The voices of experience

Nursing Homes, Sept, 2006 by Eric Bosell

I promised my mother I would never put her in a nursing home! You don't know what I'm going through!" As long-term care providers, how often have we heard these words? We understand clearly the issues families face when they seek long-term care for their loved ones. They struggle to understand complex medical and behavior problems that they had hoped would never happen. They are bewildered by insurance claims, government paperwork, and the financial implications. They agonize over feelings of guilt and inadequacy. They struggle with the reversal of roles as they, the children, must become the parents. Families in search of long-term care are trying to sort through one of the most complicated issues they have ever faced.

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This is why admissions at Josephine, an assisted living, adult day care, child care, and 160-bed nursing facility in Stanwood, Washington, and affiliated with the Evangelical Lutheran Church in America, is as much a social service office as anything else. Admissions views inquiries as an opportunity to build relationships with the family members involved in the placement decision. Staff also offer to walk potential residents and/or their family members through the Medicaid application process, even if the family may not choose to use Josephine services. Staff will even coordinate with Washington State Department of Social and Health Services (DSHS) caseworkers and financial workers to help ensure that the application is being processed in a timely manner.

"Sometimes it just means sitting and listening," says Admissions Assistant Stephanie Loff. "The family needs to talk things through as they make decisions about their loved one's care. It can be very difficult for them."

The admissions staff remains deeply involved with the resident and his or her family after the admission. Staff continue to track any state assistance applications in process, and will help the family through the steps of establishing a representative payee or guardianship, if appropriate. Admissions staff work closely with family members throughout the orientation process and serve as the clearinghouse for any room changes in the facility throughout the resident's stay.

This approach to admissions is perhaps one of the reasons Josephine, which will celebrate its 100th anniversary in 2008, has a solid reputation for providing high-quality compassionate care. But as caring and compassionate as Josephine staff might be, and as knowledgeable and helpful as they are about long-term care, they are not always the best ones to help families go through this process. The best help can come from those who have gone through the experience themselves.

This realization led Josephine to consider ways to bring those who have weathered the experience into the process. After careful deliberation, a concept was born: Develop a video presentation built around on-camera interviews with family members who have already placed a loved one in a long-term care setting.

In 2005, Josephine produced a 22-minute video entitled Choosing Long Term Care, a presentation consisting entirely of interviews with current and past residents' family members speaking openly and honestly about their own experiences. Moving beyond mere facts and figures and sound-bite testimonials, the interviewees speak directly to the emotional dimensions of the long-term care decision. Through the words (and sometimes tears) of these family members, the video highlights how Josephine's services and programs respond to the fears and concerns family members may have.

Many of those who have viewed the presentation react with gratitude and even relief. After viewing the video, one family member said, "I was reassured to hear others share what it is like when you become your mother's caregiver." Another said, "I appreciate others being willing to share their pain to help me." Admissions staff provide the video at no cost to family members seeking information about Josephine and its services. Staff also give copies of the video to hospital discharge planners so they, too, can share it with people considering long-term care. Although the project was developed with Josephine's services and programs in mind, the thoughts and feelings expressed are genuine and universal, and the video can be helpful to anyone considering long-term care for a loved one.

Josephine recognizes that while the decision for placing a loved one in long-term care has many practical considerations, important emotional needs are at hand. Choosing Long Term Care represents an exciting and innovative step forward in addressing these needs. By speaking directly to the needs of those who are seeking long-term care for a loved one, the video allows us to extend the care we provide for our residents to the family members who also need our help.

Eric Bosell is Communications Director at Josephine. For more information, phone (360) 629-2126, ext. 159, or visit www.josephinenet.com. To send your comments to the author and editors, e-mail bosell0906@nursinghomesmagazine.com.