Category Archives for Long Term Care Continuum

The Best Of…Day Services Help Seniors Stay at Home

Published on May, 7, 2001, Pawtucket Times

            Like apples and oranges, senior centers and adult day care are quite different.  But when viewed as complementary community-based services, each can be instrumental in keeping elderly Rhode Islanders independent and at home.

           While senior centers serve the independent older population, programs and services provided by adult day care centers are specifically designed for functionally or cognitively impaired adults.

          Senior centers can serve as “brokers” between the elderly and the surrounding community, creating access to a wide variety of programs and services, states Rick Ryan, former chair of the Washington, DC-based National Institute for Senior Centers and director of senior services for South Kingstown.

        According to Ryan, some people today still believe the myth that senior centers are drop-in centers or “play pens for the frail aged where persons are spoon-fed programs and services.”  Not true, he says.

        “Indeed we have come a long way,” Ryan noted, stating that “senior centers are not developed through a cookie cutting process.”  Programs across the nation are as varied and diverse as the older population that they serve.  In fact, he says, senior centers evolved in response to their surrounding communities and reflect the interest and values of those older adults who not only participate in their programs, but also help shape them.

        For those participating, Ryan stated hat senior centers offer a menu of activities, with older participants being allowed to develop and design their own programs. Activities can range from computer labs offering Internet access, yoga, line dancing, aerobics, playing cards, art classes or even shooting pool.

         Since the early 1970s, adult day care centers have existed. According to the National Association of Adult Day Services in Washington, DC., here are more than 3,000 adult day care centers currently operating nationally.

         “There are 16 state-certified adult day care centers in Rhode Island,” noted Ryan, who also is a member of the Rhode Island Adult Day Services Association, a group representing programs in all of the state’s 39 cities and towns.

         Ryan stated that adult day centers provide a comprehensive planned program of health, social and support services in a protective setting during daytime hours.  “Activities include mental processing programs such as current affairs and word association games to stimulate thinking more physical activities like volleyball, dancing and range of motion exercises.”

         Services at adult day centers are specifically designed to meet the individual needs of the elderly and strongly focus on ways to help relieve the stress of the caregivers.  Such programs are critical in assisting caregivers to maintain their loved ones at home in the community.

       Adds Sharon Rice, director of the Comprehensive Day Care Center, a program of the Jewish Seniors Agency, “One of the most important factors of a day care program is that adult children taking care of elderly frail parents don’t have to worry about how they can take care of their parents, work a full-time demanding job while caring for their children.”  She noted that most adult children prefer to have their parents “age in place” at home rather than have to institutionalize them in a nursing home.

   According to Rice, today’s day care centers in Rhode Island have undergone vigorous licensing procedures through the state’s Department of Elderly Affairs to ensure quality.

          Ensuring quality through licensure can increase the adult children’s willingness to place his or her parents in an adult day care program, she said.

         Currently, Rice states there are 30 frail elderly persons enrolled in her day care program, attending each day.  Although located in Wayland Square on Providence’s East Side, Jewish Seniors Agency program, established in 1974, also serves East Providence and nearby Pawtucket.

         Keeping a person at home is not always the best option. Rice says, because the older person becomes isolated. “Day care can promote friendship, social interaction and therapeutic activities,” she added.

        “Person with Alzheimer or related-dementia, Parkinson’s disease or  who have suffered strokes receive supportive services at the day care center from a registered nurse, a professional social worker, and a certified nursing assistant,” Rice added, noting that participants also are served kosher meals.

      When adult children are faced with care giving responsibilities for their loved ones they do have a choice – to keep the person at home and not in a nursing home, Rice quipped.  “Adult children should feel comfortable in knowing that they can keep a frail elderly family member at home and in the surrounding community.

         Herb Weiss is a freelance Pawtucket-based writer who covers aging, health care and medical issues.   He can be reached at hweissri@aol.com.

The Best of…Little Things Count When Deciding on a Nursing Home

Published April 23, 2001, Pawtucket Times          

           It isn’t easy operating a nursing facility these days.

           The high turn over rate of certified nursing assistants has drastically impacted the quality of care provided in facilities.  And this direct care staffing shortage is also financially hurting facilities too, reducing their financial stability, even pushing many towards bankruptcy.

          According to the Rhode Island Health Care Association, eight out of the state’s 105 nursing homes have filed for Chapter 11 Bankruptcy, two are currently in state receivership and two more were recently ordered closed by the Department of Health.

         In these difficult financial times for nursing facilities, especially with a state-wide shortage of certified nursing assistants, youmusts become a better shopper when seeking the most appropriate nursing facility to place your loved one.

       “Until there is a health crisis, families don’t often think about nursing facility care until it’s too late,” states Roberta Hawkins, executive director of the Alliance for Better Long Term Care who serves as the state’s ombudsman on the behalf of 10,000 Rhode Island nursing home residents.  “If  it’s possibly, just plan ahead,” Hawkins recommends.

      “Your state health department provides a comprehensive list of nursing homes and their survey results to help you determine if the facility is reputable,” states Hawkins.

       According to Hawkins, word of mouth or personal recommendations from family, friends, neighbors, hospital discharge planners, and her nonprofit advocacy group about a nursing home’s care are key bits of information to determine if the facility is well managed.

        “The Alliance also offers a free phone help line to assist matching the particular needs of a person with a specific facility,”  Hawkins adds.

       With more than 20 years of experience under her belt in assisting families find the right nursing facility for the loved ones, Hawkins gives simple tips on selecting a facility.

        Hawkins suggested that a need for upgraded services for residents requiring intensive medical care, special rehabilitation therapies and dietary requirements, along with religious and cultural needs should also be taken into account before selecting a facility.

       Location should not always be a deciding factor in selecting a nursing facility.  Carefully choose a facility that meets your loved ones medical, personality and social needs.

       In many cases, this critical decision is made only for convenience of family members or visitors.  If an elderly spouse can not drive, make sure that the selected facility is on a bus line.  Keeping a married couple close together is very important for their psychological well-being.

       Always have the older person in need of skilled nursing care, actively participate in choosing a facility even if they can’t physically visit the site.  Family members can also provide this person with brochures and admission materials.

      Don’t choose a facility on the basis of a beautiful physical exterior, fancy rugs, or glittering chandeliers, Hawkins says.  When visiting a nursing facility, always observe how staff members interact with residents and each other — look for laughter, a pleasant environment, and a strong activity program.

       For those frail residents who are bed bound, look for a stable nursing staff.

       Ask yourself, is the facility’s environment cheerful in appearance and clean?

        Are the bedrooms warm looking and do they reflect the residents individuality?  Or do they all look the same, like hotel rooms.

        Find out if residents are allowed to bring in personal belongings such as chairs, tables, lamps or even a television set into their rooms.

        For those persons who always loved nature and being outdoors, find out if the nursing facility has an outside area for sitting or walking.  Determine if this area is accessible to a wheelchair bound person who might want to roll outside to listen to the birds.  This simple amenity is very important.

        When touring a facility determine if a dining room is available for eating meals and space to allow residents to socialize with each other and participate in activities.

         Is there a real working activities room?  A resident who has always been involved in crafts and enjoys participating in group activities will want to select a facility with a well-run activities program.

         Also, be aware of how the nursing facility smells.  Sometimes you may smell strong odors of deodorants.  This might be covering up unpleasant odors.

        Listen for sounds of buzzers, rung by residents in need of help, and observe how quickly staff responds.

         When walking the halls, say “hello” to the staff you meet.  Do the staff pleasantly respond to you?  IF not, consider that they may not respond           well to your loved one.

         Walk in and talk with residents gathered in a community room.  In conversation, find out how long they have lived at the facility.  Ask if they like the facility and are they respected as individuals by staff.

         If you see residents in restraints lying or sleeping in a chair or wheelchair, this may be a red flag for poor care.  The facility may not have enough staff to allow the residents to lay down in bed for a nap in the afternoon.

         After you locate your facility, “put your name on the waiting list,” Hawkins recommends, even if the nursing facility admissions will occur months later.

         For those afflicted with Alzheimer’s and related dementia, it is wise for these individuals to be admitted earlier in the disease process to get them acclimated to the facility and for the staff to learn more about the resident’s habits, likes and dislikes.

        Herb Weiss is a Pawtucket-based freelance writer covering aging, health care and medical issues.  This Column appeared in the Pawtucket Times on April 23, 2001.