Many, if not most, nursing-home decisions are made in the midst of a crisis. But prospective residents and caregivers who prepare in advance retain more control of the process and cope better with the strong feelings evoked by such a major transition. The likelihood of a waiting list adds to the importance of advance planning. All of us, even those who are healthy, should make our wishes known to love ones in advance. Or, as caregivers, we can sensitively approach the subject before our loved one becomes incapacitated or we become exhausted. Decision making should involve the prospective resident to the greatest degree possible. Even confused people can respond to caregivers’ attempts to communicate lovingly the realities of a difficult situation. Avoiding the topic or misleading the prospective resident even if intended as kindness can have a devastating effect on morale. [Read more...]
“Medicalization” is an unfortunate fact of life in nursing homes. As in hospitals although they are called “homes” nursing homes’ medical orientation encourages a narrow approach to residents’ well-being. Loneliness, confusion, depression, and behavior problems resulting from a lack of freedom and meaningful activity are addressed medically (if at all). Drugs or other restraints are too often the first choice, rather than the last resort, in dealing with what are often sane reactions to an impossible situation. The medical model requires efficiency and hierarchy. Because it cannot incorporate the chaos of individuality and assertiveness, it treats residents as patients or cases instead of as people and rewards those who conform. [Read more...]
Complex issues arise from the tension between private enterprise and public welfare, public financing, and public health oversight. Some believe that a free-market approach would result in lower costs and care of a reasonable quality. Others believe that quality care will never be achieved through a private system. In the words of Elma Holder, Executive Director of the National Citizens’ Coalition for Nursing Home Reform (NCCNHR): “Care that is driven solely by the profit motive is unconscionable. A system that largely puts mammon first, and workers and residents last, is contrary to the maintenance of quality care.” NCCNHR, a group of advocates, professionals, and residents, is the leading source of information, analysis, and advocacy at the federal level. NCCNHR was founded in 1975, its goal to present a united consumer voice to the nursing-home industry and government. They were [Read more...]
In such a difficult time, the support of friends and relatives becomes more important than ever. With Alzheimer’s disease such support is difficult to sustain, since the stricken person loses the social traits that drew others to her: a sense of humor, kindness, special interests and talents. She also loses control over language as a means of communication. The stricken person becomes a stranger to relatives and friends, who may react with withdrawal and avoidance, appalled at the loved one’s condition. In addition, visits can be difficult to manage since the victim is often confused by any changes in the daily routine and embarrassed by her inability to remember who the visitors are. The resulting isolation of the victim may also lead to isolation of the caregiver. As relatives or friends of Alzheimer’s disease victims, it is important for us to remind ourselves that the stricken person still needs and recognizes [Read more...]
Group or individual counseling sessions can be important for the caregiver. They also are sometimes offered for the afflicted person, but only people in the early stages of the disease do well in counseling sessions. To find out about counseling programs, consult your physician or get in touch with local hospital and mental health centers that might offer such sessions. The ADRDA nearest you will also know about types and locations of help available.
Respite: In adult day health centers, people with Alzheimer’s take part in activities according to their own abilities within a supervised, structured program. These provide the ill person with attention and social interaction, and provide caregivers with much-needed intervals of rest and relief. Respite in-home services, weekend assistance programs, and long-term (one to two weeks) respite care programs are also starting to develop in some hospitals and [Read more...]