“she can be a real bi@ch! Very demanding! and wants everything done her way”
This is what one of the newer aides was told when she was hired a few months ago. She told me this today while we were talking about her taking over Lynn’s day care as his previous aide left yesterday.
There was a time that if someone called me that, it would have hurt my feelings, and depending on who said it, even offended me. Not this time. It actually made me laugh right out loud. Good! That means I am doing an excellent job as Lynn’s advocate :D
I assured her that I was a fierce advocate for Lynn, and also a wife who still deeply loves her husband. That I placed him there, in their care, because I wanted him to get the best possible care. If I see that he isn’t getting the care I feel he needs and deserves, that yes I can be, and will be, as vicious as a Momma bear. But, that I am kind hearted by nature, and it is only when Lynn’s care is lacking that there is a problem.
She told me she thought I was “as sweet as pie” and that I wasn’t expecting too much, only for them to do their job. AMEN!!! She ‘gets it'! She assured me she would do that job well and that I could retract my claws while Lynn was in her care. lol
I am still laughing about it. Glad they all took notice and know I will do whatever is necessary to assure Lynn's care. I try to be nice, I bring in treats for holidays and donuts for the weekend. I like to be liked, and I figure it can't hurt in them being kinder to Lynn as well. But, I can be a ROYAL pain in the butt when I need to be.
In the 3 years he has been there I have been happy with his level of care for the most part. I understand the aides and nurses are only human and will have an off day from time to time. I don’t mind making the bed etc to help. But I will not tolerate what I perceive as neglect.
Some of you will remember last year they had a huge turn around, his quality of care was lacking to the point I would come home in tears. I spoke to the right people, I called emergency care plan meetings, I threatened to remove him. Still things kept happening, nothing major, but enough to trouble me. Like he has double vision and they didn’t put his glasses on. Or finding parts of his breakfast smeared on his face, his chest at lunchtime! Or not being shaved for several days.
I couldn’t help but think, if this how they are caring for Lynn who has an advocate visiting daily, well good Lord! How were those who had nobody looking after them being cared for?
So, when nothing was resolved to my satisfaction, even after talking to the heads of depts. I called the Ombudsman and the State. And I also reported them for neglect with the dept of Elder abuse.
WOW!! Did that ever get some action!!! Do NOT mess with a Momma Bear! :D
I know the feeling. Once when I had a confrontation with the NH I reported it to the soccial worker at the VA. She said "they just don't know how dedicated you are to him". That was putting it nicely.
Good for you!!!!!!! Now, hold her feet to the fire and make her live up to her promises. Sometimes they get real lax if they think you are not looking!!!!!!!!!!
Shellseeker, that is a sad fact... but I am always looking, and better yet, they know it :D
Fayebay, doesn't that attitude just baffle the mind? OF COURSE we care!! But then I look around and see so many folks who have no visitors, no advocates, they have been dropped off and abandoned. Tragic, but I figure it must happen all too often. Maybe they really aren't use to people caring that much? And how heartbreaking that thought is………
I agree leaving his bkft on his face at lunch and not being shaved for several days is not OK.
Just something to keep in mind....up here in Canada we've had so many cut backs that the staffing ratio at the good care facility at the hospital is 1 care aide to 9 clients. In a private facility it is even higher. Way too many to give good care. I have friends that work as care aids and they are so frustrated and tired because they want to give good care but with their work load it just isn't possible. I know when I take my clients over there for activities I am always pitching to help the staff and clients.
Keep up the great work Nikki and make people take notice. You will have much less stress if others know you go to bat for what you are passionate about...... Glad to have you on our side....... take care....
I've been wondering about ratio of staff to residents where my hb is and found: No law exists to determine ratios of nurses to nursing-home residents. Rather, such ratios reflect what residents need and what facilities can afford, with fewer patients per nurse tending to indicate better care. The law governing nurse staffing--title 42, part 483.30 of the Code of Federal Regulations--mandates no specific ratio of nurses to nursing-home residents. It merely demands that the facility have sufficient nurses to attain the highest practicable well-being of each resident. This is, of course, nurses vs residents, and my concern is aides vs residents. They do most of the hands on work. http://www.chow.com
Today I helped my hb w/his lunch in the special wing at the nursing home. Yesterday I shaved him; today he was groomed. My observation is the unit has 1 nurse and 2-3 aides for 21 residents. Sometimes an extra aide is brought in. I just now spoke w/the director (he called because I'd turned in a "concerns" card w/3 concerns). 1. Insufficient staff for feeding, toileting, hygiene. Probably 8-10 need some level of help eating. Staff is spread thin to get all the care done. I told him it depends on level of care required, not just census. 2. Shirt had spots where fabric had been bleached. This is 2nd shirt this has happened to. Care center will reimburse me for a new shirt. 3. Activities are not always taking place when "advertised" as on activities chart; so residents sit and do nothing or wander. He said they'd gotten recognition for outstanding activities chart. I said, "Yes, the chart looks good with varied activities. Problem is it doesn't always happen." Again only 1 activities leader and aides have to toilet, do hygiene, therapies, etc. during this time as well.
So, yes, those of us who have placed our spouses have to be vigilant and be advocates for them. Caregiving goes on and on--just in a different way. Nikki's right some residents have no one to look after them and speak for them.
I also spoke to the memory care administrator yesterday with my concerns. My DW has been in the memory care unit since July 2011. My concern was also staffing, the unit when full has 28 residents. Some evenings for supper there has been 1 CNA and one cook for 28 residents, which I feel is not enough. Most evenings there are 2 CNA's on duty The administrator replied we are following the state guidelines. I replied, that may be true, but 1 CNA for 28 residents is not enough. I also go there every evening to feed my DW, with 1 or 2 CNA's of duty, would they have time to feed my DW if I did not show up?
Another concern of mine was that my DW is incontinent and in the last 3 weeks she has had 4 bowl movements in her depends when I arrived. I could smell it as soon as I approached her. I said this is unacceptable, as my DW can not tell them that she has to go to the bathroom. My DW has not been able to speak for 3 years. You may get a yes or a nod of the head at most.
Another concern there is one resident who has been hitting some residents and some day she will injure someone. Administrator replied, the nurse can calm her down, I replied, but the nurse is not here all the time.
I also said, to the administrator, what if you were in my shoes and your loved was here, would you also not be concerned if you encountered my concerns. What would you do?
I feel my concerns fell on deaf ears. But I will not give up.
'While no specific number or ratio is required, the National Citizens' Coalition for Nursing Home Reform has concluded that minimally acceptable ratios of direct caregivers to residents, for three daily work shifts, are as follows: '
Day: One direct care giver to five residents Evening: One direct care giver to 10 residents Night: One direct care giver to 15 residents
thought i would post this, as the subject seems to be prevalent among those who have concerns. Zibby is correct no legal laws that require a facility particular numbers to ratio but common sense would prevail. EACH patient there will have a 'plan of care' that is set forth and the facility has to see that that plan of care is maintained and accomplished for each person =so if there are deficits they would be in violation of completing the care plan set forth. that would definately show deficit of work force.
if you feel your spouse is not being given the adequate attention my plan if it were me would be to REVIEW the plan of care set forth and revise it to include EACH item you want given attention, ie- at intervals taken to bathroom during the day to avoid incontinence. then if they dont comply you have a legitimate gripe that the written plan of care is not being met. divvi
I've been thinking about asking to review hb's care plan and even mentioned it to the social worker. The way she talked, it was a general one fits all type. Surely not. Will have to pursue this.
Bluedaze*, does your daughter work for a large, nationwide corporation or a smaller community owned facility. Acuity level is the how I think staffing should be assigned.
I do think the staff on my hb's wing is excellent and a hard working, caring group. More of them are needed is my observation--Mealtime especially. So, that's where I'm headed now.
On the other hand, there is a situation like my daughter-in-law's mother ran into. The nursing home she was in went bankrupt and everyone had two weeks to find another place to stay. It's not easy outside of the metropolitan areas to find placement for a number of people in a short time. Many nursing homes are doing the best they can with what they receive--especially from medicare. If we want more care, it may cost more.
Zibby, I think it is sadly true that in general one care plan fits all, BUT only for those poor souls that do not have an active advocate. We review Lynn's care plan at quarterly meetings. And one can always call for an emergency care plan meeting at any given time. Which I have done a number of times. It gets attention and has to be written into Lynn's file. I think it is important to do this because the State does review these charts.
Last year, due to my call of 3 emergency meetings, when the State came to do their inspection, they asked to meet with me. Sure!! Though I do believe the facility is the best in our area, (or else Lynn wouldn't be there!) that does not mean there aren't areas in which they can and should improve. When I met with the State, I told them that I thought the whole inspection was a joke! And I do. For starters, before they come they send for the staff's records for the prior 2 weeks- to a month. This is so they can figure out the ratio. But it also puts the homes on notice that they will be coming to do their inspection soon. And even if they wait to do the hours during the inspection, they still always do them within the same time frame every year.
Last year I knew when the state was coming just from the buzz going on. The big wigs were on the floors observing the feeding process and going over some records. New service wear was brought out, sparkling plates and cups. The place was staffed with many more people than was the norm, and everything was tidied up and cleaned. Pfffft, see my point, it IS a joke! And I had no problem telling the State they were doing a huge disservice by allowing this to continue.
Sometimes, people do listen! Last year, they did the regular inspection, but also did a surprise inspection 4 months later. On that report there are violations, and I know a number of them are the ones I filed with the Ombudsman and the Agency for the Elderly.
Staffing has always been my biggest concern. It is painfully clear when they are understaffed because it shows in the residents personal care. Nothing major or Lynn wouldn't still be there. But they have to cut the corners so they can take care of too many people. So shaves aren't done, or clothes aren't changed as often etc etc. The squeaky wheel gets the oil, is very true in Lynn's nursing home. Some days they see me come in and I can see them cringe, and those days I know Lynn's care is not up to par. Someone always rushes down to "finish" getting him ready for the day. On short staffed days, if I wasn't there, would they have found the time to "finish" Lynn's care? I highly doubt it, and is another reason I go in as often as I do.
I remember when I placed Lynn 3 years ago, I though, ahhhh now finally I can take a vacation! Nope, doesn't work that way. Just because they are placed, doesn't mean my "job" is over. For a good part of the first year there I still had to do a lot of his personal care, from showers to dressing him daily. Could the staff had "forced" this on him, I am sure they could have. But Lynn wanted me, and he needed me. I was so happy that he loved me again, I was more than happy to do this little thing for him again until he transitioned.
Even during the period of time when he was so lost in that blank stare, I still went almost every day. I would sit with him, heart in my throat and try to coax a response from him. With time and a lot of effort, most days I did eventually get a response from him. Somehow, someway, he was always able to say I love you. Thanking God that period of our journey is over now and he is once again feeling better and able to communicate better.
And then since placement there was the feeding issues. He wouldn't eat well for the staff and I was left with the choice of letting him go hungry or going in to feed him. I went in to feed him. Many times twice a day. Only in the last 4 months has Lynn eaten well for the staff. It is such a HUGE relief to me. And now, I could take a trip knowing he would be "ok".
But after 3 years of going almost every single day, I have seen first hand what that does not only for his care there, but for him personally. While it is true he does not remember if I was there two minutes ago, or two days ago, it truly does have a huge impact on him if he is not given "his daily dose of love and attention"
When I have had to be away due to illness or surgeries, Lynn has always declined. This last time was when I had my shoulder reconstructive surgery in Sept. It was the longest I had ever been away from him in my whole life. I almost lost him in October. Even though my sister and the kids went in every single day to visit and feed him ice cream and the staff brought him to every function they had to give him extra stimulation.
He may not be "with it" but he clearly gets "depressed" when I am not there. Whereas, he thrives when I am there. I can only conclude that hearing my voice speak lovingly to him, feeling my gentle touch, us spending daily time together has a HUGE impact on him. We have great visits, and the time we share he is always so happy! And ....I can't help but think, perhaps this is why he does still, on some level, know me........