Wednesday, November 19, 2014

A Double Edged Sword: Gericare Chairs & Facility Accidents

This is an entry I started in November, 2014. 

Sometimes I move on to write other topics. Sometimes the topic is too "recent" to post; too hard to share at the time.

November 19, 2014

Just a couple of weeks ago leaves were changing and dropping on the ground. Some dried and were soon to be removed with rakes and bags. Others were still clinging with all their remaining strength to stay on the tree as long as possible, especially the Oaks.

Many of our aging are Oaks; standing strong against the challenges life presents, surviving, providing. 

They moved forward believing what they’re told about the “Golden Years” that seemed so far ahead that when they arrived, they still thought those years were far into the future.

And when their time was near, when their days were far less than before, how are they seen, how are they treated, how are they honored for what they have provided, given and endured?

Now, outside it's unseasonable, unexpected cold, snow and ice -- weather reflecting similarities between nature and changes in life for many of our aging population -- sudden, at levels not experienced before and with side effects not expected. 

Like the lives of our aging population and those with medical conditions that do not necessarily improve or “get better”, a bitter time of suffering, enduring and coping are everyday challenges for many who are “cared for” at levels we wouldn’t approve of for children or animals.

Gerichair -- interesting word, Gerichair, "geri" being short for Geriatric meaning "of or related to old people"  "especially for their care" according to an internet search.

A special chair used for many purposes in hospitals and medical facilities. It can be used during dialysis, blood collection and respiratory and cardiac care as well as in Long Term Care Facilities.

In general, medical facilities like hospitals and out patient centers, individuals would scream if they had to endure equipment that caused physical harm to their bodies. 

In Skilled Nursing Centers they scream, too, but who’s listening?

People in SNC's often must be moved, lifted, placed in these chairs. Use of a special lift, a Hoyer can be involved. 

In SNC's people often spend hours in these chairs with little or no adjustment (although this is medically incorrect) or only simple adjustments to change the angle of recline and not the positioning or adjustment of the body leading to sores, abrasions and other medical conditions.

It's a positive asset for eldercare when used correctly. It is a negative and an endangerment when used incorrectly. 

Unfortunately, few who place residents, oversee residents or tend to residents in Gerichairs check to make certain there are no rough edges or places that can cut, bruise or harm the elderly. Few facilities ensure their attendants and especially their RN's and LPN's are required to regularly check and notate their observations regarding the use of these "medical devices".

It’s up to the “Nursing Staff” and Administrators to determine when and if adjustments are to be made, on what basis and when. 

A few "caring" CNA's will attempt to provide caring service but they're always mindful of being found at fault for doing "more" or "less" than "directed" and so many provide services strictly as directed with no variance even when it's in the best interest of the resident.

What are the Mandated Requirements for monitoring or recording when any changes in positioning, checking with communicable individuals for their wants/needs, overseeing individuals who cannot communicate and providing caring adjustments to clothing and to the equipment to ensure comfort and physical protection?

NOTE: It's now January, 2017 and I still haven't been able to find the answer to the above question. If anyone has, would appreciate the reference taken by copying from the website so we can share with the hundreds of people now regularly reading this blog.

Are there any? Who's responsible for making them -- the individual facility, the Doctor assigned to the case, the resident RN, the Department of Health and Senior Services (no, don't think so, all they do is "uphold" what's written, they don't get involved (strange, right?) in making the guidelines/laws -- WHO IS RESPONSIBLE?

Guidelines and suggestions are common in the Long Term Care industry but generally both Medicare and Medicaid do not oversee or ensure Residents are provided with any specific care. 


In my opinion, too many residents are alone, without family or friends able to oversee and ensure their safety and well being. IT TAKES A VILLAGE used to be a popular saying about children; IT'S A GREAT SAYING TO APPLY TO OUR AGING POPULATION, TOO.

The chair used for Mom was an endangerment. Mom was physically mobile with her legs and arms. The chair had rough, raw edges and Mom would get her leg caught in between the side rail and the raised leg support. The metal raw edges cut into her leg. The facility never told us this was happening.

Always Look Beneath and Beyond When Visiting A Loved One In Long Term Care

We arrived for a visit and Mom had some gauze wrapping on an area of her leg. We asked Mom what happened but her ability to relate an incident became less and less as the Lewy Body Dementia progressed in her body and the end drew near. And, sadly, some will recite what’s been told to them by Staff as what happened when it’s not the truth. Mom said she didn’t know. Another common response from individuals with Dementia

Seeking out Staff, the Nurses (LPN’s by the way; only one RN is required to be on duty at a Long Term Care Facility in Missouri and he's/she’s busy “administering” and not on the floor --- safely tucked away somewhere and always seeming to be busy, in a meeting or somehow “unavailable”) we were told Mom’s “medical condition” was “deterioration” and the LPN claim the bandage was to cover a “sore” produced by those factors.

UNTRUTH. Mom had thrown her leg, she had thrown it against the raw metal edge and a cut had occurred. Only when we unwrapped the leg for ourselves did we see a cut, a gash and not a “sore” as we were told.

We watched her, also, and we saw this natural behaviour from a human being used to walking, used to rising from a chair, used to being active and a brain that still sent these messages and they were received and acted upon by the body. Mom's body "remembered" and acted even when parts of it were not capable of following through.

This wasn’t the first misreporting or coverup; that was standard operating procedure at the facility and I believe happens more often than not in almost all facilities.

 A Skilled Nursing Facility is designed and licensed to provide medical care. That is their focus, their reason for being; that is why in the State of Missouri they receive Federal and State Funds in the form of Medicare and Medicaid to provide specific services not available except in a hospital on a 24/7 basis.

The facility withheld a lot of information about "accidents" or grossly understated the effects of the occurrences.

No amount of contacting the Elder Abuse Hotline or the Office of the Ombudsman for the State of Missouri brought forth any real assurances these practices would cease and desist and would continue to be monitored.

No fine. No removal of abilities. Just a written report CITING the observance of a team that would on occasion visit the facility and a review to ensure it wasn't continuing when they rechecked. And for some reason, the “infraction” always seemed to “be corrected” when the facility was reviewed and then the “violations” were cited as “corrected”.

That was it. The End. Actually it was always “To Be Continued” because another incident, another accident, another negligence and another abuse was always just around the corner and we never knew when, where or how but we knew it would happen to Mom and to others and does every day in more facilities than we know.

Long Term Care Facilities are very adept at covering up and of smoothing over violations, even major infractions that take lives, as are many medical facilities, unfortunately.

To our knowledge, the facility started all over again with a "clean slate" and these infractions didn't seem to be tallied, recorded and actually seen for what they were -- human injustice on the highest level to those least capable of speaking out and most in fear of reprisal if they did.

Mom’s story isn’t unique. This is happening every day in all fifty states due to ineffective legislation with statutes, rules and regulations that are vague, open to interpretation and quite frankly, written many times to favor the Senior Facilities. Think it doesn’t happen “in your backyard”??? Think again.

Anyone who truly cared would have ensured Mom was immediately moved into another chair that did not have exposed and open sharp metal pieces. 

No one in the Administration, No Nurse responsible for the facility, no LPN who oversaw her section of the floor, no Aide, made a move to ensure Mom's safety and well being. Negligence leading to more challenges; Negligence that is really Abuse because Medical Professionals or Psuedo Medical Professionals have enough training and experience to realize what overlooking endangerment can do physically, mentally and emotionally to our aging population.

We couldn't be there 24/7 and the facility ignored our pleas they provide another chair. More sores, more cuts bandaged and more skin abrasions. We were not silent but we were only one voice. Unity and many voices raised are needed for any action to be taken.

Actually, the chair should have been repaired or eliminated from service by the facility but that would have meant spending money they preferred to allocated to paying for Country Club memberships for some of their higher level staff people. Yes, that's correct, the facility annually pays for certain organization Administrators various expenses including membership in local private clubs. Check it out, we did, if yours is a Not For Profit facility you can go online to Charity Navigator and find their tax filings and itemized reports.

Perhaps their reasoning for this allocation is  they have to prospect for future donations being a Not For Profit?  My opinion as a volunteer fund raiser for many years: There are many other ways to network and prospect that cost very little and produce the same results.

We, those of us who live outside of the walls of the Skilled Nursing/Long Term Care Facilities, who must survive, work, care for ourselves and others, continue to build a life as those within the walls of facilities did for so long, should not have to constantly stand guard, be ultra vigilant, spend hours upon hours ensuring those we love, those we care about, are safe, secure and treated with respect and dignity.

Care now. Make a difference. Raise your voice. Share the information we present. Be as effective providing protection for our aging population as we are as a society to children and animals.

Our aging population is vulnerable and easily taken advantage of and our laws are vague, weak and inconsequential in providing and ensuring protection, self determination and individual rights.

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