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August 12, 2015     Feather River Bulletin
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Bulletin, Record, Progressive, Reporter Wednesday, Aug. 12, 2015 9B ill Linda Satchwell Special to Feather Publishing As reported in the July 20 issue of this paper, Eastern " Plumas HealthCare's skilled nursing facilities have made a healthy comeback from the dismal scene three years ago, when the state attempted to both significantly reduce rates and retroactively collect the difference. The hospital and the community joined in a "David and Goliath" fight against the state and won. The fact that the two nursing facilities -- one in Portola and one in Loyalton--are now doing so well, isa testament to both hospital staff and the community at large. What makes these facilities so vital to this small rural community? One answer is that these facilities serve a small, rural community. No other choices exist within two counties, save a very small facility at Seneca Hospital in Chester at the north end of the county, nearly two hours from Portola. A second reason follows from the first: residents of a small rural community are more likely to have a safety net of friends and family close to home. A third reason is that rural residents may better appreciate the intimate setting that a local skilled nursing facility affords. On the other hand, while we're lucky to have them, living in a skilled nursing facility may not be the future any of us imagines for ourselves. It's also tied, inevitably, to the diff'multy most of us have acknowledging our own and our loved ones' deaths. Many of us don't deal with these issues until the last minute. Yet, these end-of-life choices are some of the most momentous decisions we'll ever face. There is a wealth of current literature for .... end-of-life planning as the tidal wave of baby boomers reaches the age where elder care and end-of-life planning is relevant. Always trendsetters, baby-boomers are typically more educated, and may just be more aware and better planners when it comes to the end. Time will tell. One thing is certain --shutting your eyes tight against the vanishing point on the horizon in no way erases that reality or the requisite need for planning. Whether you're helping your parents, or managing your own affairs, entering this phase of life with your eyes wide open, creating a plan, and letting others know about it, is vital. Many resources stress the fact that ff you plan, even as your abilities shrink, you can have a future that affords you a level of dignity and independence. Local options In our community, ff you or your loved one want to remain here through the end of life, there's a fair chance you'll at least consider the Portola or Loyalton skilled nursing facilities at some point. Here, then, are some thoughts, from the inside, of the people who know these facilities best. A discussion with the directors of nursing at both the Portola and Loyalton facilities reveal some strong parallels and point out some typical pitfalls, stresses, and grief, as Well as reason for hope. Portola SNF Lorraine Noble, director of nursing at the Portola facility, emphasized the guilt that family members are burdened with when they in'st visit, as well as during the several week "transition period" after the family member is brought into the facility. Typically, said Noble, it's daughters bringing in mothers, or husbands bringing in wives, with Alzheimer's disease. "They just can't do it anymore," she said, "so there's huge guilt." There is a very large Alzheimer's population in the area, according to Noble. She shows her staffa video that depicts the progression from home care to skilled nursing care for Alzheimer's patients. "It shows staffwhat these people have gone through -- because they've gone through a lot." The transition is difficult, she said, but after a couple of Tomala King, with resident Hazel Lang, is the new director of nursing at Eastern Plumas Health Care's Loyalton skilled nursing facility. She brings lots of positive energy and ideas to her job, and she loves working with her mostly elderly residents. When she was younger, she wanted to work in the ER because she liked the fast pace. "See you, help you, move on," she said. "1 wasn't tuned in to old people." Now, she feels it's what she's meant to do. "Sometimes as we age, we change. Our perspective changes... ! love that I'm able to make a difference in the care for people here [in Loyalton]." weeks, the staff gets to know off families that have spent residents and what they many years caring for an need. Families are elderly parent or spouse. It encouraged to visit as often lets them be the husband, as possible and to engage in wife, son, or daughter again daffy activities with their and spend quality time with resident family member, their loved one." "I tell them, we don't sleep. One of the difficulties in an Call us if you're up at 1 a.m. isolated, rural area is that it and you're concerned," said lacks the support services Noble. available in urban areas. After the first couple of There are no adult daycare weeks, she holds a care centers or residential care conference, and the centers; when families can no interdisciplinary team longer care for their loved attends, including doctor, ones at home, the Portola and nurses, dietary and social Loyalton SNFs are often the services, only good option. "We go through On the positive side, everything, from pain levels families here participate to low (the new resident) is with residents more than is getting along with their typical in larger cities. roommate. We learn a lot "Quite a few folks come in about family dynamics," daily," said Noble. Also, which, according to Noble, there are a number of can often be important in families who live out of the delivering the best care to the area, but whose parents lived patient, in the Graeagle area. These The facility, she said, is so children have visited here for important to these families, years, and now they're because, "we take the burden coming to see their parents in the SNF. It's a natural, if initially difficult, transition. She said she has about three families a week visit the Portola facility, "lOoking into long-term care to see what they need to do to get their loved one in, and ff it's the right option." There are a lot of returns -- patients who were here previously for rehabilitation after getting out of the hospital, whose health has declined to the point where they need long-term, skilled nursing care. "A lot of the staffhere were babysat by these folks," said Noble. "So, they've come full circle ... we are one big family; we share so much together." Loyalton SNF Tomala King, Loyalton SNF's new director of nursing, echoed many of Noble's thoughts, including the difficulty of the transition for families and residents and the vital role that the SNF staff plays in bringing a sense of family and much needed support services to all members, not just the resident. She also shared some more philosophical observations on elder care and the end of life process, which she witnesses every day. She began with an example: a patient in her early 50s came in with her caregiver. She has a progressive disease, and her doctors have told her and her husband that it's time now for long-term care. "This one is hard," said King, "because of their age... we needed to give them time to come to terms with it." King said she Called and checked in every few days. She also let the woman pick out her room. "We'll help her make it as homelike as possible." King explained that she not only told the husband that he was free to take her out whenever he wished, but that he was encouraged to join them for their coffee mornings -- a new ritual since King arrived at the facility. She said the husband told her he'd walk the dog over in the morning and that the walk would do him good. "We'll try to make him a part of our family here. They just weren't expecting this so soon," said Tomala, adding, "This is a hard job." When asked how she, her staff and patients deal with the future, which necessarily is imbued with the sense of an ending, King said, "I take it day to day." She embellished this philosophy with another story. A patient of hers who had been a schoolteacher is now suffered from dementia. One day when King was lifting her out of bed, in a moment of clarity, the woman looked King in the eye and said, "Can you imagine what tomorrow will be?" "Nothing in school or life really prepares us for these end-of-life realities," King observed. "Your perspective is related to character. How you lived your life, how good you were, the things you accomplished," all add up to how patients feel about their lives near the end, she said. "Patients say things like; 'i've had a good life,' or 'I'm tired; it's my time.' Others who maybe didn't have such a good life tend to struggle. It's taught me to live with no regrets, always do the best I can -- that's how life should be." A sadder scenario, she said, is evident for those patients ,who sit around depressed and just want to go. Their mind's ready, but the body isn't." King puts her beliefs into motion on a daily basis, encouraging residents, learning about their lives so she and her staff can help them live more comfortably. Things that make residents feel better, more like themselves, such as having their hair and nails done, or putting pictures on the walls that remind them of home, are things staff can do to help them feel good. "Because you're here doesn't mean you have to stop living," said King. Finally, King mirrored Noble's emphasis on the vital importance of a caring staff. "Other places might have a big fancy building, but what matters is human experience," said King. "A place like this can be much more intimate and caring. We are like family here." For a limited time only The Plumas Animal Welfare Society is offering worth $60 off the cost of a spay and $30 off the cost of a neuter TWICE their normal valuel! *to eligible Plumas County residents for use at Plumas County vets. Call PAWS at 283-5433 or stop by The Cathouse 2453 E. Main St., Wed. - Fri,: 12:00 - 3:00 and Sat. I0:00 - 2:00 free certificate REMEMBER: THERE Millions of adoptable cats & kittens are put to death each year: AREN'T ENOUGH HOMES FOR THEM ALL GET YOUR CAT FIXED NOW! To send a legal: typesetting@plumasnews.com To send an advertisement: mail@plumasnews.com