Tuesday, November 3, 2015
When And How To Place Your Loved In A Facility And Why
All these are questions that need to be dealt with at one point when caring for a dementia patient.
In some cases, the patient is cared for at home until the very end. In some cases.
The issue here is few even talk about placement, let alone check into it until it is inevitable. This is something that should be discussed with the patient, not behind closed doors.
Of course if the family waits till the later stages the time to talk to the patient about their feelings on placement has long came and gone.
There are many stigmas that goes along with dementia. How care facilities are now, as compared to how they were twenty, thirty, years ago is one of these stigmas.
I contend that the person who rants and raves about not placing Mom in a facility because of the smell, the antiquated building, the dated tile floors, and on and on, have probably never even been in a care facility in the last ten years.
The thing is over the last ten years these facilities have modernized. Gone is the smell of "old people". Gone is the urine smell, the pale lighting to make it drab in appearance.
These places now have wall to wall carpet, they have flat screen tv's, they have lighting that doesn't look like it came out of the 1920's. And at many of these facilities you can order what you want to eat from a menu.
Most of them do have limited staffing, this is just the nature of the beast. They are a business, and they are in business to make money. You are not going to see nurses or aids for that matter standing around with nothing to do.
Sometimes the ratio of nurses to patients is one to how many patients there are. Every facility must have a RN on sight. Then they go to LPN, and aids.
As far as hands on with the patients, the STNA's, there can be as many as a half a dozen patients to one aid. This is just the way it is.
When you are in a facility, you won't get waited on like a hospital. Sometimes you have to stay on them to make sure for instance that your loved ones pain meds are being administered on time.
Again, this is the nature of the beast. But all in all, like I said, these facilities are not like they were twenty years ago. The problem is those giving these places a bad wrap haven't been in one in decades.
Or they made some stupid promise twenty years ago never to place their parents. You will hear this all the time, "I promised Mom I would never put her in a home".
This to me is so shallow. Why would anyone put their loved ones care in jeopardy over some promise made when the person was fine.
When making such decisions no one takes into account how they or if they will be able to provide such care that is needed for in home care for a dementia patient in the later stages.
Here's whats important. There is never a downside to placing a loved one too soon. There are all kinds of downsides to placing them too late, and none of them are good.
Chances are everyone has made a solid vow to take care of their parents, spouses, kids, etc. To make sure they are getting the best care afforded to them.
And by keeping them at home when you know deep down you simply cannot provide the care that is needed 24/7, but you still do it, then you are not keeping your promise to take care of them.
By placing someone, you have not given up. You have not lost. All you are doing is recognizing and dealing with the fact that you cannot provide the care that is needed any longer.
It's knowing you can't, yet you continue to do the best you can that is a problem. Knowing when it is time is very important. Waiting to the last minute is also a mistake.
Placing a loved one is much more than loading them in your car, pulling up to a facility and announcing that you are here. Every patient has to be placed through their doctor.
None of these facilities are hotels, you can't just check in and check out. There are countless things that need to be done, and none of them happen overnight.
Payment is the first and foremost on the minds of these facilities. Like I said it is a business, and they even though they don't convey it at the time, they do want and will get their money.
You won't find a facility that will take your loved one if there is no insurance and no way to pay them by private pay. They won't have a bed taken up by someone who can't pay, and have someone that is eligible waiting for a room.
The doctor is the one who places your loved one. Not the family . This too is a misconception. Some think it is the family who makes the decision. Which it is in the beginning, but the doctor has to be the one to sign the patient into a facility.
Placing someone is indeed very difficult. Feelings of failure, to depression, to stress, and loss are all involved. I am here to tell you that first of all you are and always will be the primary caregiver.
Just because you have made the decision to place your loved one, your responsibilities as a caregiver do not diminish. If anything they are more important.
You have to make sure the facility knows your loved one. They are not just another patient. Tell them there likes, their dislikes, their fears, what agitates them.
Make a list of thing, you will never remember them all. Make sure the room where your loved one will be is surrounded by things they love. Pictures, a way to play their favorite music, the tv is able to get their favorite shows, you have their pillow there, comforter, etc.
There will be a process of them getting used to the new surroundings. And this process differs for each patient. Could be hours, days, or weeks.
The thing to remember throughout all of this is that you are doing what is best for them, not you. Placing them to me can be one of the most loving things you can do for a loved one.
You are doing something you mind says is right, but your heart tells you different. You told them you would take care of them, and you are by getting them the care the deserve and are entitled to.
Just because that care is more than you can do now, does not take away anything. They are simply in a place that can provide the 24/7 care that some families for whatever reason cannot.
I am not an expert on placing a patient. I don't think anyone is. But I am a dementia patient in the mid stage of this disease. And Phyllis June and I sat down years ago and I explained to her and our family that I indeed want to be placed when the time is right.
It is her responsibility to know when that time is. Just knowing this is what I want now, takes a huge burden off of her down the road. Will it still be difficult? Of course, but she will know that this is what I want, and we made this commitment a long time ago.
Talk about this. Don't let the possibility of placement become the elephant in the room no one mentions, yet it is there. If you haven't talked about it, there is no better time then now.
Not every family will face placement at some point. And that is wonderful. I want to change the stigma that it is wrong to do so. Because the simple truth is that it is not wrong.
If your loved one falls because you lost control of them in the middle of the night, and they are frail to begin with, the chances or breaking a hip are very good.
And for the elderly, a broken hip can be deadly. Even those who are not diagnosed with dementia and fall and break a hip are very likely to be bed ridden or even die from the injury.
There is no downside to early placement of a loved one. There is no time table to go by. There are many downsides to waiting to long for placement and all those downsides are very, very difficult at best. And can be life threatening.
© Rick Phelps 2015