Waiting for God

Residence – End of Life Needs

Retirement homes are an excellent place if all the right services are offered AND if the recipient of care is there willingly.  Many people agree to get placed because their family coerces them, or they make the decision in a state of lucidity, but as the mind slowly winds down they regret or forget their decision.  It is a difficult situation for all involved. This should be avoided whenever possible, but considering cost and level of dependence, this may be the only available option. 

While retirement communities offer many necessary services, they do not offer all the necessary services to sustain a pleasant existence. Coordinating with those providing care and keeping up to date on your loved one’s end of life experience is key. 

SeniorSynCare will help in coordinating all the services below.

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Are you exhausted trying to coordinate somebody’s end of life needs?

Do you need support keeping their community of care up to date and in-the-know?

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Many of these may be offered by the retirement residence.  It would be a good idea to have a meeting with the director responsible for residence care.  A care plan should be developed with the residence care team.  Make sure to ask for regular updates on the recipient of care.  

      • Companionship 

      • Cleaning

      • Errands

      • Exercise

      • Home maintenance

      • Meals

      • Medical support

      • Mobility

      • Personal hygiene

    Companionship 

    In a retirement residence there are usually activities scheduled.  It would be good to encourage the recipient to partake.  Depression is common, which causes people to withdraw.  To get them interested, a close family member or friend can offer to do a few with them.  

    Get to know the people at the home who are involved in providing care.  Make a point of talking to their caretakers on shift when you are there.  If you are out of town, get their email addresses, or other contact information.  Keep conversations with staff brief as they have other recipients they are also responsible for.  Doing this will give you information about the recipient of care’s wellbeing. 

    Suggestions to improve companionship (note:  Some of these are the same as for in home care not sure if should link or repeat) 

        • Communicate openly and encourage others to do so also. Try to get the person to discuss their feelings, and also their limitations. Sometimes too much socialization can overwhelm and greatly reduce quality of life. Only the recipient of care can tell you what the need and can tolerate.
              • Sometimes it is easier to get a neutral party to enter such dialogue.  Parents may not want to burden their children, or they may be proud and not want to show their weakness.  

              • It is also good support them as they learn what it is they would like to experience as they transition to ever increasing levels of dependence and ultimately death.  Discussions can progress as the person continues to decline.  Discuss ways you can help them realize their desires.  Perhaps a new hobby done other others. 

              • Be sure to be sensitive to their situation and their mental and physical state. If struggling with dementia or other mind-altering conditions, it might be difficult to interact with new people.  This adds an increased demand on those close to the recipient of care. 

              • Set a schedule for appropriate companionship if they are not getting enough interaction with the residence staff. This can be tricky when juggling appointments and personal care schedules.  Make sure visits with companions are not too long but provide adequate time for socialization.  Long visits can exhaust the recipient of care.  SeniorSynCare can help with that. 

              • You may have to hire a companion from a service to supplement what is lacking from the services offered.  Do an internet search on “finding a companion for an elderly person” and you will see a list of companies in your area that provide this service. Ask if the companion can also do other tasks such as house keeping and errands. 

              • Use technology to increase interactions, such as helping them make phone calls to or video chat with loved ones who may not be able to visit in person. Make sure that those interacting directly with the recipient of care know how to use these technologies.

        Cleaning

        Most retirement communities include house cleaning and laundry.  If not, a volunteer or paid cleaning service can provide a solution.   Keeping their place sanitary and free of clutter is important as seniors are more likely to trip over things left about.  

        Check in your location, or the location of the recipient of care, to see what services are available.  Hired cleaning can be hired individually or through a service.  While you may pay more for a service, they are usually bonded and take care of all the human resource tasks. 

        Errands

        Most needs can be met within the services offered by the retirement home. But there some things that may require somebody to run an errant. 

        Things to consider:

            • Grocery items the recipient of care would like to keep in their room

            • Hair appointments if not offered by the residence

            • Banking

          Exercise

          Increase pain, limited range of motion and decreased strength and energy makes getting enough exercise difficult.  It may seem counter intuitive, but people who are not yet at the final days and hours of life require enough physical and mental stimulation to maintain a decent quality of life. Moving is important for digestion, reducing physical pain, increase oxygen uptake for ease of breathing, good sleep, mental acuity, etc.  Link to Exercise for Palliative care patience. 

          Activities in the residence are available, but anything that would take the recipient out of the building will require planning and coordination. 

          Mental Stimulation

          Retirement residences provide several activities with the objective of stimulating the mind, provided the recipient makes it there.  Activities need to be scheduled together with arrangements for getting them there.  If the recipient is not able to do that, somebody will need to take the initiative.     

          Individual needs and interests vary, and the extent of the benefits is dependent on several factors.  If they are not getting enough stimulation during the time at the residence, there are things you can do.  Make sure you do not schedule too much, otherwise it can overwhelm and exhaust the recipient.  

              • Use video technology to staying  connected with family and friends.  The best way to stay mentally agile and healthy is to engage in conversation.  It is also essential for mental and emotional health.  

              • Listen to music together. Music helps with cognition and can help with memory recall (if listening to a song with emotional significance). Purposefully listening to music lyrics and processing them helps the mind stay active. 

            SeniorSynCare can help with scheduling.

            Meals

            Meals are provided.  Make sure the recipient gets to choose from the menu, or alternative menu.   If there are foods to be avoided, the residence staff must be notified.   It would be a good idea to check frequently to ensure avoided foods are not accidentally introduced.   The kitchen has many meals to prepare and often things get overlooked.   

            Some interesting facts: 

                • The average adult loses 3-8% of their muscle mass each decade after age 30.

                • Diverticular disease affects 50% of people over age 50 in Western countries and less than 0.2% of people in Japan and Africa

                • Human and animal studies have shown that the gut tends to absorb less calcium with age which is likely caused by vitamin D deficiency

                • 20-30% of people over age of 50 have reduced ability to absorb vitamin B12 from their diet

                • Older people are more prone to dehydration as thirst receptors become less sensitive to water changes making it harder to detect thirst
                      • Dehydration is a major cause of delirium

                  • Studies have found that older people have lower levels of hunger hormones and higher levels of fullness hormones, which means they get hungry less often and feel fuller more quickly

                  • Aging can affect your sense of smell and taste, which means foods are less appealing

                Medical support

                Most residences have resident physicians and 24-hour nursing support.  Since it is not often easy to get a person in the last years of life to their doctor appointments, this option can be attractive.  Be aware of availability.  

                Other health care services are not often available such as: Dentists, medical specialists, eye doctors, hearing clinics,

                Be sure that somebody who is lucid with a good memory (most likely the PoA) is at each appointment so that notes can be taken and follow up care properly provided.  It may be a good idea to take videos for procedures that may need to be repeated at the home (such as how to put in hearing aids or change a particular bandage). 

                and general physicians are all part of the community of care. 

                Most jurisdictions have support services, some by Province or State, others municipally, such as Para-Transport.  

                SeniorSynCare can help with coordination where videos and doctor’s notes can be directly stored for community dissemination.

                Mobility

                Retirement homes support mobility needs for personal care (bathing, brushing teeth, etc.).   These may be part of the recipients agreement, or it may be an extra charge.   Find out what is provided.  This may be a good time to look into Assisted Living.  

                Speak with the director of care, and others within the community of care to make sure mobility does not interfere with living needs.  Rooms are already designed for end of life needs, but any assisting devices such as wheel chairs and walkers, are the responsibility of the recipient or the power of attorney. 

                Personal hygiene

                Retirement homes will provide hygiene services, but the extent depends on the facility and the contract with the facility.  It may be time for Assisted Living.

                To consider: 

                    • Bathing (includes showers, baths, and sponge baths)

                    • Nail care

                    • Tooth brushing

                    • Going to the toilet and proper clean up

                    • Changing bed sheets and ensuring clean towels

                  Spiritual needs

                  Check to see if the recipient’s facility has a chapel or any religious services if that is of interest.  Our own fragility and mortality tends to create heightened spiritual needs in those nearing the end of life.  Religion and existentialism factor in as we get older.  

                  For those with an existing spiritual community, it will be important to keep them connected.  Spiritual leaders can help ensure that the person gets these needs met. 

                  For those who have no spiritual community, open discussion and becoming informed on things like what happens after death.

                  For more information see Spiritual Needs at End of Life.

                  Scheduling 

                  All these services must be communicated and coordinated.  SeniorSynCare is here for you.

                  Business woman using smartphone while working

                  Are you exhausted trying to coordinate somebody’s end of life needs?

                  Do you need support keeping their community of care up to date and in-the-know?

                  We have the tool for you for only $24.99/month.