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Moving a parent to long term care


Spryte
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Any tips?

My mom has been in rehab since late last week, but yesterday they moved her into a LTC room, and will begin helping me apply for Medicaid for her to cover the cost.

She is not expected to recover well enough to come home, and will be totally dependent on 24/7 care. I’ve taken a few days to process the grief, and now need to start planning even while processing.

I need to take her more clothes, first and foremost. And they need to be labeled - - I am baffled as to how to do that legibly. A sharpie didn’t work. Anyone order labels, like when a kid goes to camp?

But, really, how do I help her settle in? What does she need to be comfortable? How can I help her process her own grief, when we get there? When do we tell her she may not get to come home? 

My ILs are in the same facility, and you’d think I’d already know what she needs… but they had a transition period that my mom is not getting. Also, she’s more anxiety prone, and a self-proclaimed “control freak” so this transition is really difficult.

How to ease the transition, keep her comfortable, and make her feel at home?

 

 

(More posts to come, with more questions on the topic, I’m sure… bear with me here!)

 

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4 minutes ago, Laura Corin said:

Yes, I  ordered labels for my mum.

Familiar things around - is there any form of art that she can continue? Music, familiar scents?

Art is my first thought, too. I hope that she will be able to work on parts of her art again, once her broken shoulder heals. In the meantime, she’s limited.

Music is a good idea. How best to make that happen when she has a roommate? (She is not tech savvy enough to manage an iPhone for music, but maybe we can find an old CD player and headphones.)

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5 minutes ago, elegantlion said:

Besides comforts of home, I would include a decent clock. SO bought his mom one that is digital and tells the day of the week as well. It has a large display so it's easy to read the AM/PM portion too. 

Oh, good idea. I will take her clock to her. It’s the type you’re describing.

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Maybe one of those electronic photo frames that rotates pictures that you have uploaded?

A couple of books that are important to her.  Maybe a religious one and a favorite novel or two.

Notepaper, a pen, and stamped envelopes, along with a copy of her address book, or a print out of key names and addresses.

Nonperishable snacks.  

A nonbreakable vase.

 

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2 minutes ago, Carol in Cal. said:

Maybe one of those electronic photo frames that rotates pictures that you have uploaded?

A couple of books that are important to her.  Maybe a religious one and a favorite novel or two.

Notepaper, a pen, and stamped envelopes, along with a copy of her address book, or a print out of key names and addresses.

Nonperishable snacks.  

A nonbreakable vase.

 

Oh, excellent ideas. Thank you.

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Will the LTC allow you to bring( and will they launder) her own towels, pillows, and bedding? My parents hated the facility's towels and sheets.

 Will she be in physical therapy? They usually ask that the patient be in sweatpants or athletic type pants and t-shirts. My parent needed very little variety in clothes, unfortunately, and ended up in gowns and robes. Comfortable grippy socks or loafers, and sneakers during therapy.

We placed them in a nice facility, but still there were patients wandering in and out of rooms and taking whatever they wanted. Of course we were not upset with them, but it was frustrating. And sadly, be careful if she has jewelry, because health care workers are not always beyond having sticky fingers.

Edited by Idalou
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Random thoughts:

Photographs of loved ones and good times. 

Bring a few photographs of your mom for the staff to see her as she was before her decline. It helps them remember the person inside.

We had better luck with a fine-tip Sharpie.

My aunt and my grandma and my uncle all had wondrous, delight-filled responses to having the cookies they had grown up with--kolacky made with my great-grandmother's recipe. As they bit into the cookie, their faces all lit up. All three said the word, "kolacky," even long into non-verbal dementia. Consider bringing something like that when you visit her--snacks or a scent or some such.

Soft shoes with rubber soles. Consider even a slipper that has a good, stiff sole for everyday wear. 

A familiar lap blanket and cardigan sweaters or light fleece jackets that are easy to get on and off.

My aunt used to love it when I would leave her a note after our visit. She had a notebook for our notes. At the end of our visit, I'd dash off a quick note reminding her that I had visited and what we talked about. I left it open on her pillow to find later in the day. She absolutely loved reading and re-reading our notes. 

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1 minute ago, Idalou said:

Will the LTC allow you to bring( and will they launder) her own towels, pillows, and bedding? My parents hated the facility's towels and sheets.

 Will she be in physical therapy? They usually ask that the patient be in sweatpants or athletic type pants and t-shirts. My parent needed very little variety in clothes, unfortunately, and ended up in gowns and robes. Comfortable grippy socks or loafers, and sneakers during therapy.

I will ask about bedding and linens. Also about the clothing needs.

She is in a sling, and must keep one arm immobile, plus her pelvis is broken in three places. I feel like her clothing needs are fairly limited for now, while she heals. But it would be nice to get her into a better gown.

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2 minutes ago, Laura Corin said:

I would also pamper the staff. I make up a Christmas hamper every year for them.

Yes. Often there will be somone at the front desk that monitors visitors and answers calls from family members. That is the person to remain polite and interested in, as they will be the one to give your requests to the caregivers.

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2 minutes ago, Harriet Vane said:

Random thoughts:

Photographs of loved ones and good times. 

Bring a few photographs of your mom for the staff to see her as she was before her decline. It helps them remember the person inside.

We had better luck with a fine-tip Sharpie.

My aunt and my grandma and my uncle all had wondrous, delight-filled responses to having the cookies they had grown up with--kolacky made with my great-grandmother's recipe. As they bit into the cookie, their faces all lit up. All three said the word, "kolacky," even long into non-verbal dementia. Consider bringing something like that when you visit her--snacks or a scent or some such.

Soft shoes with rubber soles. Consider even a slipper that has a good, stiff sole for everyday wear. 

A familiar lap blanket and cardigan sweaters or light fleece jackets that are easy to get on and off.

My aunt used to love it when I would leave her a note after our visit. She had a notebook for our notes. At the end of our visit, I'd dash off a quick note reminding her that I had visited and what we talked about. I left it open on her pillow to find later in the day. She absolutely loved reading and re-reading our notes. 

Thank you, wonderful ideas.

I will find some photos today, and get them ready in frames … our family, but also maybe some of my mom in her travels, she traveled all over the world, and often when she mentions it to nurses when I’m around … they look at me for confirmation, like, “is she for real?” Maybe a photo of my mom in a jungle or wherever will make it more real. 

I love the notebook for notes about visits. Starting that today.

 

 

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4 minutes ago, Idalou said:

Will the LTC allow you to bring( and will they launder) her own towels, pillows, and bedding? My parents hated the facility's towels and sheets.

 Will she be in physical therapy? They usually ask that the patient be in sweatpants or athletic type pants and t-shirts. My parent needed very little variety in clothes, unfortunately, and ended up in gowns and robes. Comfortable grippy socks or loafers, and sneakers during therapy.

Be careful not to bring anything too special.  When my dad was in a similar place, my mom took him a quilt his mother had made.  It went missing.  They found it, but my mom had to go and talk to the people there before they would look for it.  
 

You can make a small photo book to give her with pictures of family that she can look at and show her caregivers.  Get a simple one printed at somewhere like Walgreens.  If it goes missing or gets damaged, you will have it saved on your account and can reprint easily.  The one I did for my fil was less than $10.

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Regarding pampering the staff -- Put a candy bowl in her room and keep it filled with individually wrapped chocolate and hard candy. Tell the staff to help themselves. Give them a reason to pop in and out of her room. That means more checking on her, more social interaction.

A notebook (or large calendar) for recording visits is a good idea. Not only will it help her remember, but it also clues you in on other family members or friends who have visited.

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2 minutes ago, Harriet Vane said:

DEFINITELY. Always a kind word and a smile. Slip them notes and gift cards and such. Do so discreetly. 

My mom has asked that I bring some of her small art pieces to give to the staff. I’m making up little gift bags for her room, so she can pass them out.

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22 minutes ago, Spryte said:

But it would be nice to get her into a better gown.

Unfortunately, what she has may not be suitable. This is a stage where people change to easy on/off clothing and clothing that fastens say all at the back. You can google for catalogs. https://www.buckandbuck.com/flannel-open-back-nightgown.html  Something like this. Amazon has adaptive clothing also.

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My mom wanted a better cell phone when she moved.  She kept that and a magnifying glass with her.

If she’s going to be immobile and in a bed/chair a lot, maybe a large iPad, some magazines, favorite DVDs or shows to watch..

some familiar food so she doesn’t always have to wait for a tray if she wants to eat.

my mom wanted lots of pink and feminine colors.  Bedding, paint, towels.  She never had that before.  So maybe if there’s some decor your mom always wanted… I certainly never knew and it surprised me.  But she enjoyed it.

Is your mom chatty? I loved the idea of the jungle ohoto, so to extend on that, a little ‘get to know me’ type thing for the staff to know her beyond an elderly bedridden woman. Family information, her jobs, travels, hobbies…. It gives a conversation starter for her and the staff, and helps them see her in a different light.

Eta- maybe one of those grabber things so she can pick things up if she drops them

Edited by matrips
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Amazon has great iron on labels for about $8/100. They ship in from Spain, so they take a few weeks to arrive, but they are well worth it. Include first and last name, and attach them to every single piece of clothing. There are shoe stickers (different seller) you can put inside of shoes (and she may well still wear them as wheelchair footpads are hard on feet).

We have done two different setups. One was live-in home style memory care facility. We put my grandparents in the same one, and they shared a bedroom. We brought furniture from home and made it look like their home. Unusual setup for sure, but it worked. We brought a bed, two arm chairs, a small end table (enough to place drinks between the chairs) and a dresser.

The other setup has been standard nursing home, all furniture and bedding provided. Honestly; if you are dealing with serious incontinence the laundry setup is going to be better if they provide sheets bedding and pads, and you provide something like a comfort throw quilt or snuggle blanket. Ask specifically what is allowed to be brought, and what is recommended. Bring nothing precious. There will be significant churn in staff and things will disappear.

Yes to gift bags, especially to managers (day and night shift). Yes to candy bowl. Yes to set you can place on walls—photos of family, photos of a significant and meaningful trip, photo of her working. Yes to her lotion and chapstick and other comfort items—but don’t bring them in unopened if you can help it. Give no incentive to steal the nice new bath and body stuff, iykwim.

Some people bring in their own tv or Alexa or kindle: this is all on her ability to track things. If she has memory issues already, I would lean towards no. 

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Forgot to add: if she still has memories of her incident, you may want to give a heads up and work on trauma reduction for showering and bath time. Calm lighting and sounds, a candle or scented product or whatever can really help. Going through another significant shift like this can take her up to 12 weeks to settle in on and if she is feeling insecure it will be harder on her. Changing and bathing were big triggers for a relative.

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5 minutes ago, prairiewindmomma said:

Forgot to add: if she still has memories of her incident, you may want to give a heads up and work on trauma reduction for showering and bath time. Calm lighting and sounds, a candle or scented product or whatever can really help. Going through another significant shift like this can take her up to 12 weeks to settle in on and if she is feeling insecure it will be harder on her. Changing and bathing were big triggers for a relative.

Yes, she’s very fearful of another fall. 
 

Also, will ask here … some of you probably remember that my mom moved in with me after being assaulted in her senior apartment … she does not always remember it, but occasionally brings it up. We have been advised by her detective *not* to share the info widely, as it makes her a target. But my mom will occasionally share what happened with a caregiver. It’s a horrific story, and I’m not sure what triggers her to remember or share it, except that it seems to come up when she’s feeling stressed. Should I warn someone at the facility about this? I don’t want them to think it’s recent, or that she’s making it up. I just try to reassure her that she is safe when it comes up, and hope they will do the same.

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14 minutes ago, Spryte said:

Yes, she’s very fearful of another fall. 
 

Also, will ask here … some of you probably remember that my mom moved in with me after being assaulted in her senior apartment … she does not always remember it, but occasionally brings it up. We have been advised by her detective *not* to share the info widely, as it makes her a target. But my mom will occasionally share what happened with a caregiver. It’s a horrific story, and I’m not sure what triggers her to remember or share it, except that it seems to come up when she’s feeling stressed. Should I warn someone at the facility about this? I don’t want them to think it’s recent, or that she’s making it up. I just try to reassure her that she is safe when it comes up, and hope they will do the same.

I think so.  A supervisor should know but should also hear what the detective said .

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I don’t think I would bother telling her that she might never get to come home. If she has memory issues, it may just be more traumatizing to keep going over it.  If she asks, I would focus on what she needs to be able to come home if that possibility is still open. At least that is what we did with my MIL, even though we knew she was never going to meet the milestones to go back to living on her own.

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Regarding the digital frames: if the care facility is set up with WiFi, get a frame that allows you to send photos via email/text.  That way, you can easily send her a photo each day--and make it a priority to do so!--which will let her know that she is in your thoughts and not forgotten.  

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2 hours ago, Spryte said:

Thank you, wonderful ideas.

I will find some photos today, and get them ready in frames … our family, but also maybe some of my mom in her travels, she traveled all over the world, and often when she mentions it to nurses when I’m around … they look at me for confirmation, like, “is she for real?” Maybe a photo of my mom in a jungle or wherever will make it more real. 

I love the notebook for notes about visits. Starting that today.

 

 

Also photo albums of family members and fun memories. Maybe you can rotate them in and out? I think that would be neat for any OT people who come in to talk with her about her memories. And it would help mom think of better times.

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2 hours ago, Spryte said:

Yes, she’s very fearful of another fall. 
 

Also, will ask here … some of you probably remember that my mom moved in with me after being assaulted in her senior apartment … she does not always remember it, but occasionally brings it up. We have been advised by her detective *not* to share the info widely, as it makes her a target. But my mom will occasionally share what happened with a caregiver. It’s a horrific story, and I’m not sure what triggers her to remember or share it, except that it seems to come up when she’s feeling stressed. Should I warn someone at the facility about this? I don’t want them to think it’s recent, or that she’s making it up. I just try to reassure her that she is safe when it comes up, and hope they will do the same.

Sadly, this is a common enough issue.  If she moves into diapers and needs intimate caregiving it's also really common for dementia victims to have emotional outbursts as it will bring back memories of prior abuse even if they don't have the specifics in their reachable memory. I would share with a female supervisor, and also share the detective's warning.  She's already a target just by her demographics, cognitive functioning, and placement.   As part of that you might ask if you can hang a wifi camera. Odds are they will say no, but I will also share that they sell incognito versions of cameras that are bundled inside of alarm clocks, phone chargers, and bluetooth speakers. If she is in a private room....

I will also give you the heads up that consensual activity between residents is also something we had to deal with, even if there was little memory of what occurred.  All of those inhibitions start to go down and all of those human needs are still present. 

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Frustratingly, I just got a call from the facility that one employee who was working on the floor with my mom in the last week has tested positive for Covid today. They are suspending all visitation for two weeks. I can drop off care packages though, and they will help her unpack them.

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17 minutes ago, Spryte said:

Frustratingly, I just got a call from the facility that one employee who was working on the floor with my mom in the last week has tested positive for Covid today. They are suspending all visitation for two weeks. I can drop off care packages though, and they will help her unpack them.

Oh, I'm so sorry!  That just makes it all even harder for you and her.  Hope your mom stays healthy. 

I'm hearing way too many stories of patients in facilities getting Covid from unvaccinated workers (my great aunt is very sick right now, in fact).  A friend of mine (fully vaccinated) got very sick with Covid after visiting her MIL in LTC who was asymptomatic from getting Covid from an unvaccinated worker also.  

 

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For my mother, we took a lot of things from home so that her new "home" felt like home.  She was an artist and had painted lots of pictures, so we hung them around her room.  At the facility my mother is in, they provide labels for all clothing themselves.  We just picked out clothes that were easy for them to put on her (she was unable to dress herself), like stretchy sweaters and sweatshirts, elastic waist pants, slippers.  And within a week, they were all labeled with her name.  I wonder if the facility your mother is in does that?

 

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I just bought these to label my kids' (rather spendy) Lands' End uniform jackets for school.  I haven't washed yet, so I can't comment on that, but they get overall good reviews on Amazon.  I found them in stock, surprisingly, at my rather rural local Walmart (in the office section, with the other Avery labels). 

 

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10 minutes ago, Scarlett said:

How does sharing what happened to her make her a target? I don’t get that.  
 

I am so sorry for all of this. You have been since a good daughter for the very beginning.

That’s a good question, I’m not really sure of the answer, only that the very good (female) detective was firm about it. Maybe because it’s happened to her before, someone might feel they can get away with it? 
 

I tend to be pretty open with most people about what happened because I think it’s something that is not uncommon, and that we need to watch for in our elderly moms and aunts. But I don’t tell people who have access to my mom, usually, because of the detective’s warning.

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I was often in the hospital for months at a time as a child and bedding was the biggest thing, especially the pillow. Everything they have beddingwise sucks and it itches and wakes you up it's awful. Good bedding and a good pillow, preferably her pillow from home.

Getting flowers means a change of view and scent. Flowers like once a month is a godsend.

If you do a digital photo thing do one with an app so you can upload new photos on a whim. This makes it a surprise instead of a routine or chore.

Call her while you raid her bathroom and ask about each product. Everything she wants can be dumped in a bucket and you can make a list when you're off the phone.

For clothes I'd do initials with a Sharpie.

I would ask the staff what you can do. They have ideas and experience that we don't.

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18 hours ago, Spryte said:

Yes, she’s very fearful of another fall. 
 

Also, will ask here … some of you probably remember that my mom moved in with me after being assaulted in her senior apartment … she does not always remember it, but occasionally brings it up. We have been advised by her detective *not* to share the info widely, as it makes her a target. But my mom will occasionally share what happened with a caregiver. It’s a horrific story, and I’m not sure what triggers her to remember or share it, except that it seems to come up when she’s feeling stressed. Should I warn someone at the facility about this? I don’t want them to think it’s recent, or that she’s making it up. I just try to reassure her that she is safe when it comes up, and hope they will do the same.

I think alerting a supervisor and select staff that will be working with her at the care facility is not going to make your mother a target(as making it known while she was living it in the community would).  But they will need to know for when it surfaces; especially as this is stressful right now.  Let them know she just needs reassurance. 

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I haven't read the replies so I apologize if this is a repeat.  I made a family photo poster through Shutterfly of each family member and hung it on my mom's bulletin board.  A reminder she was loved by her family.  She has a vase with artificial flowers that is changed with the seasons.  All real flowers are purchased through two specific local florists as some species of common flowers are not allowed on the floor and the local florists know the rules. 

My mom's facility provides labeling for her clothing.  She also has her own bedspread and has artwork she loves on the walls.  The room is very small so there isn't room for much.  Grandchildren's artwork is taped to the closet door and cheery cards are hung on her bulletin board.  She does have non-perishable snacks in a closet. 

Expect limited visitation due to Covid and the grief that comes with that.  There are long periods of time when visits can't happen.  See if the LTF has the ability to set up facetime, Skype, Zoom for your loved one.  It's a huge blessing!

Puzzles, books, journals, etc are options.  All electronic devices had to be set up and checked out by the staff before they were placed in her room. 

Thank you gifts to the staff are a kind gesture.  They are often very overworked and under appreciated. 

 

 

 

 

 

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9 hours ago, Slache said:

Regarding assault.

Admitting someone was assaulted and they couldn't defend themselves or name the perp is the problem. This labels the person as easy victim.

Yes, something like that was the intent of the detective, IIRC.

 

55 minutes ago, Mrs Tiggywinkle said:

I think alerting a supervisor and select staff that will be working with her at the care facility is not going to make your mother a target(as making it known while she was living it in the community would).  But they will need to know for when it surfaces; especially as this is stressful right now.  Let them know she just needs reassurance. 

This makes sense. I will talk to her social worker at the facility, and start there. They will know who to tell. I don’t want to make it generally known to everyone, I would worry that she’s vulnerable to something happening again. So many people in and out of her room. But I think it could easily come up again, especially with the stress of moving and recent trauma (the fall).

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Oh, one other thing.

I know many have mentioned digital photo frames. This might be in addition to a rotation of photo albums, And here's why.

When my mil passed last year, we all found it much more soothing to flip through photo books and albums versus swiping a phone or looking at a screen of shuffling photos. I truly think that something tactile in our brains is soothed by having something like that to hold and touch versus just staring at a screen where the photos are there and then gone in a moment. We were able to spend as long as we wanted looking at each photo and commenting on them. 

So just something to consider.

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23 minutes ago, fairfarmhand said:

Oh, one other thing.

I know many have mentioned digital photo frames. This might be in addition to a rotation of photo albums, And here's why.

When my mil passed last year, we all found it much more soothing to flip through photo books and albums versus swiping a phone or looking at a screen of shuffling photos. I truly think that something tactile in our brains is soothed by having something like that to hold and touch versus just staring at a screen where the photos are there and then gone in a moment. We were able to spend as long as we wanted looking at each photo and commenting on them. 

So just something to consider.

Thank you. I agree. I think, over time, I’d like to do both for my mom.

MIL has two albums made by her sister, all photos labeled in large print. They are tactile, and even the OT and CNAs will take time to flip through them with her, if we are not there.

She and FIL have a digital frame as well, and it is also nice, but sort of a different beast, just a different experience.

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I don't know if this will work for your mom, but my db added an Echo Show to Dad's room.
It allows us to "skype" with him any time.


It's hands free, his Dad doesn't have to touch it at all to turn it on, or anything.
It uses wifi.
It also can display photos (or time, weather, etc) when not in use.

It helps to touch base with them, if you can't come for a visit, or just to see how they're doing.
The extended family can get access too.

My dh calls Dad first, to make sure it's a good time to chat "on the screen".

Edited by Beth S
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The challenge with tech is whether the facility has consistent wifi for residents. The first place my dad lived said they provided wifi but it was inconsistent at his location at the far end of the building. His new facility does not guarantee wifi for residents and only has a guest log in that logs out recurrently. We could use phone as a wifi hotspot I guess, just haven't set it up yet. Definitely something to check.

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1 hour ago, Beth S said:

I don't know if this will work for your mom, but my db added an Echo Show to Dad's room.
It allows us to "skype" with him any time.


It's hands free, his Dad doesn't have to touch it at all to turn it on, or anything.
It uses wifi.
It also can display photos (or time, weather, etc) when not in use.

It helps to touch base with them, if you can't come for a visit, or just to see how they're doing.
The extended family can get access too.

My dh calls Dad first, to make sure it's a good time to chat "on the screen".

Thank you. Yes! We do have this covered, and it’s already in her room. We have one for my ILs, too. I can’t speak highly enough about the usefulness of this device in an elder’s room. My MIL has forgotten how to use the phone, so it’s out only way to call.

What I need to learn is how to send photos to it. Perhaps we could use it as the digital frame, too.

Fortunately the facility has good WiFi.

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