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Diabetes: Helping Seniors Take Control

For today’s seniors, diabetes has rapidly become an epidemic. About one in four people over 60 in the U.S. has diabetes, a condition in which the body does not properly process food for use as energy. If diabetes is not adequately managed, it can lead to serious health problems, from stroke and heart disease to kidney failure, hearing loss, blindness, nerve damage, and amputation. The American Diabetes Association reports that diabetes is the nation’s seventh-leading cause of death.

While there is not yet a known cure for diabetes, through close management – from carefully monitoring medications to adjusting diet, exercising often, and regularly testing blood glucose – most diabetics can take control of their symptoms and avoid further complications.

Meeting the challenges

Leading senior living communities are making a dedicated effort to educate and support senior residents who are living with diabetes. StoneGate Senior Living, for example, a provider of rehabilitation, skilled nursing, assisted living, and memory care services, recently partnered with ARKRAY USA and the Diabetes Store, two leaders in diabetes care. The goal was to expand StoneGate’s diabetes management program to 41 facilities throughout Texas, Oklahoma, and Colorado – providing patient education and guidance in self-management to improve residents’ quality of life.

“While diabetes can have dire consequences for adults of all ages, seniors are at particularly high risk from diabetic complications,” says Angela Norris, Senior Vice President of Business Development at StoneGate. “The body’s ability to heal wanes with age, while the presence of age-related conditions, such as impaired vision, decreased skin elasticity, reduced mobility, and a less-active lifestyle, can work against effective disease management. Also, many seniors with diabetes are struggling with memory issues. Their insulin and medications need to be closely monitored.”

Managing the disease

“Our goal is to provide a personalized diabetes wellness plan for each resident living with diabetes,” Norris says. “Our staff is trained to help residents – short term and long term alike – to monitor food intake, engage in daily exercise, regularly check blood sugar levels, and closely manage medications. We also make sure our diabetic residents have regular eye exams, skin assessments, and podiatrist visits to help prevent complications.

“Partnering with ARKRAY and the Diabetes Store has amplified our efforts to educate residents – and give them the tools to better control blood sugar, avoid the side effects of the disease, and live healthy, active lives,” Norris notes.

Maximizing nutrition

Key to managing diabetes is a healthy-eating plan that helps control blood sugar – one naturally rich in nutrients, low in fat and calories, and abundant with fruits, vegetables, and whole grains.

“We conduct a nutrition evaluation and provide support to help our diabetic residents get the daily nutrients they need,” Norris says. “We also provide diabetes management classes that help them track eating patterns and determine what foods may or may not be the best choices. Our registered dieticians help plan menus and educate our residents on making healthy food choices. Meals can be prepared in accordance with a prescribed diet.”

Making time for exercise

According to the Centers for Disease Control and Prevention, adults over the age of 65 need at least 150 minutes of moderate-intensity exercise a week, such as brisk walking, and at least two days per week of strength training that works all the muscle groups. Exercise is particularly critical for diabetic seniors to improve their ability to use glucose.

“StoneGate offers the LifeWorks Senior Wellness program, featuring purpose-driven exercise that helps diabetic seniors stay active and lower their blood glucose levels,” Norris says. “Fitness classes are designed to help maintain and improve strength, balance, and flexibility.”

Maintaining optimum health

“As baby boomers age, we can expect a continued spike in the rate of diabetes,” Norris says. “While untreated diabetes presents significant risks of a range of serious health problems, these risks can be vastly improved by appropriate medical and lifestyle interventions. Our goal is to help diabetic residents take control of their disease and – through education, lifestyle modification, and continued vigilance – stay healthy.”

CONTACT US to learn more about our services to support seniors who are living with diabetes. 

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Senior Physical Fitness: Using It, Not Losing It

“Use it or lose it,” the saying goes. These words of wisdom are true in many areas of life, but particularly for our bodies as we age. Staying fit helps to lower blood pressure, decrease the risk of falls and injuries, and slow the body’s loss of muscle tone and bone mass.

The Centers for Disease Control and Prevention recommends two types of exercise each week to improve health: aerobics and muscle strengthening. Surveys show, however, that less than one-third of Americans over the age of 65 are following this guideline.

Facing the challenges of senior fitness

“As we age, it’s important to stay focused on overall wellness,” says Stephen Chee, director of employee wellness at Lifetime Wellness. “Physical activity, regular exercise, and good nutrition are keys to staying healthy. It’s a lot like routine repairs and maintenance on an automobile. Our bodies are our vehicles for life. We need to keep them well conditioned, so they stay in top working order.”

Lifetime Wellness – in business since 2005 – is a pioneer in delivering wellness and recreation services to skilled nursing, assisted living, rehabilitation, and memory care facilities throughout Texas and Oklahoma. The company is a partner organization with StoneGate Senior Living, a leading provider of senior living services. With wellness programs in most of its 44 facilities, StoneGate offers a full selection of body-enhancing activities, from fitness and health education programs to nature walks and strength-building classes. Physical activities are complemented by spiritual, emotional, social, vocational, and intellectual wellness programs.

Myths about fitness abound,” says Chee. “Our staff strives to separate the myths from the facts – and help residents understand the role of exercise not only in maintaining stronger bodies but also in elevating mood, improving memory, and protecting the brain from age-related mental decline.”

Forming bonds through group activity

Group exercise can be a powerful antidote to loneliness, a feeling experienced regularly by more than 40 percent of seniors, studies find. “From my experience, fitness has a strong psychological component,” Chee says. “As humans, we’re designed for companionship, but as we age, many of us lose our sense of social connectedness. At StoneGate, we provide many opportunities for group exercise, which not only boost fitness but also build community.”

StoneGate’s wellness programs promote participation in physical activity groups to help improve and maintain cardiovascular endurance, as well as balance, flexibility, and muscular strength. Programs include:

  • Body Works and Fitness for Life: exercises for residents of all physical abilities
  • Sport Fitness: activities that span the sports spectrum, from kickball and volleyball to baseball and basketball
  • Music & Movement: relaxing, low-impact exercises accompanied by music
  • Sensory Shape-Up: activities that strengthen the body while engaging the senses through aromas and essential oils

Many StoneGate facilities also offer a weekly rehab fitness group for patients in transitional care who are recovering from an injury or surgery.

Fighting inflammation

Researchers have found low fitness is associated with a larger waist size and a higher degree of inflammation. “Inflammation is the body’s natural way of protecting itself when we’re injured or sick, but as we age, our cells change and can cause the immune system to continuously activate the inflammatory process,” Chee explains. “This chronic inflammation can be harmful to our bodies, and it is often linked to diseases prevalent in seniors – such as heart disease and diabetes. Increased fitness can lower inflammation and improve metabolic health overall.”

Finding the mental benefits in physical activity  

Studies suggest that aerobic exercise – any activity that raises the heart rate and facilitates movement for a sustained time – has significant benefits for the brain. “Aerobic activities release endorphins,” Chee says. “These are the body’s natural painkillers that create a natural euphoric feeling and help ward off depression.”

A popular activity among seniors is “chair yoga” – yoga exercises that can be done without getting on the floor. “Yoga stimulates the flow of internal energy throughout the body, providing healing and preventing further damage from inflammation,” Chee says. “It combines physical exercise with focused breathing, helping manage stress, improving flexibility, and enhancing mental health.”

Focusing on relationships                                                                                                         

Although education is the foundation of StoneGate wellness programs – teaching residents the facts of staying fit and providing the tools to develop healthy behaviors – the deeper principle is nurturing relationships.

“Our staff’s first focus is on making sure those we serve know how much we care,” Chee says. “We hope this knowledge, coupled with our unified engagement as a team, builds trust, sows compassion, and changes lives.”

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Senior Dining: Turning the Tables

Historically, meal service in the senior living industry has fallen short. Fresh, great-tasting, made-from-scratch cuisine – coupled with a five-star resident dining experience – has been the exception, not the rule.

But today paints a different picture. An industry transformation is in the works, with a focus on offering maximum nutrition, mealtime flexibility, and a memorable social experience.

Changing the dining culture 

Senior living communities are taking a new view of dining. It’s no longer a sidebar to the resident experience. It’s at the core – a key ingredient for health, vitality, and quality of life.

A community at the forefront of the personalized mealtime trend is StoneGate Senior Living, a leading provider of senior living services in Texas, Oklahoma, and Colorado. StoneGate revitalized its dining experience in 2007. Cheryl Korbuly, a registered dietitian nutritionist, licensed dietitian, and vice president of nutrition services at StoneGate, describes mealtime as “a premier experience built on resident choice, restaurant-style dining, and stellar customer service.

“Our goal is to meet each resident’s personal food choices and tastes while providing a pleasurable dining ambiance. Diners choose their selections from a full menu of well-balanced options. Meal orders are taken tableside and delivered in courses.”

Catering to choice 

Key to the improved dining experience is choice. Flexible times for breakfast, lunch, and dinner give residents the freedom to adopt a mealtime that meets their unique preferences.

Choice extends also to a variety of nutritious, freshly prepared, and visually appealing food options. At StoneGate communities, for example, the base menu is “Heart Healthy,” featuring meals with less fat and sodium. Selections range from abundant fruits and vegetables, including always-available fresh salads, to reduced-fat dairy options and whole-grain breads, cereals, and side dishes.

“Along with heart-healthy selections, our residents can select their favorite traditional dishes, many of which have a tie to their past,” Korbuly notes.

Popular menu items range from eggs to order for breakfast to homestyle meatloaf for lunch and grilled salmon for dinner.  Communities with large ethnic populations offer menu options that follow cultural traditions. Nutrition Services team members talk regularly with residents to discuss and incorporate menu enhancements, along with favorite recipes and special requests.

Caring for residents with dietary restrictions

When planning meals for seniors, considerations such as altered taste, difficulty chewing and/or swallowing, medication side effects, and nutrient requirements are key. Another factor is providing special diets to help manage chronic illnesses, such as diabetes, heart disease, and high blood pressure, which affect four out of five older adults. Heart Healthy meals, featuring herbs and spices as primary seasonings, are staples for therapeutic diets.

“Diets modified in texture don’t sacrifice on flavor – or fun,” Korbuly says. “For example, seniors who have difficulty chewing or swallowing may require foods that are modified in texture. StoneGate communities accommodate this need by providing pureed foods that look good, taste great, and maximize nutrients.  “Beyond Puree™” was created to enhance the quality of life for residents requiring the puree food texture, because we all eat with our eyes.”

Considering additional options

Along with enjoying meals in the dining room, residents also have the choice of eating in the leisure of their room. “The in-room dining experience offers flexible dining times, choice of menu items, and the opportunity to receive personalized service while dining in-room,” Korbuly explains. A hot mobile food cart travels from room to room, ensuring food is served fresh and at a palatable temperature. For in-between-meal cravings, snack service is offered three times daily.

Residents in memory care facilities are engaged in family-style dining, where bowls and platters of food are passed around the table. “Our goal for those with memory challenges is to recreate familiar smells and sounds, along with a welcoming ambiance that creates a sense of belonging,” Korbuly says. “We evaluate each resident’s needs and custom-tailor the experience to help them feel at home.”

Creating a recipe for success

Central to the resident dining experience is instilling a shared mindset among Nutrition Services staff. “We continuously educate our Nutrition Services team on how to be proactive in providing a ‘WOW!’ experience for everyone we serve – at the table and beyond,” Korbuly says. “Our residents deserve nothing but the best.”

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Infectious Disease: Partnering for Control and Prevention

Infectious disease can be deadly, especially for seniors. From the flu to bacterial pneumonia, these diseases account for 40 percent of deaths in older adults. They are caused by microorganisms, such as viruses, bacteria, fungi, or parasites, and can rapidly spread from person to person. Some infections, such as MRSA – the so-called “superbug” – are resistant to many antibiotics, further complicating control and prevention.

An infection often makes an underlying chronic condition worse and can lead to hospitalization and additional costs. To win the war on infectious disease outbreaks, many senior living communities are escalating their infection control and prevention initiatives and partnering with hospital-based infection prevention programs to share best practices.

Pinpointing the challenges

One organization taking a proactive stance against infectious disease is StoneGate Senior Living, a leading provider of senior living services in Texas, Oklahoma, and Colorado. “Skilled nursing and rehabilitation facilities encounter many challenges in effectively implementing and maintaining infection prevention programs,” says Rhonda Abercrombie, StoneGate’s corporate director of quality and infection control.

“Unlike patients in hospital rooms, residents in senior living communities typically frequent common spaces, from dining rooms to rehabilitation areas – and spend a lot of time breathing the same air. This can increase the risk of transmitting pathogens. We have stringent disinfection procedures because the many shared areas where our residents congregate can be breeding grounds for disease.

“If a resident tests positive for an infection, we proactively treat other residents who have similar symptoms, even if they haven’t yet been diagnosed. We want to nip any infections in the bud because they can spread so fast from person to person.”

Preparing for government mandates

Post-acute care facilities have traditionally lacked the specialized infection control training of hospitals, a challenge the Centers for Medicare & Medicaid Services (CMS) is addressing through new rules on infection control for long-term care facilities. “StoneGate communities, along with our industry colleagues nationwide, are working to comply with recent mandates from the federal government,” says Dianne Sullivan-Slazyk, StoneGate’s chief clinical officer. “These directives are designed to lower overall healthcare-associated infection rates, prevent harm to residents and healthcare providers, and reduce overall cost burdens to care delivery.”

To participate in the Medicare and Medicaid programs, CMS has mandated that long-term care facilities have a trained, certified, dedicated infection preventionist on staff by November 2019. Infection preventionists are experts in preventing and controlling the spread of infectious diseases among patients, staff, and visitors. They are responsible for developing, enforcing, and evaluating the effectiveness of infection control policies and procedures; investigating disease outbreaks; and training staff members in prevention.

An earlier CMS requirement mandated that facilities have a formal program in place for “antimicrobial stewardship” – a coordinated plan designed to optimize treatment of infections and promote appropriate use of antibiotics. StoneGate’s program was launched in 2017.

“A major concern with antibiotics is that they may not be effective in treating the specific infection a resident is fighting,” Abercrombie explains. “Or, the antibiotics given may be unnecessary. This can lead to increased risk of contracting Clostridium difficile, or ‘C. diff.,’ a bacterial infection that can spread rapidly. Antimicrobial stewardship helps ensure the right antibiotic is used at the right time – and only when it’s truly needed.”

Paving the way for a safety-first future

“An integrated healthcare delivery system is a prime opportunity for acute and post-acute care to collaborate in reducing infectious disease,” Abercrombie says. “We’re seeing many positive results from this combined effort nationwide.”

A notable success is the Veterans Health Administration (VHA), the nation’s largest integrated healthcare delivery system. The VHA implemented a systemwide MRSA prevention initiative within its hospitals, spinal-cord injury units, and nursing facilities that has significantly reduced MRSA rates across care settings.

Collaboration is particularly critical in preventing sepsis, a serious bloodstream infection that can quickly become life threatening. “Many post-acute care facilities are joining forces with acute care partners to promote early sepsis detection,” Sullivan-Slazyk explains. “For example, StoneGate has partnered with Methodist Charlton Medical Center in Dallas, TX, and Southwestern Medical Center in Lawton, OK, to educate healthcare teams through a “Suspect Sepsis, Save Lives” campaign. The goal is to increase staff awareness of sepsis signs and symptoms for immediate intervention.

“Heightened collaboration across the delivery system – coupled with the government’s focus on improving infection control in all healthcare settings – bodes well for the future of patient care. Together, we’re creating a continuing care network that delivers quality care, contains the spread of disease, and puts patient safety first.”

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After a Stroke: Recovering, Relearning, and Regaining Independence

Each year, more than 700,000 people in the U.S. suffer a stroke, and about one-third of that number lose their lives. Strokes are the fifth-leading cause of death in the nation and the third-leading cause of disability.

Also known as “brain attacks,” strokes occur when the blood to the brain becomes blocked. Brain cells begin to die, and abilities controlled by the affected part of the brain – from movement to memory – are lost.

Although strokes can afflict people at any age, those over age 65 experience nearly three-quarters of all strokes.

Racing against time

How a patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged. The earlier the stroke is identified, the better the patient’s outcome.

The American Stroke Association has offered an effective way to recognize warning signs of a stroke in progress. It’s called the FAST technique:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 9-1-1

Thanks to increased public awareness, more patients are getting help within the first critical hour after a stroke.

“Immediate treatment is critical to minimize damage,” says Tori Owens, chief executive officer at Accel Rehabilitation Hospital of Plano. “After the patient’s medical condition has stabilized, the next step is a stroke rehabilitation program. A focused, comprehensive program – delivered by a stroke rehabilitation team – can help patients relearn lost skills, regain independence, and restore the quality of their lives.”

Certified by the Joint Commission for stroke rehabilitation, Accel has consistently shown strong results for medically complex patients in their improved ability to perform everyday tasks. “Essential to patient progress is motivation,” says Anh Nguyen, MD, the facility’s medical director. “It can make the difference between successful recovery and a lifetime of physical challenges. By understanding what motivates each patient, our multidisciplinary teams provide the inspiration to work harder in achieving individual goals.”

Recovering physically, mentally, and emotionally

Research has found that patients who participate in stroke rehabilitation programs typically perform better than those who don’t participate. “Rehabilitation helps stroke patients relearn skills that are lost when part of the brain is damaged,” Nguyen says. “These skills can include coordinating leg movements to enable walking or mastering the steps involved in any complex activity. Patients learn new ways to complete tasks, such as dressing using one hand or communicating differently if their ability to use language has been impaired.”

Rehabilitation also addresses mental challenges. A new study finds more than half of the individuals who have had a stroke have difficulty with such skills as planning, organizing, and social interaction. Comprehensive stroke treatment plans include speech and occupational therapy to help patients regain lost cognitive, communication, and social abilities.

An estimated 30 percent of stroke patients develop depression, yet as many as two-thirds of those patients do not receive treatment for it. “Psychological evaluation is as important as physical assessment,” Nguyen says. “At Accel, we take a holistic approach to treating stroke patients, addressing their emotional as well as physical needs to reawaken a sense of empowerment – and hope.”

Regaining abilities through advanced therapies and technologies

Promising new therapies are extending the window of treatment following a stroke. New medications are being tested to slow the degeneration of nerve cells deprived of oxygen. Medical devices are being developed to reach stroke-causing blood clots and restore blood flow in minutes. Biological therapies, such as stem cells, are being evaluated to replace stroke-damaged brain cells.

Along with therapy innovations, rehabilitation technologies are helping stroke patients regain their strength and function. For example, robotic technology enables earlier mobility, retraining impaired arms and legs through repetitive motions. Functional electrical stimulation applies electricity to weakened muscles and can restore voluntary motor functions, from walking to reaching. Wireless technology, such as biosensors for the arms, legs, and chest, helps monitor stroke patients’ progress in recovery. Video games and other computer-based therapies can improve mobility in a simulated environment.

“With these advances in therapies and technologies, the future for stroke survivors is brighter and brighter,” Owens says. “Whatever tomorrow may bring, state-of-the-art rehabilitation programs will continue to be key to recovery – helping patients gain back the life they once knew and move forward, one step at a time.”

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Alzheimer’s disease and the family caregiver: Deciding when to make a move

Elderly father adult son and grandson out for a walk in the park.

Consider the statistics. Every 65 seconds, someone develops Alzheimer’s disease, an irreversible, progressive brain disease that slowly destroys memory and thinking skills. Today, 5.7 million Americans are living with Alzheimer’s. By 2050, this number is projected to more than double, rising to nearly 14 million.

Much of the responsibility of caring for people with Alzheimer’s falls on the shoulders of family members. A total 16.1 million Americans provide unpaid care for people with Alzheimer’s. Family caretakers can face a cascade of challenges – emotional, physical, and financial.

Coping with the stress  

“Alzheimer’s caregivers typically experience a range of emotions,” says Marie Webster, director of nursing at Williamsburg Village Healthcare Complex, a skilled nursing center in DeSoto, Texas, and one of seven memory care communities operated by StoneGate Senior Living. “Along with stress and depression, they may feel anger with their loved one and then guilt for being angry.

“The result is often burnout, or what we call compassion fatigue. This is when the caregiver is so preoccupied with the suffering of the person they’re helping that they experience their own trauma. It’s not uncommon for caregivers to develop issues with their health, from insomnia to a weakened immune system. They can also face financial challenges if, for example, they need to modify their home significantly to accommodate their loved one’s changing needs, hire in-home help, or leave their job to provide full-time care.”

Connecting with respite care

One antidote to compassion fatigue is respite care. This program gives caregivers a short-term break while professionals trained to care for the person with Alzheimer’s take on the caregiving role. Respite care can be provided in the home, at special daycare centers, or in a skilled nursing or assisted living facility that offers overnight stays. 

“You can’t care for anyone else well if you’re not caring for yourself,” Webster says. “Taking time to relax and rejuvenate can provided a renewed perspective in your caretaking role.”

Considering a move to a care community

Family caregivers of a loved one with Alzheimer’s often realize they can’t provide the level of care required at home. The strain, risks, and responsibilities may have become too much, prompting the difficult decision to move a loved one to a memory care facility.

“As a person’s Alzheimer’s progresses, they need to be in a safe environment, where care is available 24 hours a day,” Webster says. “If you’re considering a memory care facility, it’s important to gather information ahead of time and start the search early on. If you wait too long, your loved one’s memory may be so impaired that their new residence will never feel like home.

“Take time to tour potential communities. Ask questions of staff. Visit with other families whose loved one resides at the facility. Observe how the residents appear. In determining if a community is the right fit for your loved one, there are so many considerations beyond cost.”

Confirming your choice

Webster offers 10 guidelines for evaluating residential community options for a loved one with Alzheimer’s:

  1. What level of care and personal assistance is provided?
  2. How do staff ensure the stability of a routine while maximizing resident autonomy?
  3. How does the physical structure of the facility support residents with memory loss and physical limitations? How is the community secured?
  4. What is the ratio of staff to residents?
  5. What type of specialized training and continuing education have the staff received?
  6. How do staff assess and monitor disease progression?
  7. How will staff communicate with you about your loved one’s care?
  8. What is the meal experience like? Are special dietary needs accommodated, such as pureed food for those with swallowing challenges?
  9. What activities are offered to keep your loved one physically, mentally, and socially active?
  10. Does the facility take a person-centered, strength-based approach to Alzheimer’s?

“When your loved one moves into a memory care community, you’ll likely find their quality of life improves and yours does, too,” Webster says. “With the assurance that your loved one is well taken care of, you can focus on spending time with them – not as a full-time caretaker, but as a devoted family member whose main job is providing comfort, companionship, and love.”

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Assisted Living: Providing Support While Preserving Independence

Health care worker helping an elderly patient

In the spectrum of senior care, assisted living is an option that falls between independent living and skilled nursing or long-term care. Assisted living facilities (ALFs) offer a viable solution for seniors who can live on their own but may also need some assistance. A new concept just three decades ago, assisted living is the fastest-growing housing option for seniors today. Nearly 16,000 ALFs are operating across the U.S.

“In assisted living communities, residents have the best of both worlds: independence, for a self-sufficient living experience – plus the assurance that care is available if it’s needed,” says Andrea Driggers, regional director of business development at StoneGate Senior Living. StoneGate is a leading provider of rehabilitation, skilled nursing, assisted living, and memory care services in Texas, Oklahoma, and Colorado.

“Unlike skilled nursing or long-term care, assisted living is not based on a medical model. We’re developed on a social model, offering our residents choice, fluidity, and community in their lifestyles.”

Bringing peace of mind

“For many seniors, assisted living provides exactly the level of care they need to thrive in the next phase of their lives,” Driggers notes. “They enjoy a home environment in a comfortable, apartment-like setting – with medication oversight, physician appointment management, and access to emergency medical help if it’s needed. This provides tremendous peace of mind to residents and their families.”

A licensed nurse is onsite 24×7 in StoneGate assisted living communities to monitor residents and ensure all care needs are met. Residents can also receive home health services, such as assistance with bathing and dressing, from an outside provider. “Residents contract independently with these providers, who deliver services in our ALFs, just as they would in the home.”

Being independent

Fostering independence is a key tenet of assisted living. Unlike being in a skilled nursing or long-term care facility, residents can lock their doors and come and go as they please.

StoneGate assisted living communities also offer several dining options for independent decision making. “Residents can eat in the dining room when they want to or dine in their own room,” Driggers notes. “We offer restaurant-style dining, with three fresh, nutritious meals a day. Residents also have their own kitchenettes, with a full-size refrigerator and a microwave, for eating or entertaining in their own space.”

Belonging to a community

Living alone at home can lead to isolation and loneliness – feelings experienced by more than 40 percent of seniors. “Assisted living communities can be a remedy for loneliness,” Driggers says. “Living in a group setting provides abundant opportunities to connect – with a variety of activities under one roof and people to do them with.” Social events range from dances and movie nights to art classes, computer lessons, and group outings.

Residents can also participate in StoneGate’s LifeWorks Senior Wellness program, which offers a full roster of purpose-filled activities. “We promote overall wellness in body, mind, and spirit – providing everything from group fitness classes and wellness assessments to cognitive and music therapy.”

Beginning at the right time

Key to a successful ALF experience is knowing when it’s time to make a move from home to assisted living. “Often, families prolong keeping their loved one in the home setting,” Driggers notes. “They have the best intentions in maintaining mom’s or dad’s independence, but – as primary caretakers – may find themselves exhausted and ineffective as their loved one’s needs intensify.

“In skipping the assisted living option, many reach the point where mom or dad no longer meets the criteria for assisted living – for example, the ability to walk and to stand, sit, and evacuate the facility without assistance. At that point, the only options available are skilled nursing or long-term care.”

Part of the hesitance to pursue assisted living is financing. Two StoneGate assisted living facilities – Lakewest and Simpson Place – solve the cost challenge by working closely with government programs to provide funding. Low- and moderate-income residents receive financial assistance through a combination of Social Security, Medicaid, and Section 8 Housing vouchers.

Bridging to future care

As residents in assisted living experience changing needs, they can step up their living experience to skilled nursing or long-term care. “Key to our role is monitoring each resident and working with the family to transition the resident to a higher level of care if it’s needed,” Driggers says. Many StoneGate communities are multilevel, offering independent living, assisted living, skilled nursing, and long-term care – all on the same campus.

“This range of living options enables seniors to age in place, so if they fall or suffer a debilitating illness, they can move to the next level of care without having to leave the community. They can continue to experience the comfort and familiarity of friends and staff – in the community they know as home.”

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Six Steps to Finding a New Home for Your Parents

In my 19 years in the healthcare industry I have talked with hundreds of residents and family members and it helped me have a greater appreciation for what families go through when making the big, life-changing decisions for their older family members.  But nothing could prepare me for what it was like – up close and personal. I did not know how things would transpire in my own family as my parents got older and suddenly, they were both in their mid-eighties and still going strong in their own home. Mom still prepared three meals a day for my dad and he was still the very qualified designated chauffer for their daily activities and appointments.  No grass was growing under their feet!

Their health issues were relatively minor but in the last few years they became more frequent and the weight of maintaining a large home combined with my dad’s occasional hospital stay, caused a growing concern and sense of urgency.  Dad was ready to move forward. Mom – not so much. It turned out that 2018 was the year of transition for my parents. They had been married 66 years at that time and had lived in the same house for the last 50 years. Once the decision was made things kicked into high gear.  To help others avoid some of the unexpected “excitement” we faced, I would offer these suggestions.

  • Start planning NOW.  Are you currently still working and in good health?  Maybe you can do things in stages. Sell your home and move into a townhome.  Sell your townhome and move into an apartment. Sign a short lease on your apartment and start looking for the right facility to meet your “next stage” needs. You must start somewhere.  Set a goal. Pick a date. It may change once or twice but it will eventually stop moving.

You don’t want to wait until you are physically unable to be involved.  There is so much frustration if things are happening around you and you feel that you have lost control. Expect a certain amount of that at every stage regardless of the circumstances.

  • Downsize.  Recognize that you should not take everything with you to your next location so start to share your prized possessions with friends and family NOW.  Do not think you will be able to sell everything at the last minute in an estate sale and get a nice little nest egg. The value you see in something is likely more sentimental than what you would expect to make in cold cash later.

If something has value, do not wait until the last minute to try to sell things online or give them to the local drama department.  Partner with someone who has experience in this area. If you wait and must rush, you will make hasty decisions and relive your choices for some time to come.

  • Start cleaning out closets, drawers, cupboards and the hidden gems sitting in your basement or attic.  Learn to live with empty drawers.

Things that are hard to reach or seldom used are often forgotten.  Checked the expiration on your spices lately? I dare you.

  • Ask your family if they have a special piece of furniture or set of dishes or painting on your wall that they would like to care for starting now.  Knowing you are eventually going to have limited space, be open to “let it go” NOW. Remember that you have enjoyed it for a long time and it will now bring pleasure to others.  Consider the lyrics from Elton John, “Change is gonna do me good.”

Perhaps once a year someone played the beautiful piano in my parents’ home after we kids were grown and gone.  I asked about passing it on to my grandchildren but that was perceived to be first step on a path Mom was not ready to take.  By the time my folks were ready to break up housekeeping, there was not a member of the family that did not already have their own piano or lived too far to justify moving it.  My mother was crushed when she learned how little was paid for that beautiful piece of furniture when all was said and done.

  • Are you sentimental, a packrat or one box away from an episode of “Hoarders”?  Recognize yourself and take baby steps to change. If you have the luxury of time, start sorting those old love letters, special cards or magazine articles you tore out years ago because they were so meaningful at the time.  Unless they are Smithsonian worthy, this may be the time to toss them.
  • Try not to be disappointed when your family does not harbor the same level of commitment to your old books, nick-knacks, vintage clothing or gardening tools.  Time moves on. So does individual taste.

Note:  If you have a family member that wants to pass on a box of old lesson plans, dress patterns or pictures of people you do not know, accept them graciously.  If they have no value, what you do with them next is your own decision.  You have done the giver a favor.

Everybody’s situation is different but some things are the same.  You cannot understand the process until you have already lived it!  Good luck.

By: Donna Wood

Donna Wood is an Executive Assistant at the StoneGate Corporate office and has written various articles for the staff.  We have shared two of those recently regarding the local wildlife living in the “neighborhood” of the office. Donna loves to write and will be a contributing blogger on a variety of topics.  Enjoy her unique take on the various aspects of helping aging parents, working in the healthcare industry and life in the big city.

Post - Adora Midtown

Things My Parents Taught Me

In addition to trying to raise me to be a good person, my parents gave me an example by how they lived their lives.  They also shared these guidelines they wanted me to follow in life.

From Mom:

  1. Always send thank you notes.
  2. Red and purple do not go together.
  3. It is important to read to your children.
  4. Use Sir and Ma’am as well as Please and Thank You.
  5. Read your Bible every day.
  6. Don’t be a one-friender.  (You should not give up one friend to be a friend to another.)
  7. In school, if you give Valentines, you must include everyone. The same applied to invitations to birthday parties. If some of the girls from class got invited, then all of the girls were invited.
  8. You are not allowed to slam doors.  (If we did, we had to open and close the door 25 times.) 
  9. If you stay home from school, you cannot watch tv.
  10. No white shoes (or purses or dresses) between Labor Day and Memorial Day.
  11. Be willing to share your recipes.
  12. At least once a year, set a formal table setting and make sure your children are taught good etiquette.

From Dad:

  1. Do not get in the left lane and drive slowly.
  2. If you think about positive things, you will be a more positive person. Avoid thinking about negative things as much as possible.
  3. If you are going to tell a joke, be sure you know how to tell the joke, all the way to the end. Know that the pause is very important.
  4. Be willing to stand up for your beliefs, even if you are met with strong resistance.
  5. You are never too old to learn new technology.
  6. Study your Bible so you can share what you believe with others.
  7. When you have children at home, make sure you do not have any books with bad language. Don’t use bad language either.
  8. If you are about to take a family trip in the car, be sure everyone has gone to the bathroom first so you can make good time and avoid frequent stops.
  9. When you go out to eat, do not order more than you are able to eat. And, don’t waste money on jello!  You can get that at home.
  10. Always be polite to the police, even if you do not agree with them.  It could save you from a ticket.
  11. Be sure your tires are properly inflated to get the best mileage. 
  12. Keep your commitments.  

By: Donna Wood

Donna Wood is an Executive Assistant at the StoneGate Corporate office and has written various articles for the staff.  We have shared two of those recently regarding the local wildlife living in the “neighborhood” of the office. Donna loves to write and will be a contributing blogger on a variety of topics.  Enjoy her unique take on the various aspects of helping aging parents, working in the healthcare industry and life in the big city.

Post - Adora Midtown

What’s Cooking? Fresh & Healthy Dining in Senior Care

Everyone knows eating the right foods and having good nutrition is an important part of leading a healthy life. For individuals in senior living or care communities, dining and getting appropriate nutrition can often serve up a host of challenges.

Residents or patients in these communities often become “picky” eaters. Food preferences can vary, depending on changes in their mood or routine, or simply because they might be having difficulty discerning colors and temperatures. Seniors with health challenges might also experience chewing and swallowing difficulties, alongside with problems holding cups or utensils.

To address the critical importance of food and nutrition, industry-leading communities such as StoneGate Senior Living supported communities are “freshening up” their approach by focusing on nutritious meals and elevating the dining experience to create a safe, stress-free, and enjoyable mealtime.

Getting ready for mealtime

“A predictable dining experience helps residents feel in control and stay connected to who they are at the core,” says Antoinette Holford, a registered dietician and StoneGate’s education and training manager. “Supportive dining in memory care is, first, about providing healthy meals and, second, about safeguarding a sense of self.”

“We make every effort to create and maintain a familiar routine. For senior care residents living with dementia – whether in a nursing home, SNF, assisted living, or rehabilitation center – regular mealtimes provide consistency, and that’s important to their dining success. If the routine is altered, confusion can set in, affecting their mood for hours.”

What’s on the menu?

Extra care is taken to make each meal flavorful and visually appealing. Heart-healthy selections use herbs and spices as primary seasonings and for those with chewing or swallowing challenges, nutritious, eye-pleasing pureed foods are freshly prepared.

Providing ample choice is also essential, and StoneGate Senior Living supported communities dining services offer a variety of meal options. Printed menus are available for those who can read, and for those with reading difficulties, plates of food are displayed for their easy selection. Along with regular mealtimes in the dining room, room service is available at any time.

Another key to a successful dining experience is having a person-centered approach. For residents
struggling with dementia, Holford says: “We assess each resident’s stage in the dementia journey and build dining services around their individual needs.”

Food aromas, sights, and sounds evoke memories that are hidden away in the brain. For example, a person with dementia may not be able to verbalize why the aroma of roast beef and gravy is comforting to them. But we can see by their response that it is. Food can be a mood changer, in the best of ways.

Staff and family members also work together to make food decisions. The resident’s or patient’s dining history is explored and preferences are taken into account. Holford tells the story of a resident who enjoyed fast food. Day after day, his family brought him a hamburger and French fries.

When the family took an extended vacation, the nutrition services manager noticed the resident stopped eating. “She asked area fast-food restaurants for some take-out containers with their logo. Each night, the staff prepared his meal and served it to him in a takeout box. His routine was restored, and his interest in eating returned!”

Setting the table

We like to mimic the family table and set the stage for interaction. For example, a bowl of salad and a basket of bread are put on the table to pass around family style. Sometimes it works, and sometimes it doesn’t. Something that happened four or five hours or maybe even a day earlier may affect the resident’s mood and response to meal participation, though they may not be able to define it. We strive to respond to changing behaviors with patience, flexibility, and encouragement.

Every effort is made to create a calm and relaxing experience. Diners are typically seated at tables of four to six. “They can sit wherever they like, but often choose the same seat and table. Sitting in the same place enables residents to have control,” Holford explains. “They’re in their spot, and they entirely own it. We also use square edges as opposed to round, because square lines clearly define space.”

Mealtime is typically a social event. “If the resident can’t verbally participate in a conversation, just being at the table can evoke a feel-good response. The experience of being in the presence of others is stimulating in the best of ways. Our goal is not only to provide nutritious meals but also to create a sense of connection and belonging.”

Lastly, Holford reminds that having a nutritious and enjoyable dining experience in senior care relies on carefully trained frontline staff. “These are the ones who sit with residents while they eat,” Holford says. “They’re the first to observe how needs may change. They see how much a resident is eating, what they are eating, and how they are interacting with their surroundings – and can recommend new approaches to food and environment.

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