A Closer Connection in 2019

The relationship between mothers and daughters is complex and filled with nuances. And while some may enjoy a picture-perfect bond of warmth, security, and mutual understanding, most of us have had times when we just wish we knew how to connect without conflict.

Mother-daughter relationships naturally undergo major change when the daughter transitions to adulthood, and the changes can seem even more jarring as Mom ages. Sometimes, there’s a long history of conflict or disagreement that becomes enlarged as Mom needs her daughter’s help and care.

At times, when the roles of nurturing and care giving seem to reverse, both mother and daughter can be left at a loss with how to relate to one another. Here are a few tips on how to reset your relationship with Mom, and get started on building a closer, healthier connection this year:

Realistic expectations

“My mother tries to control my choices and my life.”

“My daughter has no respect for my wishes!”

Many daughters imagine that a mother should be a constant, unending source of support and unconditional love. Many moms tend to view their daughters as extensions of their own hopes and dreams. Remembering that both you and your mom are individuals in your own rights can help in maintaining realistic expectations of what each of you can and cannot do.

Sometimes communicating means having that tough conversation. “Mom, I feel criticized when you disapprove of my choice of career.” “Mom, I know you feel that I haven’t spent enough time with you lately. I’d like to apologize and explain…” Remember to discuss problems calmly and with sensitivity. If you’ve had an argument, try to resolve the issue quickly before it has a chance to fester and grow into a more serious rift.

Be quick to forgive.

When Mom seems to always be criticizing your lifestyle, your choices, or even your taste in clothing, keep in mind she’s doing it with your best interests at heart. A mother cares so deeply for her child that she will go to any lengths to give her the best of everything – even when what she thinks is best for you is eons away from what you actually choose as best for yourself!

Be a good listener.

As Mom ages, it can be difficult for her to come to terms with new limitations or dependencies. She may feel that you’re too busy for her, or that you’re moving on without her. She may be fearful of the future, sad over the past, or depressed that she can no longer care for herself.

Be sensitive to her feelings, and devote time to listening and validating her place in your life.

The only behavior you can change is your own.

As in every relationship, you can’t control what Mom says or doesn’t say to you – you can only control what your own reaction will be. When Mom makes an angry or insensitive comment, you can choose to reciprocate with hurtful words of your own, or you can make the decision to react with compassion and empathy.

Remember that it’s not easy to be a care recipient. Whether you are the direct caregiver or your mom is at a nursing home, she feels vulnerable and maybe even humiliated. This can cause her to react more strongly than she means to, and the ball is in your court to prevent it from escalating.

Balance individuality and closeness.

The basis of every rewarding relationship is healthy boundaries. Don’t be afraid of pulling back a bit if you feel Mom has overstepped hers – and at the same time, remind her that you will always remain her loving and devoted daughter.

Terminal Illness: How to Talk About It

He’s the 90-year-old patriarch of a large family spread across the world. He’s sharp and witty, blood-transfusion dependent, and dying.

She’s been battling cancer for 3 years, her loved ones supporting her all the while. Her doctor just told here there’s nothing more he can do.

As a family they never really talked about the important things, and now death is staring them in the eye. What should they do?

It can be scary and sad when your loved one is given a terminal diagnosis. You may be in denial at first, but it’s important to face reality and talk about the diagnosis. In some cases the patient only has weeks to live, and you don’t want to live with regrets that you didn’t make the most of the time left. While it’s not healthy to ignore or push down your emotions, you may need to shelve them for a short time while you deal with the pressing issues. Here are some important things to talk about after the diagnosis:

1. Prognosis

Whether or not the patient is able to communicate, it’s important for everyone involved to understand the diagnosis. If the patient is still cognizant, they should be included in the discussion. Help them understand what is happening with their illness, and what the next few weeks or months will look like. Encourage them—and their involved loved ones—to ask questions and talk about their concerns.

Knowing how much time the patient has left is also helpful for the family. Loved ones who live far away can make travel plans and come to spend time with Dad while he’s still cognizant. The family can get together to make some memories before Grandma passes.

2. Emotions

Having a terminal illness in the family can make you feel powerless, out of control, or angry. Recognize these feelings in yourself and the other family members. Talking about the illness, the patient, and the future can help your family grow closer and overcome this challenge together. You can start the grieving process when you get the diagnosis, and doing it as a family can provide incredible support.

Some families aren’t used to talking about emotions openly. It can be difficult and scary to open up to others, even your loved ones, when you’re used to putting up a strong front. In such cases it’s even more important to talk about your feelings, so you don’t bury them and leave them to fester.

Another important aspect of emotions is unresolved stories. Don’t hesitate to tell your terminally ill loved one that you forgive them, and ask them for forgiveness in return. Tell them you love them, and thank them for the beautiful memories you’ve shared.

3. Finances

If the patient has any assets, such as a home, car, stock portfolio, or bank accounts, he needs to have a will. If he doesn’t have one yet, now is the time to write one. For more information, check out this old, but still relevant, article about estate planning and wills.

Talk to the patient about their will and where it’s

4. The Patient’s Wishes

Ask the patient what he wants from his loved ones. Does he want company or space? Is he strong enough to handle larger groups of visitors? Perhaps he wants to talk about his life story, and have his family record it.

You also need to talk about the patient’s end-of-life wishes. Does she want to pursue all available therapies, or does she want to continue treatment and go on hospice? Does she have an advanced directive for a time when she may no longer be able to communicate? It’s important to have these conversations early on, before the illness progresses past the point of communication.

Confronting terminal illness is one of the hardest things your family will ever face. Talking about your loved one’s death can be a scary process. But the consequence of not having these conversations when you have the opportunity is even worse. After you get the diagnosis, keep these four things in mind as you approach the following days and weeks. And of course, if you need any help, you can reach out to our excellent social workers at Regency Nursing for support and assistance.

Medicare Advantage Plans Closer to Covering Long-Term Care

The Centers for Medicare & Medicaid Services announced in May that Medicare Advantage plans can expand their coverage of supplemental benefits. Starting in 2019, Medicare Advantage plans will be able to offer coverage of services like respite care, non-hospice palliative care or home safety modifications. Industry experts are saying this can move Medicare Advantage closer to covering long-term residential care one day.

A major downside of Medicare as it’s currently formulated is that it doesn’t cover custodial long-term care. That means if a senior doesn’t need specific skilled nursing care, but can no longer live on their own, they either need to pay for the facility out of pocket, or exhaust all their assets to go on Medicaid. Paying for long-term care is a huge financial burden on many seniors who aren’t eligible for Medicaid. The new rules will allow Medicare Advantage plans to cover in-home support services, like help with activities of daily living. Such coverage may one day lead to coverage of non-skilled nursing facility stays.

How Big is This Change Exactly?

While the changes will probably be modest in the beginning, the paradigm shift is huge. Until now, Medicare Advantage plans mainly covered whatever Original Medicare covered, with some additions like dental or vision coverage. Now, in an attempt to save more in preventable medical expenses in the long run, they will have an expanded definition of “health-related” services. The new guidelines, according to CMS, will “consider an item or service as primarily health related if it is used to diagnose, compensate for physical impairments, acts to ameliorate the functional/psychological impact of injuries or health conditions, or reduces avoidable emergency and health care utilization.”

This opens the door for long-term care services to gain coverage under CMS. In the beginning it may cover home-health services, and then it may eventually expand to cover some nursing home expenses.

Of course, these services will be subject to restrictions and requirements for coverage. Your doctor or other healthcare provider would have to recommend the service, and there will likely be copious paperwork. It’s also likely that the Medicare Advantage plans will decide eligibility for specific services based on the member’s medical needs and history. Either way, the program expansion is great news for Medicare Advantage members, and will probably increase the private plans’ share of the Medicare market.

Here are some services you can expect to see covered next year:

 

Meet Beverly, Director of Nursing at Regency Park

National Nurses Week begins each year on May 6th and ends on May 12th, Florence Nightingale’s birthday. Florence Nightingale was the pioneer of nursing as we know it, and has become the gold standard for nurses everywhere. Every year on her birthday, we celebrate International Nurses Day—a day to fete our amazing and dedicated nurses.

In honor of National Nurses Week, we spoke with Beverly, our beloved Director of Nursing at Regency Park, to get her take on nursing, long term care, and what she loves about being part of the Regency family.

Beverly, can you tell us a little about yourself?

photo of Beverly Sevilleno
Beverly Sevilleno, RN DON

I obtained my  Bachelor’s Degree of Nursing from the Universidad de Sta. Isabel, and became a registered nurse in the Philippines in 1994.  In 2004 I became certified here in the US, and licensed to practice in the states of New Jersey and New York.  I joined the Regency Grande as a night shift nurse in 2005, and was promoted to assistant to the Director of Nursing in 2007.  After two years of being ADON, I  transferred to my current position at Regency Park.

I’m also a devoted wife to my husband of 21 years, and mother to two exceptionally wonderful children ages 18 and 12

What inspired you to become a nurse?

Growing up in the Philippines, I knew I would fulfill my mother’s dream for me to become a nurse,  so I could go abroad and explore greener pastures. But looking back now, I can say that it was always my calling and destiny to be a nurse. Relatives who needed care always came to me, and even back then I found I had the heart and passion for it.

The first job I got when I arrived here was in long-term care. Over the years I’ve come to embrace and love it. Being in  a long-term care setting requires patience and diligence, which best fit my personality. I can now say this has become my passion and calling.

So you’ve been a nurse for nearly 20 years. What’s the biggest change you’ve seen in the field in that time?

Yes, I have been in nursing since year 2000.  The biggest change I observed over the years was how computerization has taken such a vital role in patient care .The transition from pen and paper to electronic medical records is just one example.

Regency is at the cutting edge of healthcare technology, enabling us to provide the best possible care for our residents. What does a typical day look like for you?

Aside from my administrative routines, on a normal day I solve the daily issues and concerns that come up. I also like to be proactive rather than reactive in my approach to nursing concerns. One thing I’ve ensured as DON is that the shift nurses take the time for personal interaction with the residents. Our nurses have a full schedule: dispensing medications, providing treatments, following up with the doctors, and completing paperwork. On top of that, they also make time to build relationships with our residents.

That’s incredible! In your opinion, what’s the most important quality of a good nurse?

The most important quality of a good nurse is service before self. To be available when needed, and to have the ability to give of yourself to provide that care. Nursing at that level is very fulfilling, because you know you’re part of the patient’s healing process.

What’s the best way for residents and their families to show appreciation to their nurses?

Appreciation is earned. As a nurse, the best is always expected from us, in terms of giving care and service. We feel appreciated when our residents and their families are satisfied and happy. Simple, sincere words of appreciation go a long way.

That’s so true, Beverly. What do you like best about being the DON at Regency Park?

Being a DON gives me satisfaction and pride.  I find mentoring others fulfilling. Also, extending and realizing  Regency’s vision and objective of providing excellent care, “Where Care Comes to Life,” actualizes my calling as a nurse.

Thanks for giving us this insight into nursing, Beverly. We appreciate your devotion to the Regency Park family. Happy Nurses Week!

How to Be A Parent to Your Parent

The family is meeting to discuss Mom. She’s fallen twice in the last two months and seems a little disoriented and mildly confused lately. She seems to be losing weight too. She’s definitely not taking care of herself – or her home – as she used to. The discussion becomes heated. Snippets of conversation can be heard: “nursing home, retirement residence, respite, hospice…” You think to yourself, I’ve heard many of these terms but I don’t know what they all mean. I don’t know what care is right for mom. I certainly don’t know where to begin.”

Now picture this:

The phone rings. It’s 10:30 at night. Immediately you begin to worry. It’s Mom. She’s fallen again for the second time this year. You realize that it’s just not safe for her to live on her own anymore. The next fall may result in serious injury. But what are the options? You ask yourself, “What decisions can I make that will benefit my mother and ensure her happiness?”

The scenarios above are replayed every day in a thousand different forms in homes throughout the country.

Children are never prepared to be parents..

The role of bringing new life into the world and the responsibility that comes along with it, can be overwhelming regardless of the books you have read, or the classes you’ve taken. Yet, most of us become parents and learn as we go, growing right along with our children.

Just as we may feel unprepared to parent our own children, we are even less prepared for a second, important parenting role – that of being a parent to our own parents. These are the people who brought us up, taught us about the world, gave us values and influenced our views. In short, these are the people who are largely responsible for who we are. They have always been Mom and Dad. We have always been the child.

Know however that you are not alone. There are options to choose from that will provide your loved one with an environment that will enrich his or her life while allowing them the opportunity to rehabilitate themselves and/or to live in security and comfort.

The following are some choices available for senior care today, with brief descriptions of what they offer:

Chore services: Volunteers buy groceries, vacuum, run errands, etc.

Home visitors: This includes meals-on-wheels, story reading, companionship.

Adult Day Care: Daytime activities suitable for seniors, lunches, therapy, games.

Home Health Care: Nurses, physical therapists, and dieticians provide in-home services.

Rehabilitation programs: These provide extensive physical, occupational and speech therapy in their offices.

Continuing care retirement communities/continuing care centers: Designed to meet the changing needs of residents, some offer services ranging up to skilled care off-site.

Assisted living centers: These offer some assistance with eating, bathing and other activities of daily living.

Nursing facilities: These offer all encompassing care including around-the-clock nursing, rehabilitation and physical therapy on-site. All in a healthy emotional and social setting with immediate access for health care needs.

This wide variety of care choices can seem confusing at first glance. They should be viewed, however, as a continuum of care, designed for the varying needs of seniors. They begin with a minimum of help, such as assistance with chores, or social activities ofered at adult day care centers, and continue on to more encompassing care, such as that offered at nursing facilities.