Comment from Carma: I work full time and have small children at home to care for. On top of that, I am now caring for my great aunt. It is overwhelming to say the least!
Jennie Chin Hansen: I understand what you’re going through, Carma. And so do 42 million Americans who like you, care for older parents, grandparents, spouses and other older loved ones. While caring for an older family member can be one of the most rewarding experiences of a lifetime, it can also be stressful.
Comment from Molly: Do you have any tips for preparing an advance directive?
Jennie Chin Hansen: I sure do!
First, talk to your relatives, friends and health care providers.
Explain your wishes so your family, friends and providers are prepared to carry out your wishes without any doubt or confusion. It’s a good idea to make multiple copies of your advance directive and distribute them to your doctors, local hospital and family members. A copy of your advance directive should be a part of your medical record.
Second, it is important to remember that you review and revise your advance directive as needed. Advance directives do not expire. Over time, you may change your mind about what kinds of treatment you would, and wouldn’t, want. If you do, you should revise your advance directive and give your friends, family, and health care providers a copy of the new version.
Comment from Christa: What are some signs that a nursing home is really prepared to care for their residents? I want to make sure the place where my grandmother is living is safe, supportive, and clean.
Jennie Chin Hansen: Here are some questions to ask yourself, or to keep in mind when you visit your grandmother:
1. Are there handrails in the bathing areas and hallways?
2. Does the nursing home accommodate special dietary needs by, for example, preparing pureed foods, and carefully monitoring meals for residents with diabetes and food allergies?
3. How many staffers are working at a given time during different shifts? And are there policies stipulating minimum staffing levels for specified numbers of residents?
4. Are the bed rails or guard rails on nursing home beds raised up? Raised guard rails on beds pose a serious injury risk for older adults, and should rarely be used to restrain patients. Likewise, residents sitting in chairs should not be restrained with seat belts or trays.
You could also visit the nursing station to monitor your grandmother’s daily activities — which staff should record in her medical chart.
You can also ask to review the services provided by the staff and inquire about any changes in medications, diet, behavior, sleep or exercise. Good luck!
Comment from Jordan: When should I call in Hospice to care for my loved one?
Jennie Chin Hansen: If you are wondering about Hospice, now would probably be a good time to learn more about the program.
Many people don't take advantage of the program and service until much later when the benefits of this degree of support and care could be realized earlier.
Technically speaking, Hospice is geared for the last six months of a person's life.
This program would be a wonderful support to you.
Comment from Guest: Do different cultures handle end of life differently? I am African American and we definitely don't talk about this in our families. How do I even bring up the conversation?
Jennie Chin Hansen: Yes. There are significant cultural differences but for every family there are opportunities to reflect on friends or loved ones who die and to reflect on their death. This opens an opportunity to talk about what is important.
Nearly every culture wants to have the person not suffer. This is a way to talk about palliative support.