If my mom is continued to be left immobile in nursing home, she will not live long. What do we do?

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peggy61 Asked September 2016

If my mom is continued to be left immobile in nursing home, she will not live long. What do we do?

Mom is resident of nursing home,she is not able to walk but stands and transfers from chair to recliner, recliner to chair. Needs assistance to and from bathroom. Recently CNA was taking mom to bathroom, her knees were a little shakey, she told the aide to sit her back in chair and give her a minute, instead the aide lowered her to the floor, with knees under her. Mom is heavy so took several to get her up. Then nursing staff deemed her hoyer lift from now on says she is too inconsistant. Mom is still able to stand and transfer as before, they will not allow her to even stand, must use hoyer for all mode of transfer, she does not get to go to bathroom. Mom has CHF, fluid builds up if she does not move heart doc say she has to stay active to stay alive. I go twice daily take her to the bathroom, exercise her, we stand up and down several times. Nursing home continues with hoyer. Mom is 94 she is still alert, begs to get up out of chair, begs to go to bathroom. If mom is continued to be left immobile, she will not live long CHF and fluid build up will get her along with stiffness of arthritis. Please tell me what to do ..

Skilled Nursing Facility

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score 0 · Answer 1

I'm so sorry. I know this is a difficult time and seeing what seems to be a step down in her functional capabilities is difficult. It's exceptionally hard during these times to remember some key pieces of information: safety is important for both your mom and the nursing staff. The aide who lowered your mother to the floor did so because she was worried that your mom would not make it safely back to the chair and could get injured in the process. I think it's easy to get caught up in the idea that the nursing staff don't care and are using the hoyer lift for convenience, but nothing could be further from the truth. It's generally much faster to do a simple transfer if the resident is able to safely transfer. Please try to understand the reasons for the decision. I'm sorry she has CHF. It might be helpful for her to have some gentle OT in her room to keep some muscle strength and keep her joints mobile.

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score 0 · Answer 2

I suggest requesting part B Medicare therapy. Changing her status from standing transfers to mechanical is a big change in function and she is entitled to therapy care. If the facility will not, or their therapists will not provide OT/PT you can look at the laws in your state. Some states allow you to take your Mom to outpatient therapy. Otherwise you could also consider hiring a personal trainer/caregiver to work with her in the facility at your own expense.

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score 1 · Answer 3

Hoyer or no hoyer, she is entering the late phase of heart failure. Time is short. Her heart may not be able to handle PT at this point. Her arthritis definitely won't like PT. I say just keep her safe and comfortable and avoid any possibility of falling.

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score 0 · Answer 4

Ask for therapy to help with strength. Can also ask to sign waiver against hoyer. Just acknowledge that they have educated you on risks. If they wont do therapy, though, they probably wont help her with transfers, either. I would look into finding a better place for her, one that assesses for need for therapy after a fall. And definitely one that has a physical therapist available to evaluate her and give a PT recommendation. Nurse aids shouldn't be the one to make this decision, when it is such an important one.

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score 5 · Answer 5

Your mother is very sick and your post suggests she's also overweight. The aide may not have been able to get her back to the chair and the floor, in that moment, was safest. Your mother can do exercises on her own in bed or in her recliner. For example, lift a leg off the ground and make circles at the ankle. There are 10-minute chair workouts for seniors. Sit and Be Fit by Mary Ann Wilson is one of the best programs for people who cannot walk anymore.

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score 0 · Answer 6

I'm asking, not suggesting: hypothetically, if the mother is still competent, could she sign a waïver specifically permitting staff to assist her to stand on request?

There are zimmer frames with built-in seats, which would permit her to sit whenever she needed to - she wouldn't have to get to a chair or bed to sit down.

I really hope you make some progress with this: unless your mother is unable to understand risk and consequences, it feels wrong for her to be denied assistance to stay mobile.

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score 2 · Answer 7

This is similar to a post I made concerning falls, the nurses and aides are not going to put their own health and safety (not to mention their livelihood) at risk to prop up someone who can not be trusted on their feet. Yes, speak to the director of nursing, but ask if there is any possibility of PT or any exercise regimen that may be implemented, otherwise I think demanding they help her walk and transfer is a lost cause.

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score 2 · Answer 8

Speak directly to the director of nursing, or put your concerns in writing and deliver the letter personally. If you have to, ask for a consult with the facility physician. You could also ask her regularly treating cardiologist to write a letter to the facility advising of the need for movement to assist in controlling edema (is she on diuretics?).

And document.

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If my mom is continued to be left immobile in nursing home, she will not live long. What do we do?

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