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We want to continue to highlight the work of our amazing adult foster care home providers in Oregon. Matt Gannon spent some time talking with Provider Hana Legesse, owner of Furlong Way Adult Foster Home in Beaverton, Oregon. She is both an Aging & People with Disabilities (APD) and Intellectual/Developmental Disabilities (I/DD) provider. Please read below to learn more about Hana. How long have you worked in the adult care home business?  When I was in high school I assisted the teachers in the special education class, and I discovered I truly loved working directly with people where I could make a difference. This stuck with me. When I graduated high school I became a private in-home caregiver where my skills to care for others really took shape. While serving my clients as a private caregiver, oftentimes they would transition from their home to other levels of care, and I would continue to work with them through their transitions. It was during this time I was exposed to what caring for a lot of people in a large place looked like and it felt very busy, to say the least. Between 2014, and 2015 I made a switch from private in-home care to adult foster home care, in both APD and I/DD homes. In 2019, I became a licensed APD care home provider and began Furlong Way Adult Foster Home in Beaverton. Earlier in 2021, I became Co-licensee of a DD-licensed Home in Beaverton. What do you believe makes adult foster care homes special? Care homes are built for companionship. Each day comes with flexibility, creativity, and one-on-one time together in many important ways, allowing the residents’ daily wishes, desires, and needs to be fully met. How the day unfolds is up to what the residents feel like doing or not doing that day. We can adapt to whatever the residents are feeling or needing and also have the time to throw in creative ideas or improvise and adapt to what is best for them at each moment of their day. This is a special way of providing care, and it is special to the residents who benefit from the one-on-one attention. We do virtually everything together, as a home and as a team, and we all are considerate of each other in what we decide to do. Companionship is key to making a difference as a caregiver, and caring for residents in a care home allows your relationships to have real depth, which I feel is special. Companionship is key to making a difference as a caregiver, and caring for residents in a care home allows your relationships to have real depth, which I feel is special. What do you love most about the work you do? This question reminds me again of being in high school and working with a teenager who was in the special education program. This student was living with Down syndrome and could not read. We worked together and tried different creative ways to approach reading, and after working with her for long enough it finally worked! She loved reading and was always wanting to do more and more, and she felt so good about herself. I love working on creative solutions to meet the needs of others, and when it works - the joy you feel is simply amazing. This is exactly what I get to do now with our homes. I also love being a part of resident care and their meaningful activities. We make sure our residents have the opportunity to participate in what matters most to them, and if that means taking a ride in the car with me to the store or going to the beauty salon together, we tailor it to what they like most and we get to do it with them. I love how I get to repeatedly have the same feeling of making a difference in our homes I felt when working in the special education classroom where it all began. What do you believe makes someone’s work successful? What makes someone's work successful is pushing through, even when things seem the hardest and not giving up. Also, staying motivated because you know what you are working toward and the difference it makes for you and all of the people around you. You also must remain positive because there will be times when you face difficult problems and obstacles along the way, but you cannot give up. Believe me, there are mornings I do not want to wake up early to go to the gym, but I push through anyway knowing it is best for me and for those who depend on me so I have the strength and energy I need to be my best. This is how you will find success. You must believe in hard work and how it pays off. You must continue to work hard, do the right thing, have integrity and understand the reason why you are doing what you do; believe in your "why" and believe in yourself. Be your own best friend and push through! You must continue to work hard, do the right thing, have integrity and understand the reason why you are doing what you do; believe in your "why" and believe in yourself. Anything else you’d like us to know about you? Our residents and team really do all enjoy being together and making decisions that best support each other. It's a very harmonious and friendly atmosphere. We are great at teamwork. We are not afraid to get out of our comfort zones to do what it takes to meet the residents’ needs and to support the entire team. We all have individual strengths, and because we recognize this and can work to those strengths, everyone achieves more. We have such a variety of skill sets and experience levels on the team and so we put all of the knowledge to good use in support of each other. I still have staff who began with me on day one. I depend on them for so much, and I recognize how they depend on me too. I invest in them by offering competitive wages, bonuses, vacation days, gifts for self-care, just to name a few. We also celebrate their birthdays and recognize and honor each of their own cultural and religious happenings throughout the year. I cannot be successful and our residents cannot be fulfilled without my team, and I make it a priority to know what they want or need to be successful. We all have each other’s back, which makes all of the difference because no one can have a successful home all on their own.
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We want to continue to highlight the work of our amazing adult foster care home providers in Oregon. Matt Gannon spent some time talking with Provider Holly Green, owner of High Lakes Care Homes in Central Oregon. Please read below to learn more about Nurse Holly. How long have you worked in the adult care home business?  We were fortunate to open our first home in Sisters, Oregon in 2019. I studied for my nursing degree at Mt. Hood Community College, which then lead me to work as an ICU Nurse in Portland at the Vibra Specialty Hospital. I later worked as a Nurse Manager in skilled nursing rehabilitation. I also spent time as the director of nursing for a memory care community in Bend. My nursing career began with falling in love with the elderly. Having been in positions to get to know and care for many elderly patients/residents, this made me realize how much I appreciate serving elders; however, I also realized I couldn’t totally give the best care to each of them like I wanted and how I believed they deserved. Sad but true, but when there are too many people in one place needing quality care and you cannot commit to real one-on-one time, you are always left feeling you wished you could have done more. I was then mentored by another licensed care home provider about how nice it is to care for people in care homes, so I became intrigued. We eventually pursued an adult foster care home in Central Oregon and seized the opportunity to make it ours. That decision has allowed our care team to serve people in the one-on-one way I’ve wanted all along. We opened our second home in Bend, Oregon in February 2021. Both of our homes are licensed as level 3 adult foster care homes. What do you believe makes adult foster care homes special? Providers are able to specialize by having a one-on-one all-around service of care. We don’t have to only focus the work on tasks alone, we also are a part of the meaningful activities for our residents, the food they like, the people in their lives who are important to them, and we create individualized care plans specifically for their best interests, in their home-based environment. This makes their experience of care more fulfilling. What do you love most about the work you do? What I love most is when you are consistent with care, and really get to know each of the residents for who they are, you are then in a position to give to them the time they require - it is so rewarding. When we first opened, we had five residents who were all on hospice. With enough time and consistent good care from our team, each resident no longer needed hospice and was discharged. This was a real example of how giving the necessary time to patients or residents, wherever you may work, can really benefit everyone involved. The choice we made to become care home providers has allowed me to be a nurse in the way I always hoped for, where people become more than patients or residents: they become more like family. ...when you are consistent with care, and really get to know each of the residents for who they are, you are then in a position to give to them the time they require - it is so rewarding. What do you believe makes someone’s work successful? Self-care - by being a model of self-care to my team so they know I understand how vital it is and how important it is to me to support their own self-care. If a caregiver is burnt out, everyone loses and it is not fair to them or anyone else. When a caregiver feels they are being taken care of, they can reach their full potential. If they feel taken advantage of, you cannot expect them to perform at a higher level. We decided our starting wages will always be at the top or above the going rate for caregivers. In order to do so, we had to position ourselves to be a highly-rated and respected adult foster care home people want to live in (with an ongoing resident waitlist). We also tell residents and their families from the beginning that all care costs are at a flat rate. There are no extra add-on charges after move-in. We find they appreciate it more this way because it assists in their comfort level and understanding of what a good and fair price is and will remain to be over the course of time. This erases the unpredictability of costs. Anything else you’d like us to know about you? I have learned how having a super supportive partner, family and friends makes all of the difference, and how none of this would be possible without the backing and assistance of my husband who cares for our children and our overall home in such a supportive way. By intentionally building a small village of family and friends who understand the sacrifice our work demands, I can be successful, which ultimately means our team and residents, our entire family, we are all successful, together. By intentionally building a small village of family and friends who understand the sacrifice our work demands, I can be successful, which ultimately means our team and residents, our entire family, we are all successful, together.
 Running an adult foster care home can be stressful enough, but when you expand or remodel, how do you know that the home you and your residents live in is up to, or even built to, current standards and codes for safety? Permits seem like an added hassle and expense, so what are they for? Are they necessary for all work being completed on the home? Why Do I need a Permit? Permits protect you and your home by having experts in the code and construction field verify your home is built to minimum safety standards by licensed, insured contractors. Part of a licensed contractor's responsibility is to know the codes and procedures for obtaining a permit when required. Permits are required by law and may be required for insurance purposes. Additionally, Oregon Administrative Rule requires any remodeling that must have a permit to be permitted. Licensing will request proof of permitted work. Also, if work was done without a permit in your home, you may be required to upgrade the home to current code standards or have the work done without a permit demolished. Building codes have evolved over time and are subject to constant change, so it is important to have a contractor who knows code, as well as the construction knowledge for the work to be performed. Who Oversees Permits? Inspections are performed by individuals who work for the local government. They are referred to as the Authority Having Jurisdiction (AHJ) and are required to have state and national certifications for their respective inspection trades. The inspector will verify the work is completed per approved plans that have been reviewed for compliance with local and state codes that state minimum requirements for structural, mechanical, plumbing, electrical and life safety. There are few exceptions for what does not need a permit, but all work done must still meet the code. Working with a Licensed Contractor Is your contractor licensed? Be sure to check the Oregon Construction Contractors Board to verify a contractor's license status. Ask your licensed contractor about the requirements for construction activities on your AFH, as they should be able to tell you if you need a permit. If you are not sure, or are not satisfied with their answer, call the local building department in your jurisdiction and they can answer your questions. Remember that it is your home and your responsibility to meet all requirements for alterations and modifications to the AFH, so when in doubt, contact your local building department. This will ensure your home meets minimum building code and safety standards, which will help keep all occupants of the adult foster home safe.
We want to continue to highlight the work of our amazing adult foster care home providers in Oregon. Matt Gannon spent some time talking with provider Shannon Carskadon with Silver Cloud Family Homes in Forest Grove. Please read below to learn more about Shannon. How long have you worked in the adult care home business?  Silver Cloud has been family owned since 1989. My husband Ron's mother started the care home in Forest Grove in the late '80s. In fact, Silver Cloud 1 was the longest-running adult family home in the state of Oregon until Ron's mother, Margarita Carskadon, retired around 2016. Ron was opening his own location in 1994 when we met and started dating. I had attended Pacific University and Portland Community College with the intent of becoming a math teacher. In 1996 we bought a home together and planned to move the adult foster home business there. Before we were even moved in, Ron was in an auto accident during the floods of '96, and I was forced into the role of caregiver, as I was part owner of the home. I quickly realized the older adult population was hugely overlooked by the healthcare system. This impacted me in a major way. I understood how these folks needed a voice in the system. They needed someone to advocate on their behalf, and this is what I began doing and have provided to my residents ever since. I never became the math teacher, and instead, I have been in service to our wonderful residents and we now own two homes in Forest Grove. What do you love most about the work you do? I didn't have any grandparents growing up. I do feel it has helped my perspective being a provider, as I feel I can relate to residents more as my friends. This has given me a unique appreciation for spending quality time with the elderly in a way I don't think is common, because I don't have any pre-conceived notions about "taking care of grandparents." I am able to meet the residents where they are in their lives and accept and enjoy them at this stage in their lives, and without expectation of what that relationship should look like. I now feel I have friends who are of grandparent age and not having grandparents as a kid, it gives me a unique appreciation for spending quality time with them in a way I never knew. I love to hear their stories, and I cherish the relationships we've built together. I am honored to be part of their story as a provider. I believe the residents truly get to feel they're surrounded by friends in our homes. I love to hear their stories, and I cherish the relationships we've built together. I am honored to be part of their story as a provider. What do you believe makes someone’s work successful? Loving the elderly is only 10% of the job. The large majority is assuming the responsibility of the work demands and taking that responsibility seriously, at all times. For example, being committed to your word, being a strong communicator, and being diligent with all administrative tasks, from charting to medication administration, and so much more. This is necessary because the margin of error is too small and the risk is too great to ever overlook. People have to have impeccable commitment to all of these things, day-in and day-out. Loving the elderly is only 10% of the job. The large majority is assuming the responsibility of the work demands and taking that responsibility seriously, at all times. Anything else you’d like us to know about you? I went through the Montessori education with my son. My philosophy of care very much lines up with the Montessori Method. This method of education has an emphasis on individuality and following your personal interests. Collaboration with different age groups and levels of ability to complete tasks is highly encouraged. Activities are geared toward the five senses and the abilities of the participant at that specific time. The process is emphasized, rather than the outcome. Focusing on these concepts creates an environment where individuals find peace and gratification from their contributions. I feel anyone who is interested in caring for others, and especially caring for people living with dementia, should read, "The Secret of Childhood" by Marie Montessori. I believe the title could be changed to, "The Secret of Human Beings."
We want to continue to highlight the work of our amazing adult foster care home providers in Oregon. Matt Gannon spent some time talking with provider Catherine Hingson with Sunset Senior Living Center in Depoe Bay. Please read below to learn more about Catherine. How long have you worked in the adult care home business? I began Sunset Senior Living Center at the Oregon Coast in 2016 when my mother had a stroke. I decided to create an environment that my own mother would be content with, where her needs would be fully met. I became licensed in 2017, and we are a class 3 home. Now I have capacity for four residents, and I have two full-time employees and one part-time employee. I live in the home with the residents. Potentially someday, 25 years from now, I may end up a resident myself of Sunset Senior Living Center. I decided to create an environment I would want to live in because I plan to live the rest of my life in the care home. We have property with three lots, and the house sits in the middle. I am going to be expanding the home to make it even larger so it is all one level, and I plan to create a rehabilitation exercise bonus room. What do you love most about the work you do? The thing I love most about this type of work is helping families. When a loved one can no longer be independent and circumstances reach a point where it is more than a family can manage, especially in today's world where they may be raising and homeschooling kids, we can be the option and take in a resident. Our family then grows, and I enjoy serving in that way. I also appreciate being able to give my team employment and help them grow in their lives. I like serving the community as a person staff can turn to, and as an option for people looking for care, other than a larger facility. The thing I love most about this type of work is helping families. What do you believe makes someone’s work successful?  To me, it is all about the whole team. I approach the business as a team experience. I have great employees and I partner with community professionals who benefit the business. We have different professionals who meet the needs of our residents by coming to our home and being involved. For example, we have technology support individuals, a bookkeeper, maintenance workers, a counselor for residents, volunteers, and others who are an extended part of the team. On more than one occasion, former residents' sons and daughters have been so impressed with the mission and quality of care at Sunset Senior Living Center, they actually come back to volunteer and support our efforts long after their parent has passed. We operate with each resident's desires in mind. Residents will take part in writing their care plan so there is a lot of individualized care. My team and community partners cover so much of the care aspects of the residents with a teamwork approach; that way families can enjoy visiting and being with their loved ones and not worry about all the other stuff. This becomes streamlined through teamwork. Sunset Senior Living Center is a "welcoming home" to all people, meaning we do not discriminate and we provide quality care to all of our residents. I pay special attention to gardening. We have a large, organic garden with 14 garden boxes. We grow much of our own fresh produce and pay special attention to nutrition. Gardening is an ongoing, meaningful activity to the extent each resident can participate. Some residents like to get their fingers dirty, while others just like to watch. The garden boxes are all planted and the radishes are the first crop harvested this week. We have a lot of homemade meals and use what we've gardened, which makes it extra special. We have a lot of homemade meals and use what we've gardened, which makes it extra special. Anything else you’d like us to know about you? One thing that sets us apart is how our ratio of caregivers to residents is usually two caregivers to three residents, most of the time. Sunset Senior Living Center has one, new full-time employee, Christopher, rounding out the team and joining caregiver Dee, house manager Dena, and owner-operator Catherine Hingson. The response time when our residents call on us is always less than five minutes, and we take all necessary measures to ensure a secure home. I have a wonderful mobility van for transporting our residents and for outings. The van gives us the freedom to plan and go do whatever we want. It also serves emergency and evacuation purposes. In an emergency situation, all of our residents have an emergency backpack ready to go, which covers up to 72 hours of supplies. We also have a storage unit within walking distance of our home with food and emergency supplies for up to a year. With all the nice weather, our residents have been going out for walks in the neighborhood and recently saw a pod of whales here in Depoe Bay! Sunset Senior Living will have one resident opening coming soon this summer. Please visit Sunset Senior Living Center online at SunsetSeniorLiving.com, or visit their Facebook page. *Photos used with written permission of the residents and staff.
Article by Matt Gannon  Life is fundamentally about relationships and our connections to others. Humans operate to gain and maintain control (in varying degrees) within relationships: to ourselves, with others, to our environment, spiritually, and to our place in the larger world around us. This is like a balancing act we operate throughout our lives. We ascribe meaning and purpose to the different relationships. Many relationships will shift and change over time, while others remain relatively the same. Within our relationships we have choices and we maintain control of our time, effort, participation level and, the interests being served - all of which shape who we are, our characters, and our identities.  The Dementia Experience Dementia is progressive. Over time dementia demands a different type of communication to find and keep positive connections in relationships. Dementia creates a loss. For the people living with dementia, there is a progressive loss in abilities and independence. When we attempt to understand the dementia experience, what can become more understood is how a person living with dementia is losing a sense of control in their lives. One thing I have come to know well in my time of caring for people living with dementia is how life for them tends to become less about content and detail - and more about feelings. I also know people living with dementia do not lose their ability to feel, understand and recognize the emotion they are having when feeling it. They may not be able to understand and express fully why they are feeling what they are, but the feeling itself is familiar. Emotional memories are very deep-rooted memories and are still often more accessible and familiar (especially when utilizing the senses). The emotional experiences of a person living with dementia can be broken down into two categories: positive & negative. They may be feeling one way or another, or a combination of both at times, but how they are feeling and what they are feeling matters when it comes to providing care. Over time dementia demands a different type of communication to find and keep positive connections in relationships. What is Person-Centered Language? When providing person-centered care and communicating with a person living with dementia, it is important to do all we can as providers so the person ultimately feels more of a sense of control - this becomes our goal in each moment. It starts with an acknowledgment and validation to the moment you share, and to what emotion you sense is being felt. This can be done by communicating with feelings, both verbally and non-verbally. What is person-centered language and why is it important when caring for people who are living with dementia? It is about respecting the individual in our care approach at all times. Once we know the person we are caring for, we can plan and deliver care to them based on our knowledge of who they are as a unique person who also happens to be living with dementia. As you read the phrases below, ask yourself how does it feel to switch from one phase to another? I have a dementia resident.......
 When we move to using person-centered terms, our approach, attitude, tone, body language, and empathy can change. It will benefit both us and the person living with dementia because what we do and say can have a significant effect on how they are feeling. If we carry the right mindset, the right attitude, and the right outlook then we are ready in our right care approach. Less is often more when choosing the words we say as we communicate to a person living with dementia. Show more, talk less is generally a good formula. We pursue short, brief, and repeated words and sentences as many times as necessary. We strive to create words together that become familiar between us and familiar to whatever activity we may be doing within our routines, we can identify the words and use them repeatedly as they become mutually understood. We can look to use words the person living with dementia tends to use or respond best to, or phrases that mean something to them. It is up to us to learn what those important words and phrases are, and when we do, to share those words with anyone else who provides care to that person. When we move to using person-centered terms, our approach, attitude, tone, body language, and empathy can change. Insert positively-charged words into statements, such as “ah, that’s a good thing, that’s a good one isn’t it, I like that, I love that, that feels good, doesn’t that feel good? that looks good, and thank you”. A positive way of communication can be to offer suggestions over telling or directing what one needs to do. When assisting a person in any way, from pushing their chair in for them to buckling their seat belt, or helping to get a jacket sleeve on, it is important to seek their sense of satisfaction or approval before moving on to the next thing/task. This can be done by simply asking, “Ok then? Are you happy with that? Does that feel good? Is that a good one?” Or even doing the thumbs-up gesture and awaiting their response before moving on, as this communicates respect and how you see them and care enough to ensure they are satisfied with what you’ve done to assist, before another task or agenda takes over. This is person-centered language.  Why is this important? How much or how little we know about a person we are caring for makes a big difference. A person living with dementia is still the “person” they have always been and in many ways will continue to be. But they are also changing and different in some ways now. What they need from us the most is to SEE them for who they are and to know what makes them unique. By doing this we are reaching the center of a person and can care for them in a way that charts their personal care course - providing a feeling of control, not taking more away. Person-centered language is part of how we communicate to people living with dementia who depend on us to understand, and to be able to connect in the most respectful ways possible. Respect matters in all of our relationships, but for the person who is living with progressive dementia that is affecting their brain, we must ensure our approach and the language of our care is received in the way our residents living with dementia require - to have the strongest relationships we possibly can. What they need from us the most is to SEE them for who they are and to know what makes them unique. By doing this we are reaching the center of a person...
Article by Matt Gannon In honor of National Caregiver Day on February 19th, we wanted to highlight the work of our amazing adult foster care home providers in Oregon. Matt Gannon spent some time talking with provider Noel Ngure, RN with Living Springs Homes in Portland. Please read below to learn more about Noel.  How long have you worked in the adult care home business? I’ve been a licensed care home owner since the Spring of 2020. In 2004, I relocated to this country after having been a a high school teacher for 12 years. I started working humbly as a CNA, went to LVN school in 2007, doubling efforts since I was in my bachelor's class at that time. I graduated in 2008 with bachelor's degree in human services with a major in management. In 2009, I started my master's degree journey and graduating in 2011 with my Masters in Education: Curriculum and Instruction. My passion of offering competent, uncompromised care continued pushing me. In 2014, I started my RN classes, and by grace, we are here today successfully. What do you love most about the work you do? The results. In 2017 I was found with Invasive Ductular Carcinoma. The care I received from my family was amazing. My RN daughter quit work to take care of me. When one day I said I'd never repay her, she replied, "Mum , Pass it on." Those are powerful words do drive us to performance. When I take care of a family member living with dementia and observe her every day, seeing the positive progress, the strength and persistent beauty despite the situation, that encourages me. When I work with a client and see them improve, change and progress with near-normal life, it makes me smile and move forward. I love the difference I am making in the lives of the people I touch in this career. The impact made is immense, and this gives me strength. I love the difference I am making in the lives of the people I touch in this career. The impact made is immense, and this gives me strength. What do you believe makes someone’s work successful? Consistency and continuity of care make someone's work successful. We are consistent in what we do and this allows better communication between our team players. Communication is key, or else we would have a big mess. Caregivers take time to talk to each other, passing over clear and concise communication. This is not about competition, it's about bringing our strength to the table and doing what each of us does best for productive results. This leads to competent care, which is encompassed by integrity. Accountability is key, every one of us has to take responsibility of what we do or what we miss. A positive attitude for both the licensee and the caretakers is very important, and we have to support each other for best results. We licensees need to allow our staff to bring their strengths to table, allow them to positively utilize their skills without focusing on weaknesses. This is not a competitive business, it's about offering competent care.
Anything else you’d like us to know about you? We are a Christian home, we practice our Christian values and have a table for prayer every morning for everyone to come to if they choose. I am hopeful in the years to come we will have more homes, caregivers, and more people reached through the care we can give.
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About Oregon Care Home ConsultingOregon Care Home Consulting & Training is the compass that helps current and future APD adult foster care home licensees successfully navigate the licensing process and have a successful adult foster care home business. ORCHC provides coaching, consultation, training, and ongoing support. This ultimately saves time, reduces stress, and improves compliance, which allows AFH/ACH licensees to focus more time on providing excellent care to seniors and individuals with disabilities.
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Disclaimer: Oregon Care Home Consulting LLC is not affiliated with the State of Oregon or Multnomah County Adult Care Home Program (ACHP). We are not State licensors, therefore we are unable to require compliance or guarantee your adult care home is in full compliance with current state and/or federal requirements. State and/or County licensors make the final determination of compliance. Additionally, we are unable to offer legal or medical advice, and no guidance provided by Oregon Care Home Consulting LLC should be construed as legal or medical advice. Always consult an attorney or doctor, when necessary.
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Disclaimer: Oregon Care Home Consulting LLC is not affiliated with the State of Oregon or Multnomah County Adult Care Home Program (ACHP). We are not State licensors, therefore we are unable to require compliance or guarantee your adult care home is in full compliance with current state and/or federal requirements. State and/or County licensors make the final determination of compliance. Additionally, we are unable to offer legal or medical advice, and no guidance provided by Oregon Care Home Consulting LLC should be construed as legal or medical advice. Always consult an attorney or doctor, when necessary.
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