Caregiving Family’s difficult long-term care journey yields unexpected result

Family’s difficult long-term care journey yields unexpected result

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BIDDEFORD – Renee O’Neil and her family know all about advocating for their parents at long-term care facilities, and the entire, often painful experience, that leads to long-term care.

O’Neil, her brother Richard (“Chico”) Potvin and his wife, Angie, and brother Jay all played pivotal roles as their parents, Richard and Doris Potvin, required their attention simultaneously.

While both parents have passed on, the experience actually has left her a richer person, Renee O’Neil says.

“What we did as a family allowed us to keep our parents home a lot longer than they would have been able to on their own,” O’Neil said. “If we didn’t get along, I don’t know how we could have done what we did.”

The experience also led to O’Neil, 52, taking a position as director of admissions at St. Andre Health Care in Biddeford, which provided her parents with their long-term care.

She took the job in February 2013, after her father was admitted there.

Every day now, she sees people going through the same process that she, her brothers and her sister-in-law went through with Richard and Doris Potvin.

“That’s actually how I got my job at St. Andre. (It) was the work I did for my parents,” O’Neil said. “There’s a lot of moving pieces.”

Nancy Drapeau, chairwoman of the board of directors at St. Andre, is pleased to have O’Neil on the staff.

“She advocated extensively for her parents.” Drapeau said. “That brought her on board. Renee’s an unbelievably dedicated person. Whatever Renee does, she does 200 percent.”

O’Neil’s advice to anyone interested in helping elderly loved ones facing long-term care is to be pro-active.

“One of the biggest things I did early on was establishing power of attorney, both for medical and financial concerns,” she said. “You do it while they are still aware. It doesn’t mean you’re making all the decisions for them while they’re able. You have to be pro-active, and do it before problems start.”

Once a loved one is living at a long-term care facility, the focus shifts to another level. Health issues are being attended to, but it’s still important to stay on top of things, O’Neil said.

“You’re no longer the full-time caregiver,” she said. “But you’re still the one looking out for them, and you can’t help it. Look for information. Many homes have quarterly meetings, and that’s how you get information.”

O’Neil also suggests finding out the best way to communicate with staff, when issues arise. Email, she said, is a good method, and you have a record that way.

Also, it might be difficult for children or anyone else caring for loved ones, but people need to have realistic expectations, she said.

“No one wants to hear that a loved one has fallen,” she said. “There are some things that are just going to happen. What you look for is a staff that is not on the defensive. They may not have the answers right off. You have to be patient because it’s not one-on-one care. It’s not a hospital.”

O’Neil, her brothers and her sister-in law were on board with their parents’ health issues from the get-go, when the Potvins still ran Potvin’s Market at Old Orchard Beach.

Richard Potvin was showing the early signs of dementia by the early 1990s, followed shortly by his wife’s kidney issues, which led to a plethora of health problems. The Potvins sold the store to son Richard, and rented a condominium for 21?2 years in Old Orchard Beach. O’Neil, her husband Jim and their two children were living in Biddeford, where they ran Jim and Renee’s Market on South Street, near Biddeford High School.

The confusing, demanding see-saw was just beginning, The family had a mother who was failing physically and a father who was failing mentally, and couldn’t understand why his wife wasn’t around.

“One was doing OK, and then the other one was not,” O’Neil said. “We started to notice that they were declining, and that they needed another option.”

So the parents moved in with Chico and Angie Potvin.

“We could see the handwriting on the wall,” O’Neil said. “But they enjoyed their son and grandchildren, and Angie was a big help.”

By the late ,90s, Richard Potvin could no longer drive, and Doris had begun dialysis. She was able to drive herself to dialysis for the first two years, joined a support group in the early 2000s, and enjoyed it.

But she began to decline, and experienced heart problems. Richard Potvin, meanwhile, was looking for things to do with his day. Then, she suffered kidney stones, and was in and out of the hospital.

The family needed a plan, and they knew it.

The O’Neils gave up their store, and worked from their home when he became a software developer.

“Fortunately, as things began getting really bad, we were able to work from home,” she said. “That’s when my mother started to do really poorly. If I hadn’t had the flexibility, it would have been extremely difficult for me to hold a job. I had a binder with 17 of my mother’s medications. She developed diabetes and had heart issues. She went back and forth from my brother’s to the hospital.”

Doris Potvin fell, broke her hip and suffered a stroke. Her husband was asking where she was.

“It was at the point where it was extremely stressful and complicated,” O’Neil said.

Rehabilitation was not successful for Doris Potvin, who went to a skilled-care unit. Richard Potvin entered an adult day service and did well there for a while, but eventually the family realized he couldn’t be safe much longer at home.

Then comes a transition that is critical, but can be difficult, O’Neil said. Skilled care is not long-term care.

“When you’re not making progress, you’re not qualified to stay on skilled care,” O’Neil said. “They both did a Goold Assessment (required for anyone seeking nursing level of care) and qualified for long-term care.”

Doris Potvin then lost her eyesight, and went from St. Andre to the hospital. She died in September 2011.

“At this point, my father was needing more help at home, and he’s asking for her,” she said. “He couldn’t really reason. You couldn’t explain things to him.”

Richard Potvin left home and went into an assisted-living arrangement in Saco, which worked well for a time.

“After she died, we didn’t tell our father,” O’Neil said. “It would have been cruel. There would have been no way for him to articulate his feelings to us.”

Richard Potvin then got to the point where assisted living no longer was sufficient. A Purple Heart recipient for his service in the Korean War, he was unable to stay at the Maine Veterans Home in Togus because the VA did not have a federal contract, O’Neil said.

“In a matter of months, or just a few months, we had to move him seven times,” she said. “And that is the worst thing you can do. Once again, St. Andre came to the rescue. They said, ‘Just bring him here, we’ll figure it out.’ ”

He went in as a skilled-care patient, but transferred to long-term care.

“At that point, they had a job opening at St. Andre for admissions director, and I applied and was accepted,” O’Neil said.”

Now, O’Neil is the one trying to help family members, many of them baby boomers like herself, attend to loved ones’ needs. Certainly, she can lend some perspective.

“I’m not you, but I have an idea how you might feel,” she said. “The security that I can offer might help.”

Of course, O’Neil had the benefit of family members who cooperated with one another.

“My heart goes out to family members who don’t get along,” she said. “That can get in the way of the care. We want to see family members come and visit their loved ones. But if they don’t, you have to respect that, as well.”

Larry Grard is a staff writer at Current Publishing.

A CLOSER LOOK

“The Goold Assessment is required for anyone seeking nursing-level of care. The assessment can be done in your home, in the hospital or nursing home by a registered nurse, who uses a laptop to collect the information to complete the assessment. The nurse will ask about the kinds of tasks you can do by yourself, what kinds of medications you take, what kinds of help you need, whether you have friends and family members or neighbors who can help, what your income is, and other questions. You may request that a family member or other person be present at the assessment. To get started, call 800-609-7893.”

Source: Maine.gov

Cover StoryYou have to be pro-active,” says Renee O’Neill, director of admissions at  St. Andre Health Care in Biddeford, where her parents received long-term care.  

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