A Pathway to Senior Care in San Diego: Resource Guide for Adult Children and Caregivers to Seniors

By Nancy Coulter Beland

Choosing appropriate and quality care for you or a loved one can be an emotional and daunting responsibility. With the horrifying stories of senior neglect and abuse in newspaper headlines over the years, how do you determine between the good, the bad, and the ugly?

In A Pathway to Senior Care in San Diego, author Nancy Coulter Beland draws upon more than thirty years of experience in senior care to reveal the ins and outs of the industry. With anecdotes from her days in the dugout, youll learn how to:

Have those difficult conversations with your loved one about power of attorney, driving, lifestyle preferences, and more
Determine which care option is right for you and your senior
Interview home care agencies
Look for signs of quality senior communities
Work with Medicare, Medi-Cal, SSI, and VA benefits
Make moving day easier on everyone
Take care of yourself in the process

Beland understands there isnt a one-size-fits-all approach to senior care. She carefully lays out each option for different care levels and provides a wealth of resource information to be sure your senior obtains the best consideration possible.

• Language: English
• Publisher: iUniverse
• Release date: Apr 14, 2010
• ISBN: 9781450212762

Nancy Coulter Beland

Nancy Coulter Beland has more than thirty years of experience in the care-giving industry. She is the owner of Starfish Resources, providing resource and placement information to seniors and their families. Beland lives with her husband in the San Diego area.

Book preview

Contents

Acknowledgments

Introduction

Chapter 1:   Losing Independence

Chapter 2:   Home Alone

Chapter 3:   Fall Prevention

Chapter 4:   That Damn Button

Chapter 5:   Dementia

Chapter 6:   Tough Conversations

Chapter 7:   Care at Home

Chapter 8:   Placement OPTIONS

Chapter 9:   Finances

Chapter 10:   Resources For Senior Care

Chapter 11:   The Lingo

Conclusion

References

Acknowledgments

I would like to express my thanks to the following people and acknowledge some resources that I utilized in writing this book. Without these people, my life would certainly be very different.

Mom, for teaching me to be resourceful and for being so supportive

Aunts Myrtle and Lois, both excellent nurses, who greatly influenced my youth and inspired me to be the best I could be

Catherine Ratelle of Summerville Senior Living, one of my former ops managers

Christine from Community Care Licensing. She was my first CCL program analyst and I one of her first administrators.

James E Marlin, who gave me my first job in California and a wealth of knowledge

Kymry Fowler, a former regional manager who taught me volumes and keeps me smiling

Rev. Laura Coulter, who is both my sister and my friend, and who got me started at the hospital when I was twelve

Lyn Kennedy, a former supervisor who also taught me volumes and became my friend

Marsha Kay Seff, a former writer and editor for the San Diego Union Tribune and Elder Care Directory, and currently the editor of Prime

Joanne Price, my friend, the owner of ResponseLink of San Diego, author of Fall Injury Prevention for Older Adults and host of ElderTalk Radio. She inspired me to write this book and is always supportive.

Pam Eliowitz, RN, author of ViralNurse—Infectious Rants, my biggest fan and friend

Sheryl Lee Dawson, my friend, editor, creative advisor, and Webmaster

Carrie Cantor, iUniverse Editor who truly helped me make this book what it is

Those who make available information and help to educate the population:

AARP

Aging and Independence Services, County of San Diego, HHSA

The Alzheimer’s Association

R. Scott Stewart, an elder law attorney who provides wonderful publications on Medi-Cal

Brad Albright, Scripps home health physical therapist

California Registry

California Department of Social Services

County of San Diego

Eldercare Referral Agency, Inc.

Elderlaw and Advocacy

Geriatric Care Organization

Homewatch CareGivers

National Association of Professional Geriatric Care Managers

Roni Lang, LCSW, Center for Healthy Aging, Greenwich Hospital, CT

Savvy Senior Lifestyles

Senior San Diego

Southern Caregiver Resources Center of San Diego (especially Veronika Glenn, retired education director)

And finally, to the rest of my family, friends, and, especially my husband, Jeff, (also my computer guru) for their support and their willingness to listen to and put up with me, my frustrations, and my stories for all these years—which at times has not been easy.

Introduction

Life’s road is a unique and individual journey for each of us. Each road includes different pathways, such as marriage, child rearing, home ownership, retirement and, for some, senior care. Many of these pathways are easily traveled upon and enjoyed, while others cause us to struggle. During the journey along these paths, many look ahead to their retirement years with the hope of enjoying life at the end of the rainbow with a proverbial pot o’ gold to support them. Unfortunately, for many, it’s more difficult and complex than that. In fact, some find that traversing the pathway in senior care can often be as toublesome and difficult as a leprechaun is elusive. Support systems become necessary. Some seniors never do get to see the rainbow they envisioned. Nor do they have a pot of gold to enjoy. Thankfully there are family members or close friends to help some of these seniors on their path. Others rely on strangers and government agencies for help.

It’s been said that there can be no rainbow without a cloud and a storm. Does life in the golden years really have to be full of stormy weather? What can you, as a caregiver, do if a storm creates a detour from your senior’s previous pathway? And what about that pot o’ gold? If your senior has managed to amass one, must they spend all they’ve saved just to survive? If they haven’t got a pot o’ gold, then what do you do? What kind of quality of life will your senior be able to enjoy while on their pathway of senior care? After weathering all of life’s storms, will they find a rainbow in their future? How can a caregiver find the support they need to best help their senior during these challenging times?

One may be able to find the rainbow if you know where to look and which direction to go on the pathway to senior care. Because each road is so unique, each senior’s pathway will be too. I’m here to be your guide through the storms and to help you navigate those detours and new pathways. With luck we’ll find that rainbow together.

During my years of experience in senior care, I found that the common thread in all the lives that touched me was that most people were not prepared for the situations they suddenly found themselves facing. They’d been detoured from their pathway and didn’t have a roadmap to find their way back. Truly, I don’t know many people who have spare time, let alone the time needed to research the options in senior care. That is, until the storm, or crisis, strikes. Ninety percent of the families I have worked with found themselves in the midst of one of these storms—very close to, if not already, feeling lost and in a panic. They didn’t know they had options or where to turn next. For example, where do you start your search for good care options when your senior is suddenly hospitalized? What if mom is not eating and is losing weight? Or she broke her hip, either causing a fall or resulting from a fall, and you realize that mom just can’t safely live alone anymore? Perhaps it was dad who got lost driving to the store only to turn up hours later in another town, not even able to remember where he was going or why? And what do you do if private caregiver Suzie Q, who was only helping with the errands, seems to have emptied mom and dad’s accounts and charged their credit cards beyond the limits of sanity? My hope is that this book will help you deal with these kinds of crises.

Since one of my mantras is Do your research and get backround checks, I should tell you who I am and why I believe you should read this book and make it your personal guide for senior care.

My pathway in health care began when I was twelve years old. I was a Candy Striper—yes, one of those girls in the white uniform with the little pink stripes. I have two aunts who are nurses, one of whom is a dean emeritus and a published author, and has a Ph.D. My older sister, who now works in early childhood education, worked at the local hospital. They all spoke of the challenges and the rewards of their work. When working at the hospital was suggested, it just seemed like the perfect thing for me to do. I was assigned to the E.R., Pediatrics, and Geriatrics departments. I enjoyed the more difficult parts of the job and often volunteered to do the dirty tasks, as allowed. The dinner conversation at my home was rarely ladylike and often a bit graphic. Bless our mother, dad, and other sisters for putting up with us. My mother knew that we were passionate about what we did and that this sort of discussion was good for our growing minds.

One of my toughest challenges during this time was when a classmate of mine was hospitalized in critical condition. His appendix had burst. I remember sitting by his bed praying and talking to him even though I didn’t think he could hear me. I was so grateful when he recovered, went home, and eventually returned to school. To this day, I’ve no idea if he knew I was there. And that’s really not important anyway.

One of my favorite parts of the job was chatting with the seniors about their lives and families. They often seemed lonely and enjoyed my company. And I learned so much from their stories. From there, the natural progression for me was to become a certified nurse’s assistant (CNA). I worked in what was then called a convalescent home. The environment was pretty awful. Most of those homes were dark, smelled terrible, and were all too sterile in design. The patients had very little quality of life. These facilities are known today as skilled nursing facilities (SNFs), and thankfully they have improved over the years. It’s my opinion that the memory of those homes is truly the reason most seniors do not want to go to a care facility today.

My life’s plan was to become a registered nurse, or RN, but as life doesn’t always go according to one’s plan, I got detoured. A car accident prevented my being able to continue with patient care. I was told I had better research other career options.

When my children were young, I wanted to stay at home with them but still wished to work. The extra pin money was welcome and I enjoyed being a caregiver, so I ran a small private day care for toddlers. When the children were older, I spent a short period of time in real estate and marketing research, but I always missed working with seniors. I had also spent quite a bit of time working hard to repair my body, which had been damaged in my younger years. This allowed me to consider patient care once again. So, I went to work as a home health aid and became certified in dementia and hospice care. I especially enjoyed my time with hospice.

One patient in particular remains in my thoughts on a regular basis. Betty Jane referred to me as her angel. I thought for sure when the time came for her to leave us, I would go to pieces. But, instead, it was a very poignant and rewarding moment for me. She actually waited for me to arrive for my shift that Monday before making her transition from this world. I felt so blessed.

After moving to California in 1999, I applied for a job as a part-time receptionist at a 199-bed low- to mid-income assisted-living facility. I was instead hired as its office manager. I soon became a licensed administrator and eventually the executive director for that property. I’ve also been the administrator for a 100-bed high-income community.

Being an administrator was the most challenging of all the jobs I’ve ever had. As an administrator you are responsible emotionally, sometimes spiritually, financially, and legally for the staff, the property, the residents, and their families. A lot can happen when one has that many variables in play. It’s not an easy job, but I enjoyed it.

Additionally, I have marketed a 125-bed assisted-living community which brought me a wider understanding of the needs and the services available in the county. My most recent employ, and my favorite position of all, was that of a hospice liaison. A liaison is part educator, part salesperson, and part social worker. My job was to educate physicians, care staff, and the general public. I would counsel family members on the specifics of this insurance benefit, obtaining legal consent signatures from the patients or their responsible party prior to their receiving services. I was also responsible for bringing new referrals in to the business. Whether the hospice is a for-profit or a non-profit, it is still a business. For me, there was great reward in this type of work. I was a top liaison for my company. I also became a very good resource for my coworkers, as I was out in the medical community so much of the time and had so many years of previous experience.

Some of my other pathways have brought me additional varied experiences. I became a certified fitness and nutrition counselor and an ordained minister. I am a student of herbology, holistic, and alternative medicine. I have also had the pleasure of being a writer and the managing editor for a local magazine. All of these experiences give me an excellent perspective on life. Personally, my family has suffered many losses and challenges, which has given me real hands-on knowledge about family dynamics during unexpected upheavals.

As an administrator, I worked closely with members of Community Care Licensing, which is a division of the state’s Health and Human Services Department. They oversee the assisted-living communities and board-and-care homes. They are still a resource for me on updated regulations and community compliance. I currently work on several committees, councils, and task forces that are overseen by Aging