Okay... We talk a lot about the things that are wrong with NHs and ALFs...

If we could set aside worries and fears and compaints for a minute and daydream....

For those whose LO lives or will live in a facility...

What would your DREAM facility be like? A new place is being developed. There are no constraints at all! Your wish is the developers command! What would it be like - please be as descriptive as possible...

For those whose LOs live at home...

The developers have asked your opinion as well... You are to be give a free coupon for this facility in the event that you and other family are unexpectedly no longer able to care for your LO... You are sharing your insights with the thought that your LO should recieve care and a quality of life that would as closely approximate what you provide as is humanly possible! You will also be given a coupon for free respite care assuming that you will (god willing) never need to use the facility... What dreams for this respite care would you share with the developers??????

Thanks!!!!

Donna

My wish list...(mom has been living with me I now need to think about placing her. Near end of life stage and totally bed-bound)

1) All employees have passed a background check for abuse and mis-treatment of the elderly.

2) All employees have been trained and tested on how to deal with AD patients without the use of constraints or unnecessary drugs with refresher classes on a regular basis.

3) Facility needs to have a good inspection and grade from the State with heavier fines placed upon them for non-compliance with better follow up inspections.

4) Employees found to be guilty of abuse or neglect should have a crimial record with the State to prevent them from being rehired in the Health Care field.

5) Mandantory that all facilities have a Resident Council for patients and their families to voice their concerns.

6) A daily journal of each patient's care,problems or needs should be printed and mailed to the family member on record on a monthly basis. This could be added into a main computer system at end of each shift.

7)Regarding short term Respice Care, same as all above with same treatment.

I can't think of anymore right now but I am sure I could come up with them.

Thanks for responding... Woking on my list and I'm gonna borrow at least one of yours... I'm hoping there will be others - can't make things happen unless we can envision what they should be...

a garden
raised planter boxes for residents willing and able to grow flowers and vegetables
an aviary
a green house
a fish pond with ducks and geese
nice, wide walking paths
picnic benches
resident dogs and cats
visiting school groups for special occasions
a bird feeder beside every window
a place for residents to cook under supervision
at least one party per unit per week
old movie videos and music in every unit
pizza nights
families that love them and visit often

Bee

all of the above, and
a chapel (sometimes the families need to reflect and pray, and seek strength)
music, soft soothing music
things from home
a monthly support group metting, again for the families
children, family sundays, who doesn't love a baby
crafts/activities
time outdoors perhaps in a beautiful courtyard
kind, empathetic nurses who really care and understand the disease
laughter/silly time
and for those dying...
peace
a place like home
a soft voice
a gentle touch

God bless all of you in your journey!

some of my attributes, to add:

-cna's with time to, training for, and the personality to sit with residents when they talk to them at various times throughout the day, unhurried
-music playing all the time - peppy in the morning, fun in the afternoon, relaxing in the evening, serene at night
-constant engagement - at differing levels of stimulation - throughout the day - from stroking and admiring teddy bears, to drum cirlces/dancing, to watching videos appropriate for pesons with dementia, sugar free/healthy tiny treats
-fresh air every morning and sunlight every morning - when the sun is there!
-a person in each area/floor with training and the right personality dedicated to th psychosocial welfare of each resident - sort of a room mother responsible for enrichment
-family staff work-group for each area - informal w/ regular meetings
-a life enrichment plan - v a medical care plan
-regular - weekly, biweekly updates on how care plans and life enrichment plans are going
-daily update - meaningful - by phone or paper on how residents day went
-matrix assignment of resident 'friendships" with staff - soemone in every department assigned a resident as 'buddy' - everyone can and should say 'hi' - but buddies would do even more
-a communication plan for each resident - review analyze and plan for what they are saying, trying to say, not say
-nursing for that unit reporting to memory care professional

Donna...

Good evening... may I add my thoughts and feelings..

I think 6 cottages facing each other in a circle . one cottage would be only a kitchen..where meals are cooked and sent to the 5 cottages...each cottage would have 10 patients and 4 staff...one med nurse to give meds to all patients..one charge nurse in each cottage with 3 support staff ..and if a family member wants to have a sitter for their loved one ...the ratio would be even better for those reidents who need more help...

comfortable chairs on the front porches....where everyone can come and sit for a while...peaceful place...staff could play guitar or some other musical instrument and pets could spend time also.

every resident.....given lots of attention...

male residents will have male staff...female residents will have female staff..

A shower for each patient every day....clean sheets every day...

beauty shop for the ladies every week...

barber shop for the men...and shaved 3 times a week...

a big buffet breakfast every morning..and each resident will wake up to smell the coffee...brewing...

fluids encouraged all day long

sunshine for all patients...everyone outside..every day....when possible and big windows to let sunshine in the cottages..

the same staff to care for the same patients each day..so they feel comfortable...and loved..connected...a family feeling....

music....

pets...

school group visits..

lots of road trips..maybe just a ride in the country...on a big beutiful comfortable expensive... bus

residents who are able..be given chores..taskes..... .with staff helping.. so residents can feel they have accomplished something....each cottage will have their own kitchen...washer and dryer.. family room..a real home like environment...for staff and residents..who take pride in being relaxed and motivated...for the welfare of the residents..

daily staff meetings to discuss issues..a team effort to work together for the good of all...
a close group of staff who know how to work together.....and are willing to help each other
who take pride in what they do.. and feel ownership in their job..

and...warm blankets every night right out of the warmer or dryer put on each resident with a good night hug....

for me it would not be about the facility...it would be all about staff...people make the place..I truly believe..and for those of us who are care-givers we know ...a smile...a touch..a calm deameanor..is what it takes for our loved ones to feel safe and valued.....thats what its all about..

at 5 thousand dollars a month for each resident...the staff could be paid well ..the food good...the evironment safe and clean ...

and family members would know their loved ones are being given good care and they could call anytime and talk with same staff...they know by name...and family members could be involved in meetings to make everyone feel part of the family...all ideas would be discussed with an open mind...and heart.....

And to make sure the staff stays on their toes and the patient always safe, cameras in every room and at the nurse's stations.

DonnaV:
You have hit upon something really big here!
Wish list:
Bright, cheery colors
Art work on the walls
Clean and fresh
Social directors with imagination to engage the residents
Talent testing: Perhaps there is a latent natural ability that can now be free to surface
Safety first. Thorough background checks for ALL staff.

I hope so, Family First... I LOVE the talent testing...

And maybe personality testing - extrovert/introvert etc where possible... To understand the type of environment - and maybe even caregivers - whe will be right for the person...

Massages - maybe even with students from massage schools, so that they will be comfortable with folks with dementia later on.

Rosie - I love the warm sheets from the dryer... You are right - the creature comforts that feel like love and home! And porches - what wonderful things!

Children around.... Maybe daycare for the children of folks who work there - reduce their stress and at the same time create intergenerational bonding. And these children would understand that people with dementia are not to be feared...

Comedies, silliness - anything that creates laughter...

More thoughts:

It would be great if a gutsy, visionary golden-hearted benefactor would come forward to subsidize this idea.

IDEA:
Drop-in center in the neighborhood where a LO and caretaker can make contact with others...A place to accompany your LO when the time is right for the LO and caretaker..when the day/mood/other health problems are in check.

- No scheduled times or minimum/mandatory attendance commitments
- Water cooler on premises, please
- Different therapies, including art therapy
- Mini-Massages available (feet,hands, neck)
- Local companies process job elements via piecework for AD patients and caretakers (assembly, etc.)
- Visiting, talented Senior Citizens who want to and are able entertain others. There is ALOT of talent among our seniors that may be "going to waste"

Perhaps a national network of drop-in centers would develop to serve the growing AD population in this country.

Everyone has such good ideas!

The number one item on my wish list is a designated caregiver for EACH resident. Oh, and every one of those caregivers is extremely qualified because the pay and benefits are so good that there is fierce competition to to work there. (You did say money was no object, yet?)

The residence will have strong ties with the community. Kids from the local schools are regular visitors and enjoy gardening, reading, and singing with the residents. The kids in the music program take turns performing concerts weekly either as solos or in small ensembles. Nearby churches are also involved with the ALF, joining the residents for craft class, sewing club, or any other activity in which the residents are able to participate.

Other than that, pretty much what everyone else said.

I wanted to add one more thought...

older adult volunteers...who would come spend time with residents each week...help the staff care for residents...these volunteers would be given responsibilities...such as answering the phones...greeting visitors...taking residents on walks..many things to help make everones day be a good one.

I sometimes tell Jeanne that she's a princess. Princess Jeanne. Of Broedeland, aka Paradise. Yes, the Princess of Paradise. She reigns over Paradise. And I call her your royal highness. And I insist that she call me your royal hinder (as in ass). --Jim

Ha!

And all staff, volunteers and family will recieve training - maybe together - to ensure that they understand how to make the most of the time with our LOs... The Princesses and Princes of this paradise!

Great idea re the drop in center is wonderful...

I would add to that appropriate accessible transportation - even in a town where I live, which is supposedly all progressive, there is no affordable easy transportation for those with difficulty transfering!

Listen up, benefactors!

Hi all,

I wanted to ask those of you who posted on this thread, if you would be comfortable with my sharing your opinions with some folks who run a couple of facilities (my guess is that you would NOT mind!) but I feel I should ask...

Thanks...

Donna

Donna...good afternoon...yes..


and may I add a blanket warmer cabinet. in each hall and at bedtime ..each patient be given one on their bed and tucked in...I do this each night for my husbands mom and she loves it..she always gives me a smile and thank you...it must feel good to her...to feel warm and safe... with a good night hug.....love Rosie

Senior volunteers, yes! I'm not a senior yet, but I volunteer at the SNF where my mom and dad lived the last two years of their lives. I play piano for the residents in between lunch and bingo! And believe me, I get a LOT out of that 30 minutes! It's loads of fun and I have a captive audience of sweet, wonderful people.

I vote for fun activities that will keep them engaged, senior volunteers, exceptionally well trained knowledgable staff and support group/education for families.

Donna, please feel free to share my thoughts about an ideal ALF/NH with others. Good luck in your quest.

Bee

Yes, yes, everything already posted. But let's not forget like residents with like residents in their room and especially at mealtimes. Mom gets put off by those far less functional than herself.

Large rooms and the ability to bring in a piece or two of one's own furniture.

Also . . . for those who are unable to get out of bed unassisted at night and are still functional enough to know how; a call bell at each bed so that if there is an urgency, the resident can reach someone.

AND . . . that the night shift will be very adequately staffed!!! Always a problem.