Here’s an idea for every residential aging facility that struggles with ambient despair (chronic melancholy, fatigue, pain, sleeplessness and anxiety) that masks itself as “activity indifference” (the resident spends her entire day in her room or a chair in the main lobby avoiding activities and other residents).
Historically, such residents have simply been written off, until the day arrives that their Activity of Daily Living (ADL) profile justifies transfer – most go to Skilled Nursing Facilities (SNF) or to a child’s home.
In most of these cases, the adult children of these residents are the POAs and advocates. Because most children are never contacted unless there’s an acute medical problem, the child is unaware there’s a problem in the first place. And even when the children are contacted about ambient despair, the child’s attitude is usually, “Hey, this is why we pay you a zillion dollars a month.”
In fact, why does the facility administrator even care about these unresponsive residents? The answer is, because after a while, ambient despair creates a “revolving door” syndrome and the cost of filling that bed with a new resident is not insignificant – just ask the Director of Marketing in an eldercare facility.
What to do?
Create a Platinum Club.
A Platinum Club is a Members-Only group whose sole purpose is to create activities that are well-attended. How? Give everyone a monthly discount (X-$5/day) where X is the current rate, to everyone who participates. In this case, that $150 discount off their monthly charge gets the kids excited; they in turn talk to their parent (“Hey dad, why aren’t you attending the Men’s Club and Resident’s Council?”)
If either parent or resident balks, no harm done. It’s just a discount.
Email Martin Bayne at [email protected]
Leigh Ann says
As an adult child of an elder; a caregiver and someone who is passionate about eldercare; and a professional in the field as well, I am put off by the cynicism of “thats why we pay you a zillion dollars a month”. While I know that there are any number of families who do not visit and who are not engaged…..for many, many families (perhaps most?) watching thier loved one become melancholy and depressed; and wanting to not partipcate in most, if any activties, is a gut wrenching process and one that most of us hate. As an industry we only serve to alienate families more if we continue perpetuate the stereotype of the “400 miles away adult child who only pays the bills and doesn’t want to be involved”. Yes, those people exist……but that paying of the bill may be all that adult child can muster in the midst of watching mom or dad slip away.
Ms. Dale Goodloe says
I don’t think this addresses the real issue which is an emotional one. No one seems to comprehend the way a person feels when they are dumped into an environment where they no longer have a purpose or reason to get up each day.
They have lost everything – their independence; often beloved pets; their own ability to make decisions for themselves; and having to adapt their needs and wants to a strict schedule – just to mention a few.
I dread the thought of when that day comes.
Judy K says
I agree, and that is why programs like “the eden alternative” are so important. we need to become really creative and formulate and share ideas that encourage involvement. Focusing on ideas that support “being needed” is a place to start. We begin to feel unnecessary as we become less involved.
Ms. Dale Goodloe says
My Mother was in a “good” nursing home for 8 years. I had visited 9 and chose this one b/c it seemed to be a friendly and cheerful place. I made countless suggestions to the mgmt. about having pets; being more flexible about dining and what food was offered; and many more things to no avail. I watched as my Mother, who was an intelligent person without dementia at age 91, become like a vegetable and recluse.
There were residents there who had altzeimers and were mixed in w/the rest of the residents. One of her roommates used to scream during the night. I still grieve when I think of how my Mother had to live for 8 years.
Shereen Singh says
Dale I work in an agedcare facility and we are trying our outmost to eliminate this issue of staying in rooms. I mean i do undertsand that there is so much to loose but then when i think of our elders in our home they have gained friendships and also adapted family as well. I mean why do they have to loose their pets, we welcome pets and mostly loved and cared by the elders themselves. I dont think they lose their independance it is just our health care systems tends to mimic drivethru system (Quick and easy). And that is the reason why we have chosen to be part of the eden alternative to cancel such clinical thinking. Please dont dread the day because i think if we change the culture now then when it is our turn then it will be a norm.
I hope this reply finds you well
John Robinson says
Martin’s posts are always worth reading! He is changing aging in the most despairing places.
Martha Stettinius (@InsideDementia) says
Interesting idea! That could very well work with assisted living residents who do not have early-stage dementia, as so many of them do. I know that my mother stayed in her room in assisted living much of the time and often refused to go to activities, but she was living with the early stages of vascular dementia and probable Alzheimer’s disease, and may have felt self-conscious joining activities that were really geared more for the “independent-living” residents, not for those on her floor who needed more assistance. Mom did not “engage” in activities until she moved into a memory care assisted living facility where the whole atmosphere was more attentive and loving, the activities were designed to be inclusive of people with short-term memory loss, and the staff were trained in dementia care. You’re right that adult children often expect conventional assisted living staff to find a way to keep their parent engaged (I know I did). Unfortunately most of these large facilities do not have enough staff to encourage residents who stay in their rooms to join activities. In Mom’s case, the case manager for her floor (serving 60 residents) finally volunteered to walk Mom to some activities. But often Mom refused, and certainly this overworked case manager did not have time to do this for all residents. I believe that for many residents, especially those with early- or middle-stage dementia, there is just not enough “assistance” in conventional assisted living. Time to rework the model!
–author, “Inside the Dementia Epidemic: A Daughter’s Memoir”
Judy K says
Your points are well taken. I am not sure what would have encouraged my mother to attend activities short of me personally taking her there, and I like many couldn’t mange to be present on a daily basis. They key may be the lack of staff to provide encouragement to participate. I think this article is pertinent to the aging issue because it begins the discussion and gives a name to “ambient despair”; a subject often overlooked when we address aging issues. Let’s continue this discussion until we come up with more satisfactory ideas for possible solutions.