There are many types of out-of-home care options for the elderly, depending on the level of care required. These may include:

· Assisted living facility (ALF)
ALFs provide maximum independence for elderly persons who remain relatively active and healthy. Typically, a healthy spouse and an impaired spouse can live together in an ALF. Most ALFs feature apartment-style living, including individual kitchens, and many services for the elderly, such as 24-hour security, transportation, and recreational and social programs.

· Residential care facility (RCF)
RCFs are for those who are no longer able to live alone and independently, but do not require skilled nursing care. At an RCF, the elderly person can receive assistance with personal hygiene, grooming, and/or other activities of daily living, as well as bedside care for minor and temporary illnesses. Typically, RCFs offer rooms, not apartments, and provide some recreational and social services for the elderly.

· Skilled nursing facility (SNF)
SNFs are also known as nursing homes, convalescent centers, and rest homes. At SNFs, elderly patients receive continuous nursing services under the care of a registered nurse or licensed vocational nurse. SNFs can provide more extensive care services than assisted living or residential care facilities. Such services include intravenous feedings, blood pressure monitoring, medication injections, and care for patients on ventilators. SNFs often provide recreational, rehabilitative, and social programs for residents.

· Others
Special care centers are available for persons with particular medical conditions, such as Alzheimer’s disease or dementia. For patients displaying violent or disruptive behaviors or presenting a danger to themselves or others, special psychiatric facilities may be an option.

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More information on the Center for Women Annual Women in Business Conference

The event will be on Friday, February 12, 2010 from 8am to 4pm.

•Have a family meeting (adult children with or without parents) with a Geriatric Nurse Care Manager to explore the above three options. Work together to create a flexible, written plan for aged parents’ holistic well-being.
•Moving is a stressor on all ages, but even more so for an aged parent who has lived in the same house for decades. Be kind and considerate, but assertive, if needed, to do best thing for parents.
•A deep and very real fear of loss of control of own life is a tremendous obstacle to moving to new environment
The Search begins:
•Tour several facilities, take notes and do comparisons. Try to visualize your parent or yourself in the residence
•Be mindful of proximity to your home or work so that seeing your parent is made easier
• Trust your senses, feelings and your initial reaction to what you see, hear and smell
•Discuss whether your cognitive parent will be placed with persons with dementia. It is best not to comingle the two groups.
•Visit facilities during lunch to see how residents interact with staff and others. Also, is the food fresh and the right temperature?

•Does there seem to be adequate staffing?
•Is the kitchen clean and pantry well-stocked?
•Does the overall atmosphere seem pleasant? Cleanliness is essential!
•Are patients “parked” at nursing stations or in front of televisions with little or no interaction?
•Are pets allowed? Sometimes keeping a pet helps aged person adjust more quickly!
•Do residents appear to be clean, groomed and odor-free?
•Does the staff treat each other with respect?
•Meet the clinical director (not just the marketing person) and ask questions
•Make sure you understand levels of care available and what determines when your parent moves from one level of care to another (and the difference in cost!)
•What occurs in a medical emergency? Will you be the first to be called after 9-1-1?
•Talk to residents. Engage them about the care they receive and the activities they enjoy (or not).
•Ask for references—other families with parents there. They can get permission to give names.
•Ask to take home information on admission criteria and house rules
•Take the time to review materials and ask questions

Work with your Geriatric Nurse Care Manager every step of the process for her professional and practical input. She will know available facilities and will help you assess which residential community will best meet your parents’ needs as well as desires for a certain lifestyle as they age. Use your professional Geriatric Nurse Care Manager’s expertise

•Start the conversation about options for parents’ with them and siblings long before a move is necessitated by medical condition or cognitive impairment. Decide:
•Will parent be able to live on her own with assistance by family or paid caregiver?
•What adaptations are recommended in the parent’s home in order for them to remain there? Or,
•Can the parent live with an adult child? Personalities are huge consideration.
•Is a residential community the best option?

Mary Peters (left) with Elizabeth Spencer

She is quick to instruct that every adult in South Carolina is required to report abuse of any kind: emotional, physical including neglect, or financial exploitation which usually involves a relative stepping over boundaries of propriety.

Elizabeth Spencer is one of a kind. Our community owes her a great debt of gratitude for the seniors she protects in her work, and for all the hours she has spent educating the rest of us. Elizabeth was a Finalist in the 2009 Healthcare Hero First Responder category. Kudos, Elizabeth!

During the holiday season, it is important to involve your loved one with Alzheimer’s or other dementia in safe, manageable activities. Encouraging the elderly to be involved in activities may enhance their cognitive recall and bring a smile to their faces.

While Alzheimer’s disease can severely diminish short-term memory, long-term memories about childhood traditions often remain well into the later stages of the disease.

Try these activities to get your loved one involved and looking forward to the activities surrounding the holidays: Gently engage your aged family member in conversations about their past holiday gatherings. Sing traditional Carols or talk about their childhood Christmas memories.

Encourage your family member to help decorate the tree, create cards, make simple gifts and wrap them. Another great idea is to prepare favorite holiday recipes together. The smell of cookies baking might prompt fond memories to be shared.

Create a calm environment and try to stick to a familiar routine so that holiday preparations or crowds won’t cause confusion or disruptive behaviors.
Just have fun with your aged loved one, and help them revisit the happy times of their lives. We hope our tips help you enjoy this special season!