Nursing Home? Be Prepared to Learn

Medicare publishes this document to assist people in checking the details and quality of care at any long term care community.

Medicare publishes this document to assist people in checking the details and quality of care at any long-term care community.

No one ever wants to think about the possibility of a nursing home. Yet long-term care may figure prominently in many of our lives.

The New York Times recently published two articles by Jane Brody about how to choose a nursing home community carefully. In part one, Nursing Home Unthinkable? Be Prepared in Case It’s Inevitable, she interviews people who point out how the biggest problem for most families is the timing — the necessity of choosing a nursing community with little time for discovery or preparation.

The piece presents a veritable checklist to help a family go about making a choice when true nursing care is required.

Best Quote in Part I

Nursing homes generally have had a bad reputation as smelly, indifferent places where people go to die. But “there are some homes that are better than being at home,” Ms. Leefer said in an interview. “And there are many more good facilities than bad ones.”

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Alive Inside: This Movie Is Extraordinary!

ec9acd50595499364a6994542e145924_largeYou know a movie speaks to the audience when people just sit there as the credits start to roll rather than getting up and moving out. That’s what happened this evening when my husband and I went to see Alive Inside, the Sundance award-winning documentary about the role that music plays in the lives of elderly people who experience brain disease and loneliness. At first, no one got up to leave.

The other day I described how we watched a preview of Alive Inside at one of Dr. Bill Thomas’ Second Wind events last March and how we were moved to tears. That only begins to describe the reactions in the movie theatre tonight. The people in front of me were tearful and talking about a relative. The young people behind me were sniffling and whispering about their grandmother. I was thinking about my family members.

As I looked around, I observed individuals with hands on their faces, hands folded in prayer, and people with eyes riveted to the screen as we all watched person after person, mostly elders, smile, move, talk, remember, and transform — as the music played. We saw exuberance, animation, even joy come on to faces that, only moments before were vacant.

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Alive Inside: Music Brings Back Memories and Dignity

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Note: If after reading this post you are interested in seeing the movie, please check out my Alive Inside movie review.

I discovered Alive Inside, the Sundance award-winning documentary film that demonstrates the power that music can exercise over memory loss, a few months ago when my husband and I shared an amazing experience attending the Second Wind Tour. This nationwide  extravaganza that travelled over the country helped Dr. Bill Thomas to launch Second Wind, his new book about aging and the importance of living in deeper and more thoughtful ways, included a partial screening of Alive Inside (check out the trailer below), and I left the event in greater awe of music than ever before. That’s saying a lot because I’m a lifelong musician.

Alive Inside

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Alive Inside, Michael Rossato-Bennett’s documentary film, tells the story of a man’s determination to try a new kind of therapy with patients experiencing severe memory loss. Dan Cohen gives iPods personalized with music to people with severe memory impairment, and then watches how they listen and respond.The results, you see them right there on the screen, are astonishing.

The fragile people, mostly elders, listening to the music begin to react, interact, and even talk about experiences that the music reawakens. They associate the music with memories that often come rushing back and often with each individual’s ability to talk about the memories. Cohen pursues his projects against considerable odds — namely a healthcare system that treats aging as a medical problem rather than a time of life. Continue reading

Roz Chast’s Graphic Novel: Serious Humor for Adult Children Caretakers

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This morning I am going to One More Page, my local independent book store, to purchase Roz Chast’s new graphic novel, Can’t We Talk About Something More Pleasant?

I’ve never read a graphic novel, although I frequently pass by them in local independent book stores. Today, however, I will buy the book and explore this new-to-me genre, really a graphic memoir, because I love Roz Chast. More personally, however, I am deeply involved, by choice, with supporting and occasionally caring for aging parents. As Chast shares her experiences and challenges, doing so with humor and pain, I recognize much of what she depicts.

This cartoonist’s elegant work, mostly in the New Yorker, is synonymous with tongue-in-cheek observation. No matter what topic Roz Chast chooses to illustrate, a viewer laughs and thinks, though not necessarily in that order.              Continue reading

Aging Parent Hospitalizations and Observation Status

Just when you think that you have settled the most significant adult child-aging parent issues — when you and your parents have spoken about medical care support, finances, and the range of their end-of-life wishes — along comes another concern to worry about, and it’s one that may be completely out of our control.

Medicare ObservationWe now need to be concerned about the possibility of a parent entering a hospital and assigned to observation status for several days. Observation means that, rather than being officially admitted as a patient, the person is there to be watched, sort of like an out-patient, but not really an out-patient. The problem is, it’s difficult to discover what status a hospital assigns a patient  — the two look almost alike with nurses, doctors, hospital rooms, blood pressure checks, etc.  Admission and observation do not look that different to the patient and family, and apparently many hospitals are not especially  forthcoming with the information.

Why is patient status significant? It’s simple, really. If your parent needs to enter a skilled nursing facility or nursing home after three days of observation status, Medicare will not pay and the family will be required to pay all of the bills, including the hospital costs. For Medicare to pay the bills, a family member must be admitted as a patient for at least three days and not assigned observation status.

Over the past year newspapers and medical or health journals have carried stories about elders and observation, and I share them here so that you can learn as much as you can.

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Great Green House Homes Article in Mass General Hospital Publication

Green House Homer MGHAn in-depth article about the Green House Home model appeared in the Fall 2013 edition of Proto Magazine, a publication of Massachusetts General Hospital (MGH) in Boston. The article, The New Nursing Home, by Cathryn Delude, describes the Green House model at the  Leonard Florence Center for Living in Chelsea, MA. The report also goes into considerable detail about the Green House Homes model, quoting Dr. Bill Thomas who came up with the concept in 2003.

The MGH Proto article also includes facts about the cost of building a completely new Green House community and provides an overview of the elder care culture change that is happening in other parts of the country. Author Delude points out that widespread success in culture change may depend on the staffing issues in elder care communities. Factors such as the huge turnover of elder care staff, their low pay, and the way that for-profit facilities maintain a staff that is about a third below the number of people that a non-profit nursing community hires.

Most Interesting Quote from the Article                  Continue reading