Living Well in a Nursing Home: Everything You and Your Folks Need to Know

291 Pages·2005·1.45 MB·English

by  Lynn Dickinson, Xenia Vosen

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Living Well in a Nursing Home
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DEDICATION
This book is dedicated with love
to our mothers, Julia and Maria,
who gave us life
and taught us well how to live it.
L.D. & X.V.
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Living Well
in a Nursing
Home
Everything You and Your Folks
Need to Know
LYNN DICKINSON, M.A., & XENIA VOSEN, PH.D.
with Severine Biedermann
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Copyright © 2006 by Lynn Dickinson & Xenia Vosen, Ph.D.
All rights reserved. No part of this publication may be reproduced or transmit-
ted in any form or by any means, electronic or mechanical, including photo-
copying and recording, or introduced into any information storage and retrieval
system without the written permission of the copyright owner and the pub-
lisher of this book. Brief quotations may be used in reviews prepared for inclu-
sion in a magazine, newspaper, or for broadcast. For further information please
contact:
Hunter House Inc., Publishers
PO Box 2914
Alameda CA 94501-0914
Library of Congress Cataloging-in-Publication Data
Dickinson, Lynn, M.A.
Living well in a nursing home : everything you and your folks need to
know / Lynn Dickinson and Xenia Vosen with Severine Biedermann.
p. cm.
Summary: “Concentrates on the positive aspects of nursing homes
and offers strategies for identifying the best facilities—a guide for maintaining
and improving relationships between the elderly and their families”—Provided
by publisher.
Includes bibliographical references and index.
ISBN-13: 978-0-89793-460-2 (pbk.)
ISBN-10: 0-89793-460-1 (pbk.)
1. Nursing homes. 2. Nursing home care. 3. Long-term-care facilities. I.
Vosen, Xenia. II. Biedermann, Severine. III. Title.
RA997.D496 2005
362.16—dc22 2005013624
Printed and Bound by Bang Printing, Brainerd, Minnesota
Manufactured in the United States of America
9 8 7 6 5 4 3 2 1 First Edition 06 07 08 09 10
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Contents

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
. . . from Lynn Dickinson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
. . . from Xenia Vosen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Why We Wrote This Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Who This Book Is For . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
How to Read This Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Part I: Making the Long-Term-Care Decision
1: Stepping into New Territory . . . . . . . . . . . . . . . . . 10
Why We Feel So Bad about Nursing Homes . . . . . . . . . . . . . 12
What We Mean When We Say “Nursing Home” . . . . . . . . . . . 14
What We Mean When We Say “You” . . . . . . . . . . . . . . . . . . . . 15
Some Assumptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
2: The Phone Call That Will Change Your Life . . . . . 18
Here Come the Changes! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Making Friends with Change . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Exercise: Determining Your Personal Change-Related
Stress Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
3: It’s Bigger than We Are: Changes in Society
That Have Affected Aging and Culture . . . . . . . 34
Why Things Are Different for Our Generation . . . . . . . . . . . . 34
Comparison: Then and Now . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Past Ways of Caring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
v
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vi LIVING WELL IN A NURSING HOME
Coping with Longevity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Improvements in Living Conditions . . . . . . . . . . . . . . . . . . . . . 47
What Long-Term Care Really Looks Like . . . . . . . . . . . . . . . 48
4: The Home-Care Instinct . . . . . . . . . . . . . . . . . . . . 52
Home Care as a First Impulse . . . . . . . . . . . . . . . . . . . . . . . . . 53
What Does “Home” Mean? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Exercise: What Does “Home” Mean? . . . . . . . . . . . . . . . . . . . 56
Your Loved One’s Condition . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Your Energy Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
The Need for Community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
The Economics of Home Care . . . . . . . . . . . . . . . . . . . . . . . . . 63
Serving Others Versus Serving Yourself:
Finding the Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
A Note about Senior Day Care . . . . . . . . . . . . . . . . . . . . . . . . . 67
Exercise: Are You Ready for Home Care? . . . . . . . . . . . . . . . . 68
Maybe We’ll Just Give It a Try. . . . . . . . . . . . . . . . . . . . . . . . . . 74
5: Your Feelings Matter More than You May Think . 76
Your Feelings Determine Your Experience . . . . . . . . . . . . . . . 77
The Nature of Emotions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
What You May Be Feeling about the Nursing Home
Decision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Emotional Soup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Exercise: Understanding Your Mix of Emotions . . . . . . . . . . . 110
Part II: You’ve Decided .. . Now What?
6: Finding the Right Nursing Home . . . . . . . . . . . . . 118
A Change in Abilities Calls for a Change in
Living Arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Different Kinds of Long-Term-Care Facilities . . . . . . . . . . . . 120
What Kind of Care Does My Parent Need? . . . . . . . . . . . . . . . 126
Beginning the Search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Location: Finding Nursing Homes in Your
(or Your Parent’s) Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
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Contents vii
Size of the Nursing Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Who Owns the Nursing Home? . . . . . . . . . . . . . . . . . . . . . . . . 136
Paying for the Nursing Home . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Facilities and Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
The Nursing Home Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Your First Visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Facility Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Taking Your Parent with You when You Visit . . . . . . . . . . . . . . 151
Waiting Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
7: Once You’ve Found a Facility You Like . . . . . . . . . 153
Talking It Over with Your Parent . . . . . . . . . . . . . . . . . . . . . . . . 153
Preparing Clothing and Other Possessions . . . . . . . . . . . . . . 155
Keeping Your Parent’s House or Apartment . . . . . . . . . . . . . 155
Moving In and Feeling at Home Are Two Different Things . . 156
The First Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Part III: Making the Most of Life in a Nursing Home
8: A Day in the Life of a Nursing Home . . . . . . . . . . 164
What Around-the-Clock Care Looks Like . . . . . . . . . . . . . . . 165
A Day in the Life of a Nursing Home Aide . . . . . . . . . . . . . . . . 166
A Day in the Life of Some Nursing Home Residents . . . . . . . 170
A Day in the Life of a Nursing Home Director . . . . . . . . . . . . 173
9: Staying in Touch with Your Loved One Who
Lives in a Nursing Home . . . . . . . . . . . . . . . . . . . 176
When to Visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
How Often to Visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
How Long to Visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
How Many People to Take when You Visit . . . . . . . . . . . . . . . . 184
What to Do During Your Visit . . . . . . . . . . . . . . . . . . . . . . . . . . 186
You Know More than You Think You Do . . . . . . . . . . . . . . . . . . 192
Special Activities for Staying in Touch . . . . . . . . . . . . . . . . . . . 193
How to Celebrate the Holidays when Your Parent
Lives in a Nursing Home . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
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viii LIVING WELL IN A NURSING HOME
10: Managing Common Conflicts in a
Nursing Home . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Conflicts Between Residents and Family Members . . . . . . . 201
Conflicts Between Residents (or, the Battle of the
Wheelchairs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Conflicts Between Residents and Staff . . . . . . . . . . . . . . . . . 205
Conflicts Between Family Members and Staff . . . . . . . . . . . 207
Conflicts Between Family Members Other than
the Resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Conflicts Within Yourself . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
11: Working with the Nursing Home Staff . . . . . . . . 220
Communication in General . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Showing Your Appreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
Offering Critical Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Can’t Get No Satisfaction: What to Do when You
Have a Complaint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
12: Other Important Things to Know . . . . . . . . . . . . 233
Dehydration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Addictions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Sexuality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Laundry Complaints (or, Nobody Is Stealing Your
Mother’s Underwear) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Money . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Housekeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242
The Use of Restraints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Changing Institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Saying Goodbye: Leaving the Nursing Home . . . . . . . . . . . . . 249
Special Goodbyes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
In Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Recommended Reading . . . . . . . . . . . . . . . . . . . . . . 258
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259