Nursing Home or Assisted Living HOW TO Decide When It’s Time , How to Choose, How to BREAK THE NEWS

hey everybody its Vicki with dementia

with grace today is Monday which means

that it's a caregiver video these videos

is a series of videos designed to help

you with the caregiving issues that you

yourself face as a caregiver on

Wednesdays we talk about behavior issues

because usually by the time somebody is

looking for answers it revolves around

either a caregiving situation that they

themselves are going through or a

problem behavior that the person that

they are caring for is going through so

these videos address those two issues

mondays are caregiver videos and they're

all down below if you're watching this

on youtube you can find you go to the

adventure with grace channel all of the

videos are listed and they hope there's

a playlist for caregivers a playlist for

problem behaviors and so that's an easy

way to find while you're there please

subscribe today we're going to talk

about an issue that has bubbled up on my

support group several times I have

gotten several posts about it on the

Facebook support group which is also

dimension with grace on Facebook and

I've gotten several private messages

saying I need an answer to this question

so instead of answering it in several

different places I decided to make it

the focus of our caregiver video today

and the question is when do I know that

it's time for my significant other loved

one fill in the blank how do I know when

it's time for them to be moved into

skilled care whether that is an assisted

living or a skilled nursing home or you

know a specialty care unit that is just

designed especially especially getting

orders out for folks with dementia so

let's talk about that number one it's a

very personal decision about how you

want to go forward and take care of

someone in the latter stages of dementia

that is usually when you have to start

looking for alternate ideas they may

have lived in your home for several

years or they may be

alone in their own home and they've

managed to be okay not great but okay

and now it has come to this time that

things are getting a little bit more

serious there are safety issues involved

personal care issues involved that

indicates that it's time to make some

decisions now again some folks like to

age in place and if the finances are

there and you can hire somebody around

the clock to stay with your mother in

her home that is wonderful and and that

might be the choice that you make but

that's still you know that's skilled

nursing and that's skilled that's having

somebody there 24 hours a day so that

may be your choice and that may work

well for your family and and and that

may be something that is doable for you

some folks either don't have the

resources the financial resources are

the are the caregivers available to them

there are some areas of the nation in

the world that you just don't have

enough people to provide 24-hour care

privately in a home and doesn't matter

how much money you have the the the the

the workforce okay that's a good good

way to put it I guess the workforce is

just not there or there's not anybody

trained to deal with folks with dementia

so there's lots of caregiving ways

there's lots of ways to care get for

somebody I don't judge any of it as long

as you're taking good care of your

person or you are finding somebody to

take good care of your person then I

don't judge how that happens I'm help

I'm able to help in any of the

situations but what I would say is you

know people need to know when is the

time and so let me tell you when the

time is is when they're no longer safe

and are they're no longer they're no

longer making good decisions about their

health care which then in turn makes

them not safe not safe looks like this

they're wandering

they're they're driving when they

shouldn't be driving and they're getting

maybe maybe getting away from their home

and getting lost they're leaving in a

stove own they are leaving the bath

water running or the water in the sink

running and causing damage like that

that is when it's indicated to you that

they are no longer safe there they're no

longer able to take care of themselves

in a safe manner the other thing it's a

medical situation where they're not

taking their medicine or they're taking

their medicine too often you know

sometimes they will forget to take their

medicine sometimes they'll take their

medicine twice and both of those issues

are are detrimental to their health

either they're not getting their

medicine or they're overdosing

themselves even by a little bit can

cause a tremendous issue they may not be

able to take care of their personal

hygiene and in that case that turns into

a skin issue a skin integrity issue if

you're not getting good good hygiene if

you're not bathing yourself if you're

not taking care of your toileting issues

in the right way that can absolutely

cause infections skin breakdown those

kinds of things that can be very

troublesome to the person and very

harder to and very hard to treat and

resolve okay so those will be some

issues of where it would be okay I'm

really my hand is forced and let me tell

you you pretty much know and and I have

had this people tell me this that you

know I was told that I would just know

when it was time to make the decision to

either you know to put my husband in a

home or find assisted living for my aunt

or you know tell my mother that you know

it's time to put Daddy somewhere is it's

too much for her to handle so you get in

those in those three situations it's too

much for the person to handle medically

physically emotionally financially it

may be too much so that would be one

trigger that would say yeah it's time

the other is safety awareness and

being able to be safe in the home in all

manners being able to stay in the home

not leave the light on the nothing light

but the stove own not you leave the

water running those kinds of things that

could cause issues and number three is

the medical model where you would say

you know they're just not able to take

care of themselves and we're not able to

go in and take care of them or bring

them here or have someone go into the

home so those would be the three

scenarios where you would then decide

okay it's time to make the decision now

leading right into that is how to find a

good home before you need it I would say

these two things before you need it

early on the disease process if you have

the time if they have been diagnosed

with something early on talk to them

doing something with them making a

decision with them and not doing

something to them or making a decision

for them is always better if you can now

there are some people who get to this

point and they never had that discussion

they never found out what their

preference was you know what their

person's preference for us aging in

place first is going to a home some

people don't mind going to a home and

all you know I bet that would be so

difficult for folks when I was actually

in you know day to day practice and I

was a nursing home memory care director

and someone would you know come and they

would tell me privately maybe after

their family left I'm so relieved you

know I don't have to worry about three

meals a day somebody's gonna do that for

me I don't have to worry about the

stairs I don't have to worry about you

know I know my memory slipping and I

don't have to worry about anything

anymore because I know that I'm safe and

I'm looked after they sometimes would

have a very good response to having

people their own age to be around people

their own age in the similar mental

capacity so that they didn't feel like

they were that they were the dumb one

and that's what they would say to me you

know I always felt

you know I was so forgetful that you

know this is our Lyon this is in stage

two three that they're able to tell me

these things and they wouldn't be able

to express it that fluently in Stage


but early on they would tell me I'm so

relieved I'm so relieved that I'm here

so sometimes it's the more of the stress

of I promised mama I would never put her

in a nursing home that's a lot of stress

to put on you it's a lot of stress to

put on yourself and you just can't say

that in this day and age people are

living so much longer with more

complicated medical cases that cannot be

managed in the home

somebody getting 8 liters of oxygen

cannot be managed in the home for

instance you know just little things

like that you know they need a skilled

nursing that cannot be provided in the

home you know you say you were born at

home and you died at home and you know

and and there was your good life in

between those two points and then it was

over now you know we can keep people

alive a lot longer but it's a more

complicated case to manage and that

cannot be managed at home sometimes

dementia is one of those diagnoses that

is very very difficult to manage

especially in the later stages and you

need more help than you can give if you

are working full time if you have a

family you know whatever it doesn't even

matter what your situation is there are

people who could sit there 24 hours a

day with somebody and have no other

responsibilities but they can no longer

make their needs at home that absolutely

happens and when that happens you need

to know that ok I'm doing the best thing

that I can for my mother given the given

the set of set of circumstances that we

have to deal with ok and don't give

yourself any any guilt so if you have

permission from your family yeah if you

don't have permission from your family

then just you just have to assume what

it's called substituted judgment to say

if she was able to make a decision what

decision would she make would she want

to be unsafe in her own home you know

what she want to be subjected to not be

able to take her own medicine and and

and and get her her medical case

complicated by the fact that you know

she's either not taking her medicine

right or she's you know she's forgetting

to take it or taking it twice I think

she would want help with that if she

could make her decision herself now your

due diligence is to find the very best

possible home that you can find and what

that looks like an assisted living a

skilled nursing a medical memory care um

that's gonna look different in your

community but just a simple google

search you know will find you know care

homes in your vicinity and then you just

need to go visit them just like if you

are shopping for a house or shopping for

our card you shop for a nursing facility

same way I am going to drop down in the

show notes a link to my blog and I will

have the information of it there how to

choose a nursing home what questions to

ends ask and I could answer there's lots

of good things that you can can use to

do your due diligence and find a good

place for your person listen there are

lots of horror stories on the news about

nursing homes about abuse and neglect

and all of those kinds of things but let

me tell you I am in and out of nursing

facilities all the time that's part of

what I do I am a consultant for folks

and I see Plus I worked in the nursing

home industry for ever it feels like

since I was a child it feels like you

know I'm not early 20s I started so over

almost 25 years now I've been in the

nursing home industry in some way and so

I know what it takes what a good nursing

home looks like what what questions you

need to ask and what are the answers you

should expect and I'm gonna write that

up and put it down below so that you can

have you can print it out you can take

it with you you know whatever but you

know there are some some some ways to

find the best home talk to their doctor

talk to nurses talk to friends you know

there are people who have their people

in these nursing homes and those are the

people that you should talk to when you

go to visit

nursing-home ask the residents are you

happy here what's the best thing about

this home what's the worst thing about

this home what is the what what could my

person expect if I were to admit them

here talk to them talk to the nurses

talk to the activities directors and the

social services people there's a

marketing person probably that's going

to be showing you around and that's

great but they're talked to tell you the

very best things and to put the very

best spin on things and to put

everything in the best possible light

the honest answers you get are from the

other residents the other residents

families the staff on the unit okay I'll

go ahead and give you a tip one of the

best things to ask is who is your

longest standing caregiver you know who

has been here the longest you know these

folks people that have moved places that

I go they have people that have been

there 20 25 30 years go and talk to

those people and say why do you still

work here after 20 years what is it you

know what is it about this place that

has captured has captured your heart and

why do you still you know work here

those kinds of things that's a good

that's a very good inside tip to talk to

the person that's been there the longest

talk to the resident that's been there

the longest and the employee that's been

there the longest and get the scoop and

tell them listen I'm having a hard time

deciding whether to place my mother here

and I need to know the dirty details I

need to know what's going on there are a

lot of really really outstanding care

givers in the world that work at these

homes and you know they would no sooner

put up with a with a mention of neglect

or abuse than you would and they they

they they take pride in their work they

take pride in taking care of the best

generation that our nation has ever seen

I think and you know they they take

pride in that and so they will tell you

straight forward what you need to know

about the place and do that five or six

more times however in many places are in

your home go a

in your area however many homes are in

your area go to all of them and conduct

the same kind of interview now telling

your person that they're going to a

nursing home

I believe in shaking hands with the

truth and I believe that we are all

adults and that we can hear hard knees

and and make good judgments about that

hard news now if you have somebody who

is in maybe stage 5 stage 6 they may not

totally understand what you're telling

them and I wouldn't tell them more than

once but I would say daddy we're at the

point where we can no longer take care

of you at home and we're gonna have to

find another home for you to live in and

then just tell him where that's gonna be

mama you know I cannot come and live

with you

you know Susie can't you know Jim can't

none of your children can come and live

with you but we are so concerned about

about you and about your safety so we

need to find a home for you you will

sometimes not have an issue with it

sometimes they understand they have

enough insight left to know that they

can't be taken care of at home sometimes

you get outright resistance and refusal

and tears and hollering and anger and

guilt thrown your way in those

situations you have to know if you're

already asking the question you kind of

already know something's got to be done

and I'm the one that's got to do it so

you know you just do what you have to do

and and place them where you know that

they will be safe and if you've done

your due diligence you've asked

questions you figured it out financially

you know you know that this is the best

choice for them at this time in their

lives then you just have to do it don't

sneak don't sneak about it

don't say we're gonna go we're gonna go

get a bowl of ice cream and then you

drive them to the place and then there

they are and you leave don't do people

like that I don't think anybody that's

looking at this video would do people

like that because you you looking up

this information and watching this video

to this point shows me that you have a

vested interest in your person and that

you want what's best for them and you're

trying to gain knowledge and

understanding of the best thing to do

for them so I don't think you're the

kind of person that would tell them

they're going for ice cream and then

drop them off at the assisted living and

not come back for a month that happens

it absolutely happens you know we have

people that say she doesn't know me

anymore y'all just take good care of her

and and you know let me know when she

passes away that absolutely happens

family members can be can be I want to

say cowards but I guess that's not the

politically correct thing to do but

you're being brave you are being brave

because you are here looking for

information so let's not talk about

those kind of people let's keep our

thoughts on your kind of people take

them and say you know mother we're

moving here because this is a safer

place and then do it

don't argue you know if she argues

that's okay the folks at her receiving

you are you know accustomed to having

folks come into their care who may not

think that they need that level of care

they may not you know want to be there

we are we are trained and staffed to

where we understand you know what is

going on and we can help smooth the

transition there are some homes who say

don't come back for two weeks that is

not my philosophy my philosophy is to

come on and come every day it's not

gonna be any worse or any better than

staying away for two weeks to me I think

you just need to be there I think you

need to tell them you know we're not

abandoning you here you know we're gonna

be here every day it will give you

you'll be relieved I believe and you can

breathe there's so many good good

testimonies to this online when you

google you know how to tell my mother

she's going to a nursing home you know

something like that Google is your

friend honey there are so many people

that say I was so relieved because I

could finally be the daughter again and

not mother's caregiver you know there

were hired caregivers there were people

in there was

in those assisted livings in skilled

nursing who were paid to be there for a

shift and go home and you know so

there's three different people across

three different shifts taking care of

your mother at home it was just you and

so you could not be the daughter maybe

that you wanted to do you couldn't do

the fun things that you wanted to do but

once you get that caregiving off of your

shoulders that day-to-day 24/7 care

getting off of your shoulders it opens

up more time for you to actually spend

with the person that you love and you

become a daughter again a son again a

husband again a wife again and you allow

us professional caregivers to take care

of your person and free up that time for

you okay there's a lot that could be

discussed but I try to keep these videos

about 20 minutes long because I know

that you have a lot going on in your

life and it's very hard for you to get

20 minutes to sit down and and and have

a conversation with somebody but I

encourage you to ask me any more

questions whatever I can whatever in

whatever way that I can help you

I would love to drop a question down

below on the under this YouTube video

and I check on those and I can answer

those questions if you need a support

group where people are going through

what you're going through

come on over to Facebook just up at the

Facebook at the top with a search bar

just search dementia with grace group

and it's also a link under here it's a

link under in the show notes you link

your own over but if you want to just

type it into Facebook we're dementia

with grace group website dementia with

grace calm that is under construction

right now so it may be up it may be down

when you try to access it but I am

available for hire we can FaceTime we

can Skype and we can get down into the

details of what you need for your person

and I'm cheaper than a plumber so it's

it's a resource that you absolutely can

use and I would love to help you you

know in these videos and then on them

you know all I have to speak in

generalities but you and I can have a

FaceTime video just like this right here

and you can tell me the details of your


and I can help you problem-solve that's

what I'm about that's what a dementia

practitioner does we consult with

families and homes to try to make the

lives of caregiving caregivers easier so

that they can have a better quality of

life with the person that they love I

don't know you but I love you I love

caregivers I love folks with dementia I

love my job I love what I do and I would

love to help you if you need me my

address and my email address is too

thick evic KY at dementia with grace

calm and you can reach me right there

very easily and I'll be checking my

emails in case you need me okay all

right I thank y'all for your time that's

gone 22 minutes now and I think that's I

think that's perfect

all right I will talk to y'all soon take

care bye