Tuesday, March 31, 2015

POA's: Witness Bandage Changes, Do A Body Check


Written March 31, 2015 in my Journal. 

One day visiting my Mom I saw her roommate's entire face was black and blue and purple. It was obvious she'd had a major fall onto her face. 

Since she was basically immobile I wondered how this could have happened. 

"Mary" was obviously on some form of drugs because she was always sleeping and no matter what time of day we visited, she was sleeping either in her bed or in her Gerri chair.

As much as we visited, we never saw a family member visiting. We wondered if they knew of the seriousness of "Mary's" fall -- however it happened.


We'd had our own challenges with falls and the facility not acknowledging the seriousness and then Mom suffering the consequences. 

Now we realize falls don't just "happen".  Yes, age and balance play a part but so does neglect.

We saw, Mom's call button detached from the wall -- neatly coiled on her bed -- something Mom was incapable of doing.

Or, it would be draped across her bed and appear to be nearby her reclining/lift chair but further examination would show it was either pulled out of the wall or removed from the wall connection.

Yes, I went so far as to take the matter to the Administrator several times. The practice was never stopped, to our knowledge.

In our home Mom received Social Security of a little more than $700 per month -- that was what she would have had to totally live on if she lived alone. 

In a facility,  the cost per month was calculated in 2012 as between $3,000 and $5,000 per month WITHOUT MEDICAL SERVICES.

Forty years we lived together as a multi-generational family and all it took was one person to destroy our family unit.

Yes, dear reader, this incident still bothers me. As it should you. This woman and others are costing you great sums of money and pain and suffering to people less capable of protecting themselves. 

Yet there continues to be no action, no insuring these activities with our Dementia suffering elderly are ended and this woman and others like her are incapable of causing so much harm and pain through inability for our Legislators to construct tighter laws and more equitable laws providing Freedom of Information and Protection of Our Most Vulnerable Populations.

In the facility, each month cost Medicaid over $5,000 a month PLUS trips to the Emergency Room at least every three months to follow up on falls, cuts, side effects from medications and infections. 

Isn't this what you thought would be avoided IF THERE WAS 24/7 SUPERVISION?  Well, unless you can afford the high cost LTC's, you will learn quickly how "insignificant" your loved one really is.

Ever check on how much one night in an ER let alone two or more hospital nights can cost with various tests including MRI's can be? 


Then there was the additional rehab needed because for each day in the hospital you're set back at least two to three days in your regular "abilities (or so I've read).

These were all medical conditions poorly treated and escalated for many reasons including failure to recognize the severity of the original problem and just plain neglect to see or handle in a timely manner.

Mom's cost to taxpayers was in the hundreds of thousands a year due to neglect that became abuse. 

If you've read this blog you know it was reported, know it was "minimalized" by the facility and by the State of Missouri.  

And my Mom wasn't the only casualty and fatality. We watched many die from neglect and live under conditions as saddening as the commercials for abused animals on TV.

Reporting doesn't work. It's like applying a bandage to a hemorrhage. Major changes must be made.

Facility Rules and Regulations and State Laws are like "bolts". Some need to be tightened, some need to be removed and replaced and some need to be adjusted.

Many times Mom came back and needed to go into the facility's "Rehab" and have physical or other therapy. 

Ignoring minor medical challenges and allowing them to escalate improved the chances of the facility providing a higher level of medical care and payment and therefore an incentive.

Then, there's "the coverup". It's a call from the facility to advise a resident has fallen but it's not an accurate description of any injuries sustained.

 Or, it's no call at all especially if the family/responsible party is only an occasional visitor or if the facility believes they can cover it with a bandage or it's in a place that won't be seen.

Mom suffered a fall and lacerations on her head one time and her facility called to tell us she'd fallen but was fine, she was sitting up and eating. 

I wanted to rush over but they told me it wasn't necessary and if I couldn't make it that day, the next would be fine as Mom had been checked out and everything was fine.

Of course, there were no x-rays (did you think they took them for falls, they usually don't). 

And, of course, when I arrived and looked at Mom's head there were open wounds that definitely needed stitches and so off to the ER we went while the facility and especially the Floor Nurse kept trying to tell me Mom was fine, those were nothing. Right.  

Four staples later, pain meds and rehab -- again -- Mom received the care she wouldn't have had without the attention of me, her accused "abuser" and my daughter (who was never accused or mentioned but who lived in the same house with Mom as my husband and I).

Today, here's the advice I would give

BANDAGES AND COVERS. Make the facility change a dressing while you're there and stand there and examine the area that's been covered. 

Do your own "body check" and ask your loved one (if they are capable of realizing) what "hurts", "pinches" or might be sore. 

Often bruises and cuts can be under clothing and in areas not visible. 

Do this frequently. 
Don't accept being told it's not time or it was just done. 
Protect your loved one.
Look beyond what you're told is reality and see for yourself.

BODY CHECKS. No this isn't a hockey term. Facilities are supposed to physically check individual's bodies to ensure there are no growths, skin changes, swelling, etc. 

Ask to see the record and read it to see who made the last examination, when and the findings. Pay for a copy and ask when the next one will be done.

BUILD A FILE.  Their file is theirs. You need your own to track medications, research their effects and understand treatments and for so much more.

READ THE RECORD AND GET COPIES.  
Yes, it's a challenge and it takes time but this is the right of anyone who is appointed by the individual resident and should be part of your consideration of placing someone in a residential facility -- 

an appointed representative to receive or request any and all information related to the care and living of an individual in a Long Term Care facility should be another certified document in your file for future care.

I read my husband's hospital file long before he was released. He spent almost 100 days in Critical Intensive Care and his record for that one stay was in excess of 1500 pages.

Know what I found out?  
According to one entry, he'd had a gynycological exam and there was a report on the findings

Now, I lived with this man for over forty years and that "exam" surprised me . . . almost as much as another report...

Another report cited my husband had had a "previous" amputation of a leg.  News to me --- and to him.


ERRORS ARE MADE. DR'S ARE NOT PERFECT. FILES GET MIXED UP.  

This is where mistakes happen and errors abound.  

MY ADVICE:  At least quarterly for Long Term Residents, arrange to READ every page of your loved one's record and not just the medical record -- all reports, all submitted to Insurance, the State, the DHSS, any and all governmental authorities, all evaluations for whatever cause or consideration or purpose.

You will be surprised at how much information is gathered on our Elderly without their knowledge or real consent. 

You will begin to learn, through becoming familiar with various "tests" and researching them and also medications and researching them, how limited the tests are.

You'll get to know how they're used to "prescribe" medications including hallucinatory drugs to control "behaviours" that are "judged" by unqualified individuals allowed to practice by your State without a license and advise absent medical personnel, Doctors, on mental health.

PROTECT YOUR LOVED ONE. PROTECT YOURSELF IN THE FUTURE.  Get to know and understand the laws that govern life and living in a Long Term Care Facility for the reality of what they are and what they do not do.

Your loved one's life can hang in the balance. 
Your future life will be determined by what you decide to do now when you can.

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