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  1.  
    I can't be at the nursing home all the time, nor do I want to be very frankly. I have asked the NH staff about this one issue several times and they tell me the same thing each time. They CAN NOT make a resident do anything they need for them to do. Such as? Shave. Brush teeth. Accept a sponge bath, even a good face wash. My husband picks at himself (face, head, arms, etc) all the time and is covered in scabs. Ugly, huge scabs that he picks at and then puts his fingers in his mouth. His nails (and toenails) have grown so long. He has brown crud under them (poo?) and it makes me wretch to touch him. He won't wash his hands before he eats (and I know where his hands have been). My daughter said she lost her lunch last time she visited with her boyfriend. Can't the NH sedate him to do the necessary things he needs attending to???? John won't let me touch him. I used to do all that stuff for him....even when he was WELL. No one can even comb his hair or wash it for him.
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      CommentAuthorbuzzelena
    • CommentTimeMar 21st 2010
     
    I'm afraid I don't think much of this nursing home if they don't have a way to handle this. Am I wrong?
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      CommentAuthormary75*
    • CommentTimeMar 21st 2010
     
    I agree with you, Buzzelena and have the same problem here.
    Stunt girl, you can send an email to the American Nurses Association, to your State's Registered Nurses Association, who may in turn advise you of the contact info. for the "Patient Quality Office."
    There are ways to get patients to cooperate (sometimes something as simple as choosing the right time of day), and good nurses will find a way to do that.
    The only time I remember from my nursing days when a patient refused care, he was told that he would be discharged if he didn't cooperate, and so he did.
    I've found that excuses are easier for the nursing home, but that solutions are what are needed, and that should be everyone's aim.
    It was interesting that the College of R.N.'s here advised me to go to the press. It would be effective, all right. But I have problems with step kids and ex-wife who are waiting for a wrong move from me, so I choose to go the route of the Professional organizations. I'm waiting to transfer my husband, and that's another route you could take.
    • CommentAuthoryhouniey
    • CommentTimeMar 21st 2010
     
    I've been a volunteer at a nursing facility for 8 yrs. The staff says they can't force any resident to do something they don't want to. But I've observed that it's an easy way out not to deal with a hard to handle resident. I've gotten some residents to do what the staff claims they refused for them. Sometimes just a different tone of voice or a little coaxing.I've picked up on a lot of things from my quiet observation at the home. Some nurses hated me when my husbands mother was a resident there.But you have to stick to your guns and demand the best for our loved one. I've even went to bat for some whom had no family.
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    yhouniey-good for you. I have noticed when I visit my husband in his ALF we spouses also look after all of the residents.
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    I do not have DH in a NH and my mother was at home as well.One thing we learned was that some AD patients become terribly fearful of showers, the shower stalls, the water all of it. What worked of us at home was to remove the shower sliding doors and put a shower chair in sideways so that mom faced out not the front or back of the shower. We also changed the shower head to one on a long cord and just used water at the gentle rain shower pressure. And we kept the shower time as short as possible but enough to get the job done.

    I have seen NH staff just flat out ignore patients who asked for help who were simply elderly and not necessarily memory impaired. With a memory impaired pt it is harder.

    Mary,
    I am concerned about your concern for trouble made from the step kids and the ex. I also have step kids but have no problems with them nor the ex. But from where I sit, and I could be wrong, they have no say in the decisions the husband though it is nice if they can be included providing they are not troublemakers. I would appreciate any light that could be shed on this question so should I end up with this potential confrontation I might have some sort of knowledge about who has what rights in a situation like this.
    • CommentAuthordivvi*
    • CommentTimeMar 21st 2010
     
    A NH resident has a bill of rights which enables them to refuse care and treatment as long as they are NOT deemed unable to do so by legal means. if they have been declared incompetent by state laws the person who holds POA for their healtcare should and must speak up for them on their behalf for adequate medical care. if a NH resident refuses care under these terms the NH must relay this info to the person who holds DPOA and document the refusal of care in his files. i would contact the omsbudsman asap and speak of this with them with reference to lack of hygiene and failure to supply the resident with adequate standards of care. divvi
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      CommentAuthormary75*
    • CommentTimeMar 21st 2010
     
    Mimi, to date the step kids and wife have cost me over 30k defending myself from harassment and defending my husband's money - to be used for his care - not to mention the grief and expenditure of my time and energy, so yes, I am always looking over my left shoulder. (There are 8 of them, counting ex-wife, 3 kids, their partners and 1 grandson).
    But to add some more info: I spoke to a retired faculty of law professor at church this morning whose mother-in-law had A-Z and was in a care facility. Her infection was to being treated consistently, "the patient refuses care etc.," and his comments on my husband were: "Only a competent patient can refuse care. The only time a care facility is not responsible for the patient's care is if the treatment has not proven effective and does not prolong life" (or words to that effect). Most interesting of all was that he said that I could bring this to the attention of the Public Guardian Trustee (I hold hold Health Care Representation and guardianship (committeeship here in Canada). I think this is a good idea. One of my concerns is that at my age, I could be incapacitated and unable to look out my husband's care at this particular facility. As the lawyer-prof pointed out, it might take me awhile to get this sorted out with the Public Guardian Trustee, but once it is done, they will follow it through. Divvi, what say you, sweetie?
    • CommentAuthordivvi*
    • CommentTimeMar 21st 2010
     
    Mary75 you have been harrassed for so long by this crowd that whatever suggestions you are given you would be wise to follow thru on that -
    the standard of care seems to be a non issue when the patient is competent. they can get away with that - but like i said in the previous post if they are considered legally incompetent then the facility would be obligated to follow DPOA requests for healthcare on the residents behalf. i sure hope this works for you friend! its been a long arduous time dealing with all this-

    let us know how you fair.
    divvi
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      CommentAuthormary75*
    • CommentTimeMar 21st 2010
     
    Thanks, divine Divvi. You are always helpful and wise. We are so lucky to have you on board.
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      CommentAuthormary75*
    • CommentTimeApr 12th 2010
     
    Thought you all would like to know that after a long wait, I finally have a room for my husband in another facility. It will be a longer drive for me, but they have double the staff of the present one. When the owner who is an R.N. is not there, her daughter is. My focus now has to be on the nursing care. My husband was there for a month after his spontaneous compression fracture of his coccyx 2 years ago, and at that time, what I saw of his care was good. So why didn't I leave him there? I couldn't get a private, and he was kicking up such a fuss that I chose the present care facility: it had a good reputation and was close. However, under new management and probably because he now needs more nursing care, I've clued in that there have been 8 transfers out since July (total of 80 patients on the wing).
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      CommentAuthorSusan L*
    • CommentTimeApr 12th 2010
     
    Great news Mary! Good for you for being such an awesome advocate!
    • CommentAuthordivvi*
    • CommentTimeApr 12th 2010
     
    yay Mary75! finally some good news. i hope it works out and is a much better facility that will work for both of you!!
    divvi
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      CommentAuthormary75*
    • CommentTimeApr 13th 2010
     
    I checked out the room today and it's no go - he's not ready for it yet; he's too with it. It's tiny, barely fits a bed and dresser, looks out on a brick wall. The rooms are grouped around a common room where there's a lot of noise from TV and group activities. No drapes and no sound insulation, so the noise is bouncing off the walls. He would have to be sedated to stay there, and since he's at high risk for fall, I can't do it. (He's already had a spontaneous compression fracture of tail bone. A fall - broken hip - would be the end of him.
    So I'll look around at others and hold this one in mind for the time when he won't notice where he is. In the meantime, I'll fill in as best I can where he is.
    • CommentAuthorSandyRN
    • CommentTimeApr 13th 2010
     
    As an R.N. I cannot even imagine any reputable facility not making sure that their patients hygiene needs are taken care of. Improper hygiene can lead to pressure sores and other infections.
    • CommentAuthordivvi*
    • CommentTimeMay 15th 2013
     
    hygiene once again for newer members