Each day I nag myself to work on the book I’m writing, 7 Actions to Take to Stay OUT of a Nursing Home. The coronavirus has pulled a plague on us, and staying out of a nursing home seems even more relevant and yet less relevant than ever in my life and in your life.
Nursing homes are one of the epicenters of the virus. In Kirkland, 20 miles away, the Life Care Center of Kirkland had some of the first diagnoses and many of the first deaths in the state of Washington. Nursing homes are a perfect petri dish for disease. You have closely packed residents with compromised immune systems. You have staff who are often poorly compensated, sometimes minimally trained, and everyone is in close contact providing the most intimate of services.
So, for the time being I am going to focus my writing on aspects of the virus that others are not highlighting and about which I have some expertise.
Dementia in the Time of Coronavirus
Are you shut in with a beloved family member with Alzheimer’s? Are you trying to support a cognitively-impaired neighbor living alone? Is your mom in an institution and you are now forbidden to visit?
Here are some important tips, suggestions, and facts
Don’t correct; only connect
One of the hardest issues for me with my difficult demented dad was not pointing out how wrong he was. When he tried to give away my mother’s pearls to a caregiver, she properly refused and told me. (Not all caregivers would be so ethical, I know). Rather than preaching that family heirlooms were not an appropriate gift, or that he should not be sexually attracted to his caregiver (which he was), I asked, “Tell me about when you and mom picked out this gorgeous necklace.” He happily complied and we agreed to safeguard it in the box at the bank.
When a person with impaired judgement wants to drive, don’t say, “You are no longer a safe driver.” This is an insult to almost every American, especially a man. Ask instead, “Dad, tell me about your first car.” Or when you learned to drive. Or how you got your first driver’s license. Long-term memory stays intact long after short-term memory is shot. Most individuals with dementia can tell you about their wedding in the 40s but are clueless about what he or she did yesterday.
When mom asks, “Where’s Dad?” never say “Don’t you remember, he died last year?” This is cruel indeed. Ask instead, “Tell me about when you met dad.” Or ask about the wedding or point to the ring and ask when they bought it.
Give choices but not too many
We are accustomed to asking, “What do you want to wear?” or “What do you want to eat?” While choices are honoring preferences are enormously important, simplify. “Do you want to wear the blue shirt or the plaid shirt”, and hold them up. Ask, “Do you want fish or chicken?” This honors control, choice and preferences but doesn’t make it an ordeal of dithering.
Contact with no contact
Supporting an institutionalized elder is going to be much more difficult during the coronavirus. Since you can’t visit, ponder the other possibilities. I’ve been exchanging postcards with a family member. As long as we still have the sacred postal system, a letter or card can brighten the day for the receiver. It also shows staff that the person they care for is valued. It also is a meaningful activity for you.
If the tools and skills are available, video chatting with Facetime or Zoom are great. Staff are usually willing to help, especially if it is as simple as handing over a cell phone. A phone call, even without the visuals, is communication but of course not every person with dementia can handle it.
Sending flowers may be an option, depending on where you live. Talking with staff will also help you learn what’s going on with the person living there, and it’s an opportunity to thank them for their invaluable service. At the present time, many of the people working in nursing homes, or any health care facility, are risking their lives. Let’s hope they don’t make the ultimate sacrifice and die, as many providers already have.
Please let me know if this has been useful. What changes would you add or suggest? What topic would you like to know about? As long as it relates to dementia, aging in place, long-term care, and similar issues, I’ll work on it. WordPress makes it easy to contact me. Follow me please!
Jeannette Franks, PhD 