Sabrina, the admission’s director, will go out to assess Mom. (She is the same one that went out a few weeks ago). As for the deteriorating condition, Buckingham is licensed for 5 levels of care, including wheelchair and bed bound residents. We are in constant communication with the families and the caregivers; and reassess each residents condition monthly to make sure everyone is being cared for with proper care and compassion.

Close monitoring and documentation is crucial. The important thing is to anticipate the behavior before it is out of control. Sun-downers is dealt with through medication administration. Other behavioral issues can be dealt with through behavior modification and involving the resident in activities, diverting her attention, etc. Sun-downers is chemical and it is critical to be sure and have the right medications in place.

Caregivers make rounds approximately every 2 hours, around the clock. They will often check more frequently when needed; we work hard to anticipate each resident’s needs, acclimate to their schedule and the routine that they are accustomed to.

We have male C.N.A.’s only when requested.

Buckingham uses Guardian Pharmacy and has had no trouble with their delivery system and set up. Our Med Techs bar- scans each ‘med pass’ (the computer system alert that is set up for each resident we administer medications to). We have 3 professionals overseeing the medication administration and constantly trouble- shooting for snags.

Beginning of the week is a better time for admission. Doctors are not as readily available over a weekend if there is a medication discrepancy (i.e. a resident may or may not take a medication that the doctor has included and prescribed on the med list).

Staffing is the same on weekends except for the administrative office. Kathy, the manager on Saturdays (she’s been here for over 20 years!) and I (Rita) am here on Sundays.

Yes, Rita recommended this as well. Buckingham can provide private sitters who specialize in this particular type of transition. It is not essential, though.

We do not turn to medicine as a first response. We try to anticipate these exact scenarios and be prepared to support her and care for her.

We have a huge variety of alternatives because food is a pleasure that we firmly believe add to the quality of life. We work hard to customize to each person’s tastes.

We use love to encourage folks to come to the dining room. We like to match up people who we think will get along well and look forward to seeing each other for meals, as encouragement as well. We will even sit with some residents ourselves to make sure they feel safe and looked after. Very often, people are embarrassed because they cannot see their food properly. We are very discreet, and make folks confident that they know exactly what to expect when in the dining room.

We try our best to bring residents to meals and activities. I understand that her sitters and caregivers have not been successful in persuading her to go to activities and to dining in her past locations. Although we will try multiple times, and different people will make attempts to involve Mom, we do not force or compel anyone against their will. As far as delivery, we have a cart that goes up to deliver meals. The server who goes upstairs, or the caregiver on each floor, takes care to prepare each person’s tray in front of them, with cutlery and encouragement…

Hospice comes every other day or so. The hospice employee helps with grooming and eating, but the Buckingham staff does that as well. We coordinate with the hospice company.

We escort, encourage and remind everyone. We sit and talk, and make sure that (especially in the beginning) each resident is comfortable and does not feel lost or out of place. We also can set up buddies, friends who will walk together to activities, etc.

We will offer an array of things to do, and let her choose. It is very empowering. Being given options and the ability to choose and create your own routine is of utmost importance at Buckingham South. We ask questions like ‘are you an early riser, a late riser, what is a typical morning routine for you’ to get to know and accommodate each resident, as if they are our only resident.

We also love a schedule. Our caregivers are given hour by hour descriptions (as detailed as possible) for the residents they care for. They also ASK each resident what/when they like to do things, and we can change if needed. We don’t like anything to feel like their schedule or routine cannot be changed. We are very lucky to have such wonderful employees (even the housekeeping and dining staff). We keep staff consistent to lessen confusion.

Yes. Our case manager does a thorough assessment and talks to multiple people (nurses, therapists) regarding care, routine, likes and dislikes.

Yes.

Housekeeping comes in every day. Deep cleaning is once a week.

We offer many things that are optional (i.e. salon, personal shopping, and personal supplies). These things are clearly delineated in a form so that you know you have the option but do not have to opt for any of them. Non-optional fees include Levels of Care, and, if you are choosing Buckingham South, it is because we are licensed for higher levels of care. It is also very clearly explained.