Change in Focus

I have loved working with seniors since I was a volunteer at 12 years old.  I have tried to work in other aspects of health care over the years, but it never feels right when I'm not working with seniors.  Obviously in assisted living our focus is providing the highest quality of life possible for our residents.

When I first started at the assisted living, my philosophy about families was that we should do as much as possible because that is what they were paying us to do.  I think my perspective was similar to others in health care, we were the experts, we knew what was best.  Through the years I have matured to realize that families have to be included to the extent they choose.  There are those families that certainly love their mother or father, but really feel under-equipped to handle the life decisions facing them now.  So while we don't make decisions without talking to the family, we are fairly certain they will agree with whatever we recommend.  While it may seem this makes things easier, to have that kind of responsibility is pretty stressful.  We better be sure we are looking at every possible option and the consequences and letting the family know what we have found before we make any kind of recommendation.  Then there are families who have their own ideas about what needs to happen regardless of what the consequences might be.  And as long as the resident would not be in danger from their ideas, it becomes our role to support the values of that family and keep our own judgements out of it.  I had an experience about 6 months ago which really brought home how important it is for some families to be involved in every tiny detail.  It is my job to assess where the family is coming from and to involve them to the extent they choose.  So the last few years, my professional growth has centered around supporting the family as well as providing care to the resident.

The last couple months, I see my focus changing again.  I am finding myself doing a lot more counseling with families on how to cope with the aging of their parents and especially coping with the symptoms of dementia.  I remember years ago when I worked in mental health and the requirement if you were going to work with substance abuse counseling that you had substance abuse in your own past.  I thought at the time how unfair it was to prevent me from promotions just because I had not had that experience in my past.  However, I can see now how my experience with my own mother makes a huge difference in how I relate to families at assisted living.  Not only when families are looking at coming to assisted living, but I get a lot of phone calls just trying to find resources.  I am certainly not thrilled to be facing my own mother's dementia, yet I can see that my own experience makes me much more empathetic when talking to families.

I had a new resident to move in this week.  She has come to assisted living after a psychiatric placement.  She had been experiencing more and more short term memory loss and it led to paranoid ideation.  I know there is this perception out there that kids just want to "put their parents" in assisted living or the nursing home to be rid of the responsibility.  But that is not the reality that I see in my day to day work.  What I face are children who are very concerned about their parents, really want them to be happy, yet also safe and who are overwhelmed by the changes they see when there is a diagnosis of dementia or the symptoms of dementia.  I feel when I can say to a family, "my mother had dementia and I have experienced many of these same things," there is a kind of relief with the children, they know I am not judging them or being patronizing, but that I can really relate and we can work together to provide the best quality of life possible for their parents.

I  made kind of a flip remark to one of my employees the other day that "God really does know what He is doing", and I am finding that to be true in this situation.  I look back on my attitudes and approach when I was a young activity staff person in the nursing home.  I loved the residents and did my best to make their lives the best I could.  But I did not have the kind of approach to help families.  To be truly helpful to families, it does really take knowing their experience from the inside.  And I really know that God does know what he is doing.