Last night, like most Sunday nights, my 84-year-old father came over for dinner. And as is usually the case, he was accompanied by his girlfriend  Ginny, an amazing 90-year-old woman who lives in his continuing care retirement community. We all have different ideas of what constitutes “old age” or “elderly”. Ask my young children, and they would probably tell you old age starts in your 50s. Most of my 30- and 40-something friends would probably say anyone 75+ falls in that category. But there would be little  debate that a woman of age 90, like Ginny, is elderly. After spending nearly every Sunday evening with her for the past eight months, I am here to tell you otherwise.

Ginny is a vibrant, fit, sharp-minded woman who exemplifies everything I hope to be if I am fortunate enough to live that long. And I’ve finally figured out her secret. Ginny has discovered the Fountain of Youth. It’s not a place, and it’s not in a cream or an injection or a surgical procedure. The Fountain of Youth is in her head – and in all of our heads if we allow it to be.

Ginny is always “up.” Everything is wonderful in her world. Every week when she comes over, she gushes about how the meal is the best she’s ever had (even when I opt not to cook and order take-out), my children are amazing (as she listens to my three girls argue over the Wii), the weather is beautiful (not the word I’d use on a sticky hot Florida summer night), etc. Her favorite phrase is, “This is such a treat” – and she uses it often. Last night as she was saying good-night, she touched my arm and said, “This is really heaven in this home. Your kids, your family, it’s just heaven.” She verbalizes positive thoughts and she says them with sincerity. I believe her optimism is the secret to her youthfulness, and it’s starting to rub off on the rest of us as well. When we first started hosting my father and her for dinner, I think we thought of it more as a favor to them, to give them a chance to get out of their continuing care retirement community and have a change of scenery and food. Now I realize that my husband and I are the ones reaping the benefits.

What Ginny has taught us – or at least reminded us – is that there really is power in focusing on the positive. She has had her share of heartache, outliving three husbands, her first who died fairly young. Through it all, though, she has never lost her love of life and living. She has held interesting jobs, traveled the world, and continues to seek out new experiences (she is currently trying to convince my father that they should take a trip to Key West). Until recently, Ginny was an avid swimmer; now she stays fit by using the equipment in her senior facility’s exercise room. According to this article from WebMD, exercise is a key to staying sharp in old age.

Thanks to Ginny, I have clear evidence that I don’t need to buy into the fancy creams and procedures to retain my youth. Those are only superficial treatments (and one way or another – by 90, the wrinkles are there). The real secret to a vibrant, youthful life comes from within, from fostering a positive  attitude and mental acuity. The Fountain of Youth is much closer than I ever thought!

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For a comprehensive online database of senior living facilities in Florida, visit Florida Senior Living Advisor.

I’ve been a fan of online shopping for years. I was what you’d call an “early adopter” – back when friends and family were still too scared to think about submitting a credit card number online, I jumped right in with enthusiasm. I love the convenience of being able to shop when I want (often late at night) and where I want(comparing several different stores and products without spending a dime on gas). So I was thrilled to learn about a new shopping website that is unlike any other I know of – Alice.com.

Alice carries all the common household items we all need – things like laundry detergent, shampoo, toilet paper and deodorant – that we buy again and again. Once you set up your free account, the site walks you through the process of selecting your favorite items and brands. You can search by product name, price or even find out which items have coupons available. Here’s the best part: shipping is free. And you can set up your account so Alice will remind you when to re-order; for example, toilet paper once a month, band-aids every three months, etc. The website says that it offers savings comparable to the big-box stores, because it allows manufacturers to sell directly to consumers, eliminating the middleman. I need to spend some more time comparing prices on my favorite items, but I have to say that from what I’ve seen so far, I’m impressed. (And remember  – no gas money spent.)

I’m telling you about Alice.com not just because I like the service for myself, but because I think it could turn out to be a great resource for the elderly and all users of Florida Senior Living Advisor. For example, my father lives in a continuing care retirement community. The facility provides weekly van trips to a local grocery store, but the residents are responsible for carrying their own items up to their apartments. I know it would make it easier for my dad if he didn’t have to worry about hauling things like toilet paper and laundry detergent, and he could focus on buying his favorite food items. I think Alice.com could also be a helpful service for folks living in assisted living, although maybe not as much for people in nursing homes, where most of these types of products are provided. My father is not what you would call computer savvy, so I’ll manage his online account and do his ordering for him. This would be a great way for family members who live far away to be able to help their loved ones in senior living facilities with a necessary task.

So check out Alice.com and let me know what you think. You can also enter to win a $250 gift certificate to Alice.com by visiting Five Minutes for Mom.

Well this is encouraging. On Friday the Centers for Medicare and Medicaid Services - the federal agency that sets quality standards for nursing homes – issued new guidelines for nursing home surveyors that emphasize the importance of “resident quality of life” and “homelike environments.” CMS says the goal is to get nursing homes to focus on resident-centered care. It’s about time, don’t you think? And just what have they been focusing on prior to this decision? Profit margins?

Last fall my father had to spend several weeks in the nursing home that is part of his Florida continuing care retirement community. He had fallen in his apartment, received treatment at a local hospital and then was discharged to the nursing home for rehabilitation and physical therapy. To be blunt, initially it was a terrible experience. When we arrived at the nursing home, they assigned my father to a room and then left us to fend for ourselves for what felt like an eternity. How wonderful it would have been to have someone – a nurse, an administrator, anyone -  take a few minutes to welcome him, explain his daily schedule, meal options, etc. Yes, I understand that he was just one of many patients they had to deal with. But a little warmth and time spent in his admission would have gone so far in starting things off on the right track. Instead I left the nursing home that afternoon with a knot in my stomach, with no confidence in the care he would receive. It certainly did not feel like a “homelike environment.”

One of the other points in Friday’s CMS report is that nursing homes should start to pay “close attention to resident’s preference for his or her own daily schedule.” I know this will be a difficult task, but how wonderful it will be for the residents in nursing homes that can fulfill this suggestion. My father prefers to eat his dinner later in the evening, 6:30 at the earliest. While he was in the nursing home, he had to eat at 5pm. That may seem like a minor issue, but to anyone who has dealt with a family member in this situation, you know that it has a big impact on their attitude and sense of dignity. One of the things that upset my father the most while he was in the nursing home was that he was dependent on the nurses and CNAs just to use the bathroom. He would have to ring the call bell and then wait, and wait, and wait, for someone to come into his room to help him up to the bathroom. As you can imagine, at 84-years-old, this was often an urgent issue for him.  But most of the nursing staff seemed to exhibit total disregard for this.

I believe that part of the problem initially was that my father was placed on a floor where most of the other residents were much more incapacitated that he was. So I think the staff was a bit slack – it is tempting to not be “resident-centered” if the resident doesn’t know the difference, and can’t even articulate any frustration. He was also placed in a corner room at the end of the hall, a bit of the “out of site, out of mind” phenomena. After my sister and I raised a fuss, he was transferred to a different floor and that’s when things turned around. He was surrounded  by more active residents, and more engaged staff members. I recall the dining supervisor found out that he had been asking for honey to go with his hot tea (which was usually served lukewarm, by the way). Just when he had given up on ever getting honey, she arrived with several small packets  delivered personally to his room. A small gesture that made a big impression.

I’m sure there are nursing homes in Florida and the rest of the country that already focus on “resident-centered care” and “homelike environments.” But there are far too many that don’t. This won’t happen overnight. But I have hope that these new survey guidelines will at least get these important issues on the table and create greater accountability for nursing homes. If you’d like to learn more about the CMS guidelines, visit http://www.cms.hhs.gov/transmittals/downloads/R48SOMA.pdf

For a searchable database of nursing home in Florida, visit Florida Senior Living Advisor.

I’m starting to think that the next hit reality TV show should be shot in a senior living facility. Judging from what I have seen at my father’s Florida continuing care retirement community, there is plenty of material. Who sat with with whom at dinner? Who said they’d call, but didn’t. Who is most likely to flirt with the new – and rare – single men who move in? The drama is endless. And I have to believe that it is not just amusing to those of us on the outside, but it is actually mentally stiumulating to those involved.

Prior to moving into his senior living facility more than a year ago, my father had spent about four years living all alone in a traditional apartment building, filled primarily with people much younger than him who were busy with their own lives. I suspect he would go days without interacting with anyone else, especially in the cold winter months when he would not venture out. Imagine eating every meal alone? It took me a while to realize that this social isolation was having a very negative effect on his mental and physical health. He, of course, denied it, trying to take pride in his belief that he didn’t “need” to be around people as much as most. How wrong he was.

Within a week or so of moving into his Florida continuing care retirement community, I could sense renewed energy in his voice. He started making friends and I could tell he was amused by the “soap opera-like” drama among residents. Within the first month, he met a female resident that he really clicked with. Here we are nearly a year later and they are still going strong, sharing meals, long walks and participating in the facility’s organized activities together. His attitude and energy are far better than when he first moved in. At times he does sound a bit disgusted by some of the gossip and nosy-ness that he thinks some of the residents exhibit. But while he may never be able to admit it, I think he does realize it is better than the alternative – living all alone.

I just learned that a nursing home in West Palm Beach has been fined $16,000 after a patient was found on the floor with maggots crawling out of his leg cast. An August 2008 report by state regulators determined that Azalea Court Nursing Home failed to provide necessary care to the resident, who had a cast on his lower leg, leading to the infestation of maggots. The patient’s broken leg was supposed to be treated every three days, but the facility could only document weekly treatment.

In April 2008, just four months before the above-mentioned incident report, inspectors cited the 120-bed facility for a series of isolated events that it said “put the health or safety of residents in immediate jeopardy.” The nursing home was put on a “watch list” and given just one out of a possible five stars as its overall inspection grade, including just one star for quality of care and quality of life measurements, according to the Florida Agency for Health Care Administration. State regulators gave Azalea Court a “J” grade for protecting residents from mistreatment and having policies to prevent abuse. That grade means there was “immediate jeopardy” to resident’s health or safety for isolated violations. You can find Florida’s watch list and get other state ratings of nursing homes here. Azalea Court has appealed the penalty.
 
I can’t help but wonder if the resident in this case has any family members nearby who oversee his care. I know that when my father fell last fall while living in his continuing care retirement facility, I was there every day afterward to check on his care and rehabilitation at the on-site nursing home. This shouldn’t be necessary – a resident in a senior living facility should get quality care whether there is a relative or friend watching or not; but I can’t help but think that in reality – at least in some senior living facility – it does matter.

What is particularly appalling about this story is the paltry size of the fine – $16,000??!! I’d like to know how state regulators came up with that amount. And more importantly, when the appeals process is complete, will the facility face any fine??

The nationally renowned advocacy group, Americas Watchdog, has created the Nursing Home Complaint Center to draw attention to senior citizens suffering wrongful death, abuse and neglect. America’s Watchdog describes itself as a “National Advocacy Group for Consumer Protection and Corporate Fair Play.” It’s the same group that has been helping to lead the charge against allegedly toxic Chinese drywall. They have also received attention for their Mortgage Inspection Service, intended to keep consumers from being cheated or overcharged when they finance or refinance their home.

According to America’s Watchdog,”once our legal team is in place, the Nursing Home Complaint Center will focus weekly press releases on elder abuse, Medicare or Medicaid fraud, Class Actions, or Wage and Hour investigations.”

They are interested in the following issues:

• Nursing homes not providing patients with minimum time per day.
• Nursing homes over billing Medicare for testing that was never done.
• Nursing homes not changing patients for a 24 hour period of time. (the patient then gets septic infections and then they often die)
• Nursing-home care firms that, instead of sending an actual nurse, send a undocumented worker to spend the day with the patient.
• Nursing homes not paying overtime to their employees, or abiding by fair labor laws.
• Possible class issues related to standard of care, drug costs, testing schemes, etc.

I will be interested to see what develops from this group. Unfortunately, I suspect they won’t have any trouble finding complaints against nursing homes to try to splash all over the evening news. Certainly there are many wonderful nursing homes throughout Florida and the entire country that are providing quality care and service to patients. But I also think that in many of these facilities, employees are overworked, underpaid and not monitored closely enough. Maybe just the creation of this complaint center will be enough to get some nursing homes to pay closer attention to safety, quality and customer service.

We’ll see. I’ll report back as I learn of updates from America’s Watchdog.

According to the Jacksonville Business Journal, an international senior living development company is building a senior living facility for people with Alzheimer’s disease, its first project in North Florida.

Sunrise Senior Living  plans to open the 65,000-square-foot facility this fall at 4870 Belfort Road next to St. Luke’s Hospital. The assisted living and Alzheimer’s care facility will be able to offer more than 90 residents a variety of amenities and services. Sunrise Senior Living operates about 450 facilities around the U.S., Canada, the United Kingdom and Germany, including eight others in Florida.

As many as 5.3 million people in the United States are living with Alzheimer’s. According to the Florida Alzheimer’s Research Center, the following is a list of early warning signs of Alzheimer’s disease. However, if someone has several of these symptoms, it does not mean they definitely have the disease. It does mean they should be evaluated by a medical specialist trained in memory disorders. The seven warning signs are:

1. Asking the same question over and over again
2. Repeating the same story, word for word, again and again
3. Forgetting how to cook, or how to make repairs or how to play cards- activities that were previously done with ease and regularity.
4. Losing one’s ability to pay bills or balance ones checkbook
5. Getting lost in familiar surroundings or misplacing household objects.
6. Neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean
7. Relying on somebody else, such as a spouse, to make decisions or answer questions they previously would have handled themselves.

There is no way to guarantee that you or your loved one will not get Alzheimer’s. However, many of the things that are good for your heart are also good for your brain. Quit smoking, get regular exercise, and eat foods such as fruits, vegetables, and fish. Avoid foods high in saturated fat or cholesterol. Other helpful lifestyle changes include keeping mentally active, staying socially involved with others, reducing stress, and wearing seatbelts and bicycle/motorcycle helmets.

If you are trying to select a Florida nursing home for yourself or a loved one, here is an information-packed website that you will want to check out – www.medicare.gov/NHcompare/Home.asp

This is the federal government’s Medicare website. One of the most useful tools they provide is their Nursing Home Compare database. This tool has a Five-Star Quality Rating System about every Medicare and Medicaid-certified nursing home in Florida and throughout the country. There are 677 Florida nursing homes in the database.

Here is a description of the rating system for nursing homes from the website:
The Five-Star Quality Rating System helps consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions.

The Nursing Home Compare Web site now features a quality rating system that gives each nursing home a rating of between 1 and 5 stars.  Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.  There is one Overall 5-star rating for each nursing home, and a separate rating for each of the following three sources of information:

Health Inspections – The health inspection rating contains information from the last 3 years of onsite inspections, including both standard surveys and any complaint surveys.  This information is gathered by individuals who go onsite to the nursing home and follow a specific process to determine the extent to which a nursing home has met Medicare’s minimum quality requirements.  The most recent survey findings are weighted more than the prior two years.  More than 200,000 onsite reviews are used in the health inspection scoring nationally.

Staffing – The staffing rating has information about the number of hours of care on average provided to each resident each day by nursing staff.  This rating considers differences in the level of need of care of residents in different nursing homes.  For example, a nursing home with residents who had more severe needs would be expected to have more nursing staff than a nursing home where the resident needs were not as high.

Quality Measures (QMs) – The quality measure rating has information on 10 different physical and clinical measures for nursing home residents – for example, the prevalence of pressure sores or changes to resident’s mobility.  This information is collected by the nursing home for all residents.  The QMs offer information about how well nursing homes are caring for their residents’ physical and clinical needs.  More than 12 million assessments of the conditions of nursing home residents are used in the Five-Star rating system.

On the Web site people will be able to arrange the order of the nursing homes according to any of the three aspects above, as well as an overall quality rating based on those three sources of information.

This just makes me sick to my stomach. Yesterday police in Punta Gorda, in southwest Florida, arrested an employee of the Punta Gorda Elderly Care Center on charges of abuse and battery on a 76-year-old resident. Police say 58-year-old Letitia Calderwood was employed as a Certified Nursing  Assistant at the facility. According to police, an employee of the center reported Calderwood had requested the assistance of her and an additional employee in helping the resident who had fallen in a bathroom. Calderwood and the two other facility employees had difficulty helping the resident to her feet and reports say Calderwood subsequently kicked in her lower back while using a profanity. Once the resident was helped to her feet, Calderwood reportedly struck her in the face with an open hand.

Detectives say Calderwood admitted to kicking and striking the resident as originally reported. She reportedly stated that her actions were done out of frustration although she knew the patient was disabled and had limited ability to stand on her own. Calderwood was arrested and transported to the Charlotte County Jail.

Thank goodness the other employees of this facility immediately stepped forward to report this alleged abuse. If you are concerned that someone you know is being abused or neglected in a Florida senior living facility, you can report it to the Florida Department of Children and Families. On their website – http://www.dcf.state.fl.us/abuse/ – you will find detailed information about the Florida Abuse Program, and how to submit a claim via phone, fax or online.

Last week, my father fell while alone in the apartment of his continuing care retirement community. I am so thankful that he was wearing his “alert” necklace. He was able to push the button, which sent an emergency signal to the security staff in his senior living building. In a matter of minutes, they were in his apartment, helping him up off the floor. Thankfully, he was not seriously injured. A continuing care retirement facility means that while my father lives in a fully independent apartment, there is a nursing home on the same property. So in a situation such as this, one of the registered nurses from the nursing home was called to his apartment to evaluate him after the fall. This gives me great peace of mind, to know that he has access to a full medical staff 24/7. Otherwise, in this case, the security officer would have had to call an ambulance to transport him to a nearby hospital.

When you are evaluating a senior living facility, be sure to ask specific questions about the safety and security measures the facility offers. In my father’s case, each apartment comes equipped with an emergency pull-cord in the bathroom. But the “alert” necklace that he wears was an optional feature that we had to order through his maintenance department.

Have you or a loved one been helped by an “alert” necklace or other safety feature in a senior living facility? Share you comments below.