All posts by Julie Boggess

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute and provides education and training to private and professional caregivers through her company Enlighten Eldercare. She lives in the Chicago Northwest Suburbs of Mount Prospect, IL.

Post COVID Long Term Care Reform

The COVID-19 pandemic must inspire significant changes in how long term care is treated and resourced.

The  COVID-19 pandemic has placed long term care in the spotlight.  Immense challenges have existed for decades, but salt is now in the wound.

Some lawyers see this pandemic as an opportunity to teach the long term care industry a lesson.  In addition, various media outlets see this as a chance to catch the big story of the devastated family member of one who lived in a nursing home.

Others see the realities of this pandemic as an opportunity to bring about reform.  Larry Carlson,  President and Chief Executive for United Methodist Communities writes about the need for more emotional and financial support for the senior housing and healthcare system https://ocnjdaily.com/letter-to-the-editor-senior-living-centers-cant-do-it-alone/.

Katie Smith Sloan is the President, and CEO of LeadingAge- the national voice for aging services providers.  She discusses the “slow-motion catastrophe” that nursing homes were last on the list for federal COVID support. An Open Letter from Katie Smith, president of LeadingAge

The Front Line

Let’s begin by acknowledging Mr. Carlson’s observation about the societal negative narrative about the people who work in long term care.  Facts:

  • 4.5 million direct care workers support older adults and people with disabilities across the U.S
  • Turnover is 40 – 60% because the work is difficult and workers are under-appreciated and under-paid
  • 42% of direct care workers rely on some form of public assistance to make ends meet

Despite the discouraging realities of this work, millions show up every shift, on weekends and holidays, and even during a pandemic.  In addition, they put themselves at risk to do the work that nobody else can or wants to do.

Direct care workers are concerned about the well-being of those in their care.   Feedback from communities trained in Compassionate Touch reveals that despite the stress and time constraints, staff still find time to calm and reassure their residents with Compassionate Touch.  Compassionate Touch®

These workers and the residents they care for deserve better- much better.   They don’t deserve disrespect or to be described as criminals.  Furthermore, they deserve respect, esteem, and wages that reflect the societal value of growing old with dignity and quality care.

I hope that a higher level of respect and helpful attention for aging services will be an outgrowth of this pandemic.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

The Trauma of Relocation for People with Dementia

 

 

A sudden relocation from home for a person with dementia can be traumatic.

My husband and I have made the decision to right-size our lives and sell our house of 23 years. For many years now, I have anticipated this moment wondering how I would feel.   Surprisingly, it wasn’t a hard decision to make.  However, I recognize that moving day could be a different story.

The decision to relocate is one we made being of sound mind and body.  As overwhelmed as I sometimes feel about our move, it must pale in comparison to what people with dementia feel when they are moved to a different environment.

Easing the Trauma of Relocation

My husband and I will adapt to our new surroundings.  I will find a place for all of our things and make our new house into our home.  The people I love most will be with me,  including my fur-babies.  I’ll drive to visit my friends and attend the same church.  All will be right in our world.

This mile-marker in my life makes me think long and hard about what moving day must be like for someone with dementia.  I can’t even imagine.  The sudden loss of leaving the familiar and the people you love must be horrifying.

Stop and think for a moment how you would feel if someone walked into your home and said that you had to leave for a new place that you had not chosen for yourself.

Imagine your behavior.  Would you be crying, screaming, punching, kicking?

The AGE-u-cate Training Institute program Compassionate Touch begins with looking at life through the lens of someone with dementia.   We discuss the grief and loss that often accompanies a person with dementia when they move into a long term care facility.

Realizing that people with dementia communicate with us through their behaviors is a pivotal moment in Compassionate Touch and Dementia Live Training.

So how can we ease a transition into a long term care facility for someone with dementia?  Here are a few tips:

    • If possible, set up their new space with familiar items prior to move-in day.
    • Remain positive and keep your personal emotions in check.
    • Minimize chaos on move-in day by limiting the number of family members present to no more than two.
    • Allow the staff to immediately begin bonding with your loved one.
    • Refrain from prolonged day-long visits until your loved one is settled in and comfortable.
    • When your loved one says, “Take me home” don’t say, “this is your new home.”  Rather, “I understand how hard this is, and I love you.”

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Transparency in Dementia Care With Family Education

Family educational programs that are fun and engaging could help ease frustrations and tensions LTC providers experience with family members.

I read with  interest an article by Martie Moore in McKnights Long Term Care News, “Truth-Telling for True Transparency: Why Does it Matter to your Organization.”

Her research occurred with parents faced with losing a child. Two findings in her study resonate.

Family members are less likely to sue when they understand what is happening to their loved ones.  They are also far more willing to give the care providers grace and forgiveness.  In contrast, families create their own version of what occurred when information is withheld.  Consequently, these opinions are difficult to turn around.

Dementia Out of the Darkness for Families

These research findings led me to think about how much effort Long Term Care providers should put into family education about the effects of dementia.

An article in the Journal of Applied Gerontology cites that family members with loved ones in a nursing home expressed the need for more education and support for involvement within the nursing home setting.

Dementia is perplexing and complicated.   No two people are identical in the way dementia strikes and plays out.  Therefore, being transparent with family members about the myriad of realities living with dementia could prove helpful.

Being accused of neglect with statements like, “my mother has not eaten in three days.”  is troubling.  In addition, how many times have we heard, “someone stole all my mother’s clothes” only to find them shoved under the bed mattress?

Topics for family education

  • The impact of memory loss on day to day living
  • Common behaviors in persons with dementia
  • Helpful communication techniques
  • Can there be Joy with dementia?
  • Well-being and Ill-Being

Consider offering a dementia workshop/R&R afternoon for family members.  To that end, a rotation of educational sessions interspersed with opportunities for a massage, manicure, chocolate, pet therapy, fancy coffee, more chocolate, support, fun, and mutual support could go a long way!

I encourage long term care providers to explore opportunities to educate families about the realities of living with dementia.  In doing so, we might be able to improve relationships and decrease difficulties driven by a lack of understanding.

 

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Joy and Dignity with Alzheimer’s

Create moments of joy for persons with Alzheimer’s and leave them with lasting positive feelings.

When telling people about my work, the response I almost always get is, “I know someone with Alzheimer’s.” A comment that usually follows is, “and it is so awful.”

Yes, having Alzheimer’s is awful. It robs people of their memories, independence, and cognitive functions. Many times, we refer to people with Alzheimer’s as “suffering” with it.

We cannot minimize the suffering, but we also shouldn’t maximize it. Finding moments of joy can help balance “suffering with” and “living with” Alzheimer’s.

Find Joy and Dignity

I participate in a networking group, “Cognitive and Memory Professionals (CAMP).” This group is lead by Dan Kuhn, Vice President of Education with All Trust Home Care in Hinsdale, IL.  The purpose of this group is to discuss current thinking about caring for persons with the many varieties of cognitive impairment.

Recently, we read and then discussed the book, “Dementia Reimagined” by Tia Powell, MD. The tag line for the book is “Building a Life of Joy and Dignity from Beginning to End.”

In my thirty-one years working in long term care, I can recite story after story of the fun and laughter shared with persons with Alzheimer’s.  The reason is this- people with Alzheimer’s forget the facts, but they remember the feelings. By making someone with Alzheimer’s feel good, loved, respected, and dignified is where joy is found.

To illustrate, a colleague at the AGE-u-cate Training Institute likened this to feelings about our kindergarten teacher. While we probably don’t remember specific conversations or interactions, we know if the teacher made us feel good or bad. We will either smile or cringe when we think back depending on the experience.

Friends, by looking through a different lens, perhaps we can discover joy lurking underneath life with Alzheimer’s.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.