Friday, 22 July 2016

Emergency Visits

When was the last time you went to the Emergency Department of your local hospital? We all know that going to the hospital in an emergency can involve many hours waiting, and be tremendously stressful for all involved. Now imagine being elderly, perhaps with some cognitive issues, and some physical limitations and disabilities. There may be no one you know with you when you are taken there. How much more difficult is a trip to the emerg. for them?

While trips to the emergency room may be unavoidable, coping and managing the stress involved comes down to being prepared. For many years now, I have talked to people about creating an 'Emergency File' of important documents that contains any necessary information for someone to access if you are incapacitated; in recent years I have included lists in our annual book of what should be included in that file (see the article How Important are your Documents? at or for more details you may download the Emergency File Document from our site's online store at

In addition to an Emergency File, it might be wise to create a one page document that can be taken to doctors appointments or on trips to the emergency room so you aren't scrambling to collect things when time may be of the essence. Consider, what a doctor needs to know in an emergency? Medical conditions, drugs/dosages, allergies, contact numbers of physicians, recent tests and results, health card and  insurance information and power of attorney info (if you are someone's POA for personal care, you should have it with you in case you are asked to present it). Because things may change frequently, this list should be updated regularly.

 If you are taking a senior to an Emergency Department or going with them, make sure they have any assistive devices they may require - glasses, dentures, hearing aids, walkers etc. are imperative - do keep in mind though that you don't want them to get lost in the shuffle so ensure that they stay with the person through their hospitalization or if they are admitted, label whatever you can or take home what they don't need for the moment. And for you as the caregiver, make sure you take what you need - money, food, your cell phone and a charger, phone numbers of important friends and family - you may have a long wait so it's important to have anything you might require with you.

Friday, 8 July 2016

Memory Care

As our regular followers know, we have been collecting data on retirement homes for 20 years now. Over this time, we have noticed significant changes in the industry as it has evolved into one that serves many levels of care with different needs. An example of this is care for people with memory issues. At one time, those with dementia were best (and only) served in long-term care (nursing homes). Over time, we have seen more and more retirement level homes offering this sort of care to their residents. Some will have special secure units; others will have security at the exits only. 

The benefit of having this sort of care in a retirement setting are great - firstly, if someone goes in when they are not impaired, and this care is possible, they can stay in their familiar setting with people they know and trust. It is easier on the resident and the family. Secondly, retirement homes have higher functioning people than long-term care in general so the activity and stimulation is greater for that person. This may translate into a slower decline than if they were in a home with very limited activity and programs. Thirdly, because of the cost factors involved, there may be extra resources for those with dementia in a privately funded retirement home than there is available in publicly funded long-term care homes. There are many retirement homes that have excellent care and resources for people with dementia. 

However, as beneficial as it may be, there are also potential issues if the security is not adequate to prevent wandering or the staff are not equipped to manage the resident's issues. By and large, most retirement homes are very up front with families about their abilities to manage people with various medical issues. Beyond liability issues for that one person, they need to ensure the safety of their other residents and staff. While it would be great if the options for care for those with dementia increased (which it no doubt will over time), I respect and applaud homes that recognize their limits and do not take on people who they cannot safely look after. 

All of this aside, while the setting itself might be nicer in a retirement home than a long-term care, it is not always the best place for someone with dementia. Each situation is different but one needs to carefully assess staffing, training and environment in light of the person's deficits. Clearly, for many cost is the prohibitive factor in the choice of care simply because those on government pensions alone would never be able to afford a private care setting (but that is a topic for another time). However, for those who can afford retirement or private assisted living, it is not a 'given' that it is the best place for your loved one if they have cognitive impairment. As with any sort of care for a senior, one has to take the time to look for a place that can meet their needs now and in the future at a price they can afford. Shop around, ask questions, tour, try the food, get references, etc. Because the person with memory impairment is particularly vulnerable, great care needs to be taken when choosing a home to relocate them to. As with anything, the best and most appropriate home isn't always the most expensive or fanciest. In some cases, the most suitable option for someone may indeed be long-term care.