Nursing Home blog, New admit

There is a pattern that follows nursing home admits. Most nursing homes have low census in the fall before Thanksgiving and then it picks up (super fast) after thanksgiving. It has been this way for the 20+yrs I have been associated with nursing homes and it is still true this year in 2012.

Fall/Autumn low census: the weather is comfortable and life just seems easier. All of the summer broken hips and pneumonia have burned through their Medicare days and have gone home. Remaining in the nursing home are two types. The truly aged people who are (Waiting for God) and those who are on Medicaid.

The remaining of this post is going to be a bit sad, I am sorry in advance, but if I think it is important for the general public to know what I am going to say.

The general public go home for the holidays and see their older family members and this is when they see one of the below listed impressions of their loved ones. This is just five of 100’s of reasons it is a safe, loving, and good decision to place a loved on in a nursing home.

1.      The elder family member has lost a lot of weight. Why is this important. All humans need at least 15lbs of extra weight to carry us through sicks times. If a person over 65 yrs has pneumonia and they are at the lowest scale of their BMI or under weight. Their body doesn’t have the resources to build an immunity to fight. Even with hospitalization it can be scary.

2.      The care giver to the elder family member is becoming run down from the extensive work of taking care of the elderly, all alone! This is a sad fact but most couples experience this, the care giver dies before the partner that was first the sick one. The care giver ignores their own health and gives so much to care for the sick one, that they usually die suddenly. So sad when if they would allow us professionals to care for them as a team, both could live.  This is probably a good time to mention that I do this blog on my free time and this blog is not associated with any health related company. I am just a nurse at home in front of her Dell computer.

3.      The elderly person has been living all 24hrs a day in a six foot space even though they have an entire house, they sleep, bathroom, eat, leisure, and live in this six foot space. I have seen it so many times when I worked for home hospice care. This is isolating, if they were in a nursing home they would have 24 hr assistance. Parties, church, concerts, pets, volunteers, you name it, nursing homes are amazingly social.

4.      Due to financial funds, the elder family member is unable to keep up the maintenance and repair of their dwelling. I have personally seen an elder woman living in her living room because her bedroom roof had caved in. She used a bedside commode (a metal chair with a bucket in the middle) she had home health assistance give her a bed bath once a week, funded by the government.  Her meals were delivered once a day by meals on wheels which was her only food a day. Why did she live there? I talked to her 3 sons, they wanted to move her, but Mom was not leaving her house. How did we finally move her to a safe nursing home? Well it wasn’t easy, it took 6 weeks of volunteers showing her pictures of parties, her Pastor agreeing to do some sermons at her now nursing home.  My part, was the food, I brought some goodies from my local nursing home kitchen. Once her sons said out loud that they were ok with her going into a nursing home, she finally moved.

5.      The elder family member is unable to drive and make SAFE everyday decisions. Such as, working the cook stove, heating units, crossing the street, ect. If you know me in the “real world” then you would know that I am a specialized Alzheimer's nurse from early stages till death. Yes, Alzheimer's die differently than an average aged in place elderly person.  Your parent might be able to fake it that they are doing ok, but most people need to listen to that nagging voice in the back of their subconsciousness saying that maybe my parent is struggling to make sense of their environment and reality.  The first stage of Alzheimer's is the roughest for me, it literally tears my heart apart to see a “newbie” nursing home resident with Alzheimer's trying to adjust. It is extremely stressful. The structured life of a nursing home is almost crippling stressful for a first stage Alzheimer's person, I cant imagine how much MORE stressful life outside of the nursing home must be for them.

The following is  true story, it is from my point of view, and I am not using their real names or any identifiable traits.

I was at a local shopping center. I was doing my weekly grocery shopping and I noticed a middle age person (Jim) attending to an older person (Peggy). Peggy was sitting on the seat of the store’s electric scooter with a front basket. Jim was walking. Jim was explaining how to control the scooter. Peggy on the scooter was unable to understand. Both were extremely stressed out. Peggy because she simply was unable to understand her environment, Jim was stressed from trying to gently explain simple instructions, over and over, and over again, only to be misunderstood.  I probably should have turned my head and moved on, I had just finished a 10 hour shift, and was starving, but that just isn't my style. But even to this day, I admit that it simply was non of my business. I approached slowly, and smiled my brightest smile, I smiled with my entire face and opened up my shoulders and body language. Both Jim and Peggy, looked at me with pleading eyes. I said my name is Kimberly, and would like to compliment this woman on her pretty pink dress. Of course they both just look at me, like huh? (I now had control of the Milieu.(By the way, I was in my scrubs without my name badge) I looked at Jim and asked him his name, and with this he went into normal social rules and formally introduced himself and his mother Peggy. I reached my hand out to Peggy and instinctively she reached to grab my hand, I asked her if she can walk? Before allowing her to rise, I looked at Jim and he nodded his head yes. I held Peggy's hand and kept her on the scooter and asked Jim where is Peggy’s wheelchair? He said it was in the back of his truck. I suggested that Peggy sit back and let Jim control the scooter while walking along side, when we reached the front of the store, I stayed with Peggy while Jim in viewing at all times went to retrieve his pick-up. I just kept her company.  After Peggy was safely in his truck, we talked. I asked what Peggy was diagnosed with. He said, Alzheimer's disease (A.D.) I chatted a bit, with veiled advice. The gist of our conversation. People with A.D. do not understand change. People want to treat them to something new and fun, such as a shopping trip, but this is the worst possible event, potentially ever. Imagine, not being able to identify, understand all of the noise, smells, crowds of people, the colors of simply everything! Most stage 1 A.D. don’t even know how old they are much less where or why they are here. It is not uncommon for me to toilet a stage 2 A.D. and have to repeatably remind them what are they suppose to be doing, as in simply urinating. 

Final thoughts: If your elder family member is not living a great life, consider nursing home placement. I personally know of at least 10 brand new nursing homes that opened this year with private room with private frig, bathroom/shower and cable tv. If you are unsure, go visit a nursing home. Spend a day with the activity director, it is amazingly social, and lively.