WEA2016 Asked August 2016
Getting families to listen about independent living?
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How do you get families to understand that independent living is just what it says it is? There are no services in these types of facilities and the staff is not in the capacity to monitor whereabouts, medications or anything else. Families are responsible for their loved ones and their needs unless they are in assisted living etc. A big frustration of mine is families depositing their aging loved ones and not wanting to listen when I tell them more services or a different facility is needed. I would love some insight on why this happens and how to get through to them.
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CWillie-We do exactly that we tell prospective residents there are NO services. It seems to go in one ear and out the other. If a resident needs to move to Long term care or assisted living I gladly let them out of their lease regardless. What sense does it make to keep them when they can't fend for themselves just to collect rent and not have a vacancy???
Why not just move the loved on into a senior apartment until they do actually need help. It is probably cheaper and may even have the rent subsidized. A phone call once or twice a day and visits to take the person shopping or bring supplies may be all that is needed in the beginning. Adding a lifeline pendant if the facility does not have an emergency call button is helpful and getting such services as meals on wheels or county health services where available. All of these things exist where I live and one of the local pharmacies will deliver drugs and basic food supplies. A local bus service is also available which is handicapped access able to go to places like Walmart. This is all in a small city in upstate NYS. Our hospice had several patients who were able to remain in this accommodation till the end of life.
Another thing that I see as a problem is that long term residents are not reassessed as often as they should be. It has also been my experience that sometimes management will keep a resident who should have a higher level of care because they don't want a vacant room, a problem in some of the older buildings because people opt for the newer options.
I completely understand that it must be frustrating when people visit your facility, see what it comprises, and then stubbornly close their eyes and move their frail, dependent elders in there anyway.
But you were asking why. And one reason is that the elder won't consider anything that involves a higher level of care = interference in their freedom of action; another is wishful thinking; another is desperation, as in "placement comes first"; yet another is cost. What it all amounts to is false economies and short-term thinking; and yes, it must leave you all too often with your heart in your mouth about how you're going to cope with these people, and your heart in your boots about the kind of conversations you'll be facing with the relatives when it all goes belly-up.
Having said that, what can you do at your end to reject applications from obviously unsuitable candidates? Do you use some kind of formal assessment?
After all, there must be distinctions to be made between Independent Living and bog-standard rental accommodation. Otherwise what's the difference between you and any other landlord, and what's the point of calling it anything?
Here's my question to Churchmouse-How can you expect a little extra TLC for your loved one when you know going in that it is IL and there are no services? It's not that they don't deserve it but if you want them to have someone to do those "extra things" for them then why not make sure they are somewhere that provides those services?
The answer to the question about it being the norm, it's solely depends on what the owners of the property have it structured as. So there is no norm per se. We have the emergency pendants as well. Some residents don't wear them and we wind up getting a call to check on them and find them on the floor where they've been for hours or days or worse. Some (my IL )apartments are not staffed to be nursing homes, or assisted living facilities. There are no nurses, no doctors, no social workers- nothing. It's frustrating and unreasonable to me that the expectation is there with a staff of three...me, my part time assistant and 1 maintenance person that we provide services. It's not going to happen. Mind you I do help by checking on residents if I get a call of concern, help them find services for utility assistance etc when I can, but bottom line with what my regular responsibilites are I can't do it for everyone let alone on a daily basis. I even find myself acting as a referee when tiffs occur between residents!!
I had a daughter of a resident get angry with me for telling her that he mother is her responsibility and that she needs to check on her more often. Once every few days is not enough. Especially when they are over 80 and ailing. I was seeing signs of problems probably caused by medications she was on. Despite the fact I am not a nurse there are many things that are just common sense. It doesn't take a rocket scientist to recognize when someone is in pain or declining. If I come to you, a family member and tell you what I have observed it's because I care. She ultimately had to come back and apologize for what she said to me. She found out I was right and she almost lost her mom behind being stubborn/hard headed. This is a regular occurrence.
I am only there 8 hours a day, I don't track anyone's whereabouts, medications or anything else. I even have some people showing signs of dementia/alzheimers and talking to their family members is like talking to a brick wall. The fear I have of them wandering away and God knows what happening overwhelms me, but what can I do my words fall on deaf or selectively deaf ears.
The only way to guarantee that they will have someone to do those things they need is to have them move to assisted living because it is just what it says it is assisted living.
Although my MIL has a neurodegenerative illness, my FIL is capable enough for them to be living there. We hired my MIL a helper, which she would have needed regardless of where they were living.
We have a big family and I think that reassured the IL's Director because he knew my inlaws have a big support system. We're all hoping they will get to live out their days there. We are realistic, willing to assess their situation, and hire more help as it's needed.
We chose IL because my inlaws needed a safe environment that was ADA accessible and had services like meals. If someone goes into IL thinking it's AL-lite, that's a bad match.
Do you work at an IL?
So it can be a first step in getting consent to leave their family homes and move into a place where at least somebody will notice if they're lying outside their front door. Whereas if you try whisking them, whammo, into a full-on care environment they will fight it tooth and nail until the day comes of the broken hip and no choice at all about where they get carted off to.
But are you running or working in an IL facility where there is no option to scale up the level of assistance? I'd have thought that continuing care is becoming the norm, isn't it?
My Dad is lucky to be in an independent living facility where there is optional care available at an added cost when the time comes. For example, my Dad has the "med option" where the facility comes twice a day to dispense his prescription medicine. And more recently I also opted for the higher care option where an Aide helps Dad get ready for bed at night, and checks on him every couple of hours.
As for families not realizing what level of care the love one needs I think is quite common. It's the family first rodeo so they aren't sure what to do or why. Many of us are in denial, I know I was when recently the IL side of the facility said it is time to think about moving Dad to the AL side of the facility.