Caregiving Thoughts #A

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Transitions are special times. Dawn and dusk, when the world changes between night and day. The change of seasons, when the world changes between green and brown. The day your advanced-in-years cared-for moves out of the house, and everything changes.

Conventional wisdom is that people should stay in their homes for as long as possible, but there may come a point when, all things considered, that’s no longer the best option. When that happens, a transition is necessary.

I wrote in Caregiver Thoughts #9 about selecting a new home. Once that’s done, it comes down to execution.

Like any move, it starts with what to take and what to leave behind. Moving from a house to an assisted-living home (somehow the term “facility” just doesn’t work for me) will likely involve leaving a lot behind. If there’s not a lot of distance involved, this is a lot easier, as you can always swap things back and forth as necessary.

While the move might be accomplished in a day, the transition will take much longer. It’s a project. While you will have sorted out the major items (room, medications, schedules, etc…) pretty quickly, there will be a million little things that will only show up after the move. It’s just impossible to identify every little thing that needs to be taken along or left behind or changed. The important thing is to expect this.

Probably the biggest thing will be adapting to new routines. The cared-for will need to learn how things work at their new home: when are the meals, meds, what activities go on, how to get assistance, what’s this thing I’m supposed to eat? etc… The caregiver will need to take over things that the cared-for might have been taking care of around the house, adjust to making visits to the new home, work out how to stay in touch, provide those things that the new home doesn’t.

The caregiver’s role will change, but not really diminish. While I’m not as concerned now about being there every day to dispense meds, or having to jump out of bed in the night or rush off from work to handle some urgent issue (there are professionals there now 24×7 who can handle those immediate things), I am taking a larger role on the financial and paperwork side. Of course, I’m still my cared-for’s patient advocate, attend all medical appointments, keep up with what meds are for what, etc…

As patient advocate, it’s also important to coordinate with the home’s medical staff. Any notes I take from a doctor’s appointment need to be forwarded on along with any specific doctor’s orders. Everybody needs to have the appointment schedule, especially if the home will be providing any transportation.

I think it’s important to set expectations at the outset. It’s probably not going to be practical to visit in person for hours every day, so take a shot at what’s doable and work towards that. Having electronic communications can help to fill in any gaps there. While staying fully in “the loop”, I think it’s in everyone’s best interests to push as many routine things onto the home’s staff as practical. The staff is there 24×7, and if they can provide a favorite food, that’s one less thing that’s subject to disruption if I get diverted.

A lot of “givens” will need to be tossed overboard. Just because something was done a certain way, or in a certain sequence, when cared-for and caregiver were living together doesn’t mean that’s now the best way to handle those things. This can leave both feeing a bit lost as that structure evaporates, and before a new pattern begins to settle in. You just have to keep going, get done what needs to be done, and see how things play out. Keeping a to-do list (at least for the caregiver) can be handy, as it gathers in one place all those things that needs to be sequenced.

Right now we’re in the middle of the northern hemisphere winter, but I know we’ll be transitioning to spring soon. The only thing that doesn’t change is change.

Awash

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The weather is finally turning more seasonable. New Year’s Day was just warm enough to go out and get the new boat permit stickers wet.

I’ve never been out on the lake when it’s been up this high, at least a meter above normal. I was able to take a “short cut” and turn out to the right across the dock when I left the boat ramp.

And there were some other interesting things to see out there.

I wish I had more time, because there’s a lot more lake to explore out there right now.

Talk about the weather…

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Yes, here it is, Boxing Day, temperatures in the upper 70F’s:

…and I’m sitting around out on the lake in shorts.

This picture is also notable because it was taken in a place on the lake that wasn’t lake before. All the heavy rain and runoff has created some more “lake” to kayak on.

Caregiver Thoughts #9

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At some point, particularly if your cared-for is of advanced age, changes will be required. Your cared-for may need increasing assistance that you just can’t provide and still hold on to a full-time job, or maybe you just can’t be there enough. Watch for these changes and get ahead of them. Too often people need to move to a higher degree of care/assistance when some crisis occurs, and that can lead to hasty decision making.

So, give some thought to these things now, and investigate options in your spare time (yeah, right, spare what?).

I’ve recently been evaluating assisted living facilities. Ultimately, so long as your cared-for is competent, it’s their decision and it will come down to what’s affordable and where they feel most comfortable. The latter is necessarily subjective, but is also the most important.

As caregiver, I think the most important thing you can do is to watch for red flags that might veto a particular facility. Here’s a list of things to consider or ask about:

  • Security: are doors kept locked? Are visitors identified and escorted? How do friends and family gain access? Can anyone walk in off the street?
  • Is there a disaster plan? Are arrangements in place to house residents elsewhere if there’s a power outage, HVAC failure, or fire? Does the facility have a generator and how often is it tested?
  • If you keep in touch with your cared-for via electronic means, is Internet access available? Phone lines? How’s the cell phone coverage?
  • What sort of medication management is available? Is there flexibility if your cared-for handles some or all of their own medications?
  • Is transportation to doctor’s appointments available? If so, what are the limitations (distance, days, etc…)? Is there a charge for this?
  • Are pets allowed? This could work both ways, depending on whether your cared-for has a pet they want to bring, or would rather not have small furry/scaly/feathery critters around.
  • How many residents are there, and how many is the facility licensed for?
  • How many staff are on site when? Pop quiz question: how many staffers are on site right now?
  • Can the facility provide all the care your cared-for requires? Meals are probably a given, but what about assistance with bathing and dressing?
  • What sort of activities are there to fill the resident’s days? Are there exercise facilities?
  • Look around: are there exit signs? Smoke detectors? Is the facility clean, neat, and organized? Do the residents appear to be comfortable and well cared for?
  • What’s the reputation of the facility? Is it well-regarded in the community?
  • Who owns the facility? Many may appear to be local, independent facilities, but most are owned by larger companies that own and operate a number of facilities. This, also, can work both ways: a local, independent facility will likely be more flexible, maybe even cheaper, but may not have the resources of a larger organization. OTOH, a facility part of a larger chain will likely have more “disaster” options (nearby “sister” facilities) and more financial backing, but may be more subject to the machinations of Corporate America, like management changes and rules that might not be as flexible as one might hope.
  • If you can, get a look at recent health department reports. My own state does not make this information available (I tried), but if you can get access, do so. Just keep in mind that one report doesn’t mean much. Look at reports over at least a year, looking for recurrent problems. I know from experience that the day the auditor shows up and wants to see a file restored from a backup, that’s the one time the tape will throw an error. If there’s something in a report, look to see that it was resolved.
  • What mechanisms are there for a resident to call for assistance? Are pull stations located conveniently, and is a pendant that can be worn available?
  • Is there a waiting list? If so, would space be available when you think you’ll need it?
  • If your cared-for has to leave the facility temporarily (for a hospital stay, or vacation), will their space be held for them, and what adjustments to fees are made?
  • How are emergency situations handled? What happens when someone falls?
  • Is there a process to address concerns?
  • What range of care is available? If your cared-for needs increasing levels of assistance, or nursing care, is that available at the facility in question, or would they need to move?

Again, your cared-for is the best one to decide where they’re going to be happy. You’re just looking to vet out the choices.

All the facilities I looked at provided respite care, where your cared-for could stay there for a week or so. This can be a good way to try out a facility, and may be an option if you, as care-giver, need to go on a business trip or something, or just need a break.

Finally, and maybe most importantly, don’t let your cared-for think that you’re just going to drop them off and disappear. Y’all have been working together for perhaps a very long time, and that needs to continue. If nothing else, you need to keep a sharp eye on things to make sure they’re getting the level of care they need (and you’re paying for). You’ll need to change your routines to accommodate regular visits and general staying-in-touch. Your cared-for will continue to need a “patient advocate”. There will likely be incidental things, like reading material, music, or a favorite food that’s not readily available, that you’ll need to provide. Take them out to dinner occasionally. Celebrate their special days. And, just be there for them.

Rain

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We didn’t have nearly the rainfall that areas to the southeast had, and few problems. I saw a total of 7.13″ of rain here at the house, and the lake is definitely higher than I’ve ever seen it in the last 16 years that we’ve been here.

Sunday, as the rain was ending:

but the runoff continues to come in from the north. On Monday:

I wouldn’t be surprised if it goes even higher (not sure at what point the spillway kicks in), as it’s usually 2-3 days after heavy rains to the north before things peak here.

Solar power update

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So far, our solar power system has provided a little over 65% of our electrical needs. I’ve been keeping a spreadsheet of the daily electric meter readings (delivered, which is what we got from the electric company; received, which is what we shoved back to the electric company; and net, the difference, which what we’re paying for). Add on the power produced by the solar panels, and I can calculate what our consumption was and how much of that was covered by the sun.

We had a string of cooler and sunny days, and without the AC running, we were able to push that electric meter backwards a good bit. I calculate that we had about 11 days of “free” (in quotes, because the system still hasn’t paid for itself yet) electricity, with our surplus offsetting some days when we had a deficit.

As winter comes, the days will get shorter and that will eat into our production, but then again we won’t be running the AC, so we should come out ahead.

The rock, the hard place

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I usually don’t wade into these sorts of topics, but there is a point that I don’t recall seeing in what media I consume. Granted, I’m no news junkie, but anyway…

There are two recent cases of police shootings that, to me, highlight a basic problem. I know I’m oversimplifying here, but bear with me. In both cases, police saw someone brandishing a weapon. In both cases, police officers took instinctively-quick action to neutralize that threat. In one case, the weapon-wielder was an extremist bent on killing as many people as he could at a convention, and the quick police action saved many lives. In the other case, the threat was a young boy carrying a toy gun.

My point, and only point, is that police are between a rock and a hard place with these situations. On the one hand, we expect police to protect us, whether that’s stopping someone from stealing our stuff, taking that drunk driver off the road, or, heaven forbid, taking out someone who wants to shoot us. On the other hand, we expect them to correctly and accurately assess those situations, perhaps in an instant, and make the correct decision every time to use or not use lethal force.

I’m glad I’m not a police officer, and for my part, I do not consider it any inconvenience to keep my hands in view when approached by law enforcement.

We now return to our regular programming.

Creature Feature 2015 #8

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I like to be out early. Is this what you’d call the crack of dawn? The clouds were certainly broken, if not cracked. (For those just joining us, you can click on the picture below to get to a higher-res version you can zoom into.)

Up at the end of the lake, I found a Heron and an Egret hanging out, and they didn’t seem to mind my hanging out there too, as long as I kept my distance (or, really, their distance).

In fact, it surprised be a bit when the Egret decided to come over to my side of the lake. Maybe she didn’t get along with the Heron…


These fawns were hanging out on the shore.

While other Herons were conducting tree-top operations.

This Eastern Phoebe was working the trees along the shore.


Ooh, make that two Eastern Phoebes.

Moving to the other end of the lake, I floated into this little backwater lagoon and, odd, I don’t remember there being a rock there…

Or two rocks … and why did that small rock seem to be pushing around the big one?

Oh….

Bluejay goes green

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No, I’ve not changed my plumage or species affiliation (yes, there is a Green Jay). It’s more in the human sense that I’ve “gone green”. I’m now harvesting most of the electricity my house uses from what falls on the roof.

What it is

How I’m doing this is with a grid-tied solar power system. This consists of a bunch (26) of solar panels on the roof to collect energy from the sunshine and convert it to DC electric current (kind of like what you get from a battery, but up to around 400 volts), two inverters in the garage to convert that to AC household current, and an electric meter that measures power going both ways, to and from the electric company.

Because we’re still tied to the electric grid, we can draw power from there when the solar panels aren’t producing enough power for our needs, like at night or when it’s too cloudy. At other times, when we’re producing more power than we need, our excess flows back into the power grid to help power our neighbors. Through the magic of “net metering”, we get credit for any power we push back up the line, and only pay for the “net” usage; that’s why we have the electric meter that records power going in each direction. Not all electric utilities do this, and some don’t credit power you send them at the same rate as what they send you, but Laurens Electric does.

Getting the project going

I actually started this process back around the beginning of 2014, but things got sidelined last year due to a family member’s medical needs. I started by contacting a number of installers in the area that I google’d up, getting quotes and reference lists, checking BBB, etc… I awarded the job to Sunstore Solar in Greer, SC because they’ve been in business a good while, I’ve seen their people in the media (so I had no qualms about them being who they say they are: always a concern when you meet people via the Internet), and they were very accommodating of my constant questions and delays (one installer I was communicating with just stopped returning my Emails).

The project went through several iterations, but we settled on an 8.5kw (that’s the amount of power that can be produced at any given moment, best case) system, which should just about cover our needs based on my electric bills.

I had another delay while the roof got re-shingled. I didn’t want to put a bunch of 25-year solar panels up on a roof that was already 16 years old, so that had to be done first.

The total cost of the project (not including the roof) came to just shy of us$40k. That’s a big chunk of change, but tax credits will return more than half of that. I just have to wait on the next couple years’ tax refund checks. Taking that into account, and the savings on my electric bill (over the course of a year, the solar power should cover almost all of it), we should break even after around 8 years, and after that, for the rest of the 25 year life of the system, it’s all savings.

The money is just one reason I did this, of course. In fact, in business, an 8-year ROI (Return On Investment) would probably get nowhere. Getting power from just what falls on the roof, with no carbon or nuclear, is the other big reason. Now, I realize that my paltry few mega-watt-hours ain’t gonna even show up on the digital readouts at the power plants, but, like a lot of things, ya gotta start somewhere. As more and more of us do this sort of thing, we will make a dent in the environmental impact.

Installation

The installation began on 8-June with the arrival of two trucks worth of installers and parts. Some of the guys started on the roof, marking out where the panels would go, while the rest of them went to work in the garage installing the inverters and all the wiring to hook it all together.


Before long my roof gained a set of pimples:

and the garage got covered up with conduit:

A note about what all that conduit is for: one has the wires bringing power down from the solar panels themselves, and going to each of the two inverters, connecting at the bottom of the disconnect switches below the inverters on the right. From there, another set of wires carries the now-AC power over to the small electrical panel on the left. There the output of the two inverters is combined. Then that has to be fed to a disconnect switch on the outside of the house, before coming back in to the main household electical panel.

Because this is a grid-tied system, there has to be a ready way for utility workers to disconnect the system when they have to work on their lines and equipment. They can shut off the power from their end, but they need to be able to ensure that no power is feeding back the other way, which can be a hazard to the workers. The inverters are designed to detect when utility power shuts off and to shut themselves down automatically, but having worked in a lock-out/tag-out environment (where energy sources have to be secured and locked out for safety), I understand the need for a way to ensure that, yes, this wire is really dead and will stay that way.

Anyway, back up on the roof, the racks that will hold the solar panels go up:

and then the solar panels themselves;


According to the spec sheet, those panels weigh 18.6kg (41 lbs.). Yeah, those guys worked hard to get this done.

Eventually all the panels made it up on the roof.

Not being one to be up on a roof myself, I understand why they had all those ropes there. The guys working on the roof were very careful to stay tied off, and it paid off as no one fell off. That would have thrown the whole project off.

By the end of the 3rd day, everything was installed, the area had been cleaned up, and a brief “smoke test” had been accomplished.

Now we had to wait on the county building inspector to come and inspect. That happened on Friday of that week, and didn’t take long. Actually, most of the time was spent by me pointing out the components and what they did. I suspect that the inspector had prior experience with these guys’ work, and knew just what he was looking for. He said it was all “neatly done”.

The last hurdle was Laurens Electric. I was thinking that, since this is a co-op, I own it and could just call ’em up and make it happen, but that wasn’t necessary. Once they got the report from the building inspector, they came out and changed the electric meter. That happened on Tuesday of the next week.

A couple days later the SunStore folks were back to formally commission the system on 18-June, which included connecting the inverters to my network so they could report back data to the manufacturer’s (SunPower) site, where I could monitor the operation and production. When we built the house, I was smart and put a network drop in the garage. Unfortunately, I put it on the opposite side from where the inverters ended up.

I said that the solar power shuts down when utility power goes off, but the inverters I put in do have a provision to provide power via a separate circuit directly from the solar panels in that event. This can be used during an extended utility outage to run a refrigerator or charge phones, so long as the sun is shining. Those outlets are mounted right below the inverters.

Early results

So far, the system is performing to expectation. With the current heat wave and running the air conditioning almost all the time, we’ve been getting a bit over half our electrical power from the solar panels. As the weather cools off, I expect that will increase, even though the days will be getting shorter. In fact, we had one day when the heat wave broke (briefly) and with cooler temperatures (mid-80’s F) and good clear bright sun, we got 92% of our power right from the sun.

There’s nothing on the inverters that’s accessible from the local network by default (they just talk out directly to the manufacturer’s portal), which is a good default setting (too many equipment manufacturers don’t even give a first thought to security), but after doing a bit of research, I found that they will speak modbus (a protocol used in industrial control and building management systems, and which I just happened to be familiar with due to my work around the data center) if you turn it on using the manufacturer’s software (SunnyExplorer). So now I’m able to read data directly and add it to my weather web site on my The Sun page. You’ll probably notice that you don’t see the green “Inverter 1” line on the graph. Both inverters have the same configuration of solar panels, so they’re generally almost identical in output and the two lines lie right on top of each other.

You can too

If you’re interested in doing this sort of thing, I suggest you contact some installers in your area. Each situation will be a bit different: different electrical loads, different siting, different financing… It would be good if you could provide a year’s worth of electric bills, or at least the kWh and cost, so they can design a system to meet your needs. Do check the specs carefully on any proposed system: at one point, I had two quotes where one was double the other; turned out that the cheaper one was also 1/2 the capacity of the other.

The future

Right now we have gas heat and hot water; everything else is electric. The next project is going to be the HVAC, and I’ll be looking into something more like a heat pump with gas backup, rather than just straight gas heat. I’ve got room and inverter capacity to add several more panels to cover that if needed.

One thing I wonder about is how we’re going to pay for all the wires and equipment that makes up the electrical grid. Ultimately, if we all put solar panels on our roofs, producing enough power for each of our needs, and if net metering continues as we have it here, there would be no money going to the electric companies because our “net” usage would be zero. Yet we’re still using the company facilities to keep us suppled when the sun isn’t shining. Maybe the way some utilities reimburse for power (different rates for what they provide vs. what you provide) is the answer, or maybe just some fixed fee for being connected to the grid. I’m sure they’re thinking about this.

Another technology that’s coming into play is batteries. Tesla recently cannon-balled into that market with household batteries to be used with renewable energy sources. Theoretically this can enable you to completely disconnect from the grid if you have the generation capacity to store enough power during the good times and battery capacity to get you through the bad times.

Some time when I get an ambition attack, I’ll put another network drop in the garage by the inverters and eliminate that cat6 wire stretched across the ceiling.

Conclusion

I’ve been wanting to do this for a long time (at least since before my Sister put up solar panels several years ago – sibling rivalry?). Finally, I’m there, and I’m glad I did it. I was taught to not leave a mess, and I’m hopeful this will help clean up some of the mess my being a productive member of this society has caused.

I think I begin to understand, just a bit, what it must be like to be a farmer. The farmer’s crops, and my power production, are at the mercy of the weather. When the clouds roll in and I see that wattage drop to next to nothing, well, there’s not a darn thing I can do about it. But the sun will shine again :).