My mom lives in ALF but has been in SNF/Rehab on and off over the last 8 months (more than 5 times) not counting the hospital trips inbetween! These facilities call me constantly to do things they are supposed to do. Having missed so much time at work and with family obligations, I'm trying to keep my job and family together. How do get these places to stop calling me so much and do what they are supposed to do?
The mumbling nurse that called me when she was ill and they didn't call an ambulance asked me the week she was admitted something I think was about medical intervention. I say I think because she was mumbling and wouldn't come out and say what she was asking me. Something about starting a tube and intervention and literally would not tell me what she was asking. I told her she had to deal with this with my brother since he has power of attorney and all her living will directives. He said he did talk to her and get those papers, instructions signed. Of course I don't know what exactly was decided because nobody tells me anything. She is in a rehab unit that is attached to a nursing home. Most of the people in rehab are joint replacement and pretty able people.
My aunt called and read the hospital the riot act while we were still at the hospital after I informed her what happened. So now they are in defensive mode. I tried talking to the nurses when we returned to tell them that they need to call 9-11 FIRST and me second if this happens again. All I got was a bunch of being talked over about protocol and rules and they blew me off. The head of nursing and the social worker came in Friday as we were leaving to go to an appointment at the doctor to "talk" and excused themselves to come back later before I could get a word out that we had time then. So now I am dealing with BS out of the rehab hospital on top of everything else.
I don't know how long she will be in rehab. She was very able bodied before her stroke and is making progress. Still having some issues walking and some more complex mental things that are not quite back but she's highly motivated to go back to her apartment and capable of making her own decisions. If she can't make it that far I will be looking for a better option than transitioning over to the nursing home at this facility. I think the senior apartments she was living at have a more assisted option.
It really bothered me that they hadn't called an ambulance and didn't/wouldn't when I told them specifically to do so on the phone. Then I ended up getting her to the emergency room in a car. What if her heart stopped in the trip and didn't restart? I think I remember CPR from high school but what am I going to do CPR on the side of the freeway? I'm trying not to turn this mess with the rehab into a nasty fight, that will just upset my mom more.
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First of all, how is your mom doing. Did she suffer a heart attack? Second, I'd file a formal complaint so fast it will make their heads spin. Is this supposed to be a rehab/skilled nursing facility that your mom is at? An ambulance is always the best choice in an emergency. You go directly from ambulance to emergency, with out the delay of checking in at the emergency desk, explaining the problem, etc. and you mom could have gotten help on the way in. Some rehab/skilled nursing facilities have an automatic DNR when they admit people. I don't know if that's the case where you mom is staying, but that could have added to their lack of decision making. You better check that out and demand some answers from the administration of this facility.
Is your mom there short term for rehab? Does she have a DNR or have they listed her as having one.
Best wishes to you and your mom. How sad is this? Hugs, Cattails
It was obvious she was having a heart attack or a major cardiac problem. She was very unwell, sweaty, pale and said her chest felt tight or like someone was putting pressure on it. We ended up driving her to the hospital ourselves. The nurse that showed up sort of pushed us to do that rather than call an ambulance. I don't know if it was because it would be quicker or some sort of liability or other issue with them?
Now I am stressed out that they won't do anything unless they call me first? What if they can't get ahold of me? What if my phone is dead? What if I am out of town? I guess I am glad they don't call me every time she sneezes but this was just bizarre and worrying sort of the opposite end of the scale from the OP
All these nursing homes are inspected by Medicare annually and they are rated on the basis of 1 to 5 stars in a variety of areas. One rating is for staffing and the list goes on. One star is the lowest rating and 5 stars the highest.
You can read about the deficiencies of any NH facility. If there have been complaints filed, etc. It will tell you if the facility is privately owned, state owned, or non-profit. Sometimes you can find a facility that is non-profit and has a religious affiliation. I found a 5 star Lutheran facility that is about 40 minutes from where I live and it has a sterling reputation. Their funds go into making their nursing home the best it can be. They are not looking to make a profit, but to provide comfort, love and support to those in need.
My dad continues to live with us, but should the day come when I can't take care of him anymore, I want to know what the options are. We have 2 nursing homes in our town, both have skilled nursing and PT, etc. One has a 1 star rating and the other has a 2 star rating. Both are For Profit organizations. I know that the 2 star rated facility made a million dollar profit last year. Too bad they won't spend more money on additional staff because their staffing is not adequate. I wouldn't take my dog to the 1 star rated facility.
So this is a way to at least gather more information about a nursing home. I would not have known about the 5 star 40 minutes from my home, if I had not gone on this site. Ironically, we have a new pharmacist at our local pharmacy and he happens to be from the town that has the 5 star place. He raved about it's reputation. I plan to visit that facility and 2 others also.
For what it's worth, it's important to know when your parent has a scheduled doctors appointment. If you can't take them, you might want to have a private pay care giver take them and sit in on the appointment. Same with other activities. It's an added cost to you, but at least you know what's needed is getting done.
Theresam: Your mom doesn't belong in assisted living. She needs much more care than they can provide. Bingo, fully staffed facility with a memory unit.
Hope this info is helpful. Best wishes, Cattails.
But after My Mom had a brain bleed, she was very confused and seemed to lack reasoning on any level and I'm not saying this to belittle mom, she was really in a bad way, I was soo scared to see her like this. Mom was placed on Excelon and increased anxiety meds, they helped tremendously. However, I had to remove the phone from her room because she continued calling me anytime, 2 a.m. for no reason saying she cant see to tell the time but called to ask me what did we talk about the 3 earlier times she had called, then get mad at me and hang up!
OH MY! It's rough but somehow, I made it! I don't want to get too comfortable either because I know that her personality can clash with me and could surface and turn my world upside down. I'm not holier than anyone and I don't push my faith off on anybody but I know my higher power helped me make it thru.
Again I say SHAME! on those AL's and NH's that arent doing their job but raking in major $$'s That's fraud!
One day at a time momcare, you are a wonderful person doing heavenly work. It will work out, time is an amazing healer.
I'm sorry about being shuffled from one place to the other with absolutely no notice to speak of!!! I think that is awful; clear and simple! The ALF my mom is in is actually fairly understanding in that respect. They are very helpful to the residents and I've seen where folks run out of money and they have given them 30 extra days to find a new place to move. For me, it's just the darn transportation that's promised, that they just never have the staff for or the van has a flat tire....or whatever. I remember the contract specifying that each resident has 30 days to move unless their health is in jeopardy and they will not just throw them out. I've never seen that happen in the 3.5 years my mom has been there. The Skilled Nursing facility has done that crap though......not to my mom but I've seen it done to other patients there. So sad and unkind. I'm truly sorry you are/have encountered this and I'm sure there is something legal that you can do but these places know that you have to deal with what they throw at you because you are just stuck between a rock and a hard place. You can't say, "my parent is staying cause I'm gonna get a lawyer because then you risk possible mistreatment and/or danger to your parent and then they know if your parent(s) have no more money and don't have the resources to take legal action. Either way you have to comply and be treated terribly. I'm dealing with that regarding the Long Term Care application for state assistance in the nursing home. When you need documents for utterly ridiculous reasons that aren't even required by law, and you don't comply, they will simply deny the application. So, if they want you to jump into a pit of fire, you jump!! I really do hope there's a place that you and your mom are finally able to feel comfortable about. And, my new friend, Sumlerc, is a very encouraging person, so I hope you get as much value of their input as I do.
Now, I have the issue of her Medicare benefits being exhausted and filing for LTC and all the absolutely ridiculous requirements they have only to prove that most people cannot afford $16,000+ per month for rehab and skilled nursing. All of which, must be approved by the SNF even before they will agree to send the application off to the state..........did I mention that her supplemental insurance benefits run out on or about 3/15/12....cause I don't want to leave that out or the fact that I encounter "road-blocks' from every direction with the records that are needed. Example....I had to drive to a neighboring state to obtain the Sale Deed and settlement sheet from the sale of her home in 2008. They would not provide it online and would not mail it!!!! AND, it still cost me $35 for the copies!!!!
Some days, I don't freak out from these issues and other days, I'm not so strong or unaffected (sp?). Then there's the days, weeks and months like now, where it's been a steady diet of opposition from the SNF, ALF coupled with the constant complaints from her like, BUT not limited to, ice water taking 4-8 minutes to arrive. I have called the Dept of Aging and tried to recruit all that I can and I have contacted the county to utilize their transportation services, which my mom actually likes, but they require a caretaker from the SNF accompany her to these appointments because they only provide the wheelchair van and drivers. The drivers do not get off the bus to help the passenger in any way as it is an insurance liability to the county and forbidden. So, simply put, the driver will not push her wheelchair into the dr's office and come back when it's time to take her back to the facility. They literally stop at the front door of the building and the wheelchair lift lowers her to the curb AND THAT'S IT!!! If she does not have a caretaker, they refuse to take her. This is where I'm frustrated with the SNF because they will come to her an hour before the appointment to let her know that they are short staffed and no one is available to accompany her. Yet, this service in particular is highly advertised and always, always a problem. I dont care if the patient is the worst patient ever, this is part of the job, it's a service promised, figure it out!
first let me say I'm so sorry for you and your having to go thru this, No one should be treated like this but our elders, they should be held in higher regard in our society; That says a lot about us as a nation doesn’t it?
I recall how I felt getting all those phone calls, and reports of my Parents behavior it was heart wrenching! I hated seeing the caller I.D. because it was either the N.H calling to complain ( state their concerns) or Mom calling to complain. After many, MANY conversations with my parents and prayers too! The calls have diminished 10 fold. Most of the issues were about control…or the loss of it. My Parents were used to doing what they wanted, when they wanted right or wrong, my way or the highway. Either they’ve gotten used to how the NH operates on a schedule and not my Parents schedule or they’ve stopped trying to control everything.
Losing or giving up control when you’ve had it most of your life must be one of the hardest things to do. I try to put myself in my Parents shoes, we as care givers really do care, It can be difficult to be the lovable carefree care giver and the loving no nonsense care giver. At least for me, it's been a real juggling act! I do realize everyone is different.
Do you think a different approach with your Mom might help? Does she have a clear understanding of when and how appointments etc are to occur? My mom wanted a schedule and it would be H.E. double hockey sticks!! if they were late or if P,T. or Smoke time took 5 mins longer than what she was told….I mean OMG!
SHAME on the AL for not doing what they promised and were paid to do, and to release your Mom like that, SHAME!! they should be reported, at least given a write up. I really hope that it gets better for you and your Mom soonest, like NOW.
I understand about the foods, my Mom does the same with food, I go in there looking to see what I’ve wasted money on because she let them expire for future use. I’ve stopped investing so much $$ but I thought maybe the foods/fridge was a good idea for someone else.
But right now Momacare, I’m more concerned about you! You’re stressing out and I understand that but you’ve gotta take hold and make this situation work for you; Are there community resources available that are free? Where I live, there are agencies that will take Senior Citizens to Dr appointments. A couple of years ago, I signed my Mom up for it but I soon knew that with her paranoia and high anxiety….it wasn’t going to work but it’s a great service. There are companies that offer a more personalized service but at a cost.
Your Mom sounds quite relaxed, I’m sorry but you sound frazzled and rightly so. Sounds like you’ve got the world on your shoulders I’m hoping you can do an assessment of resources and put them to work for you and your Mom.
Due to a workforce realignment, I am starting a new job this Mon, I’m very concerned about being the newbie and having to take off or take phone calls from the N.H. but, I’m going in faith.
Come on Momacare, we’re cheering for you, you can turn this around!
I understand we are the RP's but the reason I chose these particular places is because they advertise transport (with reasonable notice) along with multiple menu options and other activities. I'm fairly happy with the ALF but they are so resistant to transport when my mom has a doctor appointment, that it's ridiculous. They either don't have a care taker to go with her or the day is not available or the van is not working that day.......to name a few.
The NH has two wheelchair vans and also is very resistant which I think is even worse because they are in the business of "temporary" care for folks in rehab and I don't know why they would think that someone with a hip or knee replacement would not need regular follow up visits to their doctor. The vans sit constantly and does not move yet they too, advertise how they give "expert" physical and occupational therapy services for the elderly recovering from joint replacement surgery......the operative word being "recovering" from surgery or an illness causing a weakened state to their bodies. Recovery requires follow up visits to the doctor that wrote the orders to have them receive care. 99% of the reason people go to ALF's is because they either don't have family near or their family members work and can't take off 2/3 times per week for various routine needs. When my daughter was in daycare, the center transported the kids via bus back and forth to the area schools before and after school; the parents didn't leave work in the morning and afternoon to do the transportation and then go back to work everyday!!!! No one would keep their jobs.
Obviously, if my mom had to have a procedure done, I would make sure I was there for that, but routine stuff should be done by the facility as they advertise and entice the public to bring their family to them. I do realize my mom is a part of this issue too. She will call me, drama included, stating "they just told me they can't take me to my appointment today, can you do it sweetie?" obviously, I can't just walk out of work with no notice and I will suggest that she tell the transportation coordinator at the facility to just kindly reschedule the appointment to when they have someone available. Then the drama starts.....mom says, "the doctor won't wait that's long, he says I have to be seen today...that it's imperative I be seen ASAP and it can't wait longer...." yet, the doctor actually rescheduled the last appointment himself due to being in surgery and the facility agreed to the next day. A few hours later they come back to her and told her they are short-staffed and can't take her tomorrow and asked if I can do it. (according to mom) and I just told her they should not have committed to the next day without coordinating the staff schedules properly and they need to call back and explain the same and reschedule. Well, mom starts the drama again and says, "my doctor said I have to be seen ASAP and it can't wait till later this week....he told them no already!" My response was, "we'll, mom, if it was soooooo critical, the doctor would not have changed the appointment and this is really on him. The NH is doing their best, I'm sure, and he will need to understand that. Remember mom, it was his idea you go to rehab in the first place and I'm sure he's familiar with how they schedule appointments...etc,etc,etc...." she was just relentless and I finally offered to call the doctor myself and clear the matter up and she said, "DON'T YOU DARE, he is too busy to be bothered with logistics....."
So, I think you see what's going on here and it goes on all day with the calls back and forth. Mom told me that the staff kept asking why the daughter (me) wasn't taking care of it and then offered the dept of aging (through the county) wheelchair van and she agrees to it and calls me again to tell me what is happening and it looks like all is ok now. About 45min's later she calls me AGAIN to tell me they can get the county van but they won't have a caretaker to accompany her..."what should I (mom) do? I mean, the doctor is so disappointed I can't come tomorrow" I just told her I wish I had an answer for her but they will figure something out, not to worry cause they EMPLOY a transportation coordinator to handle these things. She took that answer and hung up only to call back AGAIN 1.5 hrs later to say the transportation coordinator has not come to see her and they are really gonna effect her health negatively if they don't get me there. THEN CONTINUES TO ASK, " should I try calling the coordinator again"? I reminded her that this is all stemming from the doctor changing the appointment and that if he had kept his schedule, they were ready to take her. She was kind of quiet and doesn't like me putting this on the doctors office but it is the source of the issue. She said the appointment does not take long; maybe a half hour at the most and I told her that if it was that critical he see her immediately, he could have seen her for such a short visit and still done the surgery in the same day!!!
As you can see, this issue went back and forth while I'm working, from 10:30am until around 3pm or later and it's just ridiculous. Later in the week, she was telling the resident doctor the food was so poor that she felt her nutrition was compromised and that they do bring her gluten free food but it has no flavor and she just can bring herself to eat it. She told me that the doctor suggested I make and bring her meals EVERYDAY, THREE TIMES PER DAY!! I really don't think the doctor would suggest such a thing so I called him to discuss the meal situation and left messages in his voice mail but didn't get a return call. Again, this goes in all day when mom is determined to make me do what she wants. I'm afraid she is going to be picky and complain so much that they will ask she be moved elsewhere. Just so frustrated......
She moved near me to AL about three years ago and since June, has been in and out of rehab 6 times for multiple reasons. All of which started because she ended up in the hospital from falling, UTI's, viruses and of course two ankle surgeries on the same ankle since 12/5. So I'm running to the hospital constantly, only to take her to rehab and missing so much time that I have been talked to at work. I also have to pack and unpack clothes for her for all these visits at both places; rehab and the ALF. She just recently asked I bring her different clothes because she was tired of wearing the same ones. Half these requests come from the nurses cause she asks them to call me and make these requests. All during work hours, which i just can't do anymore. I told her I would do it over the weekend and she does not like the answer but it is what it is. I've let her know my situation at work and told her if I lost my job, i would only be forced to find another in which case she would not even be able to call me since I would be new at that point.
Gesh our Moms sound very much like one in the same with my Dad filling in the rest. My Mom wants to go to the hospital every 3 months it seems for a “full check up”and can easily convince the NH that she is in dire need of hospitalization however, both she and my Dad suffers with Sundowners syndrome when they are away from the NH. Mom wants the Docs to work on her schedule…yeah right! She wants just an overnight stay, well on the last trip (Christmas 2011) she tried this and they kept her 3 days…she almost gave herself a Stroke trying to be released.
I told Mom and Dad both, hey cut it out! I can’t continue running to the hospital because of their stubbornness, the NH and Hospital will call me and keep me up to date and I’ll see you guys when you return. Dad¸bless his heart wants to walk and I understand that but facts are facts, he hasn’t been able to walk un-assisted since 2010…how many falls does it take before he either accepts it or causes something worse to happen.
I’m not so sure how you can manage your Moms meals, does she have refrigerator and microwave access and able to warm up meals? Fortunately my Parents don’t complain about their meals very much, if Dad could have it his way, all foods would come sodium or sugar loaded.
Have you spoken with the AL and NH about the Dr’s appointments? That this is a service that you are paying for they need to resolve it. Sounds like a little more communication with the NH and AL with a more organized way of managing your Mom's care can be just the relief you need.
My understanding is "we" are the Responsible Party (R.P.) so they call us. I'm thinking the only way out of the phone calls will be to remove yourself as the R.P. I've thought about removing myself but I can't! I need to be in the know about my Parents care...I just dont need to know e v e r y s i n g l e detail! These places are protecting themselves so I guess too much is better than a surprise!
Mom's phone was disconnected because it was "costing too much" costing me with her phone calls any time of day or night because of a paranoia attack or is she was ticked off about this or that and that was most of the time. The Nurses allow her to call me a few times a week at decent hrs. Other times I call for her in between visits, It's working like a charm! We must become creative.
Thanks for responding to my post. To answer your question, "what are they calling for?"......Many of the things you mentioned, but my mother has fallen quite a bit as well and each time she wants to go to the hospital or needs to go to the hospital and ends up there for a day or two depending on the injury from falling. She was told to wait for a caretaker before trying to stand or go to the bathroom by herself but she feels they don't get to her soon enough (10-15 minutes) and she attempts it on her own. She also is determined to wear these shoes that have rubber bottoms that cause her to 'stick' to the carpeting and so on and so on. Even if she falls and does not need to go to the hospital, they call me and tell me to come and see if I think she should go to the hospital!! If she gets a cold or sinus infection, she obsesses over it as to whether she should go to the doctor and wants me to call her 'in-house' doctor to come and see her even if the nurse has already done that. If she is unhappy about waiting till the next morning to see the doctor then she requests they send her to the hospital via ambulance and my husband and I end up picking her up in the middle of the night. The county Fire Marshall apparently has questioned the validity of all the trips to the hospital and the falling. Here, the ambulances for 911 are under the fire department, hence the fire marshall being involved. He was concerned that the frequent rides would stop being paid for by Medicare. It is suspected she may do this on purpose but the fire marshall has never contacted me. She does have COPD so breathing is difficult at which point she obsesses about that and calls me SEVERAL times per day to talk about it over and over. In the last 7 months she has fallen 4 times and broken the same ankle twice. As it turned out, it did not heal properly and she said she needed ankle reconstructive surgery and that it could not wait and must be done before Christmas. (two weeks prior) That landed her in rehab only to have the surgery done all over again in 5 weeks cause the incision did not heal properly and the plates and screws became contaminated. (certainly not her fault) She needed to be transported back and forth to the surgeon for follow up and the SNF cancels/reschedules the appointments, stating they don't have the staff to take her......
The ALF also avoids taking her to necessary doctor appointments. There is always an excuse as to why they cannot, yet they advertise about all the things they can provide to entice people to live there. Since June, she has been in rehab 4 times for her ankle, UTI's and COPD. Each time she needs me to pack her suitcase and deliver it before she gets there and unpack everything because the ALF worries something will be missing enroute in the ambulance???. Then, when she is finished at rehab, I have to pack everything and take her back to AL even though the SNF is supposed to transport and unpack everything only to be told they don't have enough caretakers to spare. I understand it's difficult to staff facilities, I really do but I know that when I provide a service to someone and fall short from time to time, I have to figure out the solution....not the customer. She does not like the food so the staff at the SNF asked I bring her meals EACH DAY for lunch and dinner!! Is it me, or is that ridiculous???
As for my supervisor, that would be me. I am a one woman show with customers that are starting to lose confidence because I'm falling behind. People have to work. I tell my mother this and her only comments are that they should be more understanding and that something will happen so I get to everything and if she could do this stuff herself, she would. I think that a customers' understanding can only go so far. I'm literally handling an "emergency" with her once per week; not including her constant phone calls or the staff constantly calling as opposed to the facility handling these things. My mom takes care of her own affairs, I don't handle any of that stuff, yet they call me just the same. the hospital calls me when she is being discharged, they call me if they increase or decrease dosages, etc., etc, etc.....Yesterday, they called and left a message stating she has a dr appointment today and that I needed to be there at 11am.!! She has been in a couple area SNF's due to when a bed is available and they all do the same thing. It's very frustrating indeed!!
I was the bad daughter for explaining to Mom that the NH has rules which she knew of when she ASKED to go there, they are not going to break the rules because you showed up!
I understand the NH calling for health and safety issues, but I was so tired of it all and was going go ask if they could just update me on a weekly basis...I don't need to know evertime Dad falls because he won't listen. If he knocks out or something ok but really?
My higher power knew it was getting too much for me, or perhaps after the NH came to know me, I'm available, I'm there 2-3 times a week, maybe they felt sorry for bombarding me with all of the calls of repeated non emergency incidents.
Never the less, I think I can understand where you are coming from. It's over wheming to say the least. Fortunately, I have a very understanding and sympathetic Supervisor, when I had to take the many calls away from my desk he gave me no grief. But I often wondered how I could handle all of this by myself had I worked else where.
Perhaps you should talk to your Supervisor and explain what you are going thru and talk to the ALF/SNF and say hey! I appreciate what you are doing but please can I get the calls on a Wed at 6:00 for example unless it's a matter of life and worse. It's worth a try. In the mean time, screen the calls and call back as soon as you can deal with it.( maybe I should have done that for myself earlier!)
This too shall pass! I wish you well.