Elder Care with Community and Companionship

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My mom first met Kathy Perkal at the preschool I attended, where they had weekly meetings to chat about the trials and tribulations of raising young children.

As time progressed, the greater issue of caring for their aging moms and dads began to overshadow discussions on child rearing.

Mom shared her experiences with her own mother, who was in an assisted living home in North Carolina. My grandmother’s room was a carbon copy of the one she had lived in for the past 40 years.

Even with the homelike accommodations and outstanding caregivers, my grandmother wasn’t adjusting. Ironically, the large number of residents made it difficult to socialize comfortably.

It began to feel like she was living in a hotel and not a home. No matter how often we visited, she seemed lonely. A companion was hired to stay with her, which gave us all peace of mind.

My mother and I spent years visiting, learning the “ins and outs” of assisted living and finding ways to keep my grandmother occupied.

It has now been more than a decade since she passed away and while we think of her often, we rarely think of her home or how it has since developed.

A few days ago, I ran into Kathy and we began chatting about her mother. Joan’s memory began declining at age 80. Kathy says she didn’t see “traditional” Alzheimer’s signs. Joan wasn’t forgetting her keys or acting withdrawn but the memories of her family were slowly worsening.

“Picture your world like a large circle that’s getting progressively smaller. At first it’s large — her four kids and our spouses, she could be reminded of her 15 grandchildren. Now the grandchildren are out of the circle. And I know that we, her children, are next.”

Kathy started by moving Joan from independent living to assisted living. There, Joan began placing notes everywhere, fearing she might forget her routine.

The reminders were helpful but after six months, assisted living wasn’t working. Joan wasn’t getting the level of care she needed.

Nurses came by at the required increments but there wasn’t steady companionship. They tried sitting in the den, but it was too confusing with people constantly coming and going.

Kathy hired outside aid to stay with her mother but she complained, “I don’t want this woman here, she’s staring at me all the time.” Who could blame her?

Then they found The Green House Project.

The Green House Project aims to de-institutionalize elder care, with small facilities for 10-12 elders. Anna Ortigara, a Resource Development Director for Green House, pointed out that they are not “mini nursing homes” but “small, intentional communities.”

They strive to answer the question, “What really makes it a home?” The answer: Homes designed to fit into the surrounding neighborhoods. Bedrooms centered around a hearth with an open kitchen/sitting area where elders can relax together.

Visitors can’t just walk in; they have to ring the doorbell.

In place of various caregivers are Shabbazim: trained individuals who do everything from personal care to cooking. Their multi-tasking roles mean they get to know the residents extremely well.

In fact, the “innovative staff model gives residents four times more contact” than other assisted living homes.

As a result of the small residencies and limited occupants, elders spend “50% less time being transported in Green House homes.”

And even when they are being transported, much of the time they may have someone walking with them instead of being carted around in a wheelchair.

They are no longer living in an institution but a home.

Kathy is lucky to have two siblings that live near Joan’s new residence, White Oak Cottages, but Kathy herself can’t manage weekly visits all the way from New York.

She relies on phone calls to stay in touch. Calling can be a little complicated, however, because Joan also suffers from hearing loss. Kathy often finds herself on speakerphone with her mother and the 11 other residents of White Oak.

“Mom, is it snowing up there?”

“What, dear?”

A third party offers, “She said, is it SNOWING!?”

Kathy understands that humor can help get through the days.

She offers an idea for other children of Alzheimer’s patients. “We’d send emails and create a binder of family information.”

For the last six months, from the day she moved in on July 4th, Joan has gotten a letter from her kids. Each letter starts out, “Please print and three whole punch for Joan Hogan” followed by “Today is…”

The letters were signed at the end but Joan kept asking, “but who is writing these?” so a third line was added, “This letter is from your daughter, Kathleen.”

Then, in three to four paragraphs, Kathy and her siblings would write what was going on with the family. “We realized we could have sent her the same letter every day, but because we shared it with our extended family, we enjoyed keeping it up to date.”

Joan holds each day’s letter in her hand all day; the news fresh every time she reads it. She shares it with her friends and even reads the letter to Kathy when she calls. It gives them something to talk about.

“What she’s saying is accurate and interesting, it removes some of the frustration.” Kathy jokes, “I wouldn’t need to speak to siblings for a week because she would fill me in on everything!”

For five to six months, Joan was able to put the letters in order in the binder. She can no longer do that, so a bit of organization and assistance is required when they visit.

Kathy says having her mother at a Green House home has been a great change and a big relief. I wish they had been around when we were looking at homes for my grandmother.

I can only imagine the difference it might have made, having true companionship.

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