When It's Time For the Nursing Home With a Poem

The Nursing Home

I wrote this piece in 1982. It's about my great grandmother. After 98 years she could no longer care for herself. She told me she was mad because she had lost a contest with her older sister. What contest? Whoever lives the longest wins. Her older sister lived to be 101.

"I was often with her at the nursing home. Her hair was cut short and permed. In the past her thick snow white hair reached down and past her mid section. She looked at me and didn't  seem to recognize me right away but her eyes were not so good. While talking to her I realized her hearing aid was old. Squeezing my hand in hers our palms began to sweat. We were afraid to let go. I didn't want to let go.

She told me she would never get better that getting old was not so nice. Her legs were like rubber. Her good hand was squeezing and petting mine. She told me how soft and firm my skin was. She got so tired but she didn't want to sleep afraid she would miss the day. She had so few days left.

She told me that the nurses were very nice there (especially a very young male nurse). She told me that she hated being helpless. She wanted to live in her own home. I could see the tears in her eyes. I could feel the tears in mine. I knew she would never go back home.

The family told her the nursing home was a school and that when she learned to walk she could get up and walk right out. We thought she would forget. But of course she did not.

She told me that she was in college but that she would never get out because her walking classes were only once a week. If only they would walk her more she wished out loud.

The family just kept waiting, looking at her sadly, hugging her and loving her. Some were fighting when she left the room for therapy over who would take her to the bathroom next...but loving her.

She told me that she was afraid to die. So was I. I was afraid for her to die and afraid to die myself."

Now it's 2009. I wonder about my parents. I wonder about myself.

My father is dying slowly from cancer. My mother is getting on in age but probably has twenty good years left if genetics play a part. I don't ever want to have to make the decision to put anyone in a nursing home. I don't ever want anyone to have to make the decision to put me in one. I've decided I'll choose my own home and check myself in. I'll pretend that I believe it's only for a little while.

Yes, I'm still somewhat afraid of dying....but more afraid of living long enough to revert back into an infant. However, I don't think I'll care much at that point. I just don't want to go painfully.

I wrote this poem about my great grandmother, Unabelle McCallum when I was about 17. She had it hanging on her wall for a very long time. I hadn't had my children nor my grandchildren at that point or the poem would have been much much longer.

I'm Not Yet Born

A solemn breeze passed through the sky

I'm not yet born.

It carried tenderly the seed

Through winters morn

And placed it in a bed of sand

To root a home

I'm not yet born, but leaves came forth

The bright sun shone

And from the tree came many seeds

The wind still blew

And carried them and laid them down

To start anew

And as time flourished through the years

The wind blew by

It carried forth another child

Through summer sky

Then I was born to see above

The great tree bend

We all look up and now I wait

To catch the wind.

Debra K. McKee

Copyright 2008-2009 © Debra K. McKee

Home Health Care: For Your Convenience

If you have ever heard of home health care, you probably realized that it could potentially be the best and most convenient option for you when it is time to take care of a parent or other adult who can no longer completely take care of himself or herself. This is something that happens to all of us at some point.

Home health care goes by many other names as well. These include domiciliary care, social care, in-home care, and formal care. These are all essentially the same things, and in the following it a few paragraphs we look through what all of that specifically means when it comes to services.

Home health care specifically deals with licensed professionals. These are licensed health care specialists who have gone through all of the regulated training sessions in order to be put on a list of people that can practice medicine. This is an important distinction because there are other types of care that do not require this license.

Included in this short list of licensed healthcare professionals who can provide home health care are licensed nurses, social workers who have medical experience, physical therapists who have been through regulated courses, and dietitians. These people all have medical experience thus fit in this specific category that you are concerned with right now.

This is in direct opposition to non-medical or custodial care. These are the type of people who come in and take care of the elderly more or for a social reason than a medical one. They are not licensed to do things with medication or specific medical devices, and so they have fee different function they perform at your home should you choose to hire them.

There is the matter of why you would choose home health care in the first place. Mostly because, there is going to be a time when you have to either send someone to a nursing home or hospital. If this is not something you are interested in quite yet, home healthcare is a responsible alternative where everyone gets what they need.

The cost of home health care is quite variable. Sometimes it could be quite a bit more expensive than the hospital or nursing home visit, while on the other hand, the money that you save from sending someone in your home may be to your financial advantage in the end.

Home health care is definitely something you should consider for your family or loved ones, or something that they should consider for you if you are getting on in years. It will probably become more popular in the coming years as people are more interested in keeping their family around, rather than sending them away.

Cases of Nursing Home Abuse on the Rise

In developed countries where most professionals and their families are too busy with their work and businesses, the elderly members of their families are often left in the care of nursing homes. This reality has, in fact, led to the increase in the number of nursing homes being put up in urban areas and a rise in employment opportunities for caregivers.

Unfortunately, all is not well in these nursing homes. Abuses exist in these homes for the elderly and they can go undetected or unreported. However, abuses have continuously been reported in recent years inside these institutions that were supposedly put up to provide care to the old folks. It is a sad fact that many elderly residents have been the subject of abuse by their supposed caregivers. Abuse cases have caused fear instead among families who have put their trust in these nursing homes to take care of their elderly loved ones.

In the United States, there are 15,000 nursing homes that accommodate more than 1.5 million people. These homes are divided into the for-profit ones, the non-profit nursing homes and the government operated ones. They are inspected once every year to check if they meet government standards to enable them to take part in the Medicaid and Medicare programs.

In 2008, a total of 37,150 complaints were received by inspectors and one-fifth of them involved abuse and neglect of patients. Additionally, a review of state inspection records in 2001 showed that some 5,283 nursing homes were cited for abuse violations. Reports say these abuses take the form of causing physical harm, verbal and sexual abuse or even death to the old residents such as punching, kicking and choking them. These abuses normally happen when nursing assistants are angered by the slow actions, awkwardness and clumsiness of their patients. Abuses can also be inflicted by a fellow resident who may have had a history of violent behavior or a criminal record in the past.

There had been cases of physical and sexual abuses in several nursing homes in the U.S. and a number of them have been shut down due to this problem. Government officials have already ordered a more rigid background check on nursing home residents with previous criminal history.

People facing abuse problems that involve their elderly folks in nursing homes can seek the help of nursing home abuse lawyers. These lawyers are knowledgeable about the signs of abuse among the elderly people and the steps to take to get just compensation for the sufferings caused by nursing home staff or fellow residents. They can also offer tips on how to prevent future abuses.

An abuse that results in physical injury and emotional problems can be cause for filing a personal injury lawsuit against a caregiver, nursing home or fellow resident. A legal action is the right thing to do to claim compensation for the injured person and to reform the conduct of the people and institution involved that caused the injury. An abuse inflicted on an elderly individual can only happen because of negligence on the part of the caregiver and the nursing home itself.

Caring For Our Elderly Parents and Relatives

Years ago the choice was simple, everyone chipped in to help. There was never a shortage of resources and parents lived with their children when they could no longer care for themselves. To assist in the matter, most women were stay-at-home Moms who took care of their children and parents. Those were the days when people had large families, a support system that all lived in the same city or town. Today, however, things have changed dramatically. We have stopped having the large families; if there are siblings, they frequently live far apart due to the strain of finding sufficient employment. Society has become mobile, here today, somewhere else tomorrow. So how do we care for our elderly? Off to a nursing home or assisted care living, the burden and responsibility has shifted to unrelated people to care for our elderly. It is no wonder we have lost respect for our elderly, out of sight out of mind. Old age was once thought of as the "Golden Years," but not any more. Nursing homes and assisted care living is extremely expensive. How do we plan for these costs with house payments, car expenses, college tuition, insurance fees and every day living costs? Long-term care policies only pay a fixed amount per year and have caps. So what are we to do? The bubble is going to burst at some point with the baby boomers approaching retirement age.

Doing the right thing for your Parents or elderly relatives can be daunting, demanding and stressful. The situation can be magnified if your parents have health issues e.g. Alzheimer's. My family was faced with this dilemma a year ago. My Mom's Alzheimer's was progressing and she lived in her house alone. Additionally, she lived on the East Coast, my brother in the Midwest and I in the West. We choose not to place her in a nursing home because she had severe sun-downing symptoms, i.e. paranoia, hallucinations, delusions. We were concerned that she would be highly medicated and confined to a wheel chair if placed in a facility. Our Mom has two good legs and enjoys walking and being active. Keeping an eye on her in a nursing environment would be challenging. Attention provided to patients is based on a facility's staff to patient ratio which is generally one staff member to many patients, mandated by law. Finding a good facility requires establishing a criteria checklist. Some factors to consider when searching for a facility are:

1. Facility Reputation


2. Pending Lawsuits, prior lawsuits


3. References


4. Certifications


5. Site Inspection - Visual observation


6. Are patients happy?


7. Are patients clean, dressed appropriately for the temperature and weather?


8. Does the staff know each patient's name?


9. Noise Level?


10. Facility cleanliness?


11. Is temperature controlled within each patient's room?


12. Security, Wander bracelets, anklets?


13. Wheelchair access and handicap showers?


14. Staff to patient ratio - What nursing level, i.e. RN, LPN, CNA per shift and how many?


15. Does Facility offer future and on-going training for all staff members?


16. Programs, Activities, Recreation, calendar of events for residents?


17. Emergency procedures, working fire detectors and sprinkler system?


18. Meals, Nutritionist on board, special diets for patients with food allergies or diabetes or other health issues?


19. Price, Price increases how often, historically, how much advance notice?


20. Furnished/Unfurnished?

If you decide to go the nursing facility route, make sure to visit your parent and facility on a regular basis to ensure your family member is being treated and cared for appropriately. Don't ever convey when you will be there to visit, show up at different times. Inquire immediately about any bruises, odor and request to see medication reports to review times administered. Visit with the nurse on duty to obtain daily information. If nursing home costs exceed available funds and you are over the Medicaid threshold, see if there are additional funds under Medicaid's Medically Needy Program. In some states, Medicaid will pay the difference between what you can pay and the facility's cost even if available funds exceed Medicaid's threshold.

If you are thinking about caring for your parent at home, your home will need many features similar to those found in a nursing environment i.e. safety features, shower accommodations, wheelchair/walker accessibility, door latches and i.d. bracelets for wanderers. A major difference for at home care is that you become the around-the-clock nurse, housekeeper and cook, 24/7. You will need the following skills and/or knowledge

1. Lifting skills.


2. Bathing/showering skills.


3. Toilet cleaning skills.


4. Dressing skills.


5. Denture care skills, make sure to clean and remove while sleeping.


6. Knowledge on administering medication timely with or without food, medication side effects.


7. Food preparation skills, i.e. how to prepare appropriate balanced meals, soft foods for chewing and swallowing, no tough steak or sticky chewy candy.


8. Provide mental and physical stimulation. Flash cards, puzzles, card games and walking are good activities. Ask them to write sentences and their name is a good memory exercise.


9. CPR skills so you can recognize life threatening symptoms and be well prepared for the unexpected. Knowing what signs to look for with the elderly can be life saving when time may be of the essence, e.g. stroke signs.


10. Calming skills when someone is confused and doesn't recognize you. Go with the flow and try not to get them upset, create a soothing story. My Mom wanted to know where her young children were; she thought my brother and I were still kids. Instead of explaining the truth, I said they were at their friend's home playing and they would be back later.


11. Don't leave them alone.

My brother and I decided to keep my Mom at home with us. I took her for several months and established a good treatment plan with the assistance of several specialized doctors. My brother then took over the care of her at his home. His home is more suited for elderly care, i.e. minimum stairs, bedrooms and bathroom on main floor, large, wide hallways for walker access and our Mom was accepted into a clinical study research program with a major pharmaceutical company. The company is in the last year testing a new drug for Alzheimer's before going to market.

Caring for the elderly at home, there are common symptoms to be mindful of. Dehydration with the elderly is common. When you pinch skin on the back of their hand, it should snap right back in place, if it stays pinched together, they are dehydrated. Make sure they drink plenty of fluid, water is best. Another common feature with elderly people is that they tend to have dry skin. Assist them with moisturizing their skin with a hypoallergenic moisturizing lotion. Elderly people also tend to be colder since they move around less, keep a sweater, jacket or blanket handy. Elderly may have incontinence issues so keep a change of clothes, bed pads, wipes, etc. in a diaper/travel bag, be prepared at all times for the inevitable. Keep sunglasses and tissues in the car. Pack whatever is necessary to keep them comfortable, snacks and water is also a good idea if you are away from home for a long period. Elderly can be like children. You have to do all the thinking.

Taking care of the elderly can be emotionally and physically draining, make sure to give yourself a daily/weekly breaks, don't burn out the caregiver. There are many support groups that can assist with stress. There are nursing agencies that provide per diem nurses for $18 per hour and up. Your religious institution may have volunteer services which could provide you relief for free. There are also adult daycare centers sometimes run by your hospital or city. Social interaction is good for the elderly especially those with Alzheimer's. Ask friends and relatives if they could assist for a few hours a week. For additional resources, consult your doctor and city offices. Good luck with your decision. If you have any questions, please email me. Thank you, Kathryn Alexander. www.herocardsinc.com.

How To Become A Successful Nurse

Are you interested in patient care? If yes, why not pursue a career in Nursing? Familiarize yourself with the procedures and steps on how to become a nurse. The first thing you need to do is to register and enroll in a 4-year degree program. However, you can also take short courses, focusing only on patient care training. Moreover, you need to know what specific area you want to work. You can be an ICU nurse or a nurse working in home care. Following are the basic steps on how to become a nurse.

Plan And Select A Program

As an aspirant health care professional, there are two methods available for you to select. The first one is the traditional way and the second is the practical method. Ideally, you take a Bachelor's Degree in nursing which you can complete in four years. The Bachelor's Degree program in Nursing includes regular classroom lessons in pharmacology, anatomy and physiology, nursing skills, diseases and physiology. As a student and an aspirant health care professional, performing and completing practical classes in patient care at hospitals is essential. You can experience firsthand nursing care to your patients during practical classes.

If you wish to become a home care nurse, the practical way is to take an associate degree in nursing. Soon after graduation, you can take the examination for nurses. One can complete the associate degree program or practical nursing in 12 to 18 months. The program includes practical training in patient care.

LPNs or aides can take extra courses to become a Registered Nurse. After finishing all the courses needed, one can opt to take the nursing examination as well.

Work Environment

In selecting where to work, one can choose whether to work in doctor's offices, clinical areas and home cares. Other options available are working as a company nurse on offices, personal nurse on private residences, and clinical staff at schools. If you want to pursue a career and at the same time serve the country, working as a government nurse assigned on military bases is the right job for you. This kind of opportunity can give better monetary and health benefits.

Once you know which course, getting your dream job would be a breeze after graduation. If you wish to go further in your career, you can choose to take the Master's Degree in Nursing. After completing and accomplishing the advance program, you can earn promotions and you can receive high earnings.

Final words, when applying for a job, it is helpful to highlight and emphasize your skills in planning, supervising, and monitoring patient care, record keeping, and other regular duties and responsibilities. Be confident and let your body language speak to show that you are competent enough for the job. Do not be afraid and trust your instincts.

Caregivers Do More Than Just Provide Care

In an assisted living environment, caregivers are often thought of only as "hired help."  In fact, both short and long-term relationships with caregivers offer benefits far exceeding assistance with daily living. 

The acceptance that caregivers are play an important role in the daily happiness of both the patient and family can lead to a far more positive assisted living experience.  

For residents, caregivers play a number of different roles, including:

• A friend. Just like having a roommate, the caregiver and your loved one will spend a lot of time together. And just like a roommate, a caregiver and your loved one can become great friends (or not, but that's a different discussion). The resident and caregiver have become very good friends, going to events together, watching movies together and chatting like good friends do. At many times, the "caregiver" side of their relationship is minimized, and they are friends. This is a good thing!


• A listener. The transition to assisted living can be difficult for many people. It was especially difficult for many to move from being so independent to becoming so dependent. Caregivers can be great listeners and counselors. In many cases, their experience gives them a far greater understanding of these challenges than you, and they can be a great resource for your loved one to talk through the issues.


• A cheerleader. It can be tough to get motivated for the activities of the day, physical or occupational therapy or just to get out of pajamas in the morning. It's often tough for all of us. Caregivers can serve as a great cheerleader, giving pep talks when necessary to get out and enjoy the activities of the day.


• A big brother or sister. Often in assisted living, the squeaky wheel gets the grease. A caregiver can be the first line of defense to ensure your loved one gets what they need, when they need it.

For families, caregivers can play a whole different set of important roles, including:

• Your eyes and ears. While I am lucky enough to live close to my mom, many families live far away from their loved ones. A caregiver can be your eyes and ears about general care, food, services, activities and all the other daily things. They can also share with you the reality of things, as sometimes situations can get exaggerated. Being defensive as we are, it's good to get both sides of the story before you approach management with a complaint. Example: sometimes residents think their kids are overprotective, but if they stay in touch with the caregiver, they can ensure things are okay while at the same time giving the resident his/her space.


• A concierge. It takes a lot of coordination to get your loved one to activities, doctor appointments, beauty appointments, therapy, etc. Each one of these things requires phone calls, follow up, etc. A caregiver can help to off-load much of these from you and help manage your loved ones daily weekly and monthly calendar.


• An influencer. As close as you may be with your loved one, there will always be certain topics or issues in which your opinions are not appreciated. Example: Many residents hate going to the doctor. No matter what family members say, residents can often gets defensive and and refuse to be convinced that a doctor visit is required. Because of their own experiences, they may have an aversion for doctors and hospitals. A caregiver can be an alternative communication channel, based on a different type of trust and many of the roles above, and they can be effective at helping to open them up to a different point of view.

There are more, but these are the big ones and certainly enough to get you thinking. 

While it may take a while to find the right caregiver, interviewing and evaluating caregivers on more than just their ability to provide care can be beneficial.

Fighting Depression With Assisted Living

Fighting depression is an important part of staying healthy while we age. For many seniors, the answer lies within assisted living. This might seem like it doesn't make much sense, but in reality, it is quite simple. Many senior citizens face depression because their lifestyles have changed. For instance, they may have recently lost a spouse or another close family member. Or, they might feel isolated because of the difficulty that they have leaving their home. While depression is an organic illness, it is quite possible to treat it via other methods besides antidepressants. Psychiatrists generally approach their treatment of depression through a three-fold manner: medication, exercise, and counseling.

Living in an assisted living facility most closely resembles the counseling section of the generally accepted treatment approach. Being surrounded by their peers, it is more difficult to feel the isolation that one might experience if they were cooped up in their home all day. And while being around people that care for you might not exactly replace a lost loved one, it can still give you the feeling of self worth that may have begun to disintegrate. Assisted living really is therapeutic for many senior citizens because of this reason.

The importance of the social aspect of assisted living cannot be overstated. There are many studies out there that show that being around your peers can help fight off depression. There are also studies that indicate that good mental health will often translate into better physical health, too. By staying ahead with your mental health, you are going to be taking better care of your total body health. This is a very important part of aging in a healthy manner.

Exercise also is a vital part of staying depression free. The science behind this is actually pretty simple. Prolonged aerobic activity elevates levels of serotonin within the brain. Serotonin is a neurotransmitter chemical that resides within our brains. When serotonin levels are up, the electrical impulses that our neurons (brain cells) use to communicate are sent much more easily. A fast firing brain is less likely to be a depressed brain.

What does this have to do with assisted living? Well, people are much more likely to exercise when their peers are doing so too. In assisted living, they often facilitate group exercise activities a few times a week. More importantly, in a regulated setting like an assisted living facility, there are activities designed expressly for senior citizens. While an elderly person might struggle to exercise on their own, in a secure place complete with trained supervision, exercise becomes a whole lot safer.

These combined features make assisted living residents much less likely to suffer from depression. It won't cure everyone, but it severely reduces the mental stress that someone is under. This can only have positive results.