Frequently Asked Questions:
What kind of care can Blueberry Gardens provide? Blueberry Gardens (BBG) is an Adult Family Home, licensed to care for seniors who need physical assistance due to a medical complication or age related decline or frailty, or for residents who have cognitive impairment, with specialty designation and training for all of our staff in Dementia, or “memory” care. Owned and operated by an RN/ARNP provider, we provide care all the way through to end of life, anything from some assistance with dressing, toileting, mobility, eating, medication management, etc… all the way through to the resident who requires total care in all areas. We are prepared to care for your loved one for the duration of their days and to prevent them from ever needing to move again.
What are the Blueberry Gardens homes like? Each of the BBG facilities were purpose built for this use. The center of each home is the “great room” – a large open comfortable space where the kitchen overlooks the dining room, living room and activity areas. The 6 private bedrooms (each with private baths) enter directly onto this great room. The home was designed in this manner so that when the caregivers are in the kitchen cooking, they can directly visualize and supervise the residents. This floorplan maximizes the interactions between the residents and caregivers and provides greater supervision and safety as well as greater stimulation throughout the day for our residents. Our homes have no stairs or steps anywhere, so from the front door to the back patio, residents using a walker or wheelchair have no encumbrances to their mobility and can freely move about all areas of the home. The upstairs of each of our homes (accessed by a separate entrance) is home to the resident manager of each house. The resident manager is provided with their own 2-3 bedroom/2 bath home upstairs, which is fully equipped with kitchen, laundry room, living room, etc. This CNA certified caregiver works a normal 40 hour work week, and is off on nights and weekends, but lives in the home and provides another layer of management, oversight and supervision to the care in the individual facilities. The Blueberry Gardens homes were built from the ground up, in the same neighborhood where the owner resides. As the RN/ARNP on call for the homes, Jennifer sometimes needs to come over in the middle of the night to check on a resident, and the very close proximity (two homes are literally right next door – the other three within two blocks) promotes this very close supervision and oversight.
What are the staffing levels at Blueberry Gardens? Adult Family Homes have a maximum of 6 residents living in each home. At BBG, we have two licensed caregivers working on each day and evening shift in each home to provide supervision and care to our 6 residents. From 8am to 9pm, the two caregivers attend to all of the care needs of the 6 residents. With a 3:1 resident to caregiver ratio, our caregivers are not only able to meet all of the care needs of our residents, they are able to spend 1:1 time with them visiting, doing activities, and attending to their personal individual needs.
What happens at night? BBG has a fully awake night staff. The nighttime caregiver never ever sleeps. She is alert and awake and ready to attend to the care needs of our residents during the nighttime hours. Many homes say they have “24 hour caregivers” when in reality, their caregivers sleep at night and have to wake up to attend to residents care needs. Our caregivers are always awake, alert and ready to offer companionship, care, or to assist a resident in whatever their needs are during the nighttime hours. We have 1 caregiver on staff awake and working at night, but our protocol is that we always have a 2nd caregiver in the home for safety. Our resident manager resides in the home and is available to assist the nighttime caregiver should an emergency or unusual care need ever occur.
How much is the Monthly Rate? Most Long Term Care facilities charge a monthly rate that is a moving target, using a “Points System”, or “levels of Care”. We do not do this. At BBG, we charge an all inclusive flat rate that does not increase as the resident needs more care. BBG also provides all care items, such as incontinence products, gloves, wipes, shampoo, lotion, toothpaste, linens, nail care, hair cuts by a beautician, hearing aid batteries, etc. The only change to the monthly rate over time is it increases 3% per year. Call or email Jennifer at 206-226-3590 or jennifer@blueberryseniorcare.com for our current all inclusive flat rate.
What is included in the monthly rate? Virtually everything. Our goal is to provide you with the exact cost for your loved ones care, both today and in the future. We do not charge any extras.
All of our rooms are equipped with flat screen TV and comcast cable, as well as wireless internet. We have several portable phones that residents can use in private, to make phone calls. Updates to assessments and care plans as well as all nurse delegation services are provided by the RN/ARNP owner free of charge. Should the resident require care products such as incontinence products, gloves, wipes, hearing aid batteries, ensure supplements, etc. – it is provided by Blueberry Gardens. Also included: all meals and snacks, daily laundry, haircuts and nail care, medication management, activities, linens, and close supervision day and night.
Are there any move in fees? We charge a $650 move in fee, which is billed on the initial invoice at move in. This fee is for the preparation of the residents chart and a cleaning fee to clean and repaint the room prior to the next resident.
What if we move in mid month? Blueberry Gardens charges a prorated fee for the first month, with the resident paying for only the days of the month the resident resides in the home or reserves the room for themselves. For example: If the resident reserves the room or moves in on the 15th of the month, their first invoice will be for only half a month.
How much do we pay if our resident moves out or passes away? If a resident passes away, Blueberry Gardens charges a “5 day room turnover fee” once the room is vacated of the residents personal possessions. This gives us time to paint, clean or replace carpeting, and prepare the room to show to other potential residents once it has been vacated. Since the month is generally prepaid, the balance of the prepaid month is refunded to the family for the days outside the 5 day room turnover period. If a resident chooses to move out, such as to follow a family member to another state, or because they have chosen to seek a different living facility, then a 30 day notice period is required.
What makes Blueberry Gardens unique? At BBG, our goal is stability and quality of life for our residents. As an RN and ARNP, the owner Jennifer is able to supervise the care of the residents, ensuring that they each receive close management and care planning for their individual physical or cognitive needs. A care conference is held every week, in every home, where the RN/ARNP manger meets with the staff to review the care of each and every resident, with attention to goals for the residents care, any feedback from doctors or family, discussion of any changes needed in diet, hydration status, activities, and with encouragement for maintaining mobility and independence as much as possible for the resident. With consistent, engaged and skilled caregivers, and close supervision from the resident manager, residents are assisted and encouraged to do exercises daily, to drink adequate fluids, eat well, and engage in an active and stimulated life. At end of life, most residents enroll in the hospice program and ultimately pass away in their own beds at Blueberry Gardens, surrounded and cared for by the same caregivers that they have grown to know, trust, and love.
What kind of food does Blueberry Gardens serve?< At Blueberry Gardens, we feel that food is something to be absolutely enjoyed and celebrated. Under a different tab on our website, we post our 8 week rotating menus for lunches and dinners, for you to peruse. We cook nearly all of our meals from scratch, using the freshest vegetables, fruits, meats and seafoods. We bake homemade breads and treats, and have snacks and desserts available at all times. Breakfast is served according to the residents own schedule, as we have found that the resident who likes to get up at 7am and have toast, fruit and coffee is very different from the resident who wants to sleep in until 9am and then have bacon and eggs. We assist residents with am care according to their preferred schedule and then prepare them the type of breakfast that they request. Lunches and Dinners are pre-planned and served at noon and 5-530pm, but we can accommodate requests for alterations if a resident does not like a main dish or side. At Blueberry Gardens, the caregivers sit down and eat lunch and dinner at the main table with the residents. This promotes conversation, visiting and a social experience during meals. After breakfast or after lunch is the typical time for our daily stretching/exercise session and after lunch or after dinner is when we have our scheduled activity for the day.
What if a family member wants to join resident for a meal? We strive to cook the correct amount at each meal for our residents and caregivers, to minimize leftovers and waste. We certainly can accommodate 1 or 2 visitors joining us for a meal on an occasional basis as long as we are notified at least 24 hours in advance so that we can plan to prepare more for that meal.
How are special days celebrated, such as Birthdays and Holidays? Every residents birthday is celebrated: a special table is set up with a cake that is shared with the other residents and caregivers, balloons, and flowers. We also invite family members to join us for important holiday celebrations, (up to 4 guests per resident), bringing in extra tables and chairs for our before Thanksgiving dinner, our Christmas open house, our St. Patricks day meal, our Mothers Day Brunch, our Fathers day Brunch (for the houses which have men in the homes) and our Summer BBQ. Residents enjoy helping to plan the decorations and menu for these fun occasions.
What happens if the resident has a medical crisis? If the crisis involves cessation of breathing or pulse, and the resident has a “DNR – Do not resuscitate” choice on their POLST form, this choice will be followed and the resident will be comforted but not resuscitated. All of our caregivers and resident managers are trained to assess for and respond in a medical emergency. If a resident has a significant and possibly life threatening medical emergency (such as a stroke, heart attack, sudden change in status, significant respiratory distress, etc) then 911 will be called as well as the family. If the family is not reachable or immediately available to meet the resident at the ER, then the BBG RN/ARNP or a resident manager will go to the ER with the resident and stay with them until a family member can arrive. We never send a resident to the ER alone unless the resident is alert, cognitive, and able to answer questions for themselves.
What if a resident falls? Many facilities have a policy of always calling 911 if a resident falls. This results in many unnecessary and intrusive ER visits and often unnecessary hospitalizations and medical tests and procedures. At BBG, we take responsibility for assessing our residents and only calling 911 for a fall if the resident seems at increased risk of having a serious injury or if there is serious risk of head trauma from a fall. All of our caregivers are trained to do basic assessments after a fall and to contact the RN/ARNP owner for further assessment as needed. We also have special measures in place to prevent falls, including use of motion sensor alarms near beds, carpeting in resident bedrooms (which is more forgiving should a fall occur), and sufficient staff to provide visual supervision and quick attention to residents calls for assistance.
What about family members? Many family members come to us frustrated and exhausted after months or years of filling the gaps in caregiving in their loved ones current living situation. It is often only through the efforts of the family member acting as caregiver, that the resident has avoided a higher level of care for so long. Family members are often the ones who have been filling prescriptions, purchasing incontinence products, communicating details to physicians and generally trying to maintain stability for their loved one. Many times, the involved family members are near their breaking point. BBG steps in and relieves the family member of all of this frustration and burden. Sons and Daughters are able to go back to being “family” instead of “caregiver” and generally about a month of so after moving a resident in, we overwhelmingly hear how relieved they are with the transition.
Visiting hours? Families and friends are welcome to visit at any time, although we will make some requests regarding the times of day that visits are less likely to upset the flow of the home. Generally early mornings are busy times for the caregivers as they get each resident up for the day and make their breakfast, and some of our residents are easily distracted by visitors and thus tend to not eat well if a visitor is present during mealtimes. After 8pm, some of our residents are retiring to bed, so after 8pm visits are less desirable. So generally, visiting after 10 am and before 8pm and not visiting during lunch or dinner time is preferable. Thank you.
How are medications managed? BBG takes responsibility for communicating with the residents doctor and obtaining and maintaining prescriptions for all medications the resident takes. We use “Ready Meds” as our pharmacy, this long term care pharmacy works with all insurances and they provide us with medications in a bubble packed system as well as a MAR (Medication Administration Record) where we document every dose and time that medications are given. As the RN/ARNP owner/manager of the facilities, Jennifer provides all of the Nurse Delegation to the staff and trains them in medication administration. 100 percent of our staff are licensed caregivers with special training in medication administration and are Nurse Delegated to administer medications. There is no extra charge for Nurse Delegation, this is included in the monthly flat rate.
Does Blueberry Gardens have a visiting Physician? Yes – most of our families choose to use NW Geriatrics visiting MD/ARNP service as the care provider for their resident. This service bills through medicare and makes home visits to see the resident. This minimizes the need for the resident to arrange transportation to a clinic and also prevents having the vulnerable senior sitting around in a waiting room where they are potentially exposed to patients with illness or infections. NW Geriatrics becomes the “Family Doctor” and visits all of our residents every 6-12 weeks, but is available by phone or email for questions or to review status changes as needed. Although residents can continue to go see their previous family practice physician or ARNP if they would like, most families appreciate the convenience of the visiting service and choose to transition to NW Geriatrics.
What about other medical services? Blueberry Gardens also has a visiting podiatrist, who bills through medicare and visits the home every 61 days to provide podiatric care. This podiatrist accepts most insurances and there is thus no charge to resident outside of what is billed to medicare. For the few insurance types that will not reimburse the podiatrist, there is the option to self pay for this visiting podiatry service. In between podiatry visits, the BBG caregivers trim and file toenails and finger nails and provide manicures and polish as a weekly activity. BBG also works closely with Evergreen Home Health for visiting Physical Therapists, Occupational Therapists, Speech Therapists, and Wound Care Nurses when needed.
How about Hospice? Most of our residents sign up for Hospice Care at end of life. There are several different Hospice providers we work with (Evergreen Hospice, Providence Hospice, Kaiser Hospice), but in all cases, the Hospice team visits the home and provides guidance, support, additional services (such as social work, spiritual support, music therapy) but the resident is able to remain in the home, with comfort meds to ensure comfort at end of life, and cared for by the caregivers who love and know them. Hospice is usually initiated when the resident has a gradual or sudden change in status which is life threatening and when it is not possible to treat the condition or the family or resident chooses not to continue to seek treatment. Many residents continue to live for months or even years after hospice is initiated, as it does not mean that care is withdrawn or death is imminent, it simply means that the family and resident has accepted that medical treatment/hospitalization is no longer the goal and that quality of life for the remaining time is what is most important.
Is there an additional monthly charge if a resident enrolls in hospice? Absolutely not. Hospice is a program which offers comfort and dignity at end of life and BBG very much values the philosophy of quality care that hospice offers. While some long term care facilities charge increased rates when a resident enrolls in hospice, Blueberry Gardens does not.
Does Blueberry Gardens allow smoking? No. Blueberry Gardens is a smoke free facility. None of our residents or staff smoke and smoking is not allowed anywhere on our property.
Does Blueberry Gardens allow residents to drink alcohol? Yes. Several of our residents occasionally enjoy a glass of wine or a beer and we have a few who have a nightly glass of wine or cocktail with or before dinner. We communicate with family and physician/ARNP providers about the safety of alcohol use with the residents current medications and caregivers are the ones who pour and serve alcohol if the resident chooses to enjoy.
Do you take residents on outings? No. We originally did take residents on scheduled outings to places like the museum of flight, Molbaks, or the Seattle aquarium, but we found that with the level of physical and/or cognitive impairment our residents generally have, outings away from the home were just too much for them. They often were stressed during outings and sometimes took days to recover from going out, and in reality a simple and structured routine in the home is far better for most of them. For the few residents who truly benefit from an outing, we leave this up to family and friends to do with them. Instead, we maximize scheduled and impromptu activities IN the home in order to entertain and stimulate our residents.
What kind of Activities do you offer your residents? Many! We have two visiting entertainers, one is the very popular David Arntuffus the musician, he comes to every house twice a month and plays guitar and does an after dinner hour long sing-a-long with our residents. We also have a wonderful art therapy group called “Art 2 Remember”. They provide a 90 minute art therapy session in every house twice a month as well. In addition, caregivers assist the residents with an exercise/stretching/yoga exercise session every day (after breakfast or after lunch) and we have a daily scheduled activity in the afternoon or evening. Daily Scheduled activities vary by day of the week and interests in the home but are generally: Read-a-Loud, Movie and Popcorn, Salon day (manicures and pedicures), Table top Art, Ball toss Game, Bingo, Trivia or Music, Baking activity or Happy hour fruity cocktails. We also do individual 1:1 activities with residents such as walking outdoors, picking berries or vegetables, flower arranging, letter writing, puzzles, etc. The physical layout of the home promotes interactions between the caregivers and resident all throughout the day and often the residents are visiting with the caregivers as they go about their tasks, or assisting them in the kitchen (peeling carrots, stirring ingredients in a bowl) or helping with laundry folding, dusting, etc. Many residents love to feel useful and the caregivers find ways to involve them in the day to day operation of the home in order to fulfill this need to be active.
What about haircuts and hair styling? Included in the flat all inclusive monthly rate is our visiting Beautician, who comes to all of our Blueberry Gardens Facilities and provides haircuts to our ladies and gentlemen every 6 weeks. Her services are paid for by Blueberry Gardens. Our caregivers assist our residents with showers and hair washing twice a week and will blow dry or style the residents hair for them per their preferences. Some resident request or require showers more frequently which we can also accommodate.
How can I get more information?
Please review our Blueberry Gardens website: www.blueberryseniorcare.com and our facebook page: Blueberry Gardens Senior Care Bothell WA for more info. We post images of our homes, staff, and have links on our website to 2016 and 2017 smilebox “year in pictures” which will show you what life in the AFH is like throughout the year.
We also have a testimonial page on our website and we are happy to provide you with contacts for both current and past family members of our residents should you want to speak to them directly about their experiences regarding our care.
We welcome tours of Blueberry Gardens and can schedule tours with Jennifer (RN/ARNP owner) or Joy (Office manager) on weekdays or with resident manager Anna on Weekends.
Call (800) 747-2997 to schedule.
If you are interested in moving a loved one to Blueberry Gardens and we are currently full, there is no cost to be on our waiting list. If you decide to place your loved ones name on our waiting list, we will call you and let you know as openings develop and you can then either accept or decline the available room depending on your residents needs at the time.
(800) 747-2997 info@afhseniorcare.com