Sunday, December 7, 2014

Negligence. Abuse. Mistreatment. It's more prevelant than you want to believe.

Each time I read someone's comments about their loved one "just sitting there" and "being lost to them". I wonder if the loved one really does spend all their time noncommunicative out of choice or out of necessity.

My visits to facilities have always included interacting with many who are sitting in the "common area" on the floor across from the Nurse's station. Many of them sit, stare off into space, down at the floor, or "nap". A few attempt to move around but if they "stray" out of a specific area they're "removed" and moved back to being placed, again, in the "safe area".

Sometimes, usually after a State DHSS visit, people will have little boxes attached to their wheelchairs to ensure there's an alert sounded if they get outside of a specific area.

This is another one of those "useful" and "abusive use" items. One was placed on my Mom's chair. I'd often find it on top of her nightstand and wonder if she or if someone "caring for" her removed the box. I often wondered if Julia removed it when she visited possibly hoping Mom would get into her chair and go wandering thus causing "problems" for herself and the facility.

The "black box" sounds a signal when the person wearing it on their clothing or on a walker or wheelchair goes beyond a certain point. While useful, it also ensures very limited mobility for many residents who could benefit from having activity, walking and being in the company of others not quite as "advanced" as those who are generally limited or restricted.

I remember how challenging it was for the facility when the State would come to review the facility due to a special report or for a call to the Hotline. Black boxes would be off of all but the most challenging people. 

The Floor Nurse would be running all directions, the daytime "in charge LPN over the entire floor", trying to keep tabs on those who were now "free" to move about. They were capable, you see, of moving, but the facility preferred to have them "corralled" as we often saw them, sitting in one place, hours on end ..... constantly and endlessly waiting....waiting...waiting. 

Nothing to do. Maybe a TV on and sometimes with shows you wouldn't want a child or someone with an impressionable mind or lack of capability to "turn off" the sights and sounds to see because of the violence.

Inevitably, the TV was set on that channel because the "staff" at the desk (read that as the LPN's we've mentioned who sit more than they serve) can watch their favorite soap opera or crime show or even the News, which we all know has some very violent and often upsetting videos.

Activities, you ask?  Didn't they have an Activity Director? The Director, when they kept one long enough, usually provided activities directed to first grade mental abilities.

We saw many puzzles. All had 250 pieces or more. Try picking those little pieces up with Arthritis. How about the mental challenge of so many pieces being frustrating and so difficult.

They had "things". They had "activities".

But who cared enough to ensure they were right for the residents? The State DHSS? Never seen a report including evaluating this area.

Why isn't someone looking at facilities from a standpoint of ensuring the residents aren't just shelved, aren't just pushed from one place to another, are given opportunities and "age" appropriate activities.

Sometimes I want to cry out to the world:  Why do we care so much about our children and those who are younger with mental challenges but we ignore the cries of those who cannot speak very well, who cannot be heard because their voices are contained, who are forced to live as though they were caged animals given whatever their "attendants" deem is appropriate.

Yes, it is that bad. Just ask "Jean" who's in her sixties and suffered a broken back disabling her and now she's "living" in a Skilled Nursing Facility. Always active, working, living by herself before the accident, she's now confined to a motorized wheelchair.

Because she's not capable of moving herself, she's catherized.

Because she cannot bathe herself, she depends on the facility to provide this service. They do. Begrudingly. She's been told she has to be bathed very late at night, sometimes as late as 11 PM because she's such a "challenge".

You see, she needs more than one person to assist her, to move her. She waits for almost everything; she's at the bottom of the list along with any others who require more than assistance where an Aide can walk away for a while and tend to another person and then get back to the first person when they "have time".

Accidents in facilities aren't always accidents. They're neglect. They're mistreatment. And since they reoccur and are due to decisions made for staffing, I'd call it Abuse.

Then there's the problem of training. I've watched as CNA's, not yet certified but fresh out of the classroom, come to the facility for their "practical training".

That's the scary part. They get a little hands on instruction and then they're off and on their own to handle anything and everything. My loved one and yours are depending for their life needs on someone who's basically learning as they go and not with active, by their side, someone experienced and trained working with them for any specific amount of time.

PLUMBERS, ELECTRICIANS, DOCTORS, NURSES -- people responsible for the health of homes and people -- have requirements that are much higher regarding supervised learning.

BEAUTICIANS need more hours in the classroom and working on "clients" under direct supervision than do Attendants in Skilled Nursing facilities.

Did you know, according to one resource, you can become a CNA, provided you pass a test and I'm not sure that's a standardized test, it could simply be each "certifying facility" creates their own with about 100 hours total in classroom and "on site" work?  That at some places the cost is about $500 for the entire course including classroom, facility and test fees ?

Check out your State and local programs; I checked out mine.

So, I have a question.  If a facility serves as a "training ground" for CNA's who pay for the training, does this mean the facility isn't paying them during this time and may be paid for doing the "training"?

What concerns me is we have no way of knowing the person taking care of our loved one is "in training". Yet, this person is fully responsible for all the needs and safety because, at least in the facilities I've visited and known, the LPN's aren't in the room with them and it's "on the job learning" sometimes at the expense of accidents experienced by residents.

Accidents we were told were caused by something the resident did or failed to do. Really? I believed that until I learned about the way CNA's are "trained" in general and watched how they were "trained" in Mom's facility.

KNOWLEDGE AND OBSERVATION ARE IMPORTANT to protect those who cannot protect themselves. Keep reading. Speak Up. Connect with others. Change is inevitable.

You're the reason changes are made if you become the reason changes are made.

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