Skilled Nurses Living vs Assisted Living Facilities

Skilled Nurses Living vs Assisted Living Facilities

Selecting the right residential environment for a senior that you love can be very involved. With so many residential types, fee structures, and potential benefits, finding the right place can quickly become a discouraging and confusing process. It is important to continue to research and learn as much as you can about what place is the best fit for you and your family. Sometimes the best way to understand one option is to compare it to another one. This article will seek to compare and contrast ALF (assisted living facilities) and SNL (skilled nurses living).

Differences Between Skilled Nurses Living & Assisted Living Facilities

Skilled Nurses Living

Assisted Living Facilities

1. Provides a safe environment for someone who has significant medical needs such as a ventilator, IV or medication. 1. Provides a safe environment for someone who needs only help with daily living activities such as dressing, bathing, walking, etc.
2. This is a medical living setting. It often takes place in a rehabilitation facility or nursing home. 2. This is a more residential setting.
3. These facilities are required to have a registered nurse on site for at least 8 hours a day, 7 days a week. 3. ALF have licensed practical nurses and/or registered nurses accessible and on-call, but they are not required by law to be on-site.
4. Usually SNL is short term. 4. ALF are more of a long-term plan for care.
5. The goal is to provide more short term care in hopes of returning to more individualized living. 5. The goal is to provide an individual with as much independence as he or she desires, while assisting with tasks like bathing, dressing, and meal preparation (among others). One option isn’t better than the other; both serve a unique purpose based on current need.
6. Because skilled nursing exists to help individuals following a hospitalization or sudden decline in health, it typically involves constant monitoring and round-the-clock medical care. 6. Residents of assisted living enjoy great freedom –entirely in control of their schedules – deciding how often and to what degree they need or want assistance.
7. The cost is higher due to 24 hour care that is provided. 7. Costs are less per month, however it is more of a long-term solution.
8. SNL is likely to be covered by insurance. 8. ALF is not likely to be covered by insurance, but can be covered by long-term care plans if an individual has one in their insurance plans.

There are benefits and drawbacks to both options and the best fit will differ for each family. The most important thing to consider is what you or a loved one needs. Orchard at Brookhaven is happy to help walk you through this process of decision making. If you need help deciding or would like more information, please contact us today.

Geriatric Care Manager

Geriatric Care Managers for Dementia Patients

As you and your loved one begin to navigate caregiving for someone with dementia, it may become very overwhelming. There are many plans that have to be in place and sometimes it is difficult to even know where to begin. One person who can help with this process is a Geriatric Care Manager. This individual is typically a medical professional or social worker who assists with navigating the many levels of care that are needed for someone with dementia.

Geriatric Care Manager & Services Offered

There are many things that these care managers can assist with including:

  • Discuss difficult topics and complex issues
  • Make home visits and suggest needed services
  • Address emotional concerns
  • Make short- and long-term plans
  • Evaluate in-home care needs
  • Select care personnel
  • Coordinate medical services
  • Evaluate other living arrangements
  • Provide caregiver stress relief

Finding the Right Fit

It can take some time to find a case manager who is right for your family. There are several routes that one can take in order to find the right fit. One way place to look is online. is a great resource for finding case managers. It also may be beneficial to ask others you know who might have had a case manager at some point. When interviewing for the position, you should ask questions that will give you good insight on the type of care that will be provided. Some example questions you might ask are:

  • Are you a licensed geriatric care manager?
  • How long have you been providing care management services?
  • Are you available for emergencies around the clock?
  • Does your company also provide home care services?
  • How will you communicate information to me?
  • What are your fees? Will you provide information on fees in writing prior to starting services?
  • Can you provide references?

The more questions you ask, the more information you will have. Never be afraid to ask questions when it comes to care for someone you love.

At some point in your older adult’s care, you and your family might feel completely lost and unsure. If you’re stuck and don’t know what to do, a Geriatric Care Manager can help you understand options, tradeoffs and costs. Here at Orchard at Brookhaven, we are happy to be a part of the process. We love working with all of our residents’ team members to create the best care possible. If you or someone you love are interested in finding out more about all we have to offer, contact us today.

Tips For Caregivers During the Holidays

Tips For Caregivers During the Holidays

While the holidays are a great time to spend time with those we love, when celebrations, special events, or holidays include many people, this can cause confusion and anxiety for a person with dementia. He or she may find some situations easier and more pleasurable than others. The tips below can help you and the person with dementia visit and reconnect with family, friends, and neighbors during holidays.

Maintain A Stable Environment

The holidays can be tricky. One one hand, they conjure up positive memories of the past, but on the other hand, they can be a reminder of what was. They also can be a time of added stress and extra worry.

Here are some ways to balance doing many holiday-related activities while taking care of your own needs and those of the person with Alzheimer’s disease:

  • Celebrate holidays that are important to you. Include the person with Alzheimer’s as much as possible.
  • Set your own limits, and be clear about them with others. You do not have to live up to the expectations of friends or relatives.
  • Incorporate the person with dementia as much as possible. Whether it is in simple holiday preparations, or have him or her observe your preparations. Observing you will familiarize him or her with the upcoming festivities. Participating with you may give the person the pleasure of helping and the fun of anticipating and reminiscing.
  • Consider simplifying your holidays around the home. Instead of elaborate decorations, consider choosing a few select items.
  • Encourage friends and family to visit even if it’s difficult. Limit the number of visitors at any one time, or have a few people visit quietly with the person in a separate room. Plan visits when the person usually is at his or her best.
  • Prepare quiet distractions to use, such as a family photo album, if the person with Alzheimer’s becomes upset or overstimulated.
  • Make sure there is a space where the person can rest when he or she goes to larger gatherings.

Making Guests Feel Comfortable

Explain to your guests what dementia is. Set the precedent for what is acceptable and what is not.

If this is the first visit since the person with dementia became severely impaired, tell guests that the visit may be painful. The memory-impaired person may not remember guests’ names or relationships but can still enjoy their company.

  • Explain that memory loss is the result of the disease and is not intentional. No one should take anything personal.
  • Stress that the meaningfulness of the moment together matters more than what the person remembers.

Preparing the Person with Dementia

Here are some tips to help the person with dementia get ready for visitors:

  • Begin reminding the person with dementia of who all will be in attendance. You can use photos to help jog their memory.
  • Arrange a phone call or FaceTime for the person with Alzheimer’s and the visitor. The call gives the visitor an idea of what to expect and gives the person with memory loss an opportunity to become familiar with the visitor.
  • Keep the memory-impaired person’s routine as close to normal as possible.
  • During the business of the holiday season, do your best to avoid fatigue and find time for adequate rest.

Although the Holiday Season can bring about extra worry and stress, there are some steps you can take to make it a more enjoyable time for you and your loved ones. Taking the time to prepare all peoples involved can really make a difference in the time that is spent with one another. Here at Orchard at Brookhaven, we are ready to adjust with you and your families. If you’re interested in learning more, please contact us today!

Being A Caregiver During COVID-19

Being A Caregiver During COVID-19

It is undeniable that the impact of COVID-19 has infiltrated the lives of everyone in America. From mask wearing to sheltering in place, the pandemic has forced most, if not all people, to change their day to day “normal”. A person with dementia and those caring for these persons are not excluded. For those who are already living in communities with help, it may be true that they have not been able to see loved ones as often. For those living at home, perhaps what they can do outside of their house has been greatly limited. Without doubt, it is important now more than ever to take the necessary steps to care for yourself and loved ones who may be suffering from dementia.

Avoid COVID-19 Risk of Exposure

As a caregiver, it will benefit yourself and the person you care for to reduce your risk of exposure as much as possible. Here is a list of ways you can do this.

  • Wash your hands a frequently as possible
  • Wear a mask or face covering around others
  • Reduce unnecessary trips in public
  • Physically distance from others as much as possible
  • Avoid sharing personal items
  • Disinfect your home or the home you are caring in often
  • Wash and dry laundry frequently

Keep A Routine

Navigating through a global pandemic is probably not something that most of us have had to figure out before. It is beneficial to try and maintain a daily schedule as frequently as possible. Control what you can. Create a schedule, get up and go to sleep at the same time each day, and minimize disruptions. Create an environment in your home or in the home of the person you are caring for that is relaxing and as stress free as possible. If a loved one had previously been cared for by someone else during the day, try to recreate as many of the same routines and activities as you can. This can help reduce anxiety for the person you are caring for.

Plan Ahead

Planning ahead, in the event that you do get the virus, will help to reduce any obstacles you may face. Many times, people with dementia have difficulty expressing themselves, so any symptoms they may be having are not verbalized. You should watch for changes in their behavior that might be indicators of not feeling well. If the symptoms they are showing are not life threatening, you should call before going to the doctor. With all the procedures and protocols in place, most facilities have restricted entrances.

Another thing to think about is what to do if you get sick. You should have plans in place for someone to take your place to be able to provide daily care.

It is a good idea to talk to the person you are caring for about what your plan is so that they can somewhat be prepared if you get sick.

There are many action steps that can be taken to make sure that you and someone you care for are safe. Orchard at Brookhaven has several policies and protocols in place for the safety and health of our residents, staff and their families. Residents are still able to spend time with and see family members if they so desire. If you would like to learn more about our community and safety procedures, please contact us.

Talking Therapy For Dementia

Types Of Talking Therapy For Dementia

Dementia, a cognitive disease that affects the brain unfortunately can affect so many parts of someone’s life. While movement, daily routines and lifestyle are some of the major changes that take place, talking is one of the most important. Luckily, there are therapies that exist specifically for helping with communication.

Benefits Of Talking Therapy For Dementia

Talking therapy is a service that is provided by a trained professional such as a counsellor, a clinical or counseling psychologist, a psychotherapist, or a psychiatrist. The therapies can take place in person or online. One of the best parts about these kinds of therapies is that they are designed to be specific to each individual. There is no one size fits all.

There are many different benefits of talking therapy. Most of these therapies take place in the early to middle stages of dementia. Because late dementia can really start to affect the way the brain focuses, it is best to begin talking therapies early on. Below are some of the main benefits of talking therapy:

  • Affords the opportunity to discuss feelings about recent diagnosis
  • Creates a safe space to explore many different feelings
  • Extended therapy (over several weeks) can reduce the onset of depression or anxiety
  • Provides comfort for individuals
  • Allows individuals to learn how to maintain healthy relationships with others

Types Of Talking Therapies For Dementia

There are different types of talking therapies that can help with dementia. The type you or a loved one may choose will depend on the desired results and at what stage of dementia the patient is.

Dementia & Counseling

Counseling is a broad way of categorizing therapies that include individual, group or couples sessions. Each of these aim to help someone face and deal with their problems. A counsellor won’t give the person answers, they will help to guide them with their problems.

Those who have been recently diagnosed with dementia, struggle to come to terms with how much their life is changing. Feelings of confusion, frustration, vulnerability and anxiety start to take over. Counseling can help a person to deal with and manage many of the new emotions they may be feeling.

Dementia & Psychotherapy

Psychotherapy is a term for another range of talking therapies. The type of psychotherapy that a person is offered will depend on what is most appropriate for them. A psychotherapist deals specifically with a person’s personality, belief system and experiences to help them understand what is they may be going through. Psychotherapy can help people with dementia feel less depressed and

Cognitive Behavioral therapy (CBT)

This is one specific type of psychotherapy. Cognitive Behavioral Therapy (CBT) is based on the fact that the way we think about something (our ‘cognition’) affects how we feel and then how we behave. CBT is most effective for people who are in the early stages of dementia. Their brain is less affected by the disease and therefore they are more apt to engage with the therapy. CBT sessions should be highly individualized to help meet the specific needs of the person with dementia.

Caring for a person with dementia can be burdensome and rewarding at the same time. This type of commitment can come with a lot of stress. It is best to seek out as many aids as possible to help you care for someone. Therapies are a great way to do this.

Orchard at Brookhaven is here to help our residents through their journey. Please contact us to learn more about our programs to help you or your loved one.

Managing Dementia Behavior Changes

Managing Dementia Behavior Changes

Dementia is a progressive disease. As time goes on, the brain’s functionality decreases resulting in a decrease of a multitude of other bodily functions (physical and mental). One of the most challenging aspects to handle is the changes in behavior from dementia. It is most important to try and see things from their perspective. You may not have a very clear idea of what they are thinking or feeling, so you must be as patient as possible.

Strategies For Managing Dementia Behavior Changes

There is no right way to deal with changes in behavior. The changes and needs of a person can vary depending on many different factors. Below are listed some general tips for dealing with behavior change.

  • Help them stay in touch with loved ones- facetime, write letters, call, text, etc.
  • Encourage the person to do things they enjoy or find useful- hobbies are always a great outlet.
  • Make changes to their environment if necessary.
  • Keep familiar, comforting or personal items close to them
  • Keep their sleeping environment comfortable – adjust the thermostat, use extra cushioning or pillows if needed.
  • Be aware of the person’s beliefs and thoughts and try not to argue with them
  • Set up psychological therapies with professionals, such as cognitive stimulation therapy.
  •  Ask the person’s doctor to check for any possible physical causes, including pain, and advise on any treatments.
  • Consider whether the behavior is really a problem. If it is disrupting a particular activity such as washing or dressing, ask yourself if this task really needs to be done right now or if you could come back to it later.
  • Try to remember that the person is not behaving this way on purpose. Try not to take it personally. Their sense of reality may be very different from yours and they are responding to their own needs.
  • Think about what you know about the person and their life. For example, if you know someone used to work night shifts, it might explain why they want to stay awake or go out at night.
  • Even though a person with dementia may have problems with their memory, they still feel and respond to emotions.
  • Offer the person gentle reassurance. If you need to, try stepping away from the situation to give you both time to calm down.
  • Try not to show feelings of frustration as it may make things worse.
  • Support the person to do as much as they can for themselves. The behavior may be their response to the feeling that they are not able to contribute or are not valued by others.
  • If you think they are bored, support them to find things to do that are engaging and mean something to them.

Changes in behavior can be very difficult for you. They may make you feel frustrated or distressed and affect your relationship with the person you’re caring for. You may also worry that people are judging you or expecting too much of you, or that they don’t understand the challenges you face.

Orchard at Brookhaven aims to help our residents and their families manage changes in behavior. Our highly effective staff is flexible and willing to work individuals for what they need. Please contact us today to learn more about our community and how we can help.

Feelings & Relationships With Dementia

Feelings & Relationships With Dementia

If someone you love is diagnosed with dementia, it is highly likely that your relationship with them will eventually be impacted. Dealing with these changes can be difficult and uncomfortable. As you are asked to support this person more and more, different aspects of your relationship will be affected, as well as your own feelings towards them. It is always important to remember that you are doing the best you can for them and yourself.

Relationships With Dementia

As the person’s dementia progresses and you provide them with more support, your roles in the relationship are likely to change. This change will occur depending on your relationship to the the diagnosed individual (parent, spouse, friend, sibling, etc.) You will find the many adjustments that are necessary difficult. Some aspects of this may provide you with comfort and support and you may be able to talk about many of the same things you used to. If you need to start doing tasks that the person with dementia used to do – such as paying the bills, driving or cooking – you might find this difficult to accept or get used to.

Romantic Partners & Dementia

If you’re caring for a partner with dementia, your romantic relationship is likely to change as their condition progresses. Some people find it difficult or impossible to continue to enjoy a romantic relationship with the person they are caring for when so many other aspects of their relationship have changed. However, many couples do enjoy a physical relationship and sometimes develop new ways of sharing closeness and intimacy. Sometimes you might even feel guilty for wanting to continue your romantic relationship with a partner – though it’s natural to continue to want intimacy. Although you may not be able to have these needs met in the same way, looking after your own wellbeing and getting support for yourself is important.

Dementia Care & Common Feelings

Many people have mixed feelings about being in a caring role. The relationship between you and the person you’re caring for might be complex. Here are some of the emotions you may feel as a caregiver/partner:

  • Guilt
  • Greif
  • Exhaust
  • Resentment
  • Embarrassment
  • Anger

Positive emotions are also a possibility when you are caring for a partner with dementia. If your relationship with this person has always been strong, you may feel a desire to continue to love and support them just as you always have. You may also feel a sense of accomplishment for being able to take on such a large responsibility.

It is important to remember that all of your feelings are valid. You should not try to suppress anything that you are feeling. If you can’t talk to your partner about it, you should find someone who you can speak with. Whatever you are feeling, we want to help! If you think Orchard at Brookhaven could be the right place for your loved one, please contact us today!

Tips & Tricks For Dementia Caregivers

Tips & Tricks For Dementia Caregivers

If you are the primary caregiver for someone with dementia, you are taking on a lot. It is highly likely that your stress and frustration levels are high. One of the most difficult parts of your job can be managing daily tasks. This article will provide you with some tips and tricks to making your day to day life more manageable.

Reducing Caregiver Frustrations

A person with dementia might become agitated when once-simple tasks become difficult. To limit challenges and ease frustration:

  • Schedule wisely. Establish a daily routine. Some tasks will be easier to take on during certain parts of the day. Follow the lead of the person you are caring for and be prepared to make adjustments on a daily basis.
  • Take your time. Plan for tasks to take longer than usual and leave room for this in your schedule. Allow time for breaks during tasks.
  • Involve the person. Allow the person with dementia to do as much as possible with the least amount of assistance.
  • Provide choices. Provide some, but not too many, choices every day. For example, give two choices for lunch, provide the option of playing a game in or outdoors. The choices can be simple.
  • Provide simple instructions. People with dementia best understand clear, one-step communication.
  • Limit napping. Avoid multiple or prolonged naps during the day. This can help with keeping a stable sleep schedule.
  • Reduce distractions. Turn off the TV and minimize other distractions at mealtime and during conversations to make it easier for the person with dementia to focus.

Be Flexible

As time progresses, a person with dementia is going to need more and more help.To reduce frustration, stay flexible and adapt your routine and expectations as needed.

For example, if he or she wants to wear the same outfit every day, consider buying a few identical outfits. If bathing is met with resistance, consider doing it less often. Don’t overthink simple situations.

Create A Safe Environment

Dementia impairs judgment and problem-solving skills, increasing a person’s risk of injury. To promote safety:

  • Prevent falls. De-clutter the floor. Remove anything that may cause someone to trip (rugs, chords, decor, plants, etc.) Install handrails or grab bars in critical areas.
  • Use locks. Install locks on cabinets that contain anything potentially dangerous, such as medicine, alcohol, guns, toxic cleaning substances, dangerous utensils and tools.
  • Check water temperature. Lower the thermostat on the hot-water heater to prevent burns.
  • Take fire safety precautions. Keep matches and lighters out of reach. If the person with dementia smokes, always supervise smoking. Make sure a fire extinguisher is accessible and the smoke and carbon monoxide detectors have fresh batteries.

Each person with Alzheimer’s disease will experience its symptoms and progression differently. Tailor these practical tips to your family member’s needs. Being able to go with the flow and accepting changes well can help you to provide the best care possible. If you are ready to begin the discussion of needing help with caregiving, Orchard at Brookhaven is here for you. Please contact us today to learn more about our community.

Orchard at Brookhaven

Tips For Selecting A Memory Care Facility

Each memory care community is unique. The employees, location, services offered, building structure and day to day operations will look different depending on where you are. Your job is to find the facility that best matches your loved ones needs. Just like your loved one is unique, so should their care be. The first steps in finding the right place for them is to really evaluate what their needs are. You can begin by asking the following questions to solidify a clear outline of their individualized needs.

Selecting A Memory Care Community

Below are some questions to ask yourself.

  • What behavior tendencies does my loved one have?
  • Does my loved one wander, get lost, or seek exits frequently?
  • Does my loved one need help eating or drinking?
  • What is my loved one’s level of mobility?
  • Does my loved one use a wheelchair, cane or walker?
  • Does my loved one experience accidents or need help toileting?
  • How much supervision does my loved one need?
  • What level of medical care/attention does my loved one need or currently have?

Questions To Ask Memory Care Community

The following questions can give you a better idea of the qualifications of the staff. These questions can help you gauge their knowledge and expertise:

  • Is your facility and staff accredited?
  • Is training ongoing for staff? How many hours of training do they receive?
  • Are any staff members certified dementia care managers (CDCMs)?
  • What is the staff-to-resident ratio?
  • What is the staffing ratio during the day and at night?
  • Does each resident have an individual care plan? If so, how is this determined?
  • Are residents grouped by cognitive level?
  • Can you care for wheelchair-bound or bedridden residents?
  • Are you able to care for residents who are physically aggressive or those who exhibit disruptive behaviors?
  • Can outside or visiting care be arranged? If so, who coordinates the care?

Safety At Memory Care Community

Each memory care facility will have different safety features and technology. These questions are especially critical to the well-being of your loved one:

  • How is the community secured? Are the buildings and ground secured?
  • Is a nurse on duty 24 hours per day? If not, how many hours is a nurse on duty, and what are those hours?
  • What medical services are available?
  • Is there a visiting physician? Is it easy to seek medical help if needed?
  • Are there emergency alert systems, enclosed courtyards, or color-coded hallways to reduce anxiety and assist with navigation?

Memory Care Cost and Community Policies

Inquire about what you’re paying for, what happens in the event of an emergency and other important policies:

  • Is there a thorough assessment of the applicant before admission?
  • What types of care are not provided? How are residents transitioned from memory care to skilled nursing?
  • How often do you update families about the resident’s well-being?
  • What is the policy or procedure for handling a medical emergency?
  • What is the cost structure? Is there one flat fee, or separate fees for housing and care? Are there any additional fees?
  • What is the discharge policy?

Memory Care Amenities and Features

Many memory care communities offer a plethora of amenities, so it’s important to decide what your loved one could benefit from the most:

  • What are the living arrangements? Memory care cottages? Neighborhood style?
  • Do they have a special memory care dining program? How is food served? Are escorts to meals available?
  • Do they have walking paths or circular paths for residents?
  • Are concierge services available?
  • Are there any fitness or wellness programs offered?
  • How many meals or snacks are provided?
  • What amenities or features separate you from other memory care facilities?

Clearly, there are a lot of factors that come in to play when deciding where your loved one should go for memory care. There are many things to consider.  Orchard at Brookhaven is happy to answer any and all the questions you may have. Please contact us today so we can help!

Bathing & Dementia

Bathing Someone With Dementia

Oftentimes it can be difficult to figure out what someone with dementia is trying to communicate. Especially in the late stages, there can be a lot of frustration with communication. Each person is unique and it can take some trial and error to figure out what works or doesn’t work. One aspect of caregiving that can be particularly daunting is bathing. This process can be quite involved. This article will explore some strategies that you can use to ease the difficulties you might encounter while trying to clean your loved one.

Tips For Bathing Someone With Dementia

  • Offer an incentive. If you feel that the reason a senior isn’t bathing is because they think they’ve already done it, or they just don’t see the importance of it, try associating the process with something they enjoy. Give them a fun incentive to cooperate.
  • Prioritize safety and comfort. Make sure they feel safe and comfortable in the bathroom throughout the process. If the room tends to be cool, try to warm it up before bath time. If a shower is the best route to go for your loved one, be sure to install grab bars for extra stability when getting in and out of the stall. A comfortable shower chair and a hand-held shower head are worthwhile investments as well.
  • Consider sponge baths. If a senior’s dementia is so advanced that they’re adamant about avoiding the bathroom, you may want to try a different tactic. When done correctly, a person can get clean with sponge baths, dry shampoos and no-rinse personal care products.
  • Communicate while helping the senior bathe. Whether you are assisting in the shower or giving a sponge bath, it’s important to announce each step before you do it. The senior may not understand exactly what you are saying, but it will help keep them calm and included in the process.
  • Respect the senior’s modesty. Many elderly people are understandably uncomfortable with the thought of someone else helping them bathe. Seniors are often more comfortable with someone else bathing them, both mentally and physically, if they can remain somewhat covered during the process. Many family caregivers have had success with keeping a robe or a towel draped on their loved ones and only briefly uncovering one area at a time for cleaning. This helps them stay warmer and feel much less exposed.
  • Find a stopgap solution. A full bath or shower isn’t needed every single day, but there are certain areas of the body that warrant more frequent attention. A few quick passes with an adult-sized wet wipe under the arms each day and a thorough cleansing with a bidet attachment or a peri bottle (perineal spray bottle) after toileting can help a senior remain fresh in between full showers and baths.

Bathing can be a strenuous process for both the caregiver and an elderly person. When dementia is thrown into the equation, it becomes even more difficult. There are any number of reasons why a senior with dementia may become resistant to showering as the disease progresses. Understanding the underlying causes can help family caregivers better navigate these issues and help their loved ones stay as clean, healthy and comfortable as possible. Orchard at Brookhaven is committed to keeping our residents healthy and comfortable, even in challenging situations. Please contact us to learn more about our community.