Help for families

When Shirlee Harth was diagnosed with Alzheimer’s disease at age 76, her family was willing to do whatever it took to help her stay at home. For nearly six years, Harth’s husband cared for her with help from a visiting nurse and a devoted daughter, Pam Heeter. “It was really difficult, but we wanted to keep her at home as long as possible. We didn’t find a facility until about one and a half years ago,” said Heeter, a 57-year-old South Hill resident.

After Harth fell and broke her leg, the family visited a handful of places before choosing Sunshine Gardens, a skilled-nursing center off University Road in Spokane Valley.

Heeter liked the large, well-lighted rooms and windows with views of campus landscaping. Most of all, she said, the place had a homey feel.

“The staff just seemed to me more caring and more qualified,” Heeter said. “People looked healthy and happy.”

Entrusting the care of a parent or spouse to a facility is often a leap of faith. But some area centers offer a mix of skilled nursing, facility design and specialized activities that create a sense of home for people battling Alzheimer’s and other memory impairments.

Joel Loiacono, executive director of Alzheimer’s Association’s Inland Northwest Chapter, said guilt and denial often keep families from seeking a care facility until the illness is highly progressed.

“There’s a lot of emotional baggage that goes along with this (disease),” Loiacono said.

Postponing the move can literally kill caregiver spouses, who often are in their 60s, 70s, and 80s and buckle physically under the pressure of providing 24-hour assistance.

When a family member is diagnosed with dementia-related illness, Loiacono suggests drawing up a power of attorney listing both the spouse and an alternate family member as decision makers. People with financial resources can expect to pay $3,000 to $7,000 a month at care facilities before patients exhaust their finances and qualify for Medicaid.

Loiacono tells families to conduct interviews when visiting a facility, be honest about their patient’s needs and ask how the center will meet those needs.

Above all, family members should keep their eyes open and trust their senses.

“Deep down, if you feel something is not quite right, it probably isn’t,” he said.

Shirlee Steiner of the Washington Department of Social and Health Services suggests visiting during off-hours and meals. Watch how employees interact with residents and if people get help when they need it.

“Does the food look good? Are they eating? Are they well groomed? Are they happy – that’s a big one,” Steiner said.

Check out summaries of government inspections that are available online, Steiner recommends, but be aware that even good facilities can some minor infractions.

“There aren’t many facilities that come out deficiency-free,” she said.

Sunshine Gardens, a skilled-nursing facility that’s been family owned for more than 50 years, has 40 residents with dementia. The facility once had a secure dementia unit, but it now focuses on people with latter-stages of the disease.

The facility offers a mix of activities and speech, physical and occupational therapy.

Five separate living units house 15 to 18 residents each. Units have separate central living areas and are painted different colors.

The building was designed to create a homey, less confusing environment for the memory impaired, said Kelly Rhoads, an owner and administrator of the facility.

“We try to segregate the level of care as much as we can,” Rhoads said.

A window-lined hallway features fall decorations. The changing seasonal knickknacks orient residents to the time of year, he said.

Susan Lawrence, activities director, helps residents exercise cognitive skills by offering individual activities with stuffed animals and brightly colored objects and through group activities such as like reading, baking cookies and playing music.

Sometimes people who haven’t spoken recently hear music and start talking.

“There’s something about music that will touch a memory, and it will become clearer,” Lawrence said.

Pictures in Reminisce Magazine also can trigger memories, Lawrence said.

“It gets people to smile,” she said. “It gets them to start taking about chore memories.

“It’s amazing what they share with you sometimes.”

At Park Place Retirement Community, a facility that has independent, assisted living, and an Alzheimer’s care unit that has 32 beds in a secure unit. The unit has an alarm that keeps patients from wandering, and residents participate in their former routines.

Shannon Sellers, activities coordinator, helps woman who wore makeup apply lipstick. A former knitter might wrap yarn into a ball.

Small groups make brownies, smell them baking and then eat them over coffee. Sometimes the smell triggers fond memories.

In the warm months, Sellers takes small groups outside to garden.

“I’ve learned from our residents how to prune rose bushes. They’re pointing things out to me,” Sellers said.

Memory boxes posted outside each bedroom feature photos and other personal objects that help residents find their rooms. Park Place is also creating a minisalon for facials, hand massages and pampering where residents get a respite from stress and a boost to their self-esteem, she said.

Good Samaritan Village Spokane Valley has a secure unit with 28 residents. The large, landscaped campus has independent, assisted living and skilled nursing, enabling spouses of dementia care residents to live nearby and visit frequently.

Social worker David Bruner tells nursing staff members to check their own reality at the door when caring for residents. The goal is to create a low-stress environment enabling men and women to enjoy snippets of time, whether present or past.

Sometimes all they have is past, since long-term memory is among the last functions to disappear.

If a mother holds a doll and relives caring for an infant child, the staff plays along instead of disagreeing and upsetting the resident.

“That moment will pass, and they’ll be in another moment, so you make each moment the best it can be,” Bruner said. “All we can do is live in their memories at that present time.”

The staff finds ways to understand people who can’t communicate verbally anymore but nonetheless are trying to convey a message, Bruner said. A resident who persistently tries to get out the door might be taken for a leisurely walk.

Also, Burner said, the staff is patient when residents who can’t recall words get frustrated and tries to help them communicate if they need pain medication for a headache or can’t find a restroom.

“They lose the ability to understand and create solutions,” Bruner explained.

Mary Herrick, 88, came to live at Good Samaritan in March. Although she communicates well, several instances of wandering persuaded her and her family the secure unit was best.

“The people are really nice here,” she said while holding a cup of peppermint candies given to her by an employee.

“I think it’s a nice place – a comfortable place. The food is fantastic,” she said.

Helping out in the dining room by folding napkins and tablecloths gives Herrick a sense of the familiar. She also loves singalongs and visits from students at Greenacres Elementary School.

Her daughter, Judy Scott of Spokane Valley, said not long ago her mother was incommunicative and socially isolated. Now she’s smiling and chatting.

“We think she fits in now,” her 65-year-old daughter said. “We’re happy she’s here.”