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Article by Matt Gannon, Communications Coordinator & Trainer with Oregon Care Home Consulting & Training.  At 4:30 a.m. in the dead of winter, the alarm goes off to announce the beginning of another long day. This is a day when nearly 70 people will receive breakfast, lunch, dinner, and snacks cooked from scratch at the hands of the management and talent of my wife, the dietary manager / head chef of our local memory care community. The first step, the shower, helps to wake up the brain and the body which is still somewhat sore from last week's grind, and the soul - with warm water the soul awakens to a calling, a passion to serve gracefully, and all the work that comes with it. She now dons the uniform, and steps into the shoes still damp from doing dishes with the crew three nights before. This happens regularly due to being short-staffed. She attacks the dishes with the others to make sure everyone can leave together to go home and no one is left behind. One of her shoes has a crack in the bottom from hours upon hours of being on her feet and so much water spilling into them over time...she plans to get a new pair of shoes, but you know, life is busy, and there is work to do and people depending on her - who the hell has the time? ...the soul awakens to a calling, a passion to serve gracefully, and all the work that comes with it. A work week of three back-to-back 12.5-hour shifts, and a 6-hour final day to cap it off - of grinding and a labor of love is about to kick off. This has been happening for nearly four years on a full-time schedule, and she's never late and never leaves early. The first year was while Covid was in full effect, a year with perfect attendance, another year with maybe one sick day (essentially unheard-of in long-term care), and finally, she was able to reach a point of permitting herself to begin taking vacations after two years of blood, sweat, and tears. She rises on a Monday morning to begin it all once again. She feeds our elders.  She walks quietly downstairs with the dogs to start the coffee and let them outside so they can get their fill of the morning air and do what dogs do. She prepares breakfast for our three dogs, two cats, a guinea pig, and a bearded dragon. She dishes their bowls and whispers lovely things to each one, but not before administering insulin to our geriatric and diabetic cat. She runs out to the car to start the heater so she doesn't freeze on her way to work. Now, it is time to prepare our kids' lunches for school, put fresh water in the pets' bowls, and put dog cartoons on TV so the dogs can finish their sleeping on the couch with full bellies in the living room next to the Christmas tree - while listening to Bluey, or some such show, before the rest of us wake. She bundles up in her winter coat, grabs her coffee, and tells herself, "You got this, and you know why you are going to go and grind once again - you know why you are doing this. Deep breath....let's go." She goes out to the bitterly cold morning air and falling rain, and into the car. The house is still asleep, the sun has not yet risen, Christmas lights twinkle in the foggy rain from each home, and she's on her way. You got this, and you know why you are going to go and grind once again - you know why you are doing this.... It's a short drive to the memory care community in our town, where there are elders who live out the remaining chapter of their lives. This is your mom, dad, grandma, grandpa, great-grandma, great-grandpa, neighbor, the people you always saw at church, who may have worked in your schools, built or maintained your streets and bridges, and who played a part in the community and society of your town. People who lived full lives - who've raised children, grandchildren, and great-grandchildren, served their country and did it all the best way they knew how. And, now, in their later years, fate has delivered - dementia. This has landed them a residence and room at the memory care building and a seat at my wife's tables. These are our elders, and my wife, our children's mom, feeds them. The time from the alarm waking her to pulling up to the parking lot is barely enough to prepare herself to answer the usual questions: who will show up today to work and who won't? Has that resident I love so much and who tells me she loves my food passed away since I was last there? What condition is my kitchen in and how far back will it set me to have to pick up the pieces of what someone else was supposed to do? Many unknowns, but one thing is known well - the chances of walking into what "should be" is a rare and mostly non-existent occurrence. No matter, people are depending on her, and the residents need to eat. She tells herself, "You can do this, and no matter what happens, they need me so they can eat, so here I am." Fighting back the emotions of facing the hard grind all over again, likely having to do it short-staffed (double the work), she stops for a moment and thinks of some of the brave, bleeding hearts who do work there, have worked there, and the good work and care they provide - her staff who she inspires with her unwavering standards and integrity to do the right thing always (and to wash their damn hands!), even when no one is watching because the residents deserve it. They look up to her and care about her and make it a point to let her know so, and she finds the strength to keep on going and do what needs to be done - she feeds our elders. ...she inspires with her unwavering standards and integrity to do the right thing always...because the residents deserve it. I worked as a dietary assistant, activities assistant, and certified nursing assistant in memory care for nearly a decade. I then worked as an administrator for memory care for some years. My private caregiving practice also led me to visit and serve my clients in many memory care communities across the Metropolitan area for over two decades. I know memory care and I know dementia care - it is my life's mission and passion to serve our elders who live with dementia. The doors are locked, they can't get out, and people are losing who they are and what they have as they try to make any type of sense of their day-to-day life in memory care. To say the work can be hard is an understatement. It is not because of the residents who make it hard, they make it all worthwhile in fact. Rather, it is the lack of consistency and longevity of a quality team unit that gets in the way. It is certainly not for everyone. For anyone to last even one year as a full-time worker is admirable, two years means you probably have a gift and are doing the work you are built to do, three years and you are as tough as they come, four years and the toll your emotions and body take have you questioning if you've been stretched too far at this point. This is one of the tragic truths of the work. And if a person decides this is enough then it is not because they are anything but someone who has learned they must listen to their heart and care for themselves, before it's too late. You eventually come to a place of recognizing, "I have made a difference." You are left with flash vivid memories of the many people you've served, you've touched in a meaningful way to ease their pain or suffering, who you made smile at the taste of your food, who you've won over from the taste of your food, and who felt a sense of peace and comfort by your presence and the overall satisfaction of a yummy meal. Most importantly, they feel recognized because you showed up and you showed care. You know you've made an impact, a difference, and the memories will carry with you throughout the rest of your life. Most importantly, they feel recognized because you showed up and you showed care. Taking care of yourself to better take care of others is talked about in this game, but put into action - training, mentoring, and support to see to it everyone can do this - this is not reality. So, instead, you have to save yourself to take care of yourself and you can only depend on yourself to do it, and lean on those who love you, to make sure your self-care is strong and true. And, wherever that leads you is the path you must be walking - even if it means your time in that particular place comes to an end at some point in the future. When you care deeply about the work it can hurt deeply. It is not hard to care for the people, it is all of the rest of the crap that usually gets in the way. My wife has shown so much more than mere strength. She is a model of a giving heart of service, standing up for what is right, and holding people accountable - all of this to make sure the elders are fed. What she teaches our children through the work she does is a lesson that is second to none in this world. We love her for it, we are proud of her, she is strong and brave and caring, and willing - all necessary traits the residents need in their support. She has these traits no doubt, and has exemplified this time and time again, day after day, seasons after season, year after year - she feeds our elders. ...we are proud of her, she is strong and brave and caring, and willing - all necessary traits the residents need in their support. The day is done, and she arrives home to our menagerie, her family, who couldn't be happier to see her, knowing the work she's done, the differences she's made, the fatigue and sometimes heartache she feels, and the quality and taste of all she's put out in the work day to so many. How fortunate are we all, that she feeds our elders?
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Article by guest author Alexis Baker, MT-BC, CDP, owner of Bridgetown Music Therapy  Did you know that music activates every area of the brain? It's true, scientific researchers have observed that listening to music and engagement in music-based activities can involve all areas of the brain. Music activates the “feel-good centers” of the brain, and it can even help create new neural pathways. The benefits of music are abundant and far-reaching! The music therapy process involves assessment, treatment planning, implementation, documentation, and evaluation...based on a therapeutic relationship... What is Music Therapy? As a music therapist, one of the questions I am asked all the time is “What exactly is music therapy?” The formal definition of music therapy as defined by the American Music Therapy Association is: “The clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” (AMTA, 2019) This definition can be broken into two parts:
To break these parts down further, evidence-based interventions are simply music-oriented experiences or activities such as singing, playing an instrument, moving to music, and songwriting, all of which have been studied and shown to be effective in promoting health and improving quality of life. Next, music therapy is always goal oriented. The focus is using music to achieve specific, measurable goals and objectives. A few examples of general goal areas include improving communication abilities, increasing range of motion, reducing stress/anxiety, and promoting social connection. The music therapy process involves assessment, treatment planning, implementation, documentation, and evaluation. Finally, music therapy is based on a therapeutic relationship which implies there’s an established relational bond involving rapport and consistency. This person is a professional board-certified music therapist. As a side note: According to the Certification Board for Music Therapists, there are currently only 10,000 board-certified music therapists in the U.S. Music therapists go through rigorous training to enter the field as a certified and highly-trained professional. They complete a specialized bachelor’s degree in music therapy which is like a double major. Coursework covers a wide variety of areas including music theory, ear training, music history, psychology and human behavior, human anatomy, and therapeutic applications. Music therapists are required to be competent on four instruments: guitar, piano, voice, and percussion. Training also includes 1,200 clinical training hours. Following completion of all coursework and hours, they must take and pass a national board exam to earn the credentials MT-BC (Music Therapist-Board Certified). Recertification is every five years which requires the completion of 100 CMTE (Continuing Music Therapy Education) credits. Music therapists can work with any age, all the way from babies in the womb or preemies in the neonatal intensive care unit (NICU) to older adults and end of life/hospice. Music therapists work in many kinds of settings including adult day programs, childcare programs, long term care, hospitals, schools, rehabilitative facilities, community health centers, hospice care, and private practice. Music therapists serve a wide variety of populations in these settings including but not limited to people with developmental disabilities, physical disabilities, mental health conditions, issues associated with aging, dementia and various other diagnoses, disabilities, or diseases. What Music Therapy Isn’t It’s exciting to hear about what music therapy is, but many people struggle to recognize it as a clearly defined practice. They see anything music-related and want to call it ‘music therapy.’ It’s true, music can function therapeutically in a myriad of ways, but the formal practice of music therapy is specific and limited, so let’s talk about what music therapy is not. To put it simply, music therapy is not music education or music entertainment. It can involve aspects of education and entertainment. It can even sometimes look like education and entertainment, but music therapy is different from these two fields. Music education fosters creativity and cultural understanding by introducing students to a variety of musical genres and traditions from around the world. What is Music Education?Music education is the structured teaching and learning of music theory, practice, and appreciation. It involves more than just learning to play instruments or sing—it encompasses a wide array of skills and knowledge, including reading music, understanding rhythm, harmony, and composition, and exploring music history. Music education fosters creativity and cultural understanding by introducing students to a variety of musical genres and traditions from around the world. At its core, music education helps develop essential cognitive and motor skills. Studies have shown that learning music enhances memory, improves problem-solving abilities, and sharpens attention to detail. It also boosts emotional intelligence by providing an outlet for self-expression and understanding the emotions conveyed through music. For learners of any age, music education often starts with basic concepts like rhythm and melody and gradually progresses to more advanced topics such as composition and performance. In academic settings, it is commonly taught through choir, band, or orchestra programs, allowing students to collaborate and learn teamwork. Beyond the classroom, music education is accessible through private lessons, community programs, and online courses, making it available to people of all ages. Whether someone aspires to become a professional musician or simply wants to enjoy the personal and social benefits of music, education in music nurtures a lifelong appreciation for this art form while enhancing overall personal development. Music education plays a vital role in shaping well-rounded individuals, enriching both their academic and emotional lives. Musicians and performers create experiences through their music that can evoke emotions, tell stories, or simply provide a fun atmosphere. What is Music Entertainment?Music entertainment, on the other hand, is more of a receptive experience. It’s enjoying music for the value of being entertained. Music entertainment is the broad field of performances, events, and productions centered around music as a source of enjoyment for audiences. It encompasses everything from live concerts, festivals, and DJ sets to recorded music, streaming services, and music videos. Whether experienced in person or through media platforms, music entertainment is a universal form of enjoyment that transcends language and cultural barriers. At the heart of music entertainment is the connection between artists and audiences. Musicians and performers create experiences through their music that can evoke emotions, tell stories, or simply provide a fun atmosphere. These performances might be intimate acoustic sets or massive stadium concerts, where production elements such as lighting, sound effects, and visuals further enhance the experience. In today’s digital age, music entertainment has expanded beyond live events to include various digital formats. Streaming platforms like Spotify and YouTube allow people to access vast libraries of music from artists worldwide, while social media enables fans to interact with their favorite musicians directly. Music videos, television shows, and films that feature or are centered around music have become key parts of the entertainment industry. Ultimately, music entertainment is about creating memorable, emotional, and engaging experiences. It serves as a means of relaxation, celebration, and connection, providing joy and excitement for individuals and communities alike. From the casual listener to the devoted fan, music entertainment touches lives by bringing people together through the power of sound. Music engagement is participating in music-based activities for the benefit of participating in music-based activities. What is Music Engagement? We are now aware there’s music therapy, music education, and music entertainment. All of these are important, and each serves various purposes. But what if something doesn’t fit the definition of formal music therapy? Or it’s not quite pure music entertainment, or it doesn’t fall under ‘music education’? There is one more term to introduce you to: ‘music engagement’. Engagement is somewhat of a buzzword recently. Music engagement doesn’t have a formal definition, but it does offer a helpful description for things other than pure music therapy, entertainment, and education. Music engagement can incorporate elements of all three of the above. Music engagement is participating in music-based activities for the benefit of participating in music-based activities. As a board-certified music therapist, I’m a huge supporter of music therapy services; however, having been in the field for the past 10+ years, I know that music therapy services can often be expensive and inaccessible. There just aren’t enough music therapists to serve all needs everywhere, especially within senior care. It can also be cost-prohibitive or difficult to access geographically. For example, what about rural areas? This presents several problems for which I wanted to find a solution. I created our virtual music engagement program for many reasons. At the center of it all is my passion and mission in life to use music to make a difference in older adults living with dementia. Second, this program was created in response to Covid. It started out as an alternative when the pandemic was limiting activities. It can still function in this way. Beyond Covid, however:
Finally, I created it as a music engagement program, for individuals and groups to ENGAGE with music for the purpose and benefits of engaging with music! For more information about Bridgetown Music Therapy and our virtual music engagement program for care homes, click here.
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 Nelson Kabue, LPN, operator of Orchard Adult Care Home in Multnomah County. Please read below to learn more about Nelson. Tell us a bit about your background and what lead you to work in care and service.  Nelson and Josephine I relocated from Kenya in October 2012. I initially lived in Seattle, Washington. After a while, I settled down and started hustling for a job to be able to make ends meet, and I did not know much about healthcare. After some advice, I noted how as an immigrant I needed to work extra hard. One of my friends introduced me to CNA classes, but I had to come up with $500, of which I did not have as I had used all of the money processing travel documents. I ended borrowing and enrolled into a CNA class in Federal way, WA. I graduated and got a job in a skilled nursing facility home in Renton and had a second job in Federal Way. One day, my host requested me to visit one of her friend’s homes, and so I agreed and accompanied her. Once there I noticed that this family works from home at their own schedule and I was so amazed, as I was overworking myself with two jobs and no time for myself. It was then in my heart I decided this is my dream, and the idea of owning a care home was born. After a few months, I decided to relocate to Boston, Massachusetts and got a job in a skilled nursing care facility. While in Boston, I was lucky to meet the love of my life, Josephine, and I was able to share my dream with my love. Josephine supported me by encouraging and supporting me to enroll in nursing school, as she was already a nurse herself and graduated in 2017 as an LPN. I worked at a skilled rehab in Massachusetts and acquired skills like tube feeding, catheter care, wound care, diabetic management including insulin, dementia care, stroke care, and more. It was then in my heart I decided this is my dream, and the idea of owning a care home was born. Why did you decide to start your own adult care home? While working as a nurse in long-term care, I discovered that I was not able to give attention to all my patients and advocate for their needs to their doctors. This issue bothered me for a long time, as I could not feel as I was meeting their needs. This was not attaining my goal as a nurse. I felt having a care home with few clients was a noble idea, as I would be able to advocate for patients, tailor client care plans, be able to monitor clients, and communicate with doctors and get feedback in a timely manner and take action without delay. I also loved the idea of working at home and being able to apply my skills at home while still being there for my family. Tell us a bit about what you have learned running your own care home business. Having and running a care home needs a lot of dedication. Its not always easy but I love that it gives me the autonomy to meet each client’s needs immediately. I am able to provide person-centered care as I only can have five clients for whom I am able to dedicate more time to rather than when I was employed in a big facility. I have actually surprised myself in seeing that I have leadership and management skills that I doubt would have been explored had I not opened my own home. Having and running a care home needs a lot of dedication. Its not always easy but I love that it gives me the autonomy to meet each client’s needs immediately. What do you believe makes the adult foster care home model of care unique? The adult foster home model is unique because we are able to provide medical care in a homelike environment, which is quite comforting for residents. This is especially so when time comes that one has to chose a care home, or when families have to send their mom or dad to a care home, they feel comforted because the setup is just like a home. Residents are able to continue with their day-to-day activities in a homelike and safe environment where 24hr care is available. At the same time we are promoting independence safely. Residents are able to continue with their day-to-day activities in a homelike and safe environment where 24hr care is available. What do you love most about the work you do, and is there anything else you would like us to know about you? What I love most is the satisfaction I get when I see a resident move in to our home, settle in, and blend in with other residents and begin to regain some of their strength back. I love the joy and contentment I see in the faces of residents' families when they know their family member is well taken care of. Also, I am a father of two girls, ages 5 and 8 years old, and I love sports - especially soccer and basketball. Orchard Adult Care Home: A Serene Place to Call home Where Seniors and Adults with Disabilities Receive the Care and Respect they Deserve Phone: 503-618-1133 [email protected]
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 Margaret Gikaru, RN-BSN, operator of Troutdale Adult Home Care, which is a classification 3 care home in Multnomah County. Please read below to learn more about Margaret. Tell us a bit about your background and what lead you to work in care and service.  My husband and I arrived together in the United States from Kenya in 1995. We flew into Los Angeles with only $70 between us, and I was 9 months pregnant. We started our lives in the United States in California but moved to Seattle, Washington two years later. Being African immigrants, we are used to taking care of our elderly and I helped to take care of my grandma when I was a little girl. We didn’t have nursing homes in Kenya then. When our parents grew old, we’d take care of them. It was a new experience for us when we came to America and realized we could work in care settings to take care of elders. We decided to move from California to Washington because most of our family was in Seattle. I started working as a certified nursing assistant (CNA) and started working in a nursing home in 1997. We recognized that it is easy to get a job as a CNA and raise a family. Within a few weeks, you can be working with a certificate from the state. While raising a family, we found this to be easier than having an office job, especially arriving from Kenya. I then began working in in-home care and was also working at an adult family home. I worked as a CNA for a total of six years. My husband was in a different field before we started this business, mostly in computer software engineering and health information management systems focused on global health. Switching his career to be part of this business was a challenge, but he fit in quite fast, and I value his support. At what point did you decide to become a nurse? I was encouraged by my manager at the time who was a registered nurse (RN) and was the owner of the adult family home I was working in. She encouraged me to go to school to become a licensed practical nurse (LPN). She saw something in me. In fact, she once told me if she ever got ill or needed care, she would want me to be her nurse. After graduating as an LPN, I worked at a home care agency for six years while pursuing my RN degree. After graduation, I continued working for the home care agency. Soon thereafter, I went back to the same school to get my bachelor's degree in nursing, BSN. Soon after graduation, I started working at Valley Medical Hospital, a University of Washington affiliate. I worked there for six years - three of those years were in the intensive care unit (ICU). I worked there up until January of 2021, which was right before starting our Troutdale Adult Home Care business in Oregon. Why are adult foster care homes so special?  As compared to institutional care, you can care for people in a more person-centered way. For example, regarding a resident's diet, the idea is to create an environment that is as like a family home as possible. Serving only five people we can really tailor the menu to the residents' desires, so this is never a problem. Because it is a home-like setting, we can be more flexible in involving the special and important family and friend connections. We feel it provides better outcomes for the residents in this type of care setting. We have live-in caregivers, and they get to know the residents in a uniquely special way, as compared to many other places where turnover is high and the few caregivers working must care for so many. There is more consistency here, and this is good for everyone. "We feel it provides better outcomes for the residents in this type of care setting." What does nursing add to the overall success of care homes? Because of my experience and training I can move into any high-acuity care situation with a resident and provide the right care to them with confidence, ease, and experience. When giving reports or communicating with the healthcare teams, I understand the language and can interpret important information. This is information such as what to ask and how to use my voice as an advocate, and this can make things so much clearer for everyone. This matters for quality of care. This experience and skill set makes a difference. What do you love most about the work you do? We live where we work. Having the flexibility makes a real difference and I enjoy being my own boss. Countless times in my career my patients or residents have told me they cannot do what I do for people, and they don’t know how I do it. It is in those times I know I am making a difference, and we get to make this difference in our own care home and do this together. "It is in those times I know I am making a difference, and we get to make this difference in our own care home and do this together." Anything else you'd like us to know about you? We have four kids: three boys, and one girl. In this country, there is the old motto from the Army “be all that you can be,” and as immigrants, we feel we are here to achieve our dreams. Now, we are doing just that, and we know we cannot do this where we come from. Also, as immigrants, we are so very grateful to have the opportunities we've had and to create the life for our family that we want. Together, we notice some challenges in this business. Finding caregivers is one of the biggest and we know this is a problem in many different healthcare settings. As a community of care home providers, we do not have a voice yet. We, and some other interested providers, are looking to gather and create a Council of Providers and have a seat at the table at both the state and county level to create necessary changes in the industry. You can reach out to Margaret at [email protected].
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 Cherie Bray, owner of Country Comfort Adult Foster Home in Lane County. Please read below to learn more about Cherie.  How long have you worked in the adult care home business?  I've worked in the business since July of 2015. I was a career hairstylist and was looking for something new, so I enrolled in Lane Community College's Women in Transitions (LCC WIT) Program. My co-worker from the salon later referred me to a caregiver job at Country Comfort Adult Foster Home in Veneta, Oregon. Country Comfort was established in 1999 and is a class 2 home. I ended up taking the caregiving job and after thirty days I knew this was exactly what I wanted to be doing, so I quit my other career. For the next three years, I was groomed and mentored by the provider of the adult foster home. I then became a co-licensee of Country Comfort in February of 2018. Then, in May of 2018, I took over the business completely when the previous provider retired. For about the first ninety days, I was the only caregiver and worked full-time doing everything to completely wrap my arms around the responsibility I took on, and to get my bearings. Opportunities for staffing support presented itself, and once I had that support and partnership, I was really underway. What do you believe makes adult foster care homes special? The adult foster home model is designed to enable people to live independently in a family home environment, but it is much more than that. Too many people become isolated in later life. The adult foster home gives them more of an opportunity for new connections, sustaining old connections, and supporting traditions and life experiences. We don’t want people to feel isolated at the end of their lives, and so we give them a place to feel like this transition and the experience of us all being together in the home is another positive chapter in their life. My journey from career hairstylist to caregiver opened a path to service for me that is so much more profound... What do you love most about the work you do? This career came to me as my youngest child was going to college, so I was going through the empty nesting stage which is a big change. The adult foster home allows me to continue to care for others. Being the provider of the home has afforded me so much healing in my own life through caring for others, and it distracts me from any of my own issues. This healing began to happen immediately when I took my first job and began serving others in this special way, and it continues to do so. My journey from career hairstylist to caregiver opened a path to service for me that is so much more profound than just helping someone look pretty. There was a woman living in the home early on in my caregiving career, Mrs. H., who was nonverbal and a full assist with ADLs (activities of daily living). We meet people in this stage at times, and you of course never knew them before they required the level of support you must give, even though they’ve lived a very full life up until you become a part of their life. Something special happened. I realized she would respond to my touch, and if I gently put my arms around her, she would then begin to lean into me and want me to hold her. I realized I made a difference to her with this act alone, in this world - in her world, I made a difference through my presence and through my touch. She was also the first resident I cared for who passed away. I realize still to this day, what I do as a provider, I do for her and the gift she gave me. It is successful work when you are being told that your presence and what you do makes a difference in their lives - this is what it is all about for me. What do you believe makes someone’s work successful? Positively impacting the lives of others; providing a safe home for the residents and protecting them in some of the darkest days they've ever had. It is successful work when you are being told that your presence and what you do makes a difference in their lives - this is what it is all about for me. Since taking over as sole provider, I’ve also incorporated hospice care through a community partnership. This partnership has allowed me to also be there for my residents until the very end. It makes me feel triumphant in my work of service knowing I was able to serve them the whole way home. Anything else you’d like us to know about you? I do not do this work alone. My best friend is my live-in substitute caregiver. My daughter and her husband are my backup caregivers. With the pandemic, getting staff has been the greatest challenge I have ever faced in this line of work. My husband does all of our finances and shopping so we don’t have to worry about more exposure issues. Without them, the team, I could never do this at the level I do. The residents' families also become family to us. There are residents who’ve passed away, and their families still remain in touch with us as time goes on because they value the ongoing connection. It helps them feel closer to their loved ones, I believe. Being an adult foster home provider has given me the extended family I’ve always wanted. I make sure everyone hears from me just how important they are to me. This is key. We invest in everyone's self care in different ways because it matters to us that everyone has the balance in life to be happy and not rundown. And, I know you cannot give what you haven't got, so it starts with me. Visit Country Comfort Adult Foster Home on Facebook.
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.
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...
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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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