What I Learned From a Summer Storm

What It Is WednesdayRecently, my daughter woke up from her midday nap just as the rain was finally coming in. It had been hot and muggy for days and I was so excited to smell that delicious scent in the air that I scooped her up from bed and took her out on our back deck so that I could stand barefoot, my little two-year old perched on my hip, listening for the storm to roll in.

She’d never really seen or heard thunder or lightning while outside, so when the first rumble came rolling in overhead, her eyes grew wide and she buried her head in my neck, holding on to me tightly. I rubbed her back and explained to her that the clouds were getting ready to rain. I talked about how big and strong the skies had to be to hold all of that rain and that the noise and the light were just the sky saying, “Get ready! We’re sending the rain! The plants need a drink of water!”

I pointed to the clouds moving in, expressed awe at the lightning in the distance, and then told her to wait and listen for the thunder. She looked up intently and then when she heard the thunder, she looked at me with excitement. I wondered aloud if the thunder was getting louder because the sky was getting excited to drop all of that heavy water on the grass and the trees.

We watched the distant flash and then waited again until the thundering crack rolled over our heads, the dark, heavy clouds moving above us. My daughter held her face up to the wind, listening raptly to the thunder, and then looked at me with big eyes.

“I like it!”

I smiled at her. “I like it too!”

We stood there for a long time, me remaining mindful that the lightning was keeping its distance, both us enjoying the increasingly powerful claps of thunder. I explained while we waited about the wind and how it helped the clouds to travel to all the places that need water. I explained why the clouds had become dark, that they were heavy with the water for the plants. She nodded attentively in a way that I haven’t seen often in my energetic little toddler, soaking up all of this information about a new experience.

“Thank’oo, clouds!” We thanked the clouds for bringing water, waving as they moved above us.

“Water coming, grass! You drink! Trees, water coming!” My daughter reassured the grass and trees that a drink was on the way.

As we marveled at the sky and expressed gratitude for what was coming, my daughter stilled into patience by her faith in my promise of impending rain, I heard the sound of rain falling in the next yard and then I felt the first few drops.

“The rain is here!” I smiled at her and we held out our hands and laughed as the drops fell faster and faster. I asked her if she wanted to go in and she shook her head, watching each drop collect on her arm.

Suddenly, the full rain was upon us and the downpour began, the drops pelting us until my daughter had finally decided we should go inside.

“Oh wow! Big drink! Mommy, go in the house!” I scurried inside while both of us laughed and we walked into the living room just as my husband was arriving home from the store. Daddy was instantly regailed with the story of how the clouds work and then big booms and the grass having a drink and the rain falling on our arms, and then we all watched the storm through the front window for a while.

I watched my daughter and I thought about how we shape our loved ones’ experiences with the way we frame what is happening around us. I could have run inside at the first crack of thunder because of her initial reaction and we both would have missed these precious moments. But I explained, and I expressed appreciation, and I showed no fear, and in that moment my daughter was able to hear me and see me and then enjoy a wild and beautiful show of nature.

I want to carry this moment forward with me, how I was able to speak so that she could hear and understand. I want to live in a world where this is how we learn about ourselves and each other, with careful exploration of how things work and how sacred and fascinating life is.

I want to hold the world tight when we’re afraid and then I want us to help each other refocus through carefully consideration, careful observation, gratitude for what we have, and through sharing openly when we have wisdom and perspective that might reframe our future.

I want to remember that each moment is sacred, can be a teaching moment, and that I am so privileged to be a part of these moments, never taking any of it for granted. I want to remember that I have more than many and that I have more to give with each day, observing and learning. I want to remember that my actions and what I accept about the world and how it works will frame my daughter’s future.

Let the rolling thunder of our current times be a vivid reminder of the power we have in witnessing and giving voice to what is beautiful, sacred, fragile, and important in the world. In the way that I can transform a little girl’s experience of a rainy summer sky, so too can we all bear witness to and transform the narrative around the storm we face as a nation on so many levels.

Let our voices soothe a hurting nation by saying, “I see you. I hear you. I want this to be different. I am here and will help facilitate the change. I have hope for and plan to work toward meaningful, healing growth, and I want all of this abundance to be available to everyone, not just me, and not just people like me. I am listening so that my words are infused with everything I can possibly know about the world, my own lens, and what is needed of me in the days to come.”

Let our words be the lightning that draws our eyes toward those who need us. Let that lightning summon the rolling thunder of our thoughtful actions toward change. Let the subsequent healing rain soothe what is hurt and afraid and angry in each other us so that positive changes can grow vividly green and take root in our hearts and minds.

This post is my contribution to this week’s edition of a blog hop started by Kelley Harrell of Soul Intent Arts called “What It Is Wednesday,“ which gives bloggers a chance to dauntlessly tell it like it is. Check out the inaugural post to learn more about joining in or just to read other blogs in the hop.

“What Can I Do???”

What It Is WednesdayI have seen a lot of this recently in response to recent tragedies. There is a common reaction when a societal injustice or tragedy is spotlighted and the person seeing that issue discussed openly and passionately feels uncomfortable for any of the following reasons: recognition that there is injustice, resistance to facing one’s own role in the silence around an injustice, fear of alienating others by adding one’s voice to the dissent around an issue, avoidance of one’s own biases or inherent privilege being exposed, unwillingness to explore change around an issue (such as changing one’s mind or admitting to possibly having been wrong about the issue for any reason), or uncertainty and fear around any aspect of an issue. There are many, many reasons we don’t raise our voices.

The outward reaction, if one is even given, is often some variation of, “Well, duh. That sucks, and it’s not like we don’t all know that it sucks, but what do you want ME to do about it?” There are other reactions but this one is one that I want to address this Wednesday.

Here is what you can do about an injustice or tragedy caused by some terrible fracture in our culture that leads to someone else’s marginalization, physical harm, victimization, bullying, or death:


Your voice is powerful, solely yours, and completely free. State out loud how you feel about the terrible things that hurting and angry people do to other people in today’s culture. Say it. Say it over and over. Express your dismay and your grief and proclaim it again and again to yourself, to your friends, to your family, to your local and federal government officials, to the WORLD.


It is not enough to refuse to support injustice if you want to facilitate change. Be part of the conversation to the extent that you are able (and qualified / educated enough) to be. Be present so that you might hear new information and learn about some way in which you are able to tangibly help that you would not have known of if you hadn’t added your voice to the dialogue about what’s gone wrong.

The thing about saying it out loud is that it isn’t just something to do when faced with visible and obvious injustice. It isn’t just about doing what’s right for your community, or facilitating change for others.

Using your voice can heal YOU.

Giving our feelings and our experiences a voice is one of the ways that we honor where we are at so that we can move forward into who we will be next, and silence is an active barrier to that growth, both in our community and in ourselves. Our voices (and then our ears) are tools for healing, for self empowerment, for societal dialogue, and for change.

Your voice doesn’t always have to span the globe or reach Congress. It doesn’t always have to immediately further societal improvement. Sometimes your voice can be an admission to a close friend or family member that you are not okay, prompting support and love from those who want you to be okay and are willing to bear witness to your journey.  It can also be an admission that you’re not okay with something that has happened in the world, prompting someone close to you to possibly think differently.

Your feelings and beliefs deserve a witness. Unstated, they sit silently and unmoving, sometimes festering, seldomly transmuting, often unable to grow toward resolution. Stated in an appropriate way, they are powerful catalysts to be honored, discussed, and then released to make room for change, growth, and evolution, both of ourselves and our community.

What are you carrying with you that could be spoken aloud today, either for yourself or for your community? What’s stopping you from allowing those words their journey?

This post is my contribution to this week’s edition of a blog hop started by Kelley Harrell of Soul Intent Arts called “What It Is Wednesday,“ which gives bloggers a chance to dauntlessly tell it like it is. Check out the inaugural post to learn more about joining in or just to read other blogs in the hop.

Deception in Memory Care: Assisted Living Level of Care

What It Is WednesdayAfter several years of working in multiple ways with long term care facilities, I would like to address several aspects of assisted living care and marketing that are becoming all too common in today’s long term care industry. These are things that are important to know if you are trying to place a person with dementia in facility and may not be explained to you by discharge planners or staff at facilities, either because it’s not commonly known (often due to misleading marketing) or it’s something an assisted living doesn’t like to acknowledge. Keep in mind that some of these details may be specific to Ohio, where I practice, and are based on my professional experience within my geographic area within Ohio.

This week’s important tip:


Seems pretty straightforward, right? Well, it isn’t. Many assisted living facilities market themselves as offering both assisted living and memory care, leading many to believe that these are two different things.

The memory care unit or area of an assisted living is still considered an assisted living level of care. Even if the facility’s website and marketers describe their building as offering assisted living AND memory care, what this typically means (unless it’s a nursing home that also has assisted living, in which case it’s wise to think of the two as separate entities in terms of how they’re paid for and how they work) is that the assisted living has a semi-secure area for patients with dementia who need increased supervision.

Why is this important?

Assisted living is self pay. It won’t be covered by your insurance (unless you have long term care insurance, which is a fabulous thing to look into if you can), and skilled rehabilitation (of the type where your stay is covered to some degree by your insurance after a hospital stay or surgery) is not offered at an assisted living facility. A resident can receive supportive therapies while living in assisted living, but only those therapies would be covered, not room and board, or other care needs.

Memory care in assisted living is significantly more expensive than typical assisted living care, often by thousands of dollars. In recent years, the local average seems to be around $5,000 per month for memory care in assisted living. Some facilities being lower or higher, but this is sometimes because the level of support is different, so keep in mind that a “cheaper” assisted living facilities may be priced according to a particular package of services, only to end up being just as or more expensive than others once you add a la carte services.

In Ohio, there is the possibility of applying for a Medicaid assisted living waiver, but in my experience this option is more helpful to higher functioning assisted living residents, it does not pay enough to cover the cost of memory care in assisted living, and most memory care-oriented assisted livings will not accept the waiver for memory care residents because the facility cannot afford to care for a patient in memory care with the level of reimbursement provided due to increased staffing, care, and supervision required for patients with cognitive impairment.

Capacity to manage patients with difficult dementia-related behaviors is lower in assisted living than in nursing homes offering memory care. Someday this will likely be a post unto itself, but for now just understand that not all facilities offer the same type or level of dementia/memory care, and these facilities don’t always want to come right out and explain this to you. Many will even given the impression of being able to care for resident with dementia for the “rest of his/her life,” when this is often not even remotely true, depending on level of behavioral issues and increasing physical needs that cannot be provided for in assisted living.

Not all nursing homes or assisted livings can handle all types of cognitively impaired resident, and I have yet to encounter an assisted living that offers truly behavioral memory care, as in, caring for a resident with dementia who may at times strike out at staff, shout, or engage in exit-seeking behavior. Some people with dementia may exhibit these behaviors intermittently even with the right medication and if your loved one progresses to a point that behavioral issues are a part of his or her daily routine, you will likely be looking at another move.

Understanding this is important in and of itself, but even more so when considering my next point.

Assisted living memory care facilities routinely get away with refusing to take memory care residents back from the hospital. Why? Because they are an assisted living level of care. Even though they’ve set up an area for patients with cognitive issues and have called it memory care, it is still technically assisted living level of care and most of the residents on those units are already requiring more care than is expected to be provided at an assisted living.

This is really important, because it means that your loved one could be discharged from the facility without the 30-day notice that is usually required of a long term care facility. I have had multiple assisted living facilities succeed in sending a patient to the emergency room for a behavioral incident or even a medical issue, and then refusing to accept them back because “they cannot adequately meet the patient’s needs.”

Even if this issue is behavioral and psychiatric care is given to stabilize the issue and a resident’s behavior is consistently improved prior to discharge, the facility is not required to accept that resident back, at least based on several experiences I have had with calling an ombudsman to try and report these types of issues. Assisted living facilities aren’t required to provide the level of care a resident with dementia requires, so an emergency discharge is an easy out.

If given an emergency discharge from assisted living, I also find that family and/or caregivers often have to really work hard to be reimbursed for days they’ve already paid for and if your loved one does receive a emergency discharge, be sure to take his or her belongings out of the room immediately so that you aren’t charged for every day that the room is still unable to be occupied by anyone else.

To recap, it’s important to know, before moving your loved one into an assisted living facility, whether your loved one can afford to be there, and whether he or she is truly able to be cared for long term in that environment. Memory care in assisted living can be a wonderful resource for the right person at the right assisted living with the right caregiver/family advocate.

Some of the above is useful whether placing someone who has dementia or just needs more help than can be realistically provided at home. If your loved one does have dementia (or similar cognitive impairments), this information is important to understand and can protect from unexpected issues with whatever facility you ultimately choose.

Here are some questions that are helpful to ask when touring an assisted living facility for a loved one with dementia or other type of cognitive impairment:

  • What is the monthly cost and what does that include or not include?
  • Are you able to keep residents in this memory care unit after their finances are exhausted? If so, how specifically do you do that? If not, do you assist with locating alternate placement and obtaining Medicaid to cover long term nursing home care?
  • What behaviors can you manage and which are you unable to manage? (Describe your loved one on their most difficult day and ask how the staff would handle your loved one. The ease with which the staff answer this will tell you a lot.)
  • Is your facility assisted living only, or also a nursing home? (Ask the staff to be specific and get a straight answer on this. A waffling answer is a red flag.)
  • How secure if your memory care area? How do you get into and out of the memory care area? (If your loved one is highly exit-seeking, most units are only semi-secure and pushing on the door will eventually open it.)

This post is my contribution to this week’s edition of a blog hop started by Kelley Harrell of Soul Intent Arts called “What It Is Wednesday,“ which gives bloggers a chance to dauntlessly tell it like it is. Check out the inaugural post to learn more about joining in or just to read other blogs in the hop.