Wednesday, April 10, 2013

Mom's Skilled Nursing Center Given Weeklong Special Investigation by DHSS

Two recent deaths due to what is said to have been negligence and believed could have been prevented.

Various other violations of State Rules and Regs and Rights of Residents alleged and reported.

One death certificate cited "natural causes" after resident was dropped using lift mechanism, entered Hospice and died within about a week.

Yes, both were elderly, however both were in relatively good health prior to their "accidents" and both, we believe, suffered needlessly.
Sadly, long term care facilities are not automatic safe havens for our loved ones and it's critical family members and friends visit, advocate and even become adversarial when necessary to ensure resident's health and welfare.

Move Mom if it's that bad?  My oldest son would definitely respond that way, I'm sure. Medicaid beds aren't that easy to find and actually with the State involved, Mom's probably far better off staying.

I know after having visited every facility within a twenty five mile radius there just aren't any available places in facilities that are any better.

With Mom's Lewy Body Dementia, unless she was totally incapable, moving and adjusting could be very, very difficult for her.

If you're care giving a loved one in a SNC, you understand; if you're not, you should heed the warnings as many of us will spend at least two years, according to recent studies, in a Skilled Nursing Center or other Long Term Care facility.

Today the State returned to supposedly see how much had been done since their initial examination visit that encompassed a full week.

Word around the facility among family/friends is the report is approx eighty pages -- far in excess of usual reports and probably containing numerous concerns of varying degrees.  (Update: Actual report 85 pages and as of 4/25 still not posted on internet but available at the facility to read.)

It's been interesting to see how the SNC "snapped to" immediately following the first day of visit and requests that had previously been ignored suddenly being accommodated.

Other actions were being taken by the facility within days to offset remarks made during the various examiners observations and before the report was to be generated; trying to make "points" possibly and show the State they would "do better". 

The question, however, is how long this will last; family members who've "been around for years" have seen similar investigations before; perhaps, however, not quite on this scale.

Today when I re mentioned Mom's wheelchair had fecal material on the tag and on the cushion she used and the wheelchair's sides were broken, I wasn't ignored as I had been at least a dozen times previously.

To the contrary, within five minutes housekeeping came for the chair, asked what we needed, the chair was removed and to add to the real "coup d'etat", the previously inactive and non responding to so many requests Nurse Manager suddenly appeared with a replacement wheelchair.

Times past it would be hours if and when the chair and cushion were taken away to be cleaned, actually returned clean and certainly no "replacement" would have appeared in the interim.

Unfortunately, this service doesn't counteract last Monday's experience of forty minutes waiting to have Mom taken to the toilet and having the place so short staffed (oh, wait, there was a Nurse (LPN) standing around at the Nurse's station but that's typical; the shortage is in the real caregivers, the Aides). 

One dedicated Aide was trying but they had her running from one person to the next with several emergencies, trying to move Mom's roommate from her chair into the room and eventually into bed with a lift (which was never accomplished presumably because an additional Aide was nowhere to be found). 

The Aide, ML, was running as fast as she could and then was told it was her job to "pass snacks" -- something required by the State but until the State came in for the five days had never been a practice of the facility. 

So, with the passage of Mom blocked by the chair of her roommate in a reclining position, Mom having fallen just the day before -- if I hadn't been there -- would my Mom have fallen again trying to get herself to the Bathroom?

Wait!  "Grandma" or "grandpa" as some staff call residents should just "let go" and "do it" in her/his "diaper" as some have been told they should do.

Right!  Mess yourself; sit in it; wait for someone to notice the stench when they get around to possibly checking on you maybe hours later. Or, better yet, get a bladder or urinary tract infection and have it go unnoticed and turn into Sepsis -- the fate of one of those who died recently.

Strange how our society changes from one that encourages our children to learn to toilet themselves and stop making messes in diapers and then when we're old encourages us to mess ourselves because there aren't enough people hired or in place to help us to the toilet while we still can be helped.

And when we get to the point where we can no longer use a toilet, enduring the hours of sitting in our messes until someone grants us the privilege of changing us.

My mind goes to how many times a caring parent checks the diaper of their precious little one to ensure they're changed to prevent diaper rash or other infections. Why don't we value our elderly this same way?

This is what we all have to look forward to. And we wonder why no one wants to go into a facility?  

This is why my Mom accepted so easily the story we believe was invented by JH about Lawrence, Mom's acquaintance from years ago, the "white knight" coming to rescue Mom and take her away from this less than life valuing lifestyle.

State Review of the facility isn't all that's needed. The State needs to review its own policies, procedures and standards of operation when it comes to reports to their Hot Line for Elder Abuse and the people who make decisions, those hired as quasi social workers in the DHSS to investigate reports; the people who need at the very least a GED (NOT A COLLEGE DEGREE; NO MSW; NO LICENSED CLINICAL SOCIAL WORKER designation) and a couple of years working in some form of "public" contact (fast food or retail will do).

To add to the level of questionable competency, with one year and a few extra hours of training,we now have an "Adult Protective Care Worker". That's in our State; check out your State's hiring policies for APW's and DHSS workers; it's eye opening to see who's making life decisions for adults with special needs and our elderly. More suggestions on this subject later.

A CHALLENGE:  Make time in your day at least once a week to visit with someone in a Skilled Nursing Center; take them for a "walk", read a newspaper or magazine article to them. Bring them into today's world; they mostly live in their memories but they deserve to live alongside each of us. After all, your time is coming faster than you think and if you don't value their lives today, who will value the quality of life you have tomorrow, when you need it?

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