For most of those caregiving for a loved one with Alzheimer‘s/Dementia, the thought of placing them with strangers in a “Nursing Home” is dreaded. I know it definitely was for me and so I thought it might be helpful to some, and perhaps therapeutic for me, to relate my experience.
Let me say at the outset that, contrary to my fears, “placing” was one of the best decisions that I ever made.
I guess I’ve been fairly fortunate throughout the entire experience in that many of the minutia of particulars involved seemed to fall into place automatically. All the stressful thinking about “How?, When?, Where? and How Much will it cost?” turned out to be wasted effort. Actually the decision about placing in a “Home” (Long-Term Care Skilled Nursing Facility) was made by a Doctor. He was her case-worker at a local hospital where she had been taken to the ER after the EMT’s that I had called determined that she was “failing to thrive” and should be transported to a hospital for further examination and treatment.
Some background information is probably in order. Let’s go back about three years. Dee had always been a feisty soul. A “Tomboy” to be sure and “Class Chatterbox” in school. Not the most pleasant of lives, she had suffered both physical and emotional abuse throughout much of it. All of a sudden, after thirty years of marriage, granted some of them perhaps a bit “rocky”, she decides she wants to sell the house, get a divorce, hates me and “never wants to see me again.” She wanted to live alone. (A pleasant thought in hindsight is that she probably knew somewhere inside, what the future had in store and did not want to put me through the anguish.) But does this sound like rational thinking coming from a 69-year-old woman with no car, no job, a very meager social security income and unable to balance a checkbook?
Well, I guess I wasn’t thinking clearly at the time either and by this time, somewhat fed up with her “feistiness”, I reluctantly agreed. I went on my own and (by group consensus, unable to really BE on HER own) she moved into a two-bedroom apartment with one of her four grown sons. As it happened he also had no particular place to go at the time and also had experience as a CNA which seemed at the time to be a bonus. To make a long and horribly painful story short, after one year they were both penniless, didn’t have the next month’s rent and by this time it was obvious that her faculties were becoming even further diminished. Unable to bear the thought of seeing her as a “bag-lady” living on the street, I once again entered her life. I took charge of her finances, which were in shambles, and we moved what was left of our “stuff” into a two-bedroom apartment and “lived happily ever after” right? Ha ha ha…sure. Oh, and by the way, to keep "things" legal, we DID get married once again in an informal civil ceremony. Towards the end of the ceremony, when asked, I replied, “I DO,“ she answered, “YOU BET.” Classic Vegas style.
Let me say at the outset that, contrary to my fears, “placing” was one of the best decisions that I ever made.
I guess I’ve been fairly fortunate throughout the entire experience in that many of the minutia of particulars involved seemed to fall into place automatically. All the stressful thinking about “How?, When?, Where? and How Much will it cost?” turned out to be wasted effort. Actually the decision about placing in a “Home” (Long-Term Care Skilled Nursing Facility) was made by a Doctor. He was her case-worker at a local hospital where she had been taken to the ER after the EMT’s that I had called determined that she was “failing to thrive” and should be transported to a hospital for further examination and treatment.
Some background information is probably in order. Let’s go back about three years. Dee had always been a feisty soul. A “Tomboy” to be sure and “Class Chatterbox” in school. Not the most pleasant of lives, she had suffered both physical and emotional abuse throughout much of it. All of a sudden, after thirty years of marriage, granted some of them perhaps a bit “rocky”, she decides she wants to sell the house, get a divorce, hates me and “never wants to see me again.” She wanted to live alone. (A pleasant thought in hindsight is that she probably knew somewhere inside, what the future had in store and did not want to put me through the anguish.) But does this sound like rational thinking coming from a 69-year-old woman with no car, no job, a very meager social security income and unable to balance a checkbook?
Well, I guess I wasn’t thinking clearly at the time either and by this time, somewhat fed up with her “feistiness”, I reluctantly agreed. I went on my own and (by group consensus, unable to really BE on HER own) she moved into a two-bedroom apartment with one of her four grown sons. As it happened he also had no particular place to go at the time and also had experience as a CNA which seemed at the time to be a bonus. To make a long and horribly painful story short, after one year they were both penniless, didn’t have the next month’s rent and by this time it was obvious that her faculties were becoming even further diminished. Unable to bear the thought of seeing her as a “bag-lady” living on the street, I once again entered her life. I took charge of her finances, which were in shambles, and we moved what was left of our “stuff” into a two-bedroom apartment and “lived happily ever after” right? Ha ha ha…sure. Oh, and by the way, to keep "things" legal, we DID get married once again in an informal civil ceremony. Towards the end of the ceremony, when asked, I replied, “I DO,“ she answered, “YOU BET.” Classic Vegas style.
Thus began my PART-TIME caregiving experience.
Having been “downsized” out of a life-long graphic arts career, I had been working part-time nights in security as a ”rent-a-cop.” The extra money was crucial for monthly payments on those “never-going-to-be-fully-paid” credit card bills. This worked out fairly well for a year or so until it became painfully obvious that Dee could not be left alone for any period of time. By this time her cognitive decline had worsened to the point where she could not function with a telephone as in “to call 9-1-1.” And thus began my FULL-TIME caregiving experience. I had to quit my job and within a year declared and was granted bankruptcy relief, thus alleviating some of the financial stress.
The details of full-time caregiving are almost too painful to go into here. Let’s just say they ran the full gamut from dressing, bathing, toileting and feeding to constant and stressful vigilance. Those of you who are caregivers know that it takes incredible stamina, physical strength and skills which you eventually and sadly realize you do NOT have. On Thanksgiving afternoon, 2008 I reluctantly called 9-1-1. The EMT’s had been there twice previously to help lift Dee off of the floor and to place her back into bed. (I did not have the strength to do this by myself) By this time her major and minor “motor skills” had been severely diminished. (walking, standing, holding a spoon).
So here we are…fast forward to the “placing.” In the hospital ER it was determined that her “vitals” were all acceptable but she was dehydrated, probably under-nourished and had a urinary tract infection. We were enrolled in one of those “El Cheapo” HMO’s and so the physician in charge used two criteria for placing her in a care facility; (1) what was available and (2) what was in keeping with our Health Plan. She ended up in the middle of the night being transported to some “rinky-dink” place twenty miles outside of town. Well actually, aside from the horribly inconvenient distance, the place was alright. I was just happy to get her to a place where she could get the attention and care that she needed.
In addition to our health plan which we had subscribed to for 30 years, we both were eligible for Medicare. I had previously applied for and been granted Medicaid for her. The initial Medicaid application was for Home-Care assistance but was easily transferred to Institutionalized Long-Term Care once that became necessary and thankfully, the Medicaid took effect just in the nick of time. After a few days in the Care Facility I was contacted by a Hospice organization and also signed on with them. They were to provide “additional eyes and hands” over and above the Long-Term care staff to oversee her well being. Of course Hospice cares for terminally ill patients and so their outlook is a bit on the dreary side. But they do a good job in preparing family and such for the inevitable.
The daily 45 minute drive to the Home (sometimes twice daily) for visits was getting exhausting. And so I began in earnest to search for a closer facility. The Welfare worker had given me a list of a dozen or more possible sites. After checking out many of them I finally narrowed the search down to three. Then came the next hurdles; pre-admission screening and bed availability. Again, after 2-3 agonizing weeks, I got lucky.
Two of the three called me within a day of each other and said they had room and we were good to go. And once again, God looked down and smiled upon me and said, “Here old fellow, check this one out.” As it happened the one I settled on was one that I had not even physically reconnoitered at first. It turned out to be the best on the list. I have to say that with over 200 locations nationwide, this facility was far and above beyond all my expectations.
A few days before Christmas, Dee was transported, again at night, across town in a “Medical Transport” as I raced ahead to be there when they arrived. The “Discharge Summary” and arrangements for transport were incidental nightmares also endured but all worked out in the end. With a heavy sigh of relief I looked forward to the, now, ten-minute drive to visit. Subsequently, as our lease expired at our apartment, I was once again blessed to find a wonderful “age and income restricted” one-bedroom apartment practically across the street from the Home. Now I’m down to a two-minute drive. (“Age and income restricted” - translation: old and poor. But it’s nice, very nice.)
Continued in…The Nursing Home Experience - 2
Having been “downsized” out of a life-long graphic arts career, I had been working part-time nights in security as a ”rent-a-cop.” The extra money was crucial for monthly payments on those “never-going-to-be-fully-paid” credit card bills. This worked out fairly well for a year or so until it became painfully obvious that Dee could not be left alone for any period of time. By this time her cognitive decline had worsened to the point where she could not function with a telephone as in “to call 9-1-1.” And thus began my FULL-TIME caregiving experience. I had to quit my job and within a year declared and was granted bankruptcy relief, thus alleviating some of the financial stress.
The details of full-time caregiving are almost too painful to go into here. Let’s just say they ran the full gamut from dressing, bathing, toileting and feeding to constant and stressful vigilance. Those of you who are caregivers know that it takes incredible stamina, physical strength and skills which you eventually and sadly realize you do NOT have. On Thanksgiving afternoon, 2008 I reluctantly called 9-1-1. The EMT’s had been there twice previously to help lift Dee off of the floor and to place her back into bed. (I did not have the strength to do this by myself) By this time her major and minor “motor skills” had been severely diminished. (walking, standing, holding a spoon).
So here we are…fast forward to the “placing.” In the hospital ER it was determined that her “vitals” were all acceptable but she was dehydrated, probably under-nourished and had a urinary tract infection. We were enrolled in one of those “El Cheapo” HMO’s and so the physician in charge used two criteria for placing her in a care facility; (1) what was available and (2) what was in keeping with our Health Plan. She ended up in the middle of the night being transported to some “rinky-dink” place twenty miles outside of town. Well actually, aside from the horribly inconvenient distance, the place was alright. I was just happy to get her to a place where she could get the attention and care that she needed.
In addition to our health plan which we had subscribed to for 30 years, we both were eligible for Medicare. I had previously applied for and been granted Medicaid for her. The initial Medicaid application was for Home-Care assistance but was easily transferred to Institutionalized Long-Term Care once that became necessary and thankfully, the Medicaid took effect just in the nick of time. After a few days in the Care Facility I was contacted by a Hospice organization and also signed on with them. They were to provide “additional eyes and hands” over and above the Long-Term care staff to oversee her well being. Of course Hospice cares for terminally ill patients and so their outlook is a bit on the dreary side. But they do a good job in preparing family and such for the inevitable.
The daily 45 minute drive to the Home (sometimes twice daily) for visits was getting exhausting. And so I began in earnest to search for a closer facility. The Welfare worker had given me a list of a dozen or more possible sites. After checking out many of them I finally narrowed the search down to three. Then came the next hurdles; pre-admission screening and bed availability. Again, after 2-3 agonizing weeks, I got lucky.
Two of the three called me within a day of each other and said they had room and we were good to go. And once again, God looked down and smiled upon me and said, “Here old fellow, check this one out.” As it happened the one I settled on was one that I had not even physically reconnoitered at first. It turned out to be the best on the list. I have to say that with over 200 locations nationwide, this facility was far and above beyond all my expectations.
A few days before Christmas, Dee was transported, again at night, across town in a “Medical Transport” as I raced ahead to be there when they arrived. The “Discharge Summary” and arrangements for transport were incidental nightmares also endured but all worked out in the end. With a heavy sigh of relief I looked forward to the, now, ten-minute drive to visit. Subsequently, as our lease expired at our apartment, I was once again blessed to find a wonderful “age and income restricted” one-bedroom apartment practically across the street from the Home. Now I’m down to a two-minute drive. (“Age and income restricted” - translation: old and poor. But it’s nice, very nice.)
Continued in…The Nursing Home Experience - 2
Jay
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