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Mom fell and broke her hip because of a cord left in an area she was permitted to access. Her only solace was walking and now she is confined to a wheel chair or a "comfy chair". She had to have a plate put in her hip and now she can no longer walk. She is confused and combative because she doesn't understand that she can't just get out of her chair and walk. The nursing home dumped her on the local hospital emergency room and expect them to find a psychiatric geriatric unit to help adjust her meds so she won't be so agitated. The nursing home says, they do not have the staff to watch her constantly so she doesn't get up and fall again. They put her in this situation with their negligence and now they don't want to deal with her issues. No one will take her due to her medical condition. They truly just dumped her. This is heartbreaking, she is so scared and confused. I have no idea how to help her. She is in the hospital and they are trying to find placement for her in a geriatric psych ward. I do not understand how a dementia ward in a nursing home can not deal with a dementia patient!! Would really like to hear if any one else has dealt with this issue.

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OMG, these scenarios are getting worst. Your problem is by far the most troublesome of all that I have read. To be rejected from a Nursing Home. I know that the main reason you placed your mother in there is to have her to have better care than you can provide at home. I can pray that you find a facility with not only professional people, but people who care.
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I think you need to have a meeting with the Director of Nursing to find out EXACTLY why mom is such trouble. Is she combative? Does she continually try to get up by herself? Exactly what is going on?

If it is because she is a high fall risk, then find a nursing home with a public dining room in the middle of the action. A newer facility is a likely candidate. Then it's wheelchair to the dining table, tucked under and locked. The patient then can't get up. Look for a facility that uses the dining room as a common room -- it'll have a big screen and they'll use it for activities.

In many states, nursing home patients cannot be restrained with a safety belt or food tray to keep them from injuring themselves. In SOME states with that restriction, a doctor can prescribe restraint. Find out if your state is one of those from that nursing home meeting.

I wish you success.
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No, never heard of a longterm nursing facility doing this. That is why they are who they are. Threaten to sue for their neglegence and stand by it. By law they cannot restrain her so there goes the problem. Not enough staff. You can call the omnibus (spelling) that other members have talked about. Just because they did it doesn't mean they are doing it legally.
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I think the word JoAnn was looking for is "Ombudsman". If so, it's pronounced like "AHM-buds-mun". It means a patient advocate and I think most states have one and, if so, the nursing home may be required to have a notice posted somewhere with this person's photo and contact information, usually in the state capitol. Your local "office on aging" (or similar title) can also tell you if your state -- or even county -- has such a person. That person's job is to investigate complaints and to advocate for the patient. I just can't imagine what our family would do if our Mom were to be treated this way; I'm sure you are frantic and I am so sorry for your troubles. I will pray that you find someone "official" to stand with you through to a resolution on behalf of your Mom. Angels watch over you all!
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We had a similar situation with my mom. I was getting calls early in the morning while my kids were still in bed from nurses saying my mother was up all night pestering the nurses and they couldn't get their work done. I thought taking care of my mother was their job. Within a week they called to say she had escaped from the secure memory care unit and I was to come collect her immediately, that they would no longer take care of her. I had two young children and couldn't just leave immediately. It took a few hours to find another NH to take her. It was an extremely stressful experience. Sorry you're having to deal with people who aren't interested in taking care of your mom. God bless you through this.
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Yes of course. physical restraints are not legal, medical restraints are unpleasant and immoral. Mom needs to be in a small facility. Call in a not-for-profit hospice care company to do an evaluation. They may be able to recommend a placement for her. When my husband was at that stage, we needed to place him in a small seniors-only psychiatric hopital for 2 weeks so they could titrate his medications so that he became more manageable in the Memory care unit.
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I am so sorry for your heartbreak. The hospital will help you find appropriate placement. My SIL constantly got up and fell. They have lots of tools/strategies in NH to deal with this. Including having psych and/or Dr evaluate need for sedatives, anti-anxiety meds etc. You have every right to be outraged at the conduct of the NH. When everything settles down you should really file a complaint with the State licensing agency. This will protect other vulnerable people.
Sending hugs to you and your mom.
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I am so sorry. It sounds like you do need to look into legal counsel, due to their negligence. Also, this is why you hired this facility!
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I have had a similar situation and I empathize. My then 94 year old Mom who has pretty advanced dementia had lost a lot of her ability to articulate her thoughts appropriately. One day she woke up and the first thing she said was "If I had a gun I kill myself and shoot the man." Heaven knows where that came from since my mother is probably the most gentle person I've ever known. But, according to state law, when someone says something regarding hurting themselves or others, a psychiatrist has to be called in. I was aware that a psychiatrist was going to evaluate her but was reassured by the nurse that it was just procedure so I felt relieved and thought all was well. The psychiatrist, who evaluated her in the evening when her dementia was most prominent, told the facility that she was depressed and needed 24 hour supervision. Later that day I got a call from someone at the facility who did not make it clear who she was or what her position was. I later learned she was the facility administrator. She told me my mother had to be supervised 24/7 and either I could had to do it immediately or I had to get someone to do it. If I was not able to not comply, they would move my mother to a psychiatric facility some miles away while they got her meds adjusted. I could only imagine how frightened my mother would be if they moved her. Fortunately, the social worker at the facility was kind enough to walk me through the process and put in touch with an agency that provided one on one care. It was fairly expensive ($18/hour) but even after she was deemed ok, I continued the care during the day twice a week so she could have companionship. I suggest talking to the facility's social worker to help find a home health care person. Secondly, make sure any psychiatric eval is done when Mom is at her best. Once, psychiatrist saw Mom in the morning when she was smiling and cheery, he realized she was fine. Talk to whomever you feel you need to at the facility. I finally felt I had to talk to the facility admin's boss in order to really be heard. Once that happened, attitudes seemed to shift and I felt the situation to be more stable. I truly understand how frightened you are and wish you the best.
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Today many people are being victimized by the hospitals, rehab centers & nursing homes.....There is no place for the elderly,healthy or not,to go to anymore. Having spent my entire life in the profession, I myself have fallen victim to this most recently.

The hospital,rehab & especially the nursing homes(NOT ALL OF THEM) are in the business of making $$$$$....I wish it went't so but it is.
If you have the funds, please get legal advice. I so pray that things will change.

Dumping PEOPLE into the system with no help or funds, warehousing the elderly who have no where to go is INSANE....I see this as an of terrorism with in our own society here in the USA, propitiated by the almighty dollar.
This question has hit a very personal point in my life....I have no answers....THIS IS NOT HOW IT WAS WHEN I WAS A CHILD.....one reason I moved into the medical profession but I tell you, I am now feeling lost with in it. I am a dying bread lost in the same problem.
GOD WATCH OVER YOU & LEAD THOSE WHO ARE IN A POSITION TO HELP~TO HELP.
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I don't have any better answers than the ones provided. Contact the ombudsman and have them attend meeting with you. Also the fraud dept of medicare and medicaid investigates and PROSECUTES cases of abuse and neglect. I would get them involved. Mostly, I responded because all day I have been struggling with that question with regard to my mom and her facility. How can a dementia unit not be able to adequately care for those with dementia, and, that being true, why the h*ll are they taking our money. I'd move my mother in a minute, but she's in the only dementia unit in our county with a guaranteed private room. She's lost so much to this disease, she at least deserves her own small room with dresser and twin bed. God help me, I fight on. Have resorted to taking care of a lot of her needs myself. She's "resistant to care" as they say, which I think is bs. She just needs a gentle touch, not some hurried, underpaid stranger telling her to get naked for the shower,
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Get a new nursing home for your mother and tell the old one to go jump!
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The NH my mother was in deemed my mother was too well to stay there. What a load of ##! Less than 48 hrs later she suffered an ischemic stroke there! Another patient, who was a recent amputee was discharged WAY TOO SOON. DIDN'T EVEN HAVE HIS PROSTHETIC LIMB YET!
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I had this cousin who was in a nursing home ages ago, and he was not well cared for there. I used to love calling the place and telling them to get it together or go out of business. It's a good thing the fuzz never caught on or there would have been trouble big time.
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Cak2135: NH's can put their "game face" on when the patient's family arrives. Then after family leaves, patients are sometimes waiting for hours to use the potty and other things!
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Thanks everyone for your kind words and advice. Mom is currently in a Senior Transition Unit (geriatric psych ward). When admitted to the hospital, she was severely dehydrated and they discovered the nursing had not been giving administering her thyroid meds. I do not know why YET, they were not giving her this medication. Her thyroid was so out of wack and combined with the dehydration put her in a mass state of confusion. After she was hydrated and they got her thyroid under control, she is very calm without adjusting any of her meds. We actually were able to communicate with her.
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This new role we now play in our parents' lives is all uncharted territory with no road map. It's difficult to know just what when these types of circumstances crop up. So glad it all worked out for you.
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None of the NH I have ever worked in have said that they provide 1:1 care, even in the dementia units. Some of you are saying "that's their job" to watch them 24/7 but it is not possible. Private aids or a geripscyh eval are needed for anyone who is a danger to themselves or others. That being said, it is very upsetting to family when they get these phone calls that don't make any sense to them because things are not explained properly and handled correctly. When my mom was at ALs and NHs I never really felt like I knew what was going on because I did not know how things worked and the liasons, being so familiar with how things worked, did not think to explain things to me at my level. I don't think this NH really did anything wrong except to have too high expectations of you (like you could drop what you were doing) and not explaining what was going on. I'm glad the social worker helped you out. More power to people like her and I'm sorry you had to go through this.
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These comments are heart-wrenching, because they remind me of what my father endured in two nursing homes. The first one ($10,000 monthly fee) called a doctor who was not board certified in anything their geriatric psychologist. On and on I could go. At the risk of being blocked from this site, I would urge all who want to see and understand and get a grip on what happens in some NH's, as well as insight as to how to be a caregiver, to read Before the Door Closes: A Daughter's Journey with Her Alcoholic Father. It is available through online bookstores.
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Judy: A $10, 000 monthly fee is totally UNACCEPTABLE!
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Of course your mom is scared and confused and combative. Poor thing.

Temporary placement for her in a geriatric psych ward might actually be a good thing. Often this is used to sort out the drugs the patient is on and make adjustments to help her be less confused, scared, and combative.

Has she been in the "memory care" unit of the nursing home?
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How about taking her out of that facility?
Seriously it seems they don't want to do the extra work or THEIR JOB.
Shameful.
Maybe get a hidden camera (they have teddy bears with cameras) and place it in her room. I betcha there is more to this story.
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Correction: I meant to say "geriatric psychiatrist," not "geriatric psychologist."
Llamalover47, we changed nursing homes.
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My mom became combative and frankly, very wild. The unit she was on absolutely could not handle her, nor should they be expected to. During a psychotic (wild) episode, she was taken to the ER, then a geriatric psych unit for 5 days to get her meds adjusted. Best thing that ever happened to her. The skilled nursing unit was not built or intended to handle problem patients.

This was procedure, not dumping.

She required a secure/locked unit because she was an escape risk, so she came back to a special dementia unit instead of the skilled nursing unit she had been in.
The whole facility in that unit is built for dementia patients with behavioral problems. The staff are trained for it. They aren't considered a problem in that area because that's what it's for.

There are dementia patients *not* in that unit because they don't have the behavioral problems that put themselves and other patients in danger.

Mom's geriatric psychs were miracle workers. In 5 days they got her down from being absolutely wild & out of control to being pleasant. Her permanent dosage is somewhere in between those two levels. It controls her anger, paranoia, and the violent behaviors that go with all that.

Not every nursing home or skilled nursing unit is setup to handle difficult dementia patients. And you can't know if you're going to be one or have one until it's happening.
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I am disagreeing with most of what is said here. Taking someone who is combative to the ER is not unreasonable. Sometimes there a physical things, like urinary track infection, electrolytes imbalances, etc that can cause psychotic features. These need to be checked out. Also, a geriatric psychiatric unit can be VERY helpful in adjusting medications. I think psychiatrists are the best at getting medications right and one who specializes in geriatrics is very appropriate with a person who has forms of dementia.

Most long term care facilities try really hard to care for their patients. It can be very difficult both physically and mentally on these care givers, and most need to be applauded. In the case of PAcaretaker, if you really feel the facility was neglectful, feel free to take legal action, and of course, you don't want your mother there anyway. There are good facilities with good people working in them, you just need to keep looking, as they are out there. I am in the midwest of USA, maybe facilities are better here than else where. I can only speak from my experiences in this area.
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Many times a hip fracture is plated so that the individual can eventually become weight-bearing again. If the unmanageable features of her behavior get medicated properly, maybe rehab could occur for her weight bearing. I would focus on helping her improve rather than on who is at fault for now, to help her.
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Judy: Yes, yes, but that fee! Yowzer!
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With any kind of care facility, be it NH or daycare for your tot, you have GOT to interview them. Show up unannounced. Check their investigation & complaint file with the state department of human services. Every facility is going to have something in that file, and if it's more "self-reports" than anything else, that is a good sign they are keeping a close eye on themselves.

Use your eyes, ears, nose, and good sense to evaluate what you see. It is next to impossible for a facility of any size to put on a show all the time, every day. If the residents don't look clean, the place is a mess, it's not orderly, bright, and cheerful, then those would be red flags to me.

It's not going to look like a resort full of vacationers. The people in there have serious illnesses. Some of the are going to be asleep where they sit. Some are going to be feisty and arguing like little children. Others are going to be talking to somebody invisible. Yes, some will holler and yell. Especially in a dementia unit. You will hear somebody calling out "Nurse! Nurse! Nurse!" the entire time. There is a lady on my mom's unit who does this every waking second, every day, regardless of how many nurses attend to her. It is not a sign something is desperately wrong that everybody is ignoring. It means they are not medicating her to the edge of consciousness. Imagine working there all day long.

If the place has been open a long time, that is a good thing.

It's not going to look like the marketing brochures. If it did, I'd want to know why those healthy looking people need to be in a residential long term care place.
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Yes, PAcaretaker, it happened to me, but the circumstances were maybe a bit different. Mom started throwing tantrums and the nursing home decided to move her to another building. Mom was at first happy about it, but soon enough she started to hate the new place - it did not help that there were a couple of residents there that took a strong dislike to Mom. At that time they also changed Mom's medication, which made her very drowsy - she could not walk any more - and gave her hallucinations. They finally sent Mom to the hospital where they adjusted her medication, and they ended up moving her back to the old place (but in a memory-care area). I am very distrustful of medication in general, but I have to say that the new treatment made all the difference. Mom has been doing much better since. She is walking again, and she seems both more peaceful and alert (even if the dementia is still there of course). I hope that your mom gets better.
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when I was visiting nursing homes, a director of nursing confided in my that when a home wants to discharge a resident, they send them to the hospital and simply don;t hold their bed. When they're ready for discharge, their room has been taken by someone else. Sad that the place we send our loved ones when we can no longer take care of them, also is unable/unwilling to take care of them....
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