I want to write about something I’m knowledgeable about that most everyone will have to deal with at some point in their life.
First, a little personal experience – I was serving on a Falls Prevention Committee at work when I was told that my cousin in Southern California had, for a trial period, put my then-103 year old grandfather in an assisted living facility because of fears he may fall. I went down there the following weekend. My grandfather still had his apartment – which he had been living in for 64 years. My grandfather was the oldest person in the U.S. working as a pharmacist (until he was 97). Grandpa Leonard was the kindest individual I have ever known. When he stopped driving at 98, he walked everywhere from his apartment on Sweatzer Avenue, near Melrose. Grandpa Leonard was a man of routine – Breakfast: Cornflakes, Lunch: peanut butter and jelly, Dinner: vegetarian vegetable soup.
When I came into his shared room at the assisted living facility, I was a little shocked. The room was not only very small, but there was no homely feeling. It was more like a very sanitized hospital room. He shared it with a man who coughed a lot.
Grandpa Leonard was torn between wanting to please my cousin who he thought was trying to help him and wanting to keep living in his own apartment. During my conversation with GL, he had pulled the call bell switch so that one of the nursing assistance could help him out of bed into the bathroom (I was not physically able to do it myself). No one responded and I ended up going to the nursing station to get someone. The bed was very high off the ground.
One of the things I had learned about falls is that a person is less likely to fall in an environment that he knows.
Another thing that my cousin didn’t know was that there are many groups, some free and some not, that can come over to a residence home to help either medically or non-medically. And it’s a lot less expensive than assisted living or a skilled nursing facility. It can be arranged for 1 hour a day 7 days a week if necessary.
The last thing I said to GL before I left was “GL, you call the shots. If you want to go back to your apartment, you can.”
Two weeks later, in an effort to get out of the (high) bed to go to the bathroom, he fell and broke his hip. After the surgery, he ended up in a place he had always feared – a skilled nursing facility. He had just turned 104 before the hip replacement surgery. Now he was really dependant on the nursing staff. The same thing happened in connection to no response from pulling the call bell light to get assistance to the bathroom. The response I got when I went to the nursing station was, “Yeah, we’ll be there in a minute.” For the first time ever, GL was very unhappy. He was also intimidated by the staff. GL passed on 3 weeks later from pneumonia.
Many years ago, I worked in one of Palo Alto’s best skilled nursing facilities. However, there are always going to be patient care problems. It’s not intentional. Staffing is always a major issue. A nursing assistance may have 6-7 residents to care for; that means getting them out of bed, bathing, brushing teeth, shaving and dressing them and moving them into the dining area. If someone calls in sick, the others will have to pick up the slack until that nursing assistant is replaced. Also, NAs, in my opinion, do the hardest job that most of us cannot do, yet they get paid just a little above minimum wage.
If your parent(s) needs help and still wants to remain at home, there are many services here that can help (e.g., CA Visiting Nurses Association, for home medical help). Obviously, there may be instances where living in a skilled nursing facility is inevitable, but if at all possible, to me, keeping your parents in their own home with home health care is better.
(650 493-5000, ext. 60001