Jenita

Hello – I am glad you stopped by for a visit! My Bethany Village colleagues and I are blogging about many topics of interest to older adults and their families. My niche is assisted living and nursing services. That means managing everything from staffing and scheduling to making sure we are in compliance with all federal, state and local regulations. I place a high value on quality and empathy in my work with older adults, and I try to imbue my staff with the same philosophy.

I have been at Bethany for just over six years. I have over 20 years of experience in long-term care nursing. In this business, we are challenged by a significant amount of government regulation. I love being able to meet those regulations with the quality care our residents deserve. Bethany offers a service that most people do not anticipate or look forward to, and I enjoy changing their opinion of nursing facilities and helping to ease their fears.

Sometimes our society does not value older people as much as it should. It’s very important to me to try to change this attitude whenever and wherever I encounter it. I help our residents demand the excellence they deserve when they can’t do it or don’t know how to do it themselves. Needless to say, bringing emotional and physical comfort to our residents and their families – and our employees, too – is a tremendously rewarding aspect of my work.

My husband, Mark, who is a master plumber, and I live with our 8-year-old (going on 18) daughter in Centerville, Ohio – which is also home to Bethany Village. In my spare time, I relax with reading, gardening and crafts. I am a diehard Pittsburgh Steelers fan. Most of all, I like being with my family – including our boxer, Sissy, and our cat, Crosby.

At one point in mid July, more than 100,000 million people in 32 states were trapped in one of the country’s longest and strongest heat waves ever. And we’re not done yet. “It’s like an upside down cake pan is sitting on top of the nation and trapping the hot air below it,” explained one television weather reporter.

No doubt you’ve read and heard repeated warnings about staying safe during this record-breaking, scorching weather. After a while, however, all that info can become just so much noise. But if you are an older person – or someone who is a caregiver or friend to a senior citizen – please take these cautions to heart.  Experts estimate that as many as 1,000 people – 40% of whom age 65 or older – die from heat-related causes each year.

Even healthy, active older folks have unique vulnerabilities to the kind of blistering, unrelenting heat we’ve been experiencing lately. Older brains become less sensitive to temperature-change signals and don’t recognize thirst as easily. (This is even more likely when a person has suffered a stroke.) And because overall percent of body water goes down with age, seniors are more likely than younger people to become dehydrated, which can lead to heat exhaustion (characterized by heavy sweating, muscle cramps, low blood pressure, rapid pulse and nausea). Left untreated, heat exhaustion can progress to heat stroke, causing seizures, loss of consciousness and death.

In addition to the natural impact of aging, some of the drugs seniors may take – for example, to treat insomnia, nausea, prostate conditions and Parkinson's disease – can interfere with the ability to sweat and thus raise body temperature. Alcohol and coffee also can cause the body to lose fluid and contribute to dehydration.

Potential dehydration is not the only problem caused by over-the-top temperatures. Heat also traps air pollutants in the atmosphere, creating a dangerous situation for anyone with respiratory issues, such as asthma, emphysema, chronic bronchitis or chronic obstructive pulmonary disease.

Here is some advice specifically geared toward protecting older people from the potentially deadly effects of a heat wave:

• Thirsty or not, drink plenty of water – as much as a quart of water a day is not unreasonable. For seniors taking water pills (diuretics) or restricting fluids, seek guidance from a physician.
• Keep glasses or bottles of cool water within easy reach – both for convenience and as a reminder. Refill them often.
• Try to stay inside, preferably in air conditioning – both to stay cool and to avoid air pollution.
• Wear light clothing.
• Avoid over-crowded locations and strenuous activity.
• During a heat wave, check on older relative and friends twice a day. If they don't have air conditioning, help them visit an air-conditioned location for a few hours daily, such as a movie theater, shopping mall or adult daycare center.
• If you see signs of severe heat stress, try to cool the person down right away with either a cool bath or shower or by sponging or spraying them with cool water. Seek immediate medical assistance.

For more information on dealing with the effects of extreme heat, visit the Centers for Disease Control Extreme Heat Toolkit.

If you are scouting living options for a parent who can no longer live alone or whose care requires more than a family member can provide, assisted living might be a good option. Bethany Village offers a comprehensive continuum of care that includes independent cottages, villas, and apartments; assisted living apartments, rehabilitation care, and long-term nursing care.

But all assisted living places are not the same; it pays to visit as many as you can to see everyday life in action. Sometimes what you actually see when you make a scouting visit is more revealing than answers you receive to your questions. Here are a few things to look for:


 

• Do the residents and staff seem happy? Are they smiling?
• Are the grounds nicely landscaped and well kept?
• Are the interiors – living spaces and common spaces – clean and tidy?

• Do your employees enjoy working here? Can you show me current employee satisfaction survey results? What is your turnover percent compared to the average?
• What do you do to ensure the facility follows all state and federal regulations? Do you have committees that oversee quality? Do you perform regular audits to ensure quality care?
• Do you have current resident and family satisfaction survey results you can share with me?
• What is the ratio of nurses to patients? How does it compare to other facilities?
• Do you use agency nurses or have your own employees? The organizational commitment and consistency of care that comes with having employee nurses is important.
• What do you do to keep residents as independent as possible?
• How is toileting handled for those who are not mobile on their own?
• Are rooms private or semi-private?
• What furniture and décor items can I bring in to make my parent’s room more like home?
• Can residents select their own meals?
• Do you have an onsite laundry?

As you can see, there is a lot to consider when you are investigating assisted living or long-term care for a loved one. Visit www.medicare.gov/NHCompare for information on nursing homes in your area and to compare facilities using Medicare’s Five-Star Quality Ratings, health inspection results, nursing home staff data, quality measures and fire safety inspection results.

Here is my last piece of advice – and it’s probably the most important of all: look for a facility or community that is based on a "social model," not a "medical model." A social model focuses not on what residents can’t do, but on what they can do. Feeling empowerment, independent and able to make ones own decisions is the best medicine of all.

We welcome your comments and questions about how to find the appropriate level of care for your parent(s).