Why We Do This…

This year we are celebrating our 10 years of being in business.  As I reflect upon those 10 years, I must reflect upon WHY we started this business in the first place.  I hope you will enjoy the journey with me.

Starting from an early age

As a young man, I lost my paternal grandfather to cancer at the age of 74. That left my grandmother alone for many years.  What I didn’t realize at age 12, was that I was being taught about how to care for seniors very early in my life, by my parents and my grandmother.

My father took on the role of primary caretaker for my grandma. He visited or called her daily, paid her bills, took care of her home, her car, her repairs, her day to day affairs – all the things that Grandpa used to do, even though Grandma lived 30 miles from home! My father and mother took her to parties, to church to gatherings, some of hers, some of theirs, whatever it took to make her feel whole and independent.

One thing that my parents didn’t expect to come into play was the development of dementia in my grandmother. One day, my dad showed up to Grandma’s house, and, as he went out to the garage, he found that the entire right side of the car was damaged.  When questioned, she had no memory of the incident. He knew immediately that it was time for grandma to stop driving.  She didn’t mind, because she wasn’t much of a driver anyway; Grandpa had done most of the driving.

It was very odd when things began to come up missing in the house, like the check book, the house keys, jewelry, clothing, etc.  Before I tell you more, I must say that Grandma was prim and proper. When Grandpa found Grandma, she was a NYC dancer — a ballerina. She always had on the right clothes, the right make-up, the right jewelry. She was a true city girl from the 30s.  She would wake up 30 minutes before Grandpa and get ready for the day; that way he wouldn’t see her without make up and a dress on. When he came home from work, she would be dressed up for him, all made up for the day. This is why we knew things were off when Grandma’s clothes weren’t quite right, and her makeup was not on correctly; her shoes were not well polished, and her dresses were not dry cleaned. Her outfits no longer were…well, Grandma.  They were just old clothes.

My father knew how important it was to his mother (and to his father) to keep her in her own home as long as possible, so they decided to look for a roommate.  They tried lots of things, all of which were disastrous. Some roommates claimed they had lived with older people before, and some were older people themselves. Some stated they would help Grandma or even drive her, but, for the most part, most of them ended up being more of a burden to my father than it was worth.  Some of them stole things from Grandma, manipulated her, lied to her, lied to my parents, and tried to take advantage of an aging woman with dementia, giving me my first experience with Elder Abuse. Even though I didn’t know what it was, I could feel the contention and the betrayal.

The situation escalated as my grandmother’s dementia increased. She would call my parents at night saying, “David, I want these people out of my house!” She truly believed the people on the TV were in her house, and, although they were welcomed guests for a while, it was time for them to go. This was my first experience dealing with Alternate Realities.

At last my parents had to make the difficult decision, that it was time to move Grandma away from her home. They could not find anyone to care for her in her home – they had tried that, and they would’ve been happy to move her into our home, but it was too small for another person. Her daughters were also unable to take her in their circumstances. No one was prepared for this change.

My dad found a beautiful assisted living facility near our home and asked grandma if she wanted to try living there, to be closer to us.  She was happy to live closer to family, so she gave it a try, but that situation only lasted a month or two – it also was a disaster. The care at the facility was atrocious; she was always left in her room, wasn’t well-groomed or dressed, and was not invited to the activities. She simply became a number to the facility that had sold us on an idea of quality of life for Grandma.  In that month, her memory loss escalated enormously, possibly even more in that month than she had in the previous year. This was my first experience with an Environmental Change in Dementia.

My parents needed to act quickly due to my grandmother’s rapid decrease in health. What was the solution? We knew she responded best around family and friends, and in a home environment, so my parents rented a large home for my grandmother and asked my oldest sister and brother-in-law to move in with her and take care of her. This was the perfect solution that we had been searching for!

My grandmother lived with my sister for about 2 years, and then, as her care became too great, my sister started to fatigue – my first experience with Family Caregiver Burnout.  Her care had escalated to nursing home level, and she was placed into a nursing home, which, once again, was not great care. My parents visited her every day for several hours at a time, making sure that the aides and nurses would attend to her needs.  She was on tube feeding for a year after a choking incident, and she would have remained on tube feeding if it were not for my father.  Every day, he would bring her a milkshake from McDonalds and feed it to her. After a year, she started to eat again.  My first experience with Rehab from Tube Feeding.  She passed away after two years in that facility.

Education and EMTs

When I was in college, I was trying to decide what I wanted to be when I “grew up!” One of my life-long passions was medicine – to become a doctor. I had two challenges: first of all, I was a late bloomer in the student department, but I was getting much better, and second, the sight of blood made me nauseous. Both were damming obstacles in that pursuit. I was working on the first, but I needed to figure out the second. I decided I would go to EMT (Emergency Medical Technician) school to find out if I could overcome the blood fear, and if I really like the medical field.

Some of my first experiences were nauseating, but, as time went on, I not only overcame it but thrived on the adrenaline of helping people in serious need.  When people had a serious problem, I rose to the occasion. My dad used to say, “a hunting trip is not a hunting trip unless someone gets hurt, so Rob can patch them up!”

After EMT training, I went to work as an EMT in the EMS (Emergency Medical System), running 911 calls. I loved it – everything about it! Well, almost everything.  I enjoyed performing the care, but I didn’t like some of the places I had to go and some of the things I had to see.  This brings me to my second “why.”

During my time as an EMT, I visited hundreds of nursing homes, boarding homes, assisted living facilities, adult family homes, independent living facilities, and other dwellings for the elderly.  Keep in mind the time period of about 1990. When visiting these facilities, the atrocities I saw were beyond inhumane, beyond demoralizing, beyond livable, beyond poor care — it was downright medical mal-practice! My partner and I would receive a 911 call to a board and care home (today’s definition of an adult family home), walk into the home, which was poorly lit and filthy with residents grabbing and screaming. We would struggle to find someone who works there, so we would have to look from room to room for the person we were trying to help. At last, we would find an unconscious, elderly woman, incontinent, uncared for, and lying on the floor, between the bed and the night stand. If we had not been there, she surely would have perished. This was not the only incident like this – there were hundreds exactly like them.

Making a difference

I mentioned earlier that I was trying to figure out what I wanted to be when I “grew up!” Well, not only did I have a desire to be a doctor, but I also liked business. I was an EMT, studying economics and pre-med. Due to an injury, I found myself in the business office of my ambulance company, and I began to thrive on the business side of healthcare. I changed my major to Healthcare Administration, and, near graduation, was offered an opportunity to learn how to be the Administrator of a Nursing Home, or Skilled Nursing Facility through an Administrator in Training Program.  At first, I was extremely hesitant. I had been in all of the nursing homes in my area, and they were atrocious places; why would I want to work in one? After a tour of one of their facilities and some meetings with the company’s CEO, I was convinced that this may be my opportunity to make a change!  Maybe instead of just complaining about bad facilities, I could help to raise the standards in the industry; I could make a difference!

From about 1994 to 2008 I worked in Skilled Nursing Facilities as a Nursing Home Administrator, mostly in California, and a few years in Oregon. My primary goal was to take facilities that had poor reputations and quality measures and improve them. During that time, I also had facilities that included Assisted Living, CCRC, Home Care, and the building of Memory Care.

The world of Long Term Care has changed since that time.  There are thousands of people to thank for there hard work and dedication to the cause.

The big WHY

During my time as an Administrator of facilities, there was something missing. One was the ability to provide the care individuals truly needed and wanted at any given time. Facility care is good for many reasons, but it has its limitations.  One such limitation is the staff to resident ratio. This keeps costs down, but it does not allow for quality care. On average in a nursing home, a resident gets 15 minutes of morning care to arise, dress, brush teeth, clean up, and get ready for breakfast – 15 minutes!  And, that’s if there isn’t an emergency down the hallway. Constantly, there are call lights beeping, residents calling, and people needing. It is just too much care for too few people.

Second is the couple syndrome.  What if you have a couple who want to remain together, but one had a greater need than the other? No facility has the ability, even a facility as large and complex as a CCRC, to accommodate for this need.  In a CCRC, the answer is to separate the couple to different parts of the community. I don’t know about you, but even when I have the flu, I don’t want to be separated from my wife. In fact, if I am sick, I especially don’t want to be away from her; I need her comfort!

Third is the communal factor. Most people don’t live well in communal living. College was fun, with the roommates I liked, but the roommates that were finicky – well? You don’t have much choice in who you room with, or live near, or dine with, or play bingo with, etc. in a nursing home or assisted living environment. Certainly, private rooms are available, but at a price.

Fourth is the choice factor.  This was the biggest factor here, and my biggest WHY! It all comes down to choice, the basis of all human need!  Most residents in nursing homes – and you may not believe this – as well as assisted livings and adult family homes did not choose to be there!  The choice was made for one of these reasons: either they thought they had no choice, family members chose for them, or finances chose for them.

Now you know a little bit about me, and why we (my wife included – and she has a story too), started Care To Stay Home! We want to provide seniors with a safe place to be: in their own home, where they want to be. 95% of all seniors have stated that they prefer their own homes over communal living. We believe in giving them choices! Choosing whether to stay home, downsize, or move into residential care, independent living, assisted living, etc. We help them create their own plan of care so that they can remain independent in their own home!

Care To Stay Home provides clients with the one-on-one care that no facility can provide.  Does this come at a price?  Yes, but on average, Home Care is cheaper than nursing home care and assisted living nation wide, over a 3-5-year period of time.  Couples can stay home together, family can stay together, individuals can stay where their memories are, and seniors may continue to earn equity in their homes.  After 28 years of searching for the panacea of care, I have found it.  This is why we do what we do.