No one knows how the future. We have no idea what will become of us and when the end will come. But we can all be assured that in the midst of life, there is death. I admit these opening statements are uncharacteristically morbid, but I have recently been faced with some thought provoking circumstances.
I recently got my feet wet in the area of palliative care and what an eye-opener that was. As with most persons, when the subject of palliative care is broached the immediate thought is of a wasted individual, moaning and writhing in pain as he or she slips from this life. However, nothing can be further from the truth.
Palliative care, in its simplest form, has to do with preparing for death and ensuring that one lives, until one dies. According to the World Health Organization, palliative care “is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psycho-social and spiritual”.
The aspect of palliative care which came across my path concerned the decision on where the elderly should receive care. The pain my friends felt as they grappled with this decision was as heavy as a load of canes carried on the backs of our forefathers. Guilt-ridden expressions were obvious on the faces of siblings as they contemplated placing a father who was once a vibrant entity in the home, in the hands of strangers.
As brave and committed to the task of caring for their ailing father as they were, there had come that point in time when his care was beyond their capabilities. I believe in such a situation recognising one’s short-comings is a giant step in the right direction. Placing an elderly person in a care facility is not easy but is sometimes necessary.
We all agree that while the ideal situation is for our older folk to remain in their homes, surrounded by friends, family and familiarity, sometimes it is not safe and could prove more detrimental to the family in the end. In light of these recent developments, I will share with you a few tips on choosing a place for your loved one.
• Make sure the facility you choose is registered.
• Do your research. Ask other relatives about their experience with the staff and the general care of their relative in the home. Each patient in the home has different needs but you should get a general picture of the satisfaction level of other clients.
• Look at the external grounds. Pay attention to cleanliness, curb appeal and the safety of the grounds. Is it easy for the criminal element to get onto the property, or conversely for a patient to escape?
• On entering the property, one should not be assaulted by the overpowering scent of urine or any other excretions. It is quite possible that a patient may just have been changed but there really should not be a lingering cloud of unpleasant smells.
• Staff should be genuinely friendly and appear well-dressed and professional.
• The home should be well lit and there should also be plenty of natural light, as many elderly persons have declining vision and problems with depth perception. This is one of the causes of falls in the elderly.
• There should be rails and ramps for those who need assistance with ambulation.
• The patients in the home should appear clean, comfortable and calm (most of the time!)
• The rooms should not be overcrowded. Plain and simple.
• Whilst it is difficult to put an exact ratio of how many staff members need to be on the floor at any given time due to the varying needs of the patients, ask about the staff complement. Also ask about on-call or emergency visit provision by doctors, pharmacists, physiotherapists or other specialists.
• There should be facilities for recreation as not all elderly persons are confined to bed.
• Medications and other dangerous chemicals should not be in plain view of the patients and should be well out of their reach.
• Patients’ personal files should not be visible to the public and the discussion of patients amongst the staff members should be kept private.
• There should be commodes, hand rails, and non-slip tiles to prevent falls during showers and depending on the capabilities of the patient, bathroom visits should be supervised.
• Find out about the policies for visiting and meals at the facility.
• Do not allow price to be the only determinant for choosing the facility.
• If your elderly relative is still able to give an input, ask whether he or she likes the place and would be comfortable staying there.
It is not an easy decision to make but at some point, we may be faced with such as decision and we should not make derisive comments to others who have made such a choice.
(Renee Boyce is a medical doctor, a wife, a mother and a Christian, who is committed to Barbados’ development. Email:[email protected])