Friday, February 6, 2015

Molding and Shaping Long Term Care Residents

Children Learn What They Live  -- Dorothy Law Nolte

This poem originally appeared in Reader's Digest back in the early 1970's. The copyright says 1972. We were married a few years and had our first child, a son, in August, 1971. 

As with many young mothers, I was focused on being a "great parent" and although Dr Spock wasn't who I wanted to follow like my Mom's generation did, I eagerly sought the advice of many "new" child rearing authorities. 

This poem spoke to me and continues to contain a message that's timeless and applies to human relationships at all ages and stages of life.

Seniors reflect the world around them just as children do. 

Administrators and Staff at Senior Living Facilities would do well to follow these guidelines about how you speak and what you do with children reflecting in who they become..

Seniors have long established habits and expectations, tolerances and intolerances.

Seniors enter facilities from either living by themselves or with others and have developed specific behaviours and attitudes. 

Many of these are not seen as conducive to "facility operations" and often financially costly.

Seniors have RIGHTS and the DHSS and States proclaim these rights and even mandate their being posted.

As with all RIGHTS, the writing and the posting do not ensure the practice.

Facilities cannot afford the guidelines handed down by the DHSS and the Federal Legislative Authorities on Individualized Care -- or so they'll tell you.

To change the person into a more "acceptable resident" and less "costly" to the facility, a"reconditioning" occurs.

The "older" and "more experienced" staff, especially if there's a Nurse Manager, or floor nurse in charge, who "sets the tone" and "sets the pace".

Residents "learn" as do children in schools, at camps, in organizations, what behaviors are allowed, tolerated, supported and rejected. 

ONLY they are in a 24 hour, 7 day a week, 12 months a year environment.  They're not "going home". No one is coming to get them and take them out of this environment.

Seniors lives are totally dependent on the people who run the facility, make the rules and provide the services.  

They are incarcerated. They are often hopeless. Those ads you see on TV, the marketing materials and ads, they're the "dream" of someone paid to project a positive image and entice you to "visit" and to "commit".

COMMIT. COMMITTED.  No real difference.

And then there's the "professional advice" you may receive not to visit for at least a week or even longer. Why? The "resident" needs to "adjust".

ADJUST?  To what?  If it's somewhere they want to live, what's the adjustment?


And above all, MAKE NOTES. TAKE PHOTOS. And don't sign anything that deprives you of this right to ensure your loved one is safe,secure and not being mistreated.

Skilled Nursing Centers are artisans in the practices of changing appearances to alter what is seen and heard by visitors spending only a couple of hours occasionally with loved ones. Lewy Body Dementia isn't the only "human behavior" wearing masks

Consider how we make environmental choices influencing the lives of children versus Seniors:

CHILDREN.  We check out preschools, investigate individuals we're choosing for child care and if choosing a school, we move heaven and earth and are there constantly watching, listening and ensuring "we're getting what the child needs and what we're paying for".

SENIORS.  We act out of necessity or from a visit or two with our "sensory impressions" from a guided tour or perhaps a "lunch" paid for by the facility. Marketing. Advertising. Promotion. Maybe a few testimonials. Maybe a few "conversations" with residents who are pleased with the facility and who are functioning at a high level.

We do less placing human beings into facilities than we do in buying a stock on the market. Which has more liklihood of causing extreme life effects?

Do you really know the facility and are you prepared to step away and entrust life and limb to a facility without more information than you'd get picking up a "new" item at the supermarket to try and see if you like?

DID YOU KNOW once you spend thirty days in a facility, you "live there" and if you don't have the personal ability through private pay, YOU ARE COMMITTED..... in more ways than one. Check out Medicare; less than thirty days is a "respite" or "temporary" stay. If you're private pay, you now have the challenge of moving your loved one to another facility, going through another period of adjustment which is difficult on them and you, and ensuring this "choice" is the "right choice". All the while, you're triying to keep up with your life, your job, your family, etc.

DID YOU KNOW the facility will be on their best behaviour, will ensure your first thirty days are "filled" with positives and personal attention because they're aware this is the "trial period"and after that you won't have an easy time moving or getting assistance to move yourself or your loved one to another place.

When Mom had more "capability" both physical and mental, she'd tell us about how 'ugly" the staff could be. Voicing our concerns on many occasions we were told that was someone who was a "temp" and the facility would look into it. NOT TRUE. These were employees as well as temporary hires but the more you're concerned, the more you speak up -- you're labeled, you're often not listened to and you become "a trouble maker" and someone to see but not hear.

There's a Not For Profit Organization I know little about but have found on the internet called THE EDEN ALTERNATIVE

The Eden Alternative recognizes helplessness as one of the three plagues of

They write about institutional settings and the harsh realities of living in them.

For example, "In the institutional setting staff learn that if residents cooperate with their ability to help them, it is a more efficient use of their time. 

"The price paid is for the resident to learn to wait to be helped. 

"This squelches autonomy, skills atrophy, residents become even more dependent on care givers, and have even less control over their lives. 

"Staff’s style of speech encourages learned dependency. 

"Intonation is often similar to what is used with children which causes an adult to feel devalued. 

"Research shows the person loses faith in their ability to affect outcomes in their own world."

I've spent many days and nights during Mom's lifetime and her stay in Long Term Care Facilities observing neglectful and abusive behaviors. I never realized there were others more knowledgeable than I who have recognized the same actions and practices and who have categorized them and substantiated them.

This blog is meant to open eyes, to stimulate ears to listen and hear and to move many people into positive action to reform and to restructure Senior Care in Facilities through active involvement and research.

EACH OF US holdS the keys to today and tomorrow's treatment of the elderly, of which you may play an integral part as one of the many needing care in a facility or in your home.

Action for any reform takes time and it takes people.

Will you choose to be active or will you choose to sit back and wait?

USE THE INTERNET. SHARE THIS SITE. SHOW PEOPLE THE WAY. Use Facebook, Twitter, Pinterest -- pictures of actual residents (mask their faces) who are your loved ones and what you've witnessed and they've endured in bruises, breaks and cuts. You have that right, especially if you have POA and Durable Healthcare Power of Attorney. 

WORDS INFLUENCE. PICTURES STIMULATE. How long will it be before Seniors are protected and legislation ensures a higher level of care in Facilities?

HOW ABOUT SENIORS IN FACILITIES often stacked in rooms or placed in spaces where light and access to windows in a room are controlled by a roommate and no one cares enough to ensure they get "out" and get sunlight and/or socialization.

The choice is yours. The freedom to act and to speak are yours. Drop me a line. Let me know. Ask questions. Add your experiences. My voice has been raised for some time; time to raise yours. You are most welcome on this blog and wanted.

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