this lifestyle idea has been perculating in me for quite a few years and i've actually started to set up my home for others to live in with me. we have an older man with developmental disabilities living with us, and we're interviewing now for two more 'house mates'.
i see our home as a happy medium between full independence vs institution/facility for adults of all abilities. on the flip side it means i should be able to live here forever if i choose also.
my home isn't large, but pets and equines are welcome too.
Back when my husband was keeping watch on our elderly neighbor and his mother, and doing all the lawns, house care, errands and doctor's runs for both, he thought of this idea for pre-assisted living. Only zoning wouldn't allow it here.
We live in a country setting convenient to town. He'd put in a row of house-like efficiency units. Have a community garden. A barn with some chickens, goats or what not. Then he'd do the doctor runs, errands, groceries etc. There would be a cleaning service. A weekly field trip, hairdresser/barber etc. Pets would be welcome and we would coordinate for their care as well.
Before we got married, he lived next door, and the home we live in now was newly renovated. I would have moved in over to his house, and this small, renovated house would have been available for family to come in and stay when they visited.
Of course, now we've had our fill of health care issues, and it doesn't seem like such a hot idea. But it was a nice idea in general.
A slow motion five year personal nightmare, so much so that I didn't want to read the thread and skipped most of it.
It was a lovely facility in Edina, MN, with staff who weren't just working for a paycheck, because I watched them out of their sight while visiting my late aunt who had horrific needs, well before Mom needed a place.
It cost $6K per month, just as it would have at inferior facilities such as the place where my aunt originally resided.
It was sad to see Mom's new friends drop off the perch one-by-one when I would go back to visit, and stunning the day Mom was healthy and happy and didn't know who I was until I showed her my driver's license.
Mom had wonderful loving care whether I was around or not. (I was so impressed that with my POA, I bought her shares in the place. I liked the idea that they were working for her. She/we/I ultimately made an obscene Peter Lynch-style 10-bagger profit, offsetting a significant piece of the costs.)
All I know was that from the moment Dad and then Mom became ill, I fought against bureaucracy and BS -- we won an unheard-of benefits appeal which I guess was Mom's reward for the grit she conveyed to me -- and everyone at every stage said that my being an effective advocate for my sick and attenuated parents was the greatest gift any child could provide his dying parents.
That was nice of them to do that, both for the residents and for Dale! Win-win!
Originally Posted by SmartAlex
I have a different view as a nurse in long term care. I totally agree there are good and bad places. I don't want to debate on that.
I do want to say that you and your loved ones need to make clear and understand what their final wishes are, should they not be able to make them known. Lots of families say they don't ever want a DNR (do not resuscitate) or their parent would never want that. What I find is a lot of families don't truly understand what that means.
The thing to know is that DNR does NOT mean do no care. If they have an illness or a wound, we still treat those. If they need oxygen or dialysis or whathaveyou, that is done. They are treated just as anyone else. What it DOES mean is that if the heart stops, no extraordinary measures are taken to restart it. It does mean that when the patient starts declining, comfort measures are provided for but not life prolonging ones.
It is a very common misconception that when grandma's heart stops, we all jump to CPR like it looks on TV. The reality is that CPR in a nursing home situation is rarely effective. If your loved one doesn't have a DNR signed, we will do CPR, we will break ribs and it's very traumatic for everyone. If they do make it to the hospital and survive, they are usually not the same as they were before. They may have cognitive issues from oxygen deprevation or other complications. They may be in a coma. Something we often hear is that 'mom wouldn't want to live like that.' Well if her papers had been signed and all this had been figured out beforehand, we might not be in this place.
Often my residents will tell me they are ready to go. And they generally know what they are saying. Even the ones with alzheimer's disease have their lucid moments and that is often what they say.
So... my rambling point here is get your loved one's end of life plan in order. Talk to them now, if they still can. Know what care they want and what that means.
And on a more upbeat note, my dog goes to work with me quite regularly. He is in the process of getting registered with TDInc as a therapy dog. He is allowed now and does rounds with me at least once a week. I can't tell you the effect he's had on some of my residents. I am the wound nurse, so my rounds encompass the entire building many times a day.
My other dogs have done this kind of thing too but Jasper is much more intuitive than even they were. He was asked to visit a dying lady last week by her family. He put his feet on the bed and snuggled his head up to her oxygen mask and just licked her cheek. She smiled and hugged him. And the family all cried. She had big black dogs all her life and by this point wasn't really responding to family but she did to my dog. It was a very sweet moment.
We also go to physical therapy with a few people. We have rehab patients and long term, so some do go home. We had a couple very cool moments last week with two ladies who just didn't want to participate in their therapy. But when it became throwing the ball or getting in the walker so they could walk the dog eventually, it was a whole nother story :D
These kind of stories far outnumber the sad ones. I've worked in LTC for a long time. It is a different kind of world and while it certainly has it's moments, it's not entirely sad and depressing.
Going thru this now too
"In the meantime, I would encourage everyone to sit down with an accountant or other reputable professional and PLAN FOR THE FUTURE. If you are the type, also go see a social worker or other mental health professional or life coach and PLAN FOR WHAT YOU WANT YOUR LIFE TO INCLUDE WHEN YOU ARE OLDER. "
Well, of course we haven't done any of this. And now it is catching up with us.
I feel like i know all of you well enough to tell some more of my mom's saga, after the telling off that Katherine deservedly gave me the other day.
What I have come to realize is that my parents were never very ambitious. My dad always worked, but mom was against people who worked hard, [thinks they neglected their family]. :no:
They never insisted my sister or I ever go to college. Granted, not everyone did in 1971, and I honestly didn't know anyone who did go.
My dad died about 5 years ago, and left my mom with a $15,00 insurance policy. That is all he had. She had one too, but has now outlived it. She had some money and was able to pay off their house.
To tell you about my crazy mom, [crazy in the best way,] it was found she had a cancerous growth on her nose two years ago. She wouldn't have it treated, because she said she would be dead in 6 months. That is her response to everything. She wouldn't wear seatbelts for twenty years because she said she wanted to be killed instantly!
She has been in the hospital for 3 days. She is heavily medicated, and seems MUCH better. We got her out tonight, and she is now at my sisters. They decided she was suffering from SEVERE depression, [ya think?] They were pretty insistant on home health care, but she is against it. She is afraid we are hooking her up to machines. I told her today she isn't nearly ready to die yet.
I hope this isn't a total hi jack, but it IS awful. She now wants us to get the house, but I think we have left it too late. We failed to plan.
Failing to plan DOES make things difficult. My husband and I have our wills, and insurance done. DNR orders. POA. Heck, the funerals are planned and paid for, and I'm only in my forties. Same with the parental units. It is just one less hurdle in navigating the system.
During the care plan meeting yesterday, it was confirmed that MIL is not participating in her therapy, and will probably be discharged from therapy, but not accepted back into Assited. So she's probably there to stay. She told my husband when he left "I guess I have a lot to think about tonight". Well, yeah, we've been telling you what your options were all along. Work hard to live or curl up and die.
She actually answered the phone before bedtime (which she doesn't usually bother to do) and she was talking nonsense again. Some of it is dimentia and some of it is her just making up $#!t, as she often does, to get you off her back.
DH, disturbed and worried, drank half a bottle of wine after dinner which happily knocked him out at bedtime, then at 1am he fell out of bed "Kerplunk" :lol::lol::lol: I'm telling you we're not imune to these hazards at any age!
It's a serious topic, but thank you for a giggle today. I wonder what he would think if he knew you just tattled on him on a big board. :cool::lol:
Originally Posted by SmartAlex
Oh, between my blogs and FB he's used to it. If I had put it on FB it would get back around to him within a day or two so I refrained. ;)
I just talked to him. He's done with his errands and is planning on strapping himself to the bed for a nap. He says that having to go to the emergency room for injuries sustained while falling out of bed for that reason, at his age is not cool. If he's going to hit his head on the night stand it should be for a better reason. :D
Thanks for reminding me of this. I helped my mom do this for her mother and I want to do the same for my mom as she gets to the last part of her life.
Originally Posted by Adamantane
Ironically, this is Horse Related. Owning horses, I have spent a lot of time with all the Usual Topics surrounding end of life decisions making cotton pickin' sure that I am clear on what I feel and what my interests are vs. those of the horse.
IMO, this takes practice. I'd rather practice sorting through the emotions with an animal who doesn't know what is at stake than with a person who does (or at one point who did).
Hell, maybe finding the right nursing home is just finding the right boarding barn... X 75.
It helped that I told my mom that for my grandmother-- aka, you have to show up, get a vibe, ask hard questions, be sure to advocate as much as is necessary for the older family member, and stay as involved with visits and contact as possible.
There's nothing like a family member to make sure that the blanketing and fly spray is done correctly, even in the best of nursing homes.
Tough topic. My Mother is 97 and in a lovely assisted living facility. But she was always on the go, and gets very lonely.
This place has a huge waiting list, and for years has been "the" place to covet for your later years. I remember singing carols there at Christmas, and other Girl Scout type visits. The residents used to be pretty full of life. The staff is top notch, and it's a beautiful facility. However, the 4 of us have to subsidize her living there, and she acts, and honestly believes, that her retirement has taken care of all of it. No way - she was always in debt, and her retirement is minimal. This sounds awful, but I don't think we all thought she'd be here this long.
Plus, now that so many are living for so long, the place has changed to a very quiet, and almost somber place. And all of the residents have to be somewhat ambulatory. But many are there now without their spouses. Doctors my mother used to work with. My mother's bridge playing friends. But everyone can hardly move under their own power, and you can see them just waiting...
My mother has dementia - forgets that you were there the day before, but still definitely knows who you are. When I was freed up and could visit her semi-regularly however, she got whiny and dependent if you didn't show up. Saw her Saturday, and she was crying because my oldest sister had just left, and she made an earnest effort this summer to see her often. So it's almost as if she's happier when she doesn't see you that much. Very hard to take. Then the hardest is that she does become very childlike if she has to go to the ER for anything, and will start screaming and get abusive and a mouth like a trucker for all the world to hear. My mother is known as a lovely lady, and it breaks my heart to have her sad or upset. No, it's not easy at all.
I spent the better half of the spring and summer with my FIL, in and out of the hospital and at a "rehab"...that place sucked, but was convienant (plus the best out 5 local places we checked out). The day my MIL and I moved him there from the hospital I called my husband and said "we need a plan"...
FIL passed away in the hospital at the end of July, the day we were supposed to bring him home...it sounds heartless, but I was relieved for him.
Originally Posted by Laurierace
As Unit Manager of one of the best assisted living facilities in Michigan, I have to vehemently disagree with your first sentence. The message we send to every employee is that we are not where our elders have come to die, we are where they have come to live. Our elders are treated with the same love that we would give our own family members. When there is a hospice patient under my care they are guaranteed that they will die with peace and dignity surrounded by people who love them. My heart is given to them and their families freely and without reserve at great personal expense, but with even greater reward.
I know that there are $hit holes out there that I would not put my dog in, but not every place is sad, or dirty, or warehouses for the dying. Research, visit, talk to the workers at various places before you place a loved one in a home. I can look anybody in the eye and state without hesitation that my mother will be in my facility if and when the time comes that she needs care. Families love us and respect us for the care we give their loved ones. It is not a job for the faint of heart or soul, but I leave work every day knowing that I truly make a difference in the lives of many.
A therapist knowledgeable in this things pointed out that it is healthy and typical for children and other relatives who are either responsible for or are themselves caregivers, to feel conflicted when parents are very late in the game and failing to thrive.
On the one hand one wishes everything could be made right health and spirit-wise again, though it cannot. It is sad to contemplate someone who may be a caricature of her or his former self.
On the other, it is a terrific strain to care for (or find the means to pay for the incredibly expensive the care of) an ill and lingering parent who may not even be any longer engaged with the world. Even more so if one lives far away and/or there are few others with whom to share the responsibilities. The tension is great. Lives are put on hold indefinitely.
But that frustration and dilemma are part of the deal. These feelings of conflictedness are appropriate, unavoidable, nothing to feel guilty about. All the more so if you've done everything humanly possible.
If there is any offsetting grace, it is that there is time to grieve slowly and systematically in advance.
I feel for you SA. I worked in a nursing home right out of high school and through part of college, mostly in dietary. I know the food was good and the aides were all good caring people. I know we had million dollar views out of a lot of the rooms. We had art classes and book appreciation and wheelchair exercise but it was tough. Strokes and dementia take so much away from a person.
We are currently dealing with my MIL, surgery and rehab in a nursing home, then move to senior housing close to town, and although we missed the bullet this time we definitely need to plan, from how to pay for the funeral to how to handle a long drawn out fade needing much care, because it is in the cards.
I think that is true. My grand mother was in the same nursing facility about a year with Parkinsons. Pneumonia finally did her in, but she was quite well for most of the time up until then. It was just so hard to see her long and steady decline. The pneumonia was fairly sudden and brief. When she passed I mostly felt relief. I had already said the long goodbye. I rarely feel any great loss or sadness over her absence. I have many happy memories and life goes on.
Originally Posted by Adamantane