Nursing Homes and Assisted Living: The Family's Guide to Making Decisions and Getting Good Care

by Silin, Peter S.

• ISBN13: 9780801893520
• ISBN10: 0801893526
• eBook ISBN(s): 9780801896019
• Edition: 2nd
• Format: Paperback
• Copyright: 2009-09-01
• Publisher: JOHNS HOPKINS UNIV PRESS
• More Book Details

Summary

Almost a decade ago, Peter S. Silin wrote Nursing Homes: The Family's Journey to provide family members with practical advice and emotional support. This successor volume incorporates the new and sometimes baffling world of assisted living. Nursing Homes and Assisted Living focuses on the psychological, emotional, and practical aspects of helping family members and seniors make a difficult transition.Silin approaches his subject with compassion and sensitivity, guiding readers through the process of finding the best possible care. He describes how nursing homes and assisted living facilities work and outlines the selection process; he explains how to prepare for the day a relative moves into a facility and suggests ways to help the resident settle in; he focuses on the family member's role in solving problems, obtaining good-quality care, and visiting. He also helps caregivers cope with difficult decisions, deal with emotional issues such as guilt and grief, and celebrates the tender, rewarding aspects of being a caregiver. The book includes vignettes from real-life caregivers narrating their experiences.This book provides caregivers, family members, and seniors with the information they need to effect successful transitions. It is also a valuable tool for social workers, nurses, and family therapists.Praise for the first edition"An important book about the often difficult and painful process that begins long before a loved family member enters a nursing home... A thorough, excellent and humane book that helps families navigate a difficult, traumatic life change in the most successful way possible." -- Inside GCM"Among the most valuable chapters in this book is one titled "Making a Home Better," which includes wonderful advice on how a loved one can influence what goes on inside a nursing home. His inclusion of real-life stories from the families he's encountered over 20 years anchors the book compassionately." -- Los Angeles Times"This is both a very humanistic book and a very practical one... written with the insight of a sociologist and geriatric care manager, someone who sees the human side of the equation first." -- ElderCare Online

Author Biography

Peter S. Silin is a geriatric social worker and principal of Diamond Geriatrics, Inc., a geriatric care management company in Vancouver, British Columbia. He has worked in all areas of senior care.

Table of Contents

Preface	p. xiii
Acknowledgments	p. xv
Caring Decisions
When Someone You Love Goes into Care	p. 3
Becoming a Caregiver	p. 3
Becoming "the Family Member" of Someone in Care	p. 4
Learning the Role of "the Family Member"	p. 6
Types and Levels of Care	p. 7
Other Considerations	p. 14
Alastair	p. 16
Deciding about Care	p. 19
How to Talk about Care	p. 19
Choosing the Right Time	p. 26
Stress and Burnout	p. 28
When a Parent Chooses to Live at Risk	p. 30
Making the Decision	p. 32
Your Legal Right to Make Decisions for Your Relative: A Warning	p. 33
Advance Directives and Medical Decisions	p. 35
Lydia Jean	p. 40
Family Decision Making	p. 42
Family Relationships and Care Decisions	p. 42
How to Make Family Decisions	p. 44
Family Meetings	p. 46
Keep Your Relative Involved	p. 51
Mary	p. 53
Guilt, Loss, and Grief	p. 58
What Is Guilt?	p. 58
Conflicts That Give Rise to Guilt	p. 60
Families and Guilt	p. 61
Adult Children	p. 62
Guilt, Culture, and Society Today	p. 64
When Guilt Has Other Purposes in Your Life	p. 65
Not All Relationships Were Ideal	p. 66
Guilt and Dementia	p. 68
Dealing with Guilt	p. 69
Letting Go	p. 74
Grief and Loss	p. 77
Handling Grief	p. 79
Marjorie	p. 82
The Residence
About Nursing Homes and Assisted Living Facilities	p. 87
Keeping Your Relative at Home	p. 88
Where to Start Finding a Nursing Home or Assisted Living Facility	p. 91
Applying for Seniors Housing	p. 95
About Good Care and Good Caring	p. 96
Models of Care	p. 98
On Abuse	p. 100
Specialized Dementia Care Units	p. 110
Costs	p. 111
Nursing Homes and Legal Responsibility	p. 119
Mildred	p. 121
Viewing the Residence	p. 124
Staffing	p. 126
Programming	p. 127
Policies	p. 129
Dining	p. 130
Physical Plant	p. 131
Surveys and Accreditation	p. 132
John and Joyce	p. 133
Staff Roles: Who Does What?	p. 139
Receptionist	p. 139
Administrator	p. 140
Personal Care: Nurse's Aides	p. 141
Nurses	p. 143
Dietitian and Food Services Staff	p. 144
Social Worker	p. 145
Recreation Therapists	p. 145
Rehabilitation Staff	p. 147
Housekeepers/Building Maintenance Staff	p. 148
Pharmacist	p. 149
Physicians	p. 149
Other Staff Members	p. 150
Mabel	p. 152
Nursing Home and Assisted Living Systems	p. 155
How the System Works	p. 157
A Typical Day	p. 158
Cyrus	p. 161
Moving In And Settling In
Preparations for Moving Day	p. 167
How to Prepare Your Relative	p. 167
Get to Know the Home in Advance	p. 170
Equipment	p. 172
Valuables	p. 173
Clothing and Laundry	p. 174
Plan Ahead for Moving Day	p. 176
Plan to Take Care of Yourself	p. 178
Betty	p. 180
Moving Day	p. 182
Stay Calm	p. 182
If Your Relative Refuses to Go	p. 183
Walking through the Door	p. 184
When You First Arrive	p. 185
Joan	p. 188
Settling In	p. 192
Resident Adjustment	p. 192
Changes and Differences in Behavior	p. 193
Dementia and Behavior	p. 200
Sex and Relationships in Nursing Homes and Assisted Living	p. 203
On Staying Healthy	p. 205
Your Emotional Adjustment	p. 207
The Gap in Your Life	p. 208
Phases of Adjustment	p. 210
Acceptance	p. 212
New Relationships	p. 213
Bill	p. 215
Being The Family Member of Someone In Care
Care and Care Planning	p. 221
Basic Standards of Care	p. 221
How Care Is Organized	p. 222
Care Conferences	p. 224
Charts	p. 227
Medication and Care Planning	p. 228
Medication and Pain Control	p. 230
Restraints	p. 232
Toileting and Incontinence	p. 234
Falls	p. 236
Pressure Sores	p. 237
Depression	p. 238
Alcohol, Drugs, and Other Addictions	p. 238
Roommates	p. 241
Louise	p. 244
Communication and Problem Solving	p. 247
Working the System	p. 247
Communication	p. 248
Gaps in the System	p. 251
When Things Go Missing	p. 251
Your Role	p. 252
Making Complaints	p. 254
Throwing Bouquets	p. 261
Alvin (part 1)	p. 263
Visiting	p. 267
How Often to Visit	p. 268
Visiting Someone Who Has Dementia	p. 270
Going Out and Going Home	p. 271
Ending a Visit	p. 273
Companions	p. 274
A Few More Words about Sex	p. 276
Jane	p. 277
Out-of-Town Caregivers	p. 280
Professional Geriatric Care Managers	p. 285
Lloyd	p. 286
Making a Home Better	p. 289
Include the Resident in the Change	p. 290
Individual Actions	p. 290
Working with Other Families	p. 292
Working with the System	p. 294
Working with Government	p. 300
Ann	p. 302
Difficult Decisions at the End of Life	p. 306
Living and Dying	p. 306
Talking about Death	p. 307
Facing Feelings about Dying and Death	p. 309
Decisions about Dying and Death	p. 310
Hospice and Palliative Care	p. 313
Younger People and Death	p. 314
What Occurs during the Dying Process	p. 315
After Death	p. 316
Saying Good-bye to the Home	p. 317
Donald	p. 319
Alvin (part 2)	p. 325
Accessing Care in Canada	p. 327
Questionnaires	p. 333
Some Common Medical Abbreviations	p. 345
Resources	p. 347
Index	p. 357
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