Senior Living Today
Welcome to The Ohio Masonic Communities' podcast Senior Living Today! In this podcast, we will be discussing all aspects of senior living. From debunking myths about senior living to caregiving tips and health and wellness advice for seniors, we are here to answer all of your questions, and what life is like at our communities. We are excited to share our expertise on a variety of senior living topics, with a new podcast every two weeks. We will have a wide variety of guests ranging from experts in the field to those living their best life in one of our communities.
Senior Living Today
Senior Living Basics: Activities of Daily Living and Instrumental Activities of Daily Living
What are Activities of Daily Living (ADLs)? What about Instrumental Activities of Daily Living (IADLs)? What are the warning signs that someone might need assistance with these daily tasks? How does a senior living community decide which care level a resident needs? What if a resident’s needs change and they need different help? What should I do if I notice that my loved one is needing more help with their ADLs and IADLs?
Our experts are answering these questions and more. They’re sharing specifics about different types of daily tasks like bathing. Plus, offering their best tips and tricks for how to recognize changes with a loved one – and how to talk to them about it.
Hi everyone. Welcome back to another episode of Senior Living Today. With me today is Diana Wilson, Director of Nursing for Springfield Masonic Community, and Carrie Wooten, Clinical manager of assisted living for Springfield Masonic Community. Ladies, thank you so much for joining me today. Thanks for inviting us. So since this is your first time on our podcast, Carrie, I think, Diana, we may have had you on a few years ago, but it's been been a while. Would you mind telling our listeners a little bit about yourself and how both of you got into the nursing field? Sure. So I'm I'm Carrie Wooten. I've been at Springfield Masonic Community for just over nine years now. I oversee the assisted living, assistant director nursing here. Started in nursing 25 years ago. Started out as a nursing assistant, and I worked at the hospital as a nursing assistant. Went to nursing school and, started my career in the hospital at Mercy Medical Center. Basically got into nursing. My aunt was a nurse. So I kind of thought that that might be the area that I want to go into. That's why I started out as a nursing assistant and, went to LPN school first, just to really see if that was something that was for sure going to be what I wanted to do for the rest of my life. So, obviously it is. So that's why I'm here. Here you are. Yes! Well I’m Diana Wilson I've been at Springfield Masonic almost nine years. I started out in the dementia Pathways dementia building as a clinical manager. And then grew from there. I guess you could say I've had a history of being a director of nursing. So that's, you know, something that I've always been in tune to. Been in the nursing field for 34 years. Started as a tech at a hospital in London, Ohio, while I was in nursing school. Then evolved to home health hospice. And then to long term care. So long term care has been my love. That's where I, you know, planted my feet. It's it's something that fulfills you every day. You know, different buildings that we've been in. Springfield Masonic has been the most fulfilling place I've been. There's a good team. There's residents that have stories that, you know, every day is something new and there's new people to meet. You know, taking care of people has been in my blood. I thought once upon a time I wanted to be a physical therapist. But then, you know, I guided myself to in a different direction. So, again, here I am. So, you know, we love what we do. It's hard work, but it's satisfying work. Well, we're very grateful that both of you ended up at Springfield Masonic Community with us. So today's topic is going to be about ADLs. So this is a common term used in senior living, specifically in communities that have assisted living or skilled care or are CCRC's, which are continuing care retirement communities. So Diane or Carrie, would one of you mind telling our listeners what ADL stands for and what the definition of that is? So ADLs stands for activities of Daily living, which refers to fundamental skills needed for you to be independent and care for oneself. And let's dive into what some of those activities of daily, daily living are. Let's go ahead and start with bathing. Well, bathing is, you know, an activity that you do. It's, doesn't require a lot of thought. You know, you want to take a shower every day or you want to wash up every day. So it's an activity that is just fundamental to maintain cleanliness and maintain, you know, hygiene. And are there some warning signs that family members might look for if their loved one maybe might need assistance with that activity? That could be something like if they're coming to visit, you know, they're in, you know, mom's independent at home. They might notice that her hair is a little disheveled. Or she doesn't smell always the cleanest. It could be as simple as a UTI. It could be that, you know, she forgot to take a shower when she's usually very diligent about getting her hair done or taking a shower daily. Those are the little things that they'll notice that should get their attention to kind of take a next step in looking into what could be wrong. And I know one of the other activities that I think a lot of us just move through our daily life without thinking about is getting dressed every day. So is that one of the activities that would fall under the activities of daily living? It is, yes. And that's something that, you know, if someone were to move to assisted living, let's say at the senior living community, that that would be an activity that could be helped with. It is and that is something that we could assist with if, the resident is in need of that service. Yes. So some of the other activities that we have on our list are toileting, transferring, continence, feeding. Would you mind touching on a couple of those and what that might look like at a senior living community, if someone were to receive assistance or once again, if maybe there are some warning signs that families should be looking for that their loved one might need assistance with those items. So if somebody is having some difficulty transferring, you'll notice some increased weakness, difficulty standing from one from a seated surface to a standing position, having trouble getting in and out of their car. If they wouldn't already be in a nursing facility or, assisted living facility. They can also, you know, be having more frequent falls or start falling. That can also be a sign they would transfer the mobility that families should be looking for as well. They should look for, like declines in those abilities. So there is also another set of ADLs that I would like to discuss today. And those are sometimes called IADLs or instrumental activities of daily living. And some of these include, trouble with maybe managing your finances, doing your own shopping, prepping and cooking your meals. Maybe needing assistance with transportation, household chores, taking care of your animals. So what are some warning signs for these types of activities that families should be looking for? Let's see. I would think that, you know, something that you’d be looking for is if your mom or dad, you know, typically were doing their own finances, let's say, you know, they're starting to ask you for some help or you start seeing bills maybe sitting around the home, or where they’re living at, not being paid or overdue. You know, if you have, take a look at that checkbook and you notice it’s not being, you know, balanced like it used to be. Those would be signs that you could kind of, that should be alerting you that maybe something's going on. Also cooking and that sort of stuff, housekeeping. Is their house, you know, not as clean as it used to be. Not kept up like it used to be, not as tidy as that you've seen in the past. Cooking. Maybe you're noticing that there's really no dishes in the sink when you're coming over or in the dishwasher or, things are, you know, burnt. Maybe the pans are burnt. Their stove is clean from not cooking. So there's little things that you’re going to want to keep an eye on. And they might lose interest in taking care of their pets. They're not feeding their pet like they should, or even if they're not joining, like, going to church or they're not joining the activities and the hobbies that they used to love. They don't go to the senior center or they don't go to lunch with their their ladies, friends or things like that might be something to indicate that there might be a change of cognition or a change of ability. And which do family members typically notice changes with first? Their ADLs or their IADLs? Do you see that one is normally more common than the other? Usually the IADLs are noticed first, because those are more complex activities that support independent living. When they're in the community and often require more cognitive skills, more thinking and more process and different steps of, of their processes that they have to remember. And those are those are what are noticed first. And I know this might be a difficult conversation maybe if a family member notices that their loved one is struggling with some of these activities, whether it is the IADLs or the ADLs. So do you have any tips for how family members can approach this conversation with their loved ones, or how they should handle the situation if they do notice that their loved one is struggling with some of these activities? I think it's just be proactive. Really, you know, be involved with your loved ones’ lives, you know, you know, if not daily or a couple of days a week, see what's going on in the home, have those conversations. And when you start seeing little changes, I think that's a good time to start having conversations about, you know, what the future might look like, you know, with them slowly, gradually versus just bring it on them, you know, at the last moment of, hey, if we have to move and do some changes here. I think that's going to be better for the person that's considering, you know, being brought to a continuing care retirement community versus just let's go now. So I think just having those starting those conversations early and really being alert and in-tune to what's going on in your your loved one's home is an important kind of a way to, start that conversation. They could also reach out to their family physician or their, you know, their parents’ family physician to see if they have any suggestions or maybe get some physical therapy or home health care in there to, you know, kind of get some additional eyes and some assessments in place to see if there is truly a decline or if it's, you know, physical ailments or an illness that could be resolved easily before they go to the next steps of needing increased assistance at home. And I'm sure that varies for each situation. I'm sure there are some situations where maybe that person can stay in their home a little bit longer with some assistance before they actually need to move to a community. And if they do need to move to a community, how does a senior living community like, Springfield Masonic Community determine what care area would best meet their needs? Are ADLs a factor in determining that? They are, in assisted living. So what we would do in assisted living, we would schedule a time to go visit with the resident in their home. We have a sit-down and just kind of evaluate their cognitive ability. Then we kind of look at functioning functionally where they're at, what type of services that they might need if they come to our campus, and where the best place would be for them, whether it's, you know, in a social model assisted living, the medical model assisted living, or in the health care setting. And let's say that once somebody moves in, they need assistance with a certain set of ADLs, but the longer they stay with us, maybe their needs change. How do you handle that? Can they move from maybe one tier to another or from one care area to another if needed? They can. So in assisted living, we, after they're admitted, every three months, we do another evaluation if we're noticing changes, typically every three months. But if we're noticing changes more frequently, we can do it, you know, as needed. And we can change their tier level, increase their nursing services that they're currently on. When we're noticing those changes, that's the time that we would have conversations, you know, with them and or their medical power of attorney, what we're seeing and the changes that we need to make. You know, certainly if that changes the tier level, that is a conversation that we have as well to keep everyone informed of what's going on. If it's something where they're needing additional assistance that you know, they're no longer appropriate for our assisted living, then, you know, you know, I would talk with Diana and, you know, and we would look at that for transitioning someone over to the health care setting. And that could involve the need for like a secure building, like our Pathways building where they might have, you know, for stages of Alzheimer's disease or middle stages, just depending on where they're, they're at in their cognition level at that time We could bring them to the secure building, or we could also bring them to long term care. Give them a skilled stay if it's only a short term issue or a post hospitalization, then they would get physical therapy evaluation, occupational therapy evaluation, a speech evaluation to evaluate all of their abilities. And I think that's one of the big benefits of choosing a continuing care retirement community when looking for senior living is that you do have that peace of mind if your needs change or if you need a higher level of care, you have the ability to move to that within the community, rather than having to find a new community to move to. It could be temporary, you know, a temporary stay at assisted living or the SNF, the skilled nursing facility, or at the...It's also an opportunity for a long term solution for some. So as we close out today, do you have any suggestions for our listeners who might have a family member who's starting to struggle with their ADLs? Or maybe they have recently moved their family member into an assisted living community. And, you know, they're just struggling with that transition process. Do you have any advice for those family members? They should remember it's a team effort. You know, the the, staff here at Springfield Masonic are involved in assessing their, their loved one every day. But they're also part of that equation if they see something wrong. You know, there could be status quo and then show decline in cognition or, or ability to transfer, not eating as well, because they spend the most time with them, although were with them too. They knew their loved one best. And, you know, they can, you know, share that with the team since it is a team effort and an interdisciplinary team approach to be part of finding solutions if there are some, or what should be the next steps for them. So, you know, we can give them that direction if it comes to that. Well, it was such a pleasure having both of you with us today. You really did a great job at breaking down what ADLs are for our listeners and explaining some of the changes that they might need to be on the lookout for with their loved ones. So thank you for sharing that information. Thanks for having us. Thank you For our listeners as always, be sure to like and subscribe to the Senior Living Today podcast so that you never miss a new episode. And we will be back again in two weeks.
