Experts Dig in with Doggies for Dementia with Guest Lori O’Leary, RN, Case Manager
Welcome to Experts Dig in with Doggies for Dementia (Foundation). This episode of Experts Dig in with Doggies for Dementia (Foundation) is with Lori O’Leary, RN, Case Manager. I’ve wondered about the impact on those with dementia and their families. Needless to say, this is complex given the consequences to all of us and especially those with cognitive problems such as dementia. Lori O’Leary gives us a look at what it has been like for those with dementia in long term care and their families, and how it feels to be a health care provider, registered nurse during this scary and uncertain time.
About Lori O’Leary
Lori shares her experiences as a registered nurse specializing in home health care. She cares for people at home and in long term care communities which means she makes “house calls.” One big difference between hospital nursing and home health is that when patients are seen and evaluated, they are in their own home-nurses are guests. In the hospital, patients are in the healthcare “home.” I loved home health care, and even after becoming a nurse practitioner, I made house calls. There is something special when you can assess a patient holistically-body, mind and spirit at home versus in the hospital. Home health care nurses and other professionals are special people who recognize the value in the difference, and I loved hearing Lori’s take on this. Home health care nurses’ communication skills are top notch since they are the care managers and keep dialogue open between patients, families, physicians, long term care staff and other health care professionals. I’m delighted we get to share this episode with you, because we just chatted nurse to nurse with an undertone of my desperation of not knowing how to make things better…yet.
Many of the people Lori sees are in long term care and have various types of dementia. When Covid-19 struck the United States, decisions needed to be made about the best way to protect some of our most vulnerable citizens. The elderly and those with health issues were at once the most highly impacted group hit with Covid and had the worst outcomes with many dying. We heard horror stories on the news. Once the risks were evident, lock downs were issued and there was confusion as to how we would respond as a country, in each of the states and even every long term care community. Executive teams were balancing safety, protecting all residents, a variety of government ‘suggestions and guidelines,’ families’ worries about their loved ones and fear over the inability to see them, their own staff safety, increased financial responsibilities and the potential of a public relation nightmare should Covid-19 strike their community and it make the news. WOW! What a list of concerns. We hope you enjoy this episode of Experts Dig in with Doggies for Dementia and welcome your comments.
In My Opinion
Values and Our Elders, Those with Dementia and Our Most Vulnerable Citizens
The general consideration most of us on the outside heard was that we needed to protect our long-term care residents and the best way to do this was to maintain a lockdown. What happened if a staff member became ill or a resident contracted Covid-19 was largely up to each long term care community. Families reported vast differences in LTC communities with regard to isolation, visitation policies, and essentially how the residents were treated. The manner in which our most vulnerable were treated during this time at once became a microcosm of how our society views the elderly and other vulnerable citizens. Communities may be located a few miles or even blocks from one another and have different policies. The lack of governmental guidance is well documented in the press. Opinions varied between experts in long-term care, however, anyone in direct care could see the horrific outcome of isolation and loneliness to the elderly and especially those with dementia. Some describe it as elder abuse and a clear violation of patient rights and human rights. The rallying cry became “Keep Our Residents Safe and Covid-free” however this was a pinhole view and neglected to reflect the emotional impact of isolation, toll on families, and health care providers.
Even when bars and restaurants were open, some families could not see their loved ones while others could see them from 6 feet away with protective masks and a plexiglass barrier. Imagine not seeing someone you love who is elderly and ill and after months of worry not being able to even touch or hug them? Many who previously cared for themselves with prompts or reminders could no longer walk, feed themselves or recognize family. This happened while many families watched from a window or a video stream. Some residents thought they were in jail, not understanding a quarantine, lock down or why people wore masks. Not seeing another human face without masks or gloves and being sequestered to their room alone likely caused more harm than the virus itself. I wonder if the death rates secondary to Covid-19 will include the many who declined and essentially passed secondary to isolation and loneliness? Some residents started to improve once visitation and community activities resumed, however many continue to decline while others died without their families. I am not sure how I would handle this if I was still clinical. I was a nurse 40 years and was a patient advocate, first and foremost. When the protection or the cure is as or more detrimental than the disease, we must STOP and reassess. Lives depend on it. These are my opinions, and I welcomed hearing from a health care provider. We have spoken with families directly impacted, and I am delighted to have Lori O’Leary, a fellow nurse on Experts Dig in with Doggies for Dementia.
Who is to Blame?
We all must do better knowing what we now know. This happened on our watch. The good news is that we are also the solution. Families have joined to have a voice to make change, but often felt the lack of support all around. Long term care communities are filled with many very caring individuals who followed corporate and government guidelines. Frankly, most of us (all?) were not prepared for a pandemic like this. Chaos ensued and out came a variety of opinions and concerns like I mentioned above. Facebook groups comprised of families directly impacted and those of us who want to help (including long term care provider, by the way) were formed and rallies were held all round the country. The buzz of frustration over not being heard was loud. Caregivers for Compromise is one of those groups. It began as a national group and when the numbers grew, each state formed one also. There is power in groups, and I was happy to raise awareness. Each night I reviewed the posts and stories and was completely broken hearted.
This is the time to show how we value people in our country and in the world. How we handle this part of the larger crisis will be our legacy. It’s going to take some listening and CHANGE. Big moral and ethical decisions need to be made. Families have a choice about where their loved ones live if long term care is needed. They have learned to include questions about how a pandemic was and will be handled. Is it corporate or local rules? What are their options? This time around, families have few if any options. This takes my breath away, as it should all of us. You’ll find certain parts of our Experts Dig in with Doggies for Dementia where I’m left speechless-a rare occurrence. 😀 After all, no one among us will escape having someone we love age.
Lori is a registered nurse and case manager. She worked with residents in long term care, families, long term care staff and the physicians or advanced practice nurses/physician assistants. I was delighted to speak with her because she had an insider view of how the pandemic and quarantine impacted her patients, many of whom are long term care residents with dementia.
And Now…Let’s Hear From Lori!
Who Are We?
About Family Caregiving
Family caregiving is something most of us didn’t prepare for and go into without full knowledge of everything we need to know. More and more people of all ages are becoming family caregivers for their ailing family members and caring for those with dementia has unique needs as well. There are many different (>400) types of dementia. How have we, the United States, done to take care of our elders and those with dementia? I’m pretty sure you know how I feel about this. I would love to hear any and all opinions, including other health care providers and families. Our mission is to raise awareness.
Experts Dig in with Doggies for Dementia supports families impacted by dementia including family caregivers. Even if you are not the direct caregiver for your loved one or they are in some form of long term care, you’ll want to know this information. The more we all know, the more compassionate and kind we can be. The stigma associated with dementia is BIG and our job is to learn more and do better.
We’re delighted to have our guest Lori O’Leary, RN, Case Manager with Experts Dig in with Doggies for Dementia today. The views she expresses are hers and not necessarily the views of her employer.
Thank you Lori!