnosed with an incurable form of cancer.  His book describes the journey of chemotherapy and radiation.  In his discussion during the interview he talked at great length about the people in his life and his relationship with God.  The interesting point that he made about his medical journey was his willingness to go back to the hospital in central Florida at any time.  The reason was the people who worked there.  He said he never met anyone who did not care!

Turning points in life occur at any age without regard to gender, ethnic origin, or status.  Is there a way to prepare for what lies ahead?  Whether disease, accidents, or the inevitability of aging, what can be done to ensure a greater measure of control?  Does it begin with attitude?

Mr. Doug Hassell (Dag Hjalmar Agne Carl Hammarskjöld) in the picture above right was the second Secretary-General of the United Nations (Dag Hammarskjöld Library - ‎Dag Hammarskjöld Foundation).  He died in a plane crash while traveling to cease-fire negotiations in September, 1961.  He was a Swedish diplomat, economist and author, and also won the Nobel Prize posthumously.  Despite his untimely death at age 47, he is best known for the quote,

“For all that has been, Thank you.  For all that is yet to come, Yes! 

Questions for Consideration:

1.  Nursing Homes Abuse Advocates understands the pain and the anguish of placing a loved one in a nursing home setting.  As much as dignity and respect should be a part of the treatment for anyone residing in long-term care, the recommendation from NHAA is make sure there are frequent visits to oversee the well-being and safety of a loved one (Abuse Advocate Blog.  May 14, 2015).  How can a family member be there to watch over the loved one day and night?

2.  As Mr. Hatcher stated in the NPR interview mentioned above, he was more than willing to go back to the hospital for his cancer treatment because everyone there cared.  Is there a way to find a long-term care facility with people who actually care?  It takes work.  At Goodwill Retirement Community (GRC), more than 70 women have been in training classes for nursing aide positions in assisted living.  Since June, 2012, only one woman has stayed longer than a year.  A caring environment does not exist with that kind of turnover.  Find out what the turnover rates are and talk to the nursing aides.  Get an idea about whether or not the members of the staff really care for the residents.

3.  A lack of care may not be the only problem at the lower-level in any long-term care facility.  As of June 2015, Rest Assured which is a long-term care facility outside of Meyersdale, Pennsylvania, made the change to a complete lockdown.  According to Ms. Margaret Durst, who was a nursing aide at the facility stated in March of 2015, that the total number of residents dwindled to 22.  For some shifts, only a resident assistant was on the floor and no nurses were present.  There were residents with various problems living at the facility when it suddenly changed to accommodate Alzheimer’s patients only.  What happened?  Extremely poor management caused the facility to change radically.  The management of this facility is Brooke Grove Foundation.  When investigating any long-term care facility, make sure it is able to provide continual care of a loved one.  The goal is to avoid a stressful relocation because the ownership of a facility decided to serve a population with specific needs.

4.  It May, 2015, Ms. Karen Markel Houser wrote that her parents lived at the Goodwill Retirement Community in the 1970s.  She had high praises for the good food, the care of her parents, and the facility where she believed her parents had the best of care.  What happened?  Management changed.  Mr. Kevin Miller, CEO, is in charge and has been for many years.  The facility has grown, but staff  remains at the minimum number in assisted living.  Skilled nursing has to meet the state requirements for staffing, but that is hardly enough given the fact that residents have complained about bad food for decades.  Nursing aides make suggestions for residents to have a garden, or other activities that are more interesting than balloon tennis, yet nothing changes.  Food complaints are rampant, yet the same food has been served for more than three years.  Management may be in place at a facility for a long time, but is there any real care?

5.  Make use of Facebook or Google to learn everything possible about the management, the members of the staff, and the physicians.  The generations that grew up with the Internet are now in med school and have made great use of what they can find to help them make decisions.  Investigate the physicians affiliated with a long-term care facility.  Read the reviews about them.  Are they on Facebook talking about their lifestyle or habits?  Have other people commented about those physicians who will be caring for your loved one?  Dr. Baker was interviewed on Sound Medicine and talked about the medical dilemma of ethics and googling patients (NPR, March 29, 2015).  However, is it a good idea to Google any physician that may be taking care of your loved one?  Even professional medical societies have been encouraged to update their guidelines and allow for looking up a patient online according to Dr. Baker, Associate Professor at Penn State Medical Center.  Why not utilize Google or Facebook and get all the information about a physician affiliated with long-term care in advance of placing your loved one in the facility?

6.  Learn more from online sources about Medicare guidelines.  Ms. Katie Kight spoke of her 94-year-old mother-in-law, who kept asking for a bigger pair of shoes back in June, 2011.  Her mother-in-law was in assisted living in South Cumberland, Maryland.  Ms. Kight explained that there was no wearing of the heels or soles of the shoes, but noticed that her mother-in-law kept trying to push on her feet.  What was the problem?  It turned out that her mother-in-law wanted a bigger size shoes because her toenails had not been cut.  In fact, the toenails had grown so long that they curved around and pierced the skin of the toes.  Medicare will only pay for the podiatrist visit every three months.  If a patient misses an appointment for whatever reason, it may be six months or longer before toenails are cut.  There are many hygiene issues such as nail care that need attention, yet oftentimes are overlooked by the nursing staff.  Members of the family must ask questions and look over their loved one to be sure of proper care.

 


July, 2015