Tuesday, December 31, 2019

Children Valued, Aged Devalued

What is one of our greatest accomplishments in life? 
Being able to go from one place to another.

When we're babies, parents talk about all the "accomplishments" and can't wait (at least with the first child) for them to walk. 

It's a "brag right" for parents when a child "walks" at an early age; they equate it to intelligence and other socially valued abilities

Why did Mom's facility work so hard to take away her ability to walk?

Why do most Long Term Care Facilities move new residents who may arrive "walking", albeit with a walker, work to remove the walker for a wheelchair and welcome the "bedridden" as an asset to their facility?

Mobility requires more observation, being vigilant, responding to people directly instead of to a "call button", having to "find them" to check vitals, administer meds or do one of a dozen things to "check on and "service" the individual.

Wheelchairs need to be pushed or the resident has to have strength, coordination and determination to move a wheelchair any distance. Limiting mobility reduces the amount of "space" they can get to and through, the chances they will "wander" or "go where they need to be located or removed from. 

Facilities see Self Driven "Chairs" providing a hazard to residents, staff and visitors. A resident who arrives with a motorized "transporter" will have to prove frequently they have the physical, emotional and mental ability as measured by the facility to continue to have the "right" to use it.

There is no "standard" of measurement for evaluating and no LTC Facility guidelines as a part of recognized systems and procedures I've found outlining, as some States have for residency in Independent/Assisted/LTC facilities andeach facility can therefore determine their own "standards".

Those 'in charge" constantly seek the "assistance" of family members to "encourage" the elderly to "give up" their wheels -- much the same as when they were driving a car.


Often the "powers" at the facilities "pad" reports and find ways to use language that seeks to discredit and minimize the true capabilities of residents in LTC facilities.

Especially for those in Medicaid beds, where the facility believes they do not receive enough compensation, there is a lot of "creative writing"
Bedbound is highly desirable for those "in charge" in a Long Term Care facility. 

If you can medicate and keep as many residents as possible  "comotose" or "awake and aware" at disignated times with drugs prescribed by the Doctor to a "competent" resident -- you can have a lower staff to resident ratio, cut expenses and limit need to hire or employ.

QUESTION:  Ever ask yourself who reviews the medications a resident is "prescribed" by a Doctor -- one who is basically "employed by the facility"?  

Over all these years I've never been able to find any documentation, State or Federal, mandating disclosure to those with Medical POA's. 

But I do know from personal experience, how easy it is for a person focused on manipulating and controling how easy it is to gain their confidence over time and showing "interest" through "private talks" how a person, a Registered Nurse, can control and ensure the elderly does what they want, when they want and how they want. I still carry the scars from the mental and emotional damages done by Julia.

MOST DESIRABLE RESIDENT?  The one who is placed on Hospice when the facility only allows "their own" Hospice program to be given to residents.

IS THIS LEGAL? That's a great question. 

As are so many other actions taken by LTC's but are practiced because WE DO NOT QUESTION, WE DO NOT RISE UP AND SPEAK OUT LOUDLY AND TO ALL Local, State and National organizations and legal departments responsible or interested in Our Aging Population -- how their lives are managed in living arrangements where they are under supervision by a group, organization or entity.


Back to the comparison of the "child" who is encouraged, supported and rewarded for actions that involve movement and "independence":

I realize the answer now, several years later, but let's start the questioning process:

The small child is encouraged -- it's a "rite of passage for parents" -- LOOK....WE HAVE A WALKER....NO LONGER AN INFANT.....NOW A "CHILD"...getting ready to move about in the world, still needing help, needing assistance, but we've achieved their progression....unless, of course, there is a physical challenge...but then parents start to move heaven and earth, go anywhere and everywhere, whatever it takes...to gain some form of mobility, of independence...

KEY WORD ---  INDEPENDENCE  Wanted for a child; discouraged and removed from our aging population.

Read your State Laws and Definition of Long Term Care. The System. Those who write the Laws. They have determined "who can" and "with what needs" reside in LTC -- also Assisted and Independent Living. And, honestly, they're obsolete and as archaic as many other laws we once lived with and now see how detrimental they were for human beings.

It's about Fire Codes and Safety --  they'll tell you. 

Before my first child was born, I saw a poem in a Reader's Digest written by Helen Lowry Marshall:  Children Learn What They Live.

Adults also learn what they live and when they are denied independence, made to believe they are incompetent and live lives of more and more isolation and lessening of providing actions and activities that build self worth and ability -- they wither and .... 

Friday, November 29, 2019

Beneath The Surface: Look, Listen, Touch When Visiting

Moving "up the ladder" on the age chain.
As we age so do our relatives and family members. 

We transit through the "joining together " and "moving apart" that comes with and through the circle, the cycle of life.

Unless there's a serious illness or other disrupter, we hardly notice the days turning into weeks, month and years except to mark the seasons and the occasions for gathering, sharing and often celebrating

Then comes the day, the week, the month and the year of making decisions turning life inside out when we face the closest generational change when we notice our cousins, with whom we grew up or aged together, experiencing health changes and looking so different in the pictures we take -- more like our Aunts and Uncles.

Early Onset Dementia.  It arrives like a thief in the night, under the cover of darkness -- light seeming to be drawn slowly as through a pin prick and leaving behind a developing and ever growing darkness.

I didn't "grow up" with my cousin who's now in the memory care wing of an Assisted Living facility. I don't know her except through select memories.

Seeing change doesn't require being close to someone -- it's visible when it's noticeable and recognizable when you've been through it.

We often measure life by goals reached and achievements made -- if we're fortunate -- or by overcoming challenges, obstacles, set backs and life crises. 

If they're younger, say not into their fifties, it's a "life challenge"; not welcomed or wanted but we see mostly hurdles to jump, times to get through and progress to make towards.... "that" time...when we'll "be there"...but not now, not here...later...maybe...

Next comes the "between time'. We're between the front and the second row at funerals; not having babies usually and struggling with teens and early "adulthood" in our offspring or family additions. 

Suddenly...we find ourselves having "achieved" some of our life's goals of having a family and all it entails and now we're....what....still moving in the direction of the unknown, the unexpected and sometimes the unwanted.

LOOK, LISTEN, TOUCH WHEN VISITING A LOVED ONE IN A FACILITY... we continue to need recognition as a valued individual person, not just someone to "visit", to "spend time with". 

You go. They stay. They wait. So much time to think, to consider, to wonder but not to dream, to really "dream" as when we grow old -- older---we've made it or not, we've had it or not, we've known it or not -- according to the worldview on aging.

Few see the real human being who is aging. They see what they're told to believe, what they're supposed to know and what they should do and how it should be done.

For many it's an "obligation" -- something to work into "our schedule. For some they're the "only ones" in the area and those "outside" call occassionally but find "communication" difficult so they tend to make those calls less and less frequently.

Then there are those who "passed" on really staying connected and aware and certainly didn't find time let alone any financial ability to "help", even when grave illness and severe challenges created severe financial challenges.

These are the ones who usually "rise up" when someone, who they see as "concerned", connects with them to "complain about" or somehow find fault with the primary family/friends who make time, create ways and include the Senior in their lives.

It's always so easy to look at something from a distance and find fault when you want there to be fault either because of "self guilt" of many years of "neglect" or walking away because this was one thing they didn't have to "deal with" in life.

We experienced this "disconnect" and "accusations". Strange how even the one son who could have seen more did not consider how his grandmother was "aging". He who is known for being so "informed" and "capable" did not apply his skillsets to investigate and understand. But then, few do.

If you call, connect with, or in any way "enter into" or "remain" a part of a loved one's being in a Long Term Care Facility, you need to recognize what you see is not what they're getting on a daily basis and there are many challenges those of us who are frequent visitors see with the loved one and other residents.

Step out of your comfort zone for you too are moving in the same direction -- towards needing caregiving. Life is a circle, you enter dependent, become independent and often return to one or more levels of "dependency".

Look, listen, touch and most importantly do not take anything for granted. That "bandage" may be concealing a very serious problem. Those Dr recommended "compression" socks may hide bruises or worse.

Be Aware. Do more than accept what you're told.

And, take pictures. Make notes. Keep records.


Do not be afraid to report what you see, what you hear and what you smell including calling the DHSS Hotline to report the facility.

You are the gatekeeper of the present and the future for as the tree of life grows and develops it bends and breaks with the pressures it endures.

Sunday, October 6, 2019

Reaching Out, Touching Lives, Making A Difference

Met with another daughter of a mother with Lewy Body Dementia earlier today. Julie was her name. 

How strange. Julia -- with an "a' was the name of the woman who abused Mom and claimed I was the abuser -- see many entries about this nightmare created by a woman who is still licensed as an RN and to my knowledge is still "providing care giving services" to Seniors. 

Wonder if she's still focused on working with those whose children live out of State -- or did her experience with me and Mom show her she could "expand" safely even into families that were multigenerational?

Julia reapplied to the State of Missouri and reactivated her expired RN license -- it made her a "required" and UNQUESTIONED mandated reporter of "elder abuse".

She'd told me once...well before the time when she came into our immediate family life.....she often helped them "get rid of things" and even helped to "move them into facilities".

How convenient, I think now.  Get their and their children's trust and confidence, then you can move in to move on to your next "conquest"?

Julia decided, in my opinion,Mom was a "good mark" to exploit and I, who had the same name as her mother, someone she did not have a good relationship with, "deserved" to be separated from my mother. 

Those are the conclusions I've drawn with the passing of years since Mom's death.

I've had a slight "aversion" to that name ever since -- know I shouldn't but if you read about how she manipulated, controlled and destroyed the life we had as a multigenerational family for almost four decades -- you'll understand.

Checking this Blog; wondering if it's still "being read" meaning reaching someone, somewhere who is struggling with understanding and going through the "jello" of LBD or even other types of Dementia, I saw someone had just read the entry dated Sunday, April 20, 2014 (wow.....over five years ago) and titled: Constructing Change: Teepa Snow, Whoopi Goldberg, Kelsey Grammar

Although there have been new discoveries about the brain and about Dementia, including Lewy Body Dementia, in the more than five years that have passed since I wrote the entry, it's still relevant and useful as are my other varied entries to date spanning over seven years.

I met with Julie today after she reached out to me from an entry I made on line in a "local" Neighborhood chat site where people ask for help with many things including care giving for loved ones.

She'd been to a Neurologist and so many others who had no real clue about what was going on or misdiagnosed what they saw as so many other afflictions.

We sat and talked about where she is with her Mom. She'd just been told by their Primary Care Doctor her Mom had Lewy Body Dementia with Parkinsons.

FASCINATING. And he was with one of the three associated hospitals of the main hospital where I first saw the words as a diagnosis of Lewy Body Dementia, possibly mid to late, after Mom was hospitalized with a urinary tract infection.

PROGRESSION.  
     WORD IS SPREADING. 
           KNOWLEGE IS GROWING. 

We are succeeding in raising awareness about this debilitating medical challenge.

I asked her where her Mom had been "placed" in the measuring of "how far along" with the challenge and she said he hadn't mentioned.

I encouraged her to reconnect with the Dr and ask for a further diagnosis as to whether it was, in his medical opinion, early, mid or late stage.

IT'S TIME ... MEDICAL COMMUNITY.  

THIS IS A CRITICAL AREA OF NEED FOR INFORMATION, DIRECTION AND GUIDANCE.

We live with it every day. It's at the top of our life's list.

We need your "engagement" in our challenge.

We need you to "become involved" more directly, with greater consideration of OUR NEED TO KNOW, TO UNDERSTAND...so that we can shift this burden to a more manageable load as we continue to walk with and beside family members and friends as they walk this ever varying road called LEWY BODY DEMENTIA.


SCARY, TOO.  Misdiagnosis can lead to providing medications that can cause severe damage and bad reactions and unfortunately.....even death.

i realize Lewy Body Dementia is difficult to determine but you, the medical community simply need to put more value on this disease as has been previously placed on others and we'll have more ability to manage, if not control, its effects and affects.

It's time to be informed about ALL the  "TYPES" of Dementia. 

IT'S TIME TO FIGHT DEMENTIA AS WE ONCE RECOGNIZED AND JOINED TOGETHER TO FIGHT CANCER AND HEART DISEASE.

And....I have to admit....

What surprised me was when Julie told me she had to wait a year to "get into the program" at the hospital to go through more analysis of the disease.

WAKE UP AMERICA!  

WOULD WE DO THIS TO A CANCER PATIENT?  

Or maybe we do? Although my personal recent experience has been medical facilities for two friends acted quickly when they were discovered to have Cancer.

Or, is it because Julie's mother is fortunate. She's in an Assisted Living facility, a nice one -- although as Julie said, she's not really sure how "hands on" and "capable" they are.

We talked about the three levels of living for Seniors -- Independent, Assisted and Long Term -- and the State requirements for residency by individuals in their levels of capability or need.

Julie's Mom is one of the more fortunate as she has good Insurance Coverage -- few people do -- for these services.

Perhaps the Dr. felt there were limited spaces in the program and because the mother was in a residential care facility the "immediate need to know" the level of the Mother's Dementia and any "assistance" was perhaps not as "urgent" as for others.

OR.....perhaps the Doctor believes the woman is really doing better than she actually is.

Although he could see the LBD and noticed the symptoms of the shaking (labled as Parkinson's), he might not realize TIME IS OF THE ESSENCE.

People with LBD who are provided with mental stimulation, environments providing levels of mental challenge that works for the individual with physical activity and interaction that stimulates -- even attempting new skills or additional skillsets -- CAN POSITIVELY AFFECT THE  DISEASE PROGRESSION AND STAVE OFF MORE RAPID PROGRESSION.

Yes, it works. We watched it work. 

We didn't realize it at the time because we did not know about LBD but daughter and I now know we effectively helped Mom to live longer and a better life because of what we did for and with her.

And -- quality of food and types of food

And -- keeping mind and body active.

We could not stop the disease that is Dementia -- and that is what it is, just like Cancer which we're told "lies in wait in our bodies".

We gave Mom an environment that stimulated her mind and body and we found that even when she had periods of Aphasia, as mentioned in another article I wrote, she retained more independence and capability.

It was a difficult journey. The memories still present challenges. 

I would not have asked to live many times in life I've been given but I am grateful I was also, somehow, provided then and now with the ability to find ways to be of service to others who walked, are walking and will walk this disruptive life path.

Sunday, September 22, 2019

World Of Differences: RIP Jesse Combs: a lesson she continues to teach

Media sets the pace in the length of our strides and often tries to determine whether we walk or run and in which direction.  

Ever so slowly over many years the "personality newsperson" has edged into the industry and now appears to be, at least on the national level, the rule rather than the exception.

There are thousands of "media influencers" many of whom we can carry in the palm of our hands or out into far corners of the world; they have great power to wield.

Took a few minutes to watch CBS several mornings ago and listened to a report on the female race car driver who was killed trying to break the women's land speed record.

On line and on screen Jesse Combs was referred to as the "fastest woman on wheels". 

CBS made a point of showing how "different she was" and citing how she did many usually "male" activities like repairing cars.

This comparison to what is typically "male" and typically "female" continues the division and the separation of men and women in STEM and in the work community in general.

Media who continue to use terminologies and comparisons from "another century" fail to serve the public for whom they work and often cause continuation of past practices of discrimination and lack of inclusion.

Competition. Sports and activities throughout our early lives build into us the NEED to "rise above, stand out, be first".

Less time is devoted to Team Work, supporting others in achieving goals, with more time devoted to those who "stand  out" rather than building the skills of those "with ability" being not chosen, not selected, overlooked and undervalued.

Our educational system is based on individual achievement and measurement and so is the majority of our work evaluation. 

The most admiration seems to go to the "winning team" or the "top achiever". We're not taught enough to value the experience, the "working together".

Even in sports that are "team oriented" we seldom see the team as a group lauded for their achievements -- we feel a need to "single out" and "find" one or a couple of "outstanding athletes" giving awards, higher compensation and recognition.

However, a few months ago when the St Louis Blues won the Stanley Cup, we saw how teamwork wins -- they were a unit, they worked together. 

There were outstanding plays and exceptional players but the focus each one gave was of the group and the people who supported and believed in them.

And, today at all levels on rinks around America you'll see some young girls and young women out there, showing how they can move alongside, with and independently to "bring home the gold" as a team.

When the St Louis Blues "brought the cup home", they didn't "hide it" -- they took it and continue to take it around the St Louis area allowing more people than ever before to be a part of the "achievement", to feel "they too" had participated and "brought home the cup".

Young boys AND girls have touched, felt the pride and seen the possibilities of hard work individually and as a team. 

Way To Go Blues!

Even their "image" of "Gloria" and "Stanley" sets a new level of recognition for a sports "mantra" to be shared.

While singular achievement is critical to a society, working together is also critical to asking questions and finding answers. 

One person may discover but it often takes a community, a group, a team to bring the idea to fruition.

In my current search for enlightenment in the Senior Long Term Care "industry" I believe it's not just the facilities but also society, groups and organizations and especially laws and practices at all levels that are the challenges to ensure we grow older and walk our live's path not dreading or fearing what's "to come".

I cannot look and not seek to learn when I  find a problem.

It often sets me on another journey I'd not seen or preplanned but life is not always as we'd planned, as we wanted, as we believed it would or should be.

And it often brings me and those who choose to learn....enlightenment.

It's our choice, yours and mine, individually, if we accept and simply wait our turn or if we choose to recognize and shine the light for others to follow and understand. 

It's when we build awareness, foster involvement and encourage action we teach a lesson and learn from it at the same time.

Wednesday, September 18, 2019

Generational Shift; Moving The Bar To My Level

A death of someone close or closer in age reminds us of our own mortality. 

We listen, watch and learn as we see others move along the path of life, dying and death.

A funeral. Same Church Mom was taken to; her choice; our love of her to fulfill, to participate, to ackowledge her departure.

A cousin by marriage. Close in age but not really close as we lived "in the city" and she and her husband lived "in the country" far enough in time and distance and leading their lives having and raising a family as we were.

My time. But it really wasn't. Thinking back. Yes, there were occasions, events, special times. 

The direction was always "moving ahead" against odds and challenges purposely moved aside in order to move ahead -- education, activities, family times -- prioritizing the positive while dealing with the negatives life hands out without any respect for to whom, when, where, how many times and how much disturbance is given.

Now I supposedly have "my time". 

Desires to continue to become -- before my time not to have choices, preferences, capability and capacity enter my life's door and that final curtain is drawn.

Life isn't selective although it often feels like it is; we are born, we live and we pass through this life.

No matter what you believe about here, now, there, whenever, as we walk, run, stand and wait watching others and ourselves move through life challenges, it's always a learning experience.

My cousin is now faced with "the process" of the absence and change that accompanies losing a spouse of many years.

Remembering the "period of adjustment" most in our age group went through as we married and started "cohabitating" -- so different from many today who chose to live together.

I wonder....if/when they marry and one or the other departs this life...will it be the same....I think the loss will be but the memories will be slightly changed.

How do we react to the loss? Each of us has our own tape measure; each of us has a life affected in different ways and so reacts at the moment and each step along life's continuing road very differently.

Some judge. Some evaluate. Some decide. The "some" being family, friends, acquaintances even. 

Sad but true; others are really thinking either been there, done that or glad it's not me or what now for her/him.

We are residents of the here and now asked to consider, evaluate and conclude about today, the future and the hereafter -- meaning our leaving this life.

Best we can do, in my opinion, is stop judging, start talking and above all live today as it will soon be tomorrow built on yesterdays.

Friday, August 16, 2019

Fence Sitters....It's Time To Read, Write and Speak UP!

Do you question your Doctor? Do you question their recommendations, services, communication?

Think what it's like when you have limited ability to communicate let alone be heard.


Let's do some research. 


Here's a website providing State by State "regulations"


The report is from 2010---does that mean the regulations and practices have not changed since that time?


Here's the website:


https://theconsumervoice.org/uploads/files/issues/Harrington-state-staffing-table-2010.pdf


Here's the top of the first page:


FEDERAL STAFFING: 1 RN 8 consecutive hrs/7 days/wk & 1 RN/LVN for 2 remaining shifts. 


Must have 1 RN who is full-time DON (5 days/wk); if fewer than 60 residents, DON may also be Charge Nurse.


 (For 100 residents, LN .30 hours per resident day (hprd) would be required.) SC= State Code SAL = State
Administrative Law (Rules and Regulations) SDP = State Departmental Written Policy


The State of Missouri info is here:


MO SUFFICIENT STAFF: to attain or maintain the highest practicable level of physical, mental and psychosocial well-being


LICENSED STAFF (RN, LPN/LVN) 1 DON RN included in 1 RN Day and 1 RN/LPN Eve & Night and 1 RN on call if only LPN on duty 

When DON is LPN, an RN should consult 4 hours per week.

DIRECT CARE STAFF No minimum requirement (RN .08) LN .24 SAL: MO Code of State Regulation 19 CSR 30-85 (34)- (38) Eff. 1-30-04. http://www.sos.mo.gov/adrules/csr /current/19csr/19c30-85.pdf

SAL: Intermediate Care Facility: 1 DON RN/LPN. If LPN is DON, RN must be a consultant 4 hrs/wk included in 1 RN/LPN Day on duty and 1 RN/LPN on call 24hrs/7days.

Online Updates: Missouri Code of State Regulations: http://www.sos.mo.gov/adrules/csr/csr.a sp Legislative Updates: Missouri General Assembly: http://www.moga.mo.gov/statutesearch/

Missouri, for some reason, and other States as well, created "loopholes" most probably to "benefit" donors/supporters with vested interests -- I "bolded" the specific words that allow LTC's in Missouri to operate without sufficient ON SITE Medical Personnel:  "1 RN on call if only LPN on duty".

"on call" -- not in the facility, not able to assist with a life or death situation (this is an LTC and emergencies are constant)


We listen to reports of the 60's; we give vocal "honor" to our Veterans from WWII, Korea, Vietnam. 


We value families and many support valuing the unborn. 


WHERE DO WE SHOW WE VALUE OUR AGING POPULATION -- THE MOST VULNERABLE?


Do you write your Congressperson?  Time to put in a word about how people, many of whom still vote (LTC's often serve as Polling Places or bring Absentee Ballots to residents) are "in harms way" without GOOD HEALTHCARE IN LONG TERM CARE & GOOD QUALITY OF LIFE.


Remember.....not everyone in LTC is a Senior---laws vary.


Speak Up! Speak Out!


There are members of a Generation who have been labled "The Silent Generation" -- YOU ARE THEIR VOICES and those moving up in the age brackets or the medical needs statistics


You are the voices of those removed from speaking out, who are being silenced by drugs, who have advanced Dementia or who have no means to make private calls or use a computer to contact their Congressperson.


YOU ARE THE VOICE FOR EACH PERSON as we move along life's road and often find ourselves in places we'd prefer not to be in ways we wouldn't consider and with people who are "doing a job" without realizing how very low the standards are and how very high the needs remain.


Remember the history lessons....they came for.... I didn't speak up....


Think your time in LTC is far in the future?  Think about medical conditions where you'll need at least a short term stay...or possibly longer -- say 100 days. 


Read, write, share the information and advocate....advocate and bring about change!



Monday, July 29, 2019

Planted: Flowers For Carol; Remembering What Others Want Forgotten

The bright yellow chrysanthemum plant reminds me every time I look out my kitchen window, walk outside my back door, of the friendship and concern we had for each other, Carol and our family.

We'd bought it for her birthday. We'd celebrated her birthday for the past several years as we'd celebrated all the holidays spending time together.

In Hospice. Not her choice. Read the entry Last Rites for Carol.

We weren't told she passed.  I knew they wouldn't contact me. They don't recognize residents when they die. As a family we had a small reception at the facility when Mom passed but we had to go personally around to people and "invite them".  

Death isn't to be acknowledged although they lead people down the last path they'll travel every day and along the way they make friends in the facility. Friends who learn "through the grape vine" -- if they're lucky.

We weren't considered anyone worthy of being told, I suppose. Seven plus years of friendship, providing for Carol and being there for her wasn't enough. 

We didn't have a signed slip of paper, no POA or other directive. I'm sure Carol was told we'd be contacted but it's now been almost two months and not even a card or phone call

OH,BUT THERE HAVE BEEN THE SOLICITATIONS FROM THE PARENT COMPANY FOR DONATIONS TO "HELP" THE RESIDENTS.  

What they really mean is for selected individuals to "help themselves" to increases in already high salaries (for ten or more well over $100,000 each) -- in a Not For Profit.

We had brought her some small gifts. 

We often brought things she needed or wanted. 

Lotion, liquid soap, shampoo, deodorant -- daily items of brands she preferred. 

Baseball style hats from our travels which she loved. 

Some clothing items; she bought things from their onsite "charity shop" which she loved and once worked in but something from "the outside world of shopping" lifted her spirits as it was new, truly "hers" and specially chosen for her.

No clothing any more; she wore only hospital gowns. 

A few times they dressed her -- when I spoke up and insisted. But I had no "power", no "right" and they knew it. So they continued placing Carol's feet on death's path.

They had her open the door by "agreeing" to go into Hospice. She had no idea what "hospice really meant" -- the removal of medications she'd taken for years to help with her Lupus, for example.


Carol's facility was "tired", I'm sure, of our "intervention"; of our calling attention to the violations of personal rights of residents and of bringing to light their medical practices of putting residents on enough drugs to keep them sleeping night and day and not "needing" attention except when the CNA's "got around to it". 

I wonder if my concern she had been waiting over two years for the false teeth they promised, had endured that amount of time going through a "few teeth" pulled each time and my encouraging her to speak up about not having the teeth contributed to THEIR DECISION for her to go on Hospice. 

Last count, she had around fourteen remaining teeth and none of them were the type that provided good "mastication" of food.

Carol was not terminal.  She was not refusing medication. 

We watched the facility end Mom's life. 

We watched the facility end Carol's life. 

Along the way we saw how the Administrators kept the numbers of paid staff down, the residents "out of it" and therefore the expenses down and the Bonuses at year's end always "UP" -- for the selected few.

You and I would be sent to jail for taking as many psychotic drugs as as they put Carol on  but because they were "ordered" by a Doctor, NO ONE SEEMED TO CARE -- THEN OR NOW -- will you and I also go through this "planned death"?

She didn't want to go back to the hospital. 

She had numerous infections. Especially urinary tract.

Sitting in your own excrement and urine for long periods of time and then failure to effectively clean the area is the cause but no one really seems interested.

And so it's now July, almost the end of the month, reminding me of my friend, Carol, gone before her time. 


She was a liability to the facility. She'd started speaking up. 

She wanted answers to questions and no longer accepted as easily or readily their answers.

We were involved and had contacted DHSS.

That was a problem, I'm sure. 

A CNA told us it was. It should be a problem -- but not for the staff, for those in decision making for daily living choices including on site and remote Executives who prefer to raise funds and increase compensation and expenditures for their benefit rather than resolving the daily living challenges of residents.

Carol's Long Term Care uses HIPPA to eliminate any and all communication with friends and family who aren't "legally" appointed as a Medical Power of Attorney.

This includes posting, publishing, acknowledging or advising frequent visitors/friends of the residents of the passing of someone they've cared about, yes, loved, and cared about and for.

We weren't casual visitors or those who lived far away. 

We formed a friendship, a support system and even when times were challenging, we tried, as much as we were allowed and sometimes in ways to ensure safety and well being by going behind their "closed doors" to bring in outside "forces" to ensure our friend was treated fairly, justly and considering her wants and needs.

Who will follow in our footsteps? WILL YOU?  Do you understand the importance of vigilance and oversight?

Don't walk away. Run towards. Stop by often. Or get someone to ensure the safety and well being of your loved one.

Think the facility "guards" life?  Think again. Unless you're more valuable to them alive than dead, you're just a number in the progression of residents especially in the lower cost facilities.

Monday, June 24, 2019

Reality Check: Time Is Finite; Waste Not, Want Not


Dear Sam’s Club,

Here’s an example of how you turn more people away and decrease market share:

My experience this morning in my local Sam’s Club.

“Are You a Plus Member? “

I wasn’t really listening. Thinking about all I had to do today and looking for my credit card after presenting my Sam’s Club “old” membership card which they hadn’t changed when I “demoted” my membership from Plus to “Regular”.

“Not at this time,” I replied.

“Well, I can change that by adding $8.00 today.”

“No thank you”, I replied, “It’s due for renewal in a little over 30 days, I’ll wait until then.”

“You Aren’t Supposed To Be Here Now….”  He said.

Surprised by the negative admonition, he added, “Well, I can give you a one time “Courtesy” pass.” Which he did and which appeared in large print on the screen making me feel really bad about “not knowing better”.

“You’re supposed to be here after 10 AM.”

Really. Must have missed the Memo. But then I don’t shop Sam’s Club “regularly”.

That’s why I don’t get the “upgraded” membership – the extra “kickback”, excuse me, bonus reward, for spending up to a certain amount. No….I have credit cards that reward me without putting constraints on where I shop and with whom I shop.  

I tried the “Plus membership and found it a waste of money. This was before the Home Delivery and other “benefits” now added to the program which I don’t want or need.

I’m a Senior. I’ve seen lots of us in this age group shopping at Sam’s Club, especially earlier in the morning. Of course, for all I know they could be Plus Members. It’s just I notice demographics; it’s been my training to observe, to evaluate and to make positive changes based on various marketing analytics.

When it first opened, “our” Sams’ Club” was “the place” to buy our business supplies, home items, stock our freezer and feed two growing sons who could empty the refrigerator before I could get all the food out of the bags and into storage for, if I was lucky, a few days, before making another trip to what was then a great way to save on everyday items and larger quantities of food and other supplies.

This was pre Amazon and so many others who now lead the way along with other Membership and Non Membership businesses all seeking to retain, build and increase market share.

Sam’s Club Membership is $45 or $100 for Plus

All I want to do is walk through the door of this Warehouse Shopping giant and buy the items I use in bulk and be on my way.

Now, I’m told, my spending is welcome only during certain times that interrupt my morning which for me is an important part of my business day. It used to be 9 AM and now I found out it’s been raised. 

Next thing I know, it could be Noon or later before I’m “welcome” to spend my money in their facility that is mass market, bulk buying with a little bit of regular sized items at somewhat discounted pricing they hope you’ll pick up while you’re there.

For the record, I liked shopping at Sam’s Club; it apparently only likes my shopping there during times they determine and change and then publicly admonish you if you should “violate” their protocol.

I get the benefits concept of the levels of membership; I don’t get the discrimination of shopping times except for the fact having staff come in and opening your doors at 7 AM, for example, means more cost of staffing, etc (I am a business person, after all).

 So…..open for a few, charge for this “benefit” and no longer “card” people at the door to ensure they have the level of “membership” before they load their cart and get in the checkout line?

Poor policy.  Poor procedures. Speaks volumes about the business……

Yes, I work, have my own business and place a value on time and opportunity. We share a car, daughter and I, because we can’t afford two cars and we’ve come a long way in eight years because we’ve lived the lessons of life we’ve known and learned and one of them is to consider how we use what we have and what we are given.

We’ve survived and now we’re returning to being able to thrive and that includes choosing with whom and where we shop and spend time.

I wasn’t interested in the “perks” – not even the add ons for “just” an additional $40 when I was finally able to afford, yes afford, “going back” to Sam’s Club.

Sam’s seems to be equating or trying to become more “niche market” by excluding rather than including the community. That’s a business choice. A model. Poor one. Chosen one. Out of touch.

I always research when I “come up against” challenges like this one. Here’s what I found on the company’s website comparing the two membership levels benefits:

“Early shopping hours  Get in and out faster without the crowds starting at 7AM Monday - Friday (not available at all clubs) https://www.samsclub.com/sams/pagedetails/content.jsp?pageName=aboutSams

NOTE:  Their own website states “Not available at all clubs”. 

And, you’ll notice there is no on line posting about what time we “lesser customers” are allowed to spend “our money”. Wow! Discrimination seems to be changing again and refocusing on new categories.

So….how many of you reading this take the time to read the sign posted outside Sam’s Club door?  Last time I read it Plus Members were admitted earlier at that 7 am time and regular hours were 9 AM for others. Today I saw the 10 AM. Or maybe your Sam’s Club has other hours??

What about that “security” person who stands at the front entry who USED TO CHECK YOUR CARD before you could even enter.  Not now. You don’t need to show it, you just grab a cart and if you have  anything to “return”, they put a sticker on the item but anyone could walk in and look around.

I’d been surprised visiting Costco several months ago when no one asked to see my membership card and then surprised again when Sam’s Club seemed to “pick up” this practice and we no longer needed to “present” the card for membership.

As someone with a degree in Marketing Management – the ship has sailed….and it’s leaving behind many who don’t need to “walk in” to get what they want or need – it can be delivered, it can be waiting for pickup, it can be from many “bulk buyers” and “discounters”.

Walmart/Sam’s Club used to lead the way, were highly innovative and often controversial.

Now, they’re followers instead of leaders.

This lack of customer consideration and service lowers them even further in my opinion.

For the record, Sam’s Club … when we were celebrating a historical WIN in St Louis, you missed the shot.

Not a single St Louis Blues shirt or any other memorabilia was on your tables, racks or in your stacks. While at Costco---they were flying out the door.

I believe I made the right choice when we joined Costco. I was going to renew Sam’s also for the “convenience” – they’re on the way back from where I drive to take my daughter to work on the day’s I use the car. Guess that won’t be my plan any more because it takes away from “my time”.

It’s my choice, as a consumer. I do not see the benefit for our spending even the “small additional amount” which I can use to donate to a local charity or spend on something else we still need and have been putting aside purchasing – even at Sam’s Club.

My time is valuable. Even one hour. I’ll spend part of that time driving a little farther to where, at least from what I’ve seen, I’m still appreciated as a customer, a member.

Interesting how when the major force behind some businesses is no longer involved changes that aren’t focused on understanding what you say, how you say it along with what you do and how you do it, make the difference between revenue generation and revenue reduction.