Episode Transcript
Alena Goergen:
What people maybe don’t realize is they push and push, but most of the time your loved ones, they don’t want you to burn out the candle at both ends. They don’t want to become a burden. You know, that’s a term we hear a lot is we didn’t want to be a burden so we said it was time to come here, and so I think you don’t ever want them to feel like they were a burden, but you want to make sure they’re getting the best care and they’re as safe as possible. And someday, for most people, that means requiring some skilled care.
Courtney Collen (announcer):
This is the “Health and Wellness” podcast brought to you by Sanford Health. The conversation today is about navigating aging services and how to shop for senior care with tips from the inside. Our guest is Alena Goergen, director of nursing at Good Samaritan Society – Miller Pointe in Mandan, North Dakota. Our host is Matt Holsen with Sanford Health News.
Matt Holsen (host):
Thanks for being with us here today, Alena. We appreciate it.
Alena Goergen (guest):
Of course. Thank you for having me.
Matt Holsen:
Yeah, you bet. First off, tell us a little bit about your grandparents and when did you know it was time for a change?
Alena Goergen:
Yeah, for us, I think every family’s probably a little bit different. But for us, you notice changes in them. Things that they leave out on the counter because they don’t want to forget. Maybe a day missed in their MediPlanner here, or maybe some changes with their activities of daily living.
You just notice those subtle changes, maybe falls. You know, for my grandparents, my grandpa was falling, and my grandma wasn’t taking her medicine routinely, so (laugh), we felt like it was time they got a little bit more assistance.
Matt Holsen:
Yeah. What’s the difference – for people who don’t know – between assisted living and nursing home care? How do you know what level of care you need?
Alena Goergen:
You know, that can be difficult. Both assisted living and nursing home staff can absolutely guide you through that layer of questions.
Assisted living typically has some requirements. Your loved one needs to be able to ambulate independently, so walk with a walker or a cane and do that alone. They typically have to be able to use the restroom themselves.
And skilled nursing is a little bit different. We provide a little bit more of that comprehensive care. So, if they need help ambulating from their bed to their chair or getting from their bedroom to the dining room, need help using the restroom, need help bathing, those are the things in skilled care that we can provide for them.
Matt Holsen:
When it came to your family and your grandparents, was home care an option?
Alena Goergen:
We did some services with home care, and then I think, you know, my grandma’s got some dementia, and her disease progressed to the point where the pop-ins from home care wasn’t enough. She needed more 24-hour supervision, and that supervision we needed to have provided by a skilled nursing facility.
Matt Holsen:
A lot of the talk, usually when you’re making these decisions, is the financial component. How did you navigate that from long-term care insurance to Medicare managed care and maybe Medicaid?
Alena Goergen:
Absolutely can be very complicated. I would encourage people to go and visit with social services at their prospective facilities. They’re very, very knowledgeable, very useful.
For my family, it was a little bit easier. My grandparents were North Dakota Medicaid prior to going to the nursing home, so that was a very smooth transition. There is a little paperwork involved, but like I said, social services was instrumental in assisting us with getting that stuff completed and making sure we had all the i’s dotted and the t’s crossed.
So, as far as nursing home insurance, and Medicare, that’s very complicating. But the nursing home, between the business office and social services, can answer a lot of questions about who pays for what and when they pay and what kind of liability a family would have. So, I would encourage anybody to go visit with them and get those questions answered.
Matt Holsen:
Yeah, how did you feel when you were navigating this? A professional who works in long-term care, and you’re saying it’s complicated?
Alena Goergen:
Probably, that was my biggest hiccup was that I, as the director of nursing, I focus on the clinical care of the residents. I don’t focus on how they’re going to pay to live here. So, it was definitely my biggest learning curve in making sure that they could come and that they could stay and that we were going to get the bills paid and get them what they needed.
So, yeah, I absolutely had to lean on social services quite a bit to help me through that. But we got there.
Matt Holsen:
You have some great teammates, I bet. Before moving to Miller Pointe, had your grandparents received other senior services?
Alena Goergen:
They had, yes. And the community’s got some great home and community based services, they’re called. So, we did have laundry service coming in, we had an aide coming in that would help with bathing. I primarily did the medication pack refills, but we did have them come in and do some cleaning, some cooking.
So, some of those services are available, and they definitely helped my grandparents be able to stay in their home longer. And that’s usually the goal is to stay at home as long as they can until that becomes not a reality.
"I would encourage people to go and visit with social services at their prospective facilities. They're very, very knowledgeable, very useful." Alena Goergen, Good Samaritan Society - Miller Point
Matt Holsen:
How long have you been a nurse, and how long have you been working at Miller Pointe?
Alena Goergen:
Yikes. I have been a nurse 19 years. I’ve been at Miller Pointe 15, actually.
Matt Holsen:
Did you look at anything through a different lens when you were thinking about the center being your grandparents’ home?
Alena Goergen:
Yes and no. I mean, there’s always going to be, you know, that transition from home to a facility comes with a little bit of guilt, I guess I would say. You know, everybody feels a little bit of that when you need the help and you can no longer do the care yourself.
But for us, I think, I run a facility so that I want to bring my grandparents there, and so it was an easy decision to make. I want them to be here. I know that it will come with some challenges, but I know what kind of care they’re going to get, I know what to expect from the staff, and I wouldn’t want them to be anywhere else.
Matt Holsen:
When you mentioned feeling guilt, what do you mean by that?
Alena Goergen:
I think a little bit of caregiver — just the burnout, and you can’t push to the point where you’re now suffering or doing without. And I think you try so hard to meet all of their needs at home so that you can meet their wishes of staying home and staying together, and that becomes too burdensome.
And I think what people maybe don’t realize is they push and push, but most of the time your loved ones, they don’t want you to burn out the candle at both ends. They don’t want to become a burden. You know, that’s a term we hear a lot is, we didn’t want to be a burden, so we said it was time to come here. And so, I think, you don’t ever want them to feel like they were a burden, but you want to make sure they’re getting the best care and they’re as safe as possible. And someday for most people, that means requiring some skilled care.
Matt Holsen:
Let’s talk about the surprises. What has surprised you the most through this experience?
Alena Goergen:
How little I knew about the financial part (laugh), for sure (laugh). And I think how important the family involvement is in making sure that the facility can develop a care plan that is really all-inclusive and kind of adopts all of your loved one’s nuances and their niches.
They meet with the dietitian, and I saw her go into the room and visit with them, and she came out, and a couple breakfasts later, my grandpa was like, “Boy, I sure hate wasting all this milk.” And I said, “Well, just tell them you don’t like milk; you’ve never drank milk before.” And he said, “Well I didn’t tell him that because I didn’t want to seem picky.” So those details, that family involvement, and giving us all that information, you know them better than everybody else.
So, it was surprising to me how much I needed to convey to the staff to make sure that they knew these are their preferences, these are their likes and dislikes. These are kind of their routines and their tendencies, and this is their religious preference and those types of things to make sure that transition is as smooth as possible.
Matt Holsen:
And as a staff member, you welcome that input, I would assume, right?
Alena Goergen:
Absolutely, absolutely.
Matt Holsen:
As a director of nursing and now a family member of Miller Pointe, what questions should a family member ask when looking for a nursing home for their loved one?
Alena Goergen:
I think that’s going to depend on your loved one. You know, for my grandparents, they’re not group activity kind of people. So, I didn’t need to know a lot about the activity calendar, but I did need to know about what offerings we had for religious services, because they are religious. And so, I needed to know that information.
We have some families who come, and their loved ones are card players and they’re craft-doers. They want to make sure that we’re going to offer those services.
So, focus your questions around the things that are going to meet the needs of your loved ones that you’re bringing in. You know, if you have questions about laundry, if Mom was real particular about how laundry got done, let’s ask those questions so we can hammer that out in the beginning.
And food, lots of food preferences. So, let’s talk about those, and focus your questions on the things that are most important to your loved ones so that we can make sure that we’re going to meet their needs from day one.
Matt Holsen:
A little more tailored experience.
Alena Goergen:
Yes.
Matt Holsen:
Who would you suggest folks reach out to ask those questions or to meet before they make these decisions?
Alena Goergen:
I think there’s a handful of people. I do a lot of tours as the director of nursing. I meet with a lot of families and answer those questions. Social services, they have a lot of the answers that people are looking for, so we tailor a lot of those tours to them when they’re available. But really anybody in the clinical staff or in social work can help you answer whatever questions you may have about that transition.
Matt Holsen:
How are your grandparents doing today? How did they adjust to the move?
Alena Goergen:
Great, actually. They’re doing very well. They live in a double room, which that was their goal is to just live together forever. Doing really well. Happy to be together, happy to have the care that they kind of knew they needed, and happy to know that their loved ones can just come and visit and be their family member and not their caregiver. They love that.
Matt Holsen:
Yeah, that’s the ideal situation. What should a family member expect in terms of communication and updates on their loved ones?
Alena Goergen:
Lots of communication, actually. The nursing home facility should be updating you anytime there’s a clinical change with your loved one, anytime there’s a medical change, anytime there’s a treatment change, anytime we have a question on how you want something to be handled. Communication with the nursing staff and the social services staff is really a very ongoing open line of communication.
We also have a lot of families who call just to check in and we welcome it. You call and just say, “Hey, I was thinking about Mom. How was her day today?” We’re happy to tell you. We know that she’s your mom. You know, we get it (laugh); our loved ones live there too (laugh).
Matt Holsen:
Absolutely. And how would you frame that for those family members? Because that interaction improves their quality of life, their well-being, right?
Alena Goergen:
It does.
Matt Holsen:
Like, don’t feel like you’re bothering the staff.
Alena Goergen:
Absolutely not. No. We love to know that they have people out there that care about them. We love to know that you’re engaged and that you want to be involved in their overall care and that you want to provide feedback to us. You know, every opportunity we have to learn something more about the patient is a better situation for them. We learn about them, and they have a better experience.
Matt Holsen:
What does a typical day look like right now for your grandparents?
Alena Goergen:
Well, really, they’re retired. They remind me a lot. So, (laugh), they can do whatever they want, but breakfast, they do. My grandpa’s a minister, so they do Bible studies together. They will attend the music activities that occur after lunch, and then in the evening, most of the time, they have a family visitor, so they’ll do that.
Matt Holsen:
They’re living the life.
Alena Goergen:
You know what, they’re having a great retirement. (Laugh)
Matt Holsen:
That’s great to hear. What role do family members have in the care of their loved ones?
Alena Goergen:
Yeah, it’s instrumental, and I’m learning that more from this role than I ever had in all my years in long-term care is how much my involvement helps the nursing staff provide the best possible care. My grandparents, they currently love the staff that are taking care of them, and it’s because they know things.
You know, at Christmas time we do gifts; the staff buy gifts for all the residents. And my grandpa got malt mix, and he said, “How did they know I like malts?” “Well, I told them you like malts (laugh).” He still talks about getting this malt mix from the staff at Christmas time, and he was so excited. But it was information that they sought out from his family member to provide a more tailored experience for him. You know, for him to feel like they knew him and they care about his well-being on top of just his happiness is huge for them. It’s a trust factor that builds over time, and it’s really invaluable.
Matt Holsen:
I was about to say, those little things do mean a lot and build a lot of trust, that’s for sure. We’re talking about tips from the inside. What are some pro tips for family members who want to support their loved one after they move into a nursing home?
Alena Goergen:
You know, I think there’s lots you can do, and I think it’s a tailored thing towards your specific family member.
Like I said earlier, my grandma’s got dementia, and so we put together a lot of photo books of the olden days, and her siblings, and her cousins, and her home. And being able to bring those and go through them with her, it’s a great experience for her.
My grandfather likes to play on his computer and watch train videos, and he was in the Air Force, so he watches a lot of videos, you know, things about the military. And so, we made sure that he got his computer set up.
And so those little things that, you know, you bring those things to help have a pleasant experience when you visit, and you bring the things in that help them have a pleasant day when you’re not there to visit. I think just overall it’s a warm, home-like environment that they can enjoy, and they can feel like they’re safe and well cared for and not a burden to anyone really.
Matt Holsen:
Is there anything else that we haven’t covered yet that you’d like our audience to know when it comes to tips from the inside?
Alena Goergen:
I think I would say come and visit. I think there’s a lot of misnomers out there about skilled care, and I think getting a feel for the place, taking a tour with one of the employees, looking at the other residents as you walk around and seeing how comfortable they are and them enjoying each other, making friends with other residents, and enjoying activities. I think it really helps people get a better feeling and a little bit better layer of confidence when you’re looking for placement for your loved one.
That is a scary experience. We know that. I know that firsthand, and so I understand, but I think, getting to know these facilities and just giving them a chance, we are never going to turn down an opportunity to take you on a tour and answer your questions. So, to be able to do that and kind of get a feeling as you walk around that this place is actually really warm, and these people look well-groomed, and happy, and well cared for, I think it would really ease a lot of that.
Courtney Collen:
This episode is part of the “Health and Wellness” series by Sanford Health. For additional podcast series by Sanford Health, listen wherever you hear your favorite podcast. And on news.sanfordhealth.org.
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Posted In Bismarck, General, Healthy Living, Rural Health, Senior Services
