Way O/T -- nursing homes

[springer02]

Hi All,

I just got back to Virginia from a quick and unexpected trip to Western Michigan where my 80 year old Mother has been admitted to a nursing home.  She never told me that she wasn't feeling well and then bam, I get a call from her neighbor who is taking her to the ER.  They found that she was severely dehydrated, had a septic bladder infection and the leg that she's had circulatory problems with is totally numb, the foot was purple. She was hospitalized  for four days and then admitted to the nursing home, her own wishes. I'm brain dead from it all but I have a gazillion questions.....

She seems happy as can be expected there, the staff seems nice and the place is pretty clean.  What should I look for?  Where can I check for violations?  Are there support groups (other than you guys, of course) for people like me?  She did sign a power of attorney naming me, I'm the only child. She agreed to let me take over paying her bills and I had the mail forwarded to me.  Her neice, my cousin, is her financial advisor and we went over everything and she's set for a good long time.

What am I forgetting?

One thing that I think I learned is that when you fly US Air and get their special medical emergency fare, you're flagged as "suspicious" and probably will get your stuff hand searched.  I did, both ways.

Anyway, thanks in advance for your help.

Tena

[birol]

Hi All,

I just got back to Virginia from a quick and unexpected trip to Western Michigan where my 80 year old Mother has been admitted to a nursing home.  She never told me that she wasn't feeling well and then bam, I get a call from her neighbor who is taking her to the ER.  They found that she was severely dehydrated, had a septic bladder infection and the leg that she's had circulatory problems with is totally numb, the foot was purple. She was hospitalized  for four days and then admitted to the nursing home, her own wishes. I'm brain dead from it all but I have a gazillion questions.....

She seems happy as can be expected there, the staff seems nice and the place is pretty clean.  What should I look for?  Where can I check for violations?  Are there support groups (other than you guys, of course) for people like me?  She did sign a power of attorney naming me, I'm the only child. She agreed to let me take over paying her bills and I had the mail forwarded to me.  Her neice, my cousin, is her financial advisor and we went over everything and she's set for a good long time.

What am I forgetting?

One thing that I think I learned is that when you fly US Air and get their special medical emergency fare, you're flagged as "suspicious" and probably will get your stuff hand searched.  I did, both ways.

Anyway, thanks in advance for your help.

Tena

Sorry to hear about your mother. I hope she will do well in the nursing home.

One issue they are having in Ontario is, nursing homes are heavily medicating elderly residents with behaviour controlling drugs without obtaining anybody's explicit consent. They are hiding behind a "well patient was out of control, without patient's consent we can not inform his/her family of their medical situation, so our doctor's act in patients best interest scene). They prescribed anti-pysyhocatic (sp) pills to a lot of eldelery people with no-one's consent. They are being sued big tiem of course. Just make sure they inform you of any prescription changes, additions, deletions and so on. You ahve to be reposnsible for their medical life.

Good luck to both of you ....

[luvourjayco]

Being a geriatric nurse for a good long time the best way to check out any home is to walk around and get to know the staff and residents. You'll soon find out the good, bad and the ugly. Happy staff interact with the residents and are encouraged to do so. Of course there are always though that are there for the paycheck and nothing else. Are residents encouraged to bring in their own belongings and make the place their own. Is family encouraged to visit any time at all and participate in events? Call some friends that have had parents in long term care have they heard rumours? Most of this is unofficial but you really get to know the places that way. Ensure staff are to notify you if there are any changes in medication or her general well being or even if they just feel something is off. Often things change only slightly and the clues are hard to find but someone closer to her will know what is going on and it could indicate the beginings of something that can be nipped in the bud.  
Good luck to you and your mom she's really lucky to have someone like you on her side.

[Preacher]

I always tell people with loved ones in a nursing home that visitation is the most important thing they can do.  It obviously is good for the person in the nursing home, but it also keeps the staff on their toes.  As a pastor who is in nursing homes quite a bit, I can tell you that those patients whose families visit often get more attention then those whose don't.  Shouldn't be that way, but that is the way it is.  I encourage family and friends to visit often (daily if possible, but no less than once a week) and vary your visiting times.  This way the staff never knows when you might be in.  Also if you see anything suspicious bring it up to management IMMEDIATELY.  This can stop a lot of problems and also lets them know you are watching them.  Also talk to families that have loved ones in the nursing home or potential nursing home.  And don't be hesitant about moving your loved one to another nursing home if this one consistantly has problems.

One other thought.  Depending upon your mothers ability to take care of herself after she gets over this problem, you might want to look into an assited living place.  We had my MIL in one before she passed away.  It gives the patients more freedom and does not have the feel of a nursing home, but they do get assistance with their needs.  They prepared three meals a day, did her laundry, cleaned her "apartment", gave her her meds, etc.  They also had activities for the residents such as bingo, exercise classes, shopping trips, field trips, lectures, games, etc.  If you mother, once she gets well, is somewhat able to take care of herself with assistance, this might be another way to go.

[slowpez]

Having been a complaint investigator and nurse surveyor in nursing homes for DHEC for several years I would also like to add that your should ask to see their annual inspection report.  Every nursing home that accepts federal dollars (ie: medicaid or medicare) must be inspected yearly.  The report must be posted where residents and families can easily access it.  This should give you and idea if the nursing home has any problems with abuse, it's ability to rehabilitate its residents, and the overall quality of life residents can enjoy while staying there.  It will be difficult for you to monitor the home by frequent visits at odd hours as suggested but if you could find someone who can do that for you it would be a big help.  You might also look into geriatric case managers (RNs who monitor the care of their geriatric patients).  Our state publishes survey results on its website so you might check and see if your state does.  Hope this helps some.  This can be a difficult time for families.

[ForestCreature]

Sorry to hear about your mother. The nursing home thing is never easy to do, but necessary at times.
 
 What should I look for?
 Take time to really listen to what your mother is saying when you speak on the phone, listen for changes in her voice for signs of unhappiness or even personality changes. If she appears to be getting unhappy question why and don't take  "there is nothing wrong" for an answer if you have even the smallest concern.  Don't discount even the smallest complaint from your mother, address them with the home immediately to let them know you are paying attention even if it is by long distance.
 
  Have her friends and other relatives stop by for frequent visits and keep in contact with them, elderly parents or grandparents do not always tell you what is going on around them.
   
Another thing is to not have any jewelery or valuable belongings there, even a wedding ring. Things walk off even in the best of nursing homes.
 
  Where can I check for violations?
 Here is a couple links to websites that lists offences and other info of homes
 
 http://www.memberofthefamily.net/registry/mi
 
 http://mel.lib.mi.us/social/SOC-aging.html
 
 
Are there support groups (other than you guys, of course) for people like me?
 Don't know of any in particular, but I'm sure they are out there.
 It's a tough road, I've been there with MIL and my Grandmother. Unfortunately both ended in hospice situations.  Family &  friends  support helps alot.
 
 As preacher said,  looking into assisted living is a great option when she is released from the nursing home.  Aside from being good for Mom, it will give you a little peace of mind knowing she isn't alone.
 
 

[Camperroo]

Having a parent in a nursing home can be very stressful, especially if you are a distance away.  If it is within possibility can you move her to a facility closer to where you live.  My mom, who is essentially a healthy woman with all her faculties, went into a nursing home for short-term care to recover from a vertebra fracture and we were there every day, but at night when everyone went home the nasties came out to work...I'm not exxagerating.  These people acted as if they were doing the patients a tremendous favor by responding to their requests for assistance or help.  I'd personally like to go and pound the person who was so cruel to my mother, but I'm letting the state take care of it by having the nursing home investigated, they've already fined them for several things and made them make repairs to the facility.   This is a facility that is well touted in our community and has all the bells and whistles when you walk in.  Everyone in admissions is all smiles and how can we help you.  But they forget all about you once your mom is in and you are out.

I don't care how pretty the facility is or how nice the wallpaper, you need to spend some time there, watch the staff very carefully not just with your mom but watch how they treat other patients when they think you aren't listening or watching.  Don't be afraid to confront them or tell them upfront you will absolutely not stand for any form of elder abuse, from disrepecting your mom to physical harm...that you will seek and press a formal complaint for any infraction.   In my mother's case she asked to use the restroom shortly before retiring for the night, but the lazy witch who came in didn't want to help deal with getting her out of bed and using the wheelchair to get to the bathroom, so she gave my mom a bedpan, or shall I say, shoved it under her.  My mother became quite frightened by her action and asked her to please be gentle and not spill it.  What did the rotten witch do...she spilled the contents of the bedpan all over my mom and the bed and then left the room never coming back to clean up mom or the bed.  She lay in urine soaked bedding and nightclothes all night.  She was too afraid to push the button for help because she feared this woman being the one to come back to help.  She waited through till morning and when the PT aide came in she asked for her help, told her what happened and she immediately placed a call to my dad telling him he might want to hot foot it down there.  We immediately removed my mother.  I'm still boiling mad just thinking about what was done to her.  

I'm don't mean to scare you, but nursing homes are not always well run and people try to blame it on funding, but funding has nothing to do with how a person respectfully treats another person.  Keep a close eye on your mom, call everyday, ask to speak to the floor nurse everyday so they know you are checking in.  Have a close friend or member of her church perhaps come by as often as possible to make sure she is in good health mentally and physically.  If my mom ever needs recuperative care again, it will be set up at her home with Visiting Nurse Association visits instead.  Never again will she be subject to the mercy of a nursing home.

[B-flat]

Wow, this is surely valuable info...the good, the bad and the ugly.  As has been said, you cannot read a book by it's cover....er, wallpaper.  I have been in some extremely nice facilities only to notice some not so nice things going on with step-daughter who had suffered a stroke at age 34 and was mentally nd physically handicapped.  First thing was meds not properly given, next was alerted by visitor that an older resident was taking things from her room, and next that a younger employee was fooling around and next falls started occurring.  Visiting at variable times does not always turn up these things.  You have to have all antennas raised, listen and check out any complaints made to the state agency that oversees elder abuse.  If anything is wrong, see the manager of the facility. If the situation is not taken care of, find another facility.  Look for cleanliness, signs of bruises, changes in patient behavior and listen to what other people are saying.  Make conversation with other families in the common visiting areas, if possible, to ask questions.  Nursing homes are a difficult thing to deal with.

[springer02]

Thank you, everyone, for your helpful suggestions.

So far, so good.

We haven't found or heard of any problems with the nursing home.  My Mom seems happy there, we're thinking that she's at peace with her decision to be there and she knows she can't take care of herself at home.  We tried the visiting nurse thing a few years ago after she was discharged from rehab after surgery and it didn't go well at all for numerous reasons.

When I was there this weekend, I flat out asked her if she wanted to move here and she said, "NO."  This is a proud woman who has lived within 30 miles of where she is now forever.

I guess for now she'll be there and I'll fly home whenever I can.  Not the easiest thing for me but I'm not the person in question here.

Again, thanks for your help and support!!

Tena

[tlhdoc]

I can't add anything to the advice you have received from the others, but I wanted to say I am sorry to here about your Mom.  It is good that she has excepted the nursing home and is in a good frame of mind.