How do you find good care for a parent who can no longer stay at
home? How do you know what to look for, where to go?
One thing you don't do is throw money at the problem. In other words,
the most expensive care is not necessarily the best.
Based on ten years of working with people with Alzheimer's in every
possible range of care, including a year spent at one of the most
respected traditional nursing homes in California, I place nursing home
care at the bottom of the choice list for people with Alzheimer's.
The traditional medical model has NOTHING to offer the resident with
dementia. Nothing, except to be nursed. Most people with Alzheimer's
do not need nursing unless they have another medical condition
that requires it.
Merely having multiple medical conditions does not require it. Many elders
have multiple medical conditions and live happily at home.
The medical model of care is the most destructive to persons with Alzheimer's.
Think about it. It is based upon nurse-patient physical care patterns,
requiring the patient to be obedient, to conform to treatment requirements,
and assumes a general frailty that requires much rest, most of it bedrest.
It also demands competence.
What does the person with Alzheimer's need? First and most important,
a relationship. That person needs the psycho-social model of care.
More specifically, the person needs a psycho-social model of care that
allows safe movement, kindly structuring, no memory demands, no conformity
demands and offers a supportive environment for the individual with
dementia.
What would such an environment offer? Interpersonal relationships with
staff. An activity-based day. Home-like surroundings. Primary colors.
Bright but not harsh lighting. Safe wandering. Pets. The right background
music. A great deal of individual attention.
What do people with dementia get in the average nursing home? Long
clinical corridors with hard floors, so falling means bruises and
broken bones. Every corridor and every door alike. A lot of ordering
about--ringing of alarm bells--hard cold lighting--little to do--
little staff attention.
What does it cost you? From $3,000 upwards, private pay. Special care units? More expensive.
Usually less well decorated, often the oldest wings of the nursing home,
overtired staff. One Activity Director for anything from 20 to 50 residents.
These units are all too often geriatric prisons.
And it is a scandal, because we already know a lot about what people
with dementia need. However, until families start demanding better, you
won't get it.
It is not the dying of the light you should rage against - it is the ugly
state of most special care units in nursing homes. This is the growth
industry of the future. Don't let it be done on your parent's misery.
Look around. Look for somewhere quiet and kindly. Look for somewhere
you wouldn't mind living yourself, if you had to. Your best bet is
the small private care home, often called the adult foster home,
where up to five or six people live in family-style care.
In these places, people with dementia can get all the care they
need, including complete help with bathing, dressing, grooming and
eating. That so-called skilled nursing care you hear about --it is
a euphemism for wiping the behinds of people who cannot do that
anymore. Hate to put it that way, but families need to know in order
to make good, supportive meaningful choices for their parents.
Care homes are licensed and inspected by the state, complaints are
looked into and they can be good or bad, just like nursing homes.
But they can be much more supportive of the demented.
I have seen such places. They make a very short list so far. But of the
hundreds of places I have seen, I would like to stay at a place
like one of the following, if I had Alzheimer's Disease. And
it would cost a whole lot less.
FRYE'S GUEST HOUSEin Napa, California, is a beautifully converted Victorian, housing eight residents. It feels just like home. A big factor in the atmosphere is their commitment to staff training -- extremely rare with the owners of small care homes.
KENSINGTON COTTAGES in Bismarck, North Dakota, is notable for encouraging relatives to come and live with the person with Alzheimer's! The apartments were designed for Alzheimer's patients and their caregiver. It maintains family life, while offering dementia programs.
THE HEART OF HOPE CARE HOME in American Samoa is multi-generational and offers care for multi-conditions. It works because of spaciousness and, most of all, because of the spiritual approach to caregiving.
SELECT GROUP HOMES 4730 30th St W., Bradenton, Fl 34207 phone 941-753-5264 webpage: www.selectgrouphomes.com email mjbbb@aol.com ) In process of developing five group homes. The first one is completed. Also a team can provide care at your home. We have not seen these homes, but have been in correspondence with the owner. She describes them as follows: "The nurturers of this cluster of group homes are all in the belief that Demntia residents need psychosocial care and a lot of one on one attention...each caregiver will have 3 residents to care for...Our goal is to give the memory impaired resident everything that he/she needs, medically, emotionally, and spiritually to function freely and with as much dignity as possible...full time recreation therapist...staff will be trained continuously in all aspects of caring for our special residents."
