Monday, December 28, 2015

Florida Leading The Way In Full Disclosure on Senior Care Facilities Violations Made Public

Here  we "grow" again!  Meaning I'm learning, sharing and together we're adding to what we know about caring for others and ourselves in those "later years".

I start working on a project, get involved and always seem to find my way back to information about Senior Living or "Mature Adult Care" as I'm finding seems to be a new age description of life after 50. (Although some would say since 50 is the "new" 40 and Long Term Care is usually for people far beyond that "portal" of five decades.)

I was actually looking for a different work position. The job I have is ok but not using my experience and falls far short of keeping my brain stimulated much less adding to my knowledge and capabilities. I'm not ready to be a machine and crank out more of the same, I want challenge, I need to feel I'm positively contributing to my life and my community. 

Brain challenge. Positive activity. It's what most of us need and want in life. It's important for children and adults and even when the brain is challenged and incapable of performing at the highest levels.

Several mouse clicks later, I stumble on this website about how Florida is "shining the light" on facilities in their counties who provide what they call "Assisted Living" but seems more like the level of "Long Term Care" in Missouri.

On May 18, 2015, I wrote a blog entry "Way To Go North Carolina, Wake Up Other States" commending their inclusion of specific information reporting on Senior Residential facilities with statistics at a glance and a clearer reporting of violations and fines. 

You can click through on the title of the blog entry to read what I wrote at that time.

Who's next? Or who's also following this enlightening lead?

Let me know, readers, if you've checked your state and found any others that reveal these direct and far more informative statistics and updates on Care Giving in Residential Facilities. 

Make a comment and give me a website and I'll share it.

We're making a difference, you as readers and I in posting as we climb above the 10,000 mark. Love to see that double and with your input, we'll all be more informed!

REMEMBER:  We live, learn and grow together when we share information and help others today while building a better tomorrow for ourselves and those who come after us.

Monday, December 21, 2015

My Mother's Purse

As we're taught, so we learn. 

Mom taught most lessons by example. 

My Mom was raised in the times of "Spare the rod and spoil the child." 

She told me about how her father sat at the table, took the first helpings of whatever he wanted and then the children and then her mother got whatever was left. 

He was the enforcer, sitting at the table with a "switch" across his lap and finding any excuse to "make an example" of one or more of the many children, ten in all, in the family.

Mom welcomed the "new" parent-child relationship guides, like Dr Spock, and was kinder and gentler while guiding, directing and showing by example.

Mom valued education -- school and what she could learn by herself. 

I remember how she went back for her GED when I started college; she didn't tell me until she was ready to graduate. 

I was and am so very proud of her taking that major step when she was into her 50's.

The times I grew up in taught by books on raising a child, making a home, repairing things around the house and the family car. There were books for dreaming, too, including magazines.

News came at specific times. Published in the "news"paper and then seen on TV; the 60's truly began the Information Age. 

Not like today, of course, when information is at your finger tips -- literally -- and available 24/7 even as it's happening.

We thought we certainly knew more than our parents and their parents -- the same as every "new" generation.

We believed what we were told and it sometimes took months and even years to find out what we'd originally been "told" was far from what actually happened.

So, if you think media is "controlled" today, you should go back in time and listen to broadcasts "the way they were". We built "trust" on people we believed; sometimes we found out we'd misplaced this trust. 

My Mother's Purse. I watched the other day as a very small child took their mother's purse off her lap, opened it up and started rummaging through it for something they wanted. 

No request for Mom to see if she had it, no consideration it was "her purse". The child wanted and sought immediate gratification and did what is now considered "normal" -- took immediate action to satisfy that want.

Much has been written about the "helicopter parents" and the "generations of entitled children".  Where did they come from and why are they growing in number?

I never "went into" my Mom's purse -- not even when I was a grown woman -- without her asking me to do so.

Mom never had very much to keep in her purse but what she did have, she valued. 

I saw her take things from her purse over the years and add things as life advanced. When she'd ask, I'd bring her purse to her and never thought about going into it or through it. That was my Mom's purse. Not mine.

Mom taught me to respect other people's property. 

She taught me to ask permission. 
Mom taught me respect for others and to value each person not for who they were but for what they did with their lives and what they did for others.

My daughter was raised with the same foundation of life values. 

It might be "old fashioned" and it might seem out of place in today's world, but integrity and honesty should have no expiration date among the generations.

What have you practiced? What do you teach others by what you say and do? 

My mother's purse was a simple example of living a life valuing the world and all we come in contact with every day.

I still have her last purse. Can't part with it just yet. It shows some wear; it went everywhere with her almost to her end of days. 

When she stopped taking it along, we'd pick it up and take it with us. She'd passed the point of "needing" and even of "wanting" anything inside its many compartments.

To me and to my daughter, it was Mom's/Grandma's Purse:
A part of who she was and a part of life as we knew it with her as we shared so many years many great memories.

Wednesday, December 16, 2015

All States Do Not Have Federally Mandated Area Agencies on Aging

I started to write about my challenges with the Ombudsman program and began researching the program. 

This led to the discovery not all States have Area Agencies on Aging as Mandated by Federal Law of 1976. 

There are seven States and the District of Columbia without this program.

You can read more about advocacy and Long Term Care areas of the Federal Administration on Aging under the Department of Health and Human Services on this website  

Here's a short sample of what's included:

"SUA / AAA Finder

To locate a State and/or Area Agency on Aging (AAA) start by clicking the state on the map below or select the state from the drop down list.    After the State Agency on Aging information is displayed you will be prompted to search for the local AAA.    A few states (AK, DE, NV, ND, NH, RI, SD and WY) and the District of Columbia do not have AAAs so contact the State Agency on Aging to locate local resources.    To find resources in the U.S. Territories, please use the drop down list and select the location."

States were required to set up Area Agencies on Aging back in 1976 but there are still more than 10% of the States and DC without this MANDATED AGENCY?  

Didn't realize Area Agencies on Aging, a Federal Legislation dating back almost forty years was an "option".

Writing this blog, advocating for Seniors, I'm learning every day how what we think exists, what we believe we have for our "later years" can be "smoke and mirrors".

Once again, the consumer "aging in place" or necessitated having to enter into Independent, Assisted or Long Term Care facilities appears to not have certain levels of advocacy depending where you live or choose to live as a Senior.

Who oversees Seniors rights? Who makes determinations on violations? Who intervenes when there is a question of neglect or abuse -- in these areas?

What rights do Seniors have in these States and who ensures they're guarded and enforced?

These are questions each of us should be asking along with those of us who live in States with Area Agencies on Aging.

Research. Read. Get actively involved now. The time will come when you will wish you had, when you face being "housed" and sign away or don't have the mental capacity or capability (dignosed or not) to act to change the system.

It appears along with researching when we decide where we'll continue to live as we grow older, we need to continue to practice researching as we did about housing costs and values, taxes, ratings of educational facilities for our children.

We need to know more about Senior Living than what's available in an "area" where we would want to live, what "looks good" and where we might feel "comfortable".

Friday, December 4, 2015

Financial Abuse, Medicare, Facilities and Individuals

Did you know Medicare does not cover long-term nursing care?

Medicare does not provide coverage for people who need to go into nursing homes indefinitely because they are disabled or can no longer take care of themselves.

Medicare does not cover daily custodial care, such as assistance with eating,bathing and dressing.

Medicare  does not cover assisted living or adult daycare.

For more info, click through to a site you've probably used for general information, Web MD

The clock of life is ticking.

We found out about these non-inclusions with Mom and with my husband.

You have to be destitute, you have to give up everything you have (in Missouri if you're a single person you can only have less than $900 of "assets") and then they take away your Social Security, if you go into LTC, except for a small amount, believe it's now up to $40 per month.

Think that's enough?

What could someone possibly need in a facility, anyway -- isn't everything provided?

Let's talk about that:  

Facilities provide what they have and want to provide. So, if you need a better quality of paper pants, you or your family will most likely have to provide those -- as we did as long as we could for Mom.

That may not include "daily needs" you're used to having: Denture cream? Mouthwash? Soap that isn't harsh to older skin? Clothing? 

Any type of technology including a TV -- forget the ones around the center,the staff controls those and you watch what they want to watch, when they want it on.Pajamas, robe, shoes, socks, underwear? 

Medical care beyond what Medicare pays? 

Point of Interest:  Who chooses what plan and type of plan a resident receives in Long Term Care?

When you're in the "outside world" -- you do. In a facility, they choose.

That's just touching the surface.

So many of our elderly depend on the generosity of visitors and friends and family. 

This sounds like a horrible comparison but I remember visiting some zoos in areas where the animals begged for food from visitors; it was obvious they were underfed and undercared for.

Many humans possess an attribute called DIGNITY.

Some won't ask, some won't infer, some will just silently make do, as they learned from lives through the struggles of economic hard times. While our generation of those who lived through "The Great Depression" is lessening, we have many who've gone through hardships and losses through economic declines and losses.

Think of this generation who's gone through Bank and Financial Institution failures, Foreclosures and losses of homes -- what will they be like when they're in Long Term Care -- probably similar to those I see and saw when Mom was there.

I believe what we're seeing ,experiencing and feeling today isn't just complicated by the "Baby Boomer" generation but by generations faced with financial hardships, major setbacks and low wages not enabling establishing "safety nets" like LTC Insurance and IRA's.

People whose only real source of future possible income in homes they occupied and were paying for who were hit and are still being hit by FORECLOSURE will be the first and second waves that will test the strength of our economy and our social development.

And facilities often practice "revenue generation" through their residents by "taking them" for services they really don't want or even need. My Mom was constantly "beseiged" by not one, but two, workers who would try to "escort her" to the Beauty Salon to have her hair done, her nails done -- all in the name of getting that extra money, that small amount, directly into the facility's bankroll instead of "sitting" in an account for the resident.

We took Mom to get her hair permed and cut. She didn't need this "service" but the facility saw an opportunity and tried to convince her. While Mom still had some ability to discern, some cognition and capability, she'd tell them to go away but that didn't stop the next "wave" of facility employees from trying at another time, in another place, to convince Mom she "really needed something done" in between or it would "make her feel so much better to have "X" done".

Our Long Term Care Facility Residents and even those in facilities that are Independent Living and Assisted Living are truly at the mercy of those who work there and those who make the rules.

Be ever watchful. Examine your loved one's account and see what uses were made from the small amount they were "allocated". 

Get that Power of Attorney now and ensure that revocation can only be made through visiting an impartial Elder Care Law Attorney or other Attorney. Ensure your loved one and your family isn't preyed upon as we were.

Best suggestion I have, take over your loved one's total care including managing the "little money" they have by providing it directly to them or using it for those "special things" that make their day a little brighter.

I'm not naiive, I know there's financial abuse and some will not receive any money if this is done. My advice is for the caring, the concerned and the loving families. 

For those who aren't, we need better supervision and accounting in facilities and ensuring residents are truly getting what they want, when they want it and that means more Ombudsman, at least one per facility, checking in, checking up and keeping records to ensure Elder Financial Abuse isn't practiced by facilities.

Times change. People seldom do. If you're in those "Golden Years", the ones that come before darkness falls and you become dependent, look, listen and act to ensure your life isn't manipulated or controlled by someone you expect or would never expect to play a major role in your care giving.

Tuesday, December 1, 2015

Rampant Infections and Falls In Long Term Care Facilities Possible Causes

The State and the Federal Government "collect" statistics on the elderly in Long Term Care. Unfortunately, they don't collect the reasons for the problems, especially the rampant infections and falls. 

Come walk with me and see what I saw and see.  Open your eyes and then open your computer and let the world know what goes on behind the closed doors of many "average" Long Term Care Facilities.


CNA's move from room to room, resident to resident, assisting one and then another without washing hands or putting on gloves.

Food is delivered to a room by someone who simply picks up a tray and may handle plates, glasses and cups, utensils and even pieces of food or even assist a resident with eating without going first to wash or clean their hands.

Toilets are used by roommates who have infections and disease without any wiping or other cleaning in between uses by one or the other resident.

Toilets are often left without attendance or cleaning after a resident "has an accident".

Walkers and wheelchairs are seldom cleaned and evidence of fecal material or the smell of urine can be noticed sometimes from a distance but usually through close examination without the resident in place.

Handles on walkers and wheelchairs are often loose, brakes don't hold or lock securely by older hands that do not have the strength to engage the locks.

Placement of a roommate limited to a Gerry Chair used as a barricade forcing the other resident to remain in a chair or other fixed placement.

Dining trays left in rooms for hours after the resident has finished and allowing a resident with Dementia to eat food that may have spoiled causing intestinal distress and even infection.

Dirt and grime in places usually unseen -- behind furniture, under beds, behind curtains.

Thorough cleaning of rooms limited to once a year.

Thin blankets placed on the beds of aged residents living in a room with large windows where they sit or sleep nearby.

Call buttons disconnected from the wall or often just pulled loose enough so they don't connect.

Relocating call buttons for Dementia patients -- moving to another side of the bed, clipped in another area. Confusing and challenging for those who can think clearly let alone those with memory difficulties.

Teeth seldom brushed. Dentures seldom removed for thorough cleaning. 

Hearing aids placed in pockets of CNA's uniforms when giving a shower and then "gone" to the resident who needs them so desperately.

Limiting movement.  Restricting. 
A form of restraint without tying someone down.
Punishing for asking the wrong question, speaking up about something or speaking out.

Once or twice a year inspections that are anticipated or expected hide the reality of these places of residence no one would chose if they truly had the choice.

Socks and shoes hide peeling skin, sores and maybe even bruises.

A cut or bruise? Are you told as we were the resident fell but there was nothing to worry about. No Xray, no Dr's visit and there's a visible gash or huge black and blue mark.

Food brought to the floor sitting for an hour or more without benefit of a steam table or refrigeration.

Residents being fed, two or more at a time by the same attendant who wipes their mouths, breaks bread or handles food first for one and then for another -- and we wonder about those germs that run rampant in facilities?

Forced isolation through not attending to a light or call for help. Those "in their right minds" soon find the facility has ears and eyes and sees and hears everything and there WILL be repercussions from some staff.

Showers given at 10 PM or even later with residents woken from sleep because the staff had the time and the resident "wanted the shower" that day.

Privacy is a luxury in a shared room with a constantly open door. Men live across from women. Some have lost the ability to understand what being dressed completely or even at all means.

Medications that leave otherwise cognizant people slumped in chairs or constantly sleeping.

Lifts used on residents without the upper body strength or grip to "hold on" or "hang on" and subjected to one person trying to hold up the person while trying to manuever them. 

And you're told your loved one "fell"?  Actually, she/he was dropped.

This and more are what men and women go through every day in many Long Term Care Facilities. 

Walking through the entry, into the common area, or even visiting in one room and spending an hour or two won't always give you access to seeing the reality, the harsh truth of how human beings who contributed and provided for themselves and others are now treated.

Abuse? Neglect? Staff that's overworked and exhausted?

Sadly, this is happening in facilities everyday and it will continue until we open their doors wider and ensure there is more public connectivity and supervision.

Where do we look for the answer? How about down the halls on the main floor and inside the offices at this facility and at the headquarters of the owners of the business or organization.

As with places we may work, management and ownership write the rules and regulations, they either enforce or look away, run an honest and caring facility or one that could care less.

What can be done? Speak Up, Speak Out. Most of all, those of you who don't go to visit someone in a facility, make a New Year's Resolution early and "adopt" an older resident of a facility. Visit. Listen. Learn. Observe.

Then raise your voice. Use the tech tools of the internet and ask the hard questions and make the statements about what you've seen and heard. 

If Not Me, Then Who . . . . ask yourself. 

The clock is ticking. If you're "lucky" enough to live to that really old age or have the misfortune to become incapacitated, you, too will have the "pleasure" of being a resident of Long Term Care. 

We're all busy with lives of our own but we cannot afford to ignore the challenges of eldercare.

Tomorrow is just a day away!