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    • CommentAuthorOnewife
    • CommentTimeJul 26th 2017
    Today I was told by memory care facility that I will need to hire a aid for 4 hrs in the am and 4 hrs in the pm. Dh is falling and he needs more one on one. They feel Dh is pulling staff away from other residents. He had two falls today within a hour. They suggested I could staff w family, but that would be impossible. Everyone who is capable and willing is at work. Dh has just turned 60 and is on hospice. I am paying 6200 a month and I don't know how I can afford much more. The other option is to bring him home with caregivers. If I brought him home I would be walking right back to square one. Our home has steps up and down and he would still be a fall risk. Director of nurses has suggested more meds for agitation. This is what happens when I miss 3 days of visiting due to stomach flu. I dod try to push back on facility. My mind is racing to find a solution any ideas?
    Dear Onewife ........

    It seems as if it's time for your DH to be confined to a wheel-chair.
    When I placed my dear Helen in a facility, they had a way of getting her used to it.
    Every day they would get her up in the morning and into the wheel-chair.
    They strapped her into it so she could not get out of it,

    They did this with most of the patients there and occasionally they would move them around
    so they would not get bored. Some of them learned to move the chair themselves.
    • CommentTimeJul 26th 2017 edited
    I wish that I had ideas that would help you. It is a tough spot to be in. You need the help, and you're already paying plenty. I know that help varies in different states and countries, and so the first thing to do is find someone who knows how the system works where you live.
    Thinking off the top of my head, these people should know or could find out: the Social Worker and/or the Director of Care in the facility, your husband's doctor, your political representative, your local Alzheimer's Society, your clergyman.
    There are people on this site who are more knowledgeable than I am. I'm sure they will be along shortly to share their expertise. My gut reaction is that if the facility can get you to supply this extra help they will put pressure on you to do so. I can't see how they could justify to any investigating party why they did not provide adequate care to your husband. If your husband suffered neglect because of their failure, I can see it making big headlines in the newspapers, and I can see them losing their license.
    To me, it's the same tactic that the Emergency Departments of hospitals use when they want to discharge their patients home,and the family clearly states they are unable to care for the patient. Legally, the hospital cannot discharge a patent onto the street, but they will make all kinds of noises saying they can and will.
    That's my opinion, and I sure hope someone comes along to either confirm, or give you the straight goods.
    Yes, I agree with Mary. It is the facility's responsibility to care for your husband, not yours. I think they are trying to bully you into doing their job for them.
    • CommentAuthorxox
    • CommentTimeJul 27th 2017
    It sounds like he is requiring more care and the ALF isn't equipped to provide that level of care. If my wife was in that situation I don't think she would need an aide but I she would be set to another level of care, which they would provide but at a higher daily rate.

    I did have to pay for 24 hour/day aides for my wife when she had violent episodes. But those were limited (most was a week at a time but very expensive, so I sympathize about the extra costs.

    Contact hospice. They may have ideas or possibly provide additional resources.

    I am concerned that more meds to help with agitation might make the falling problem even worse. Unless the agitation is getting him to be walking around more.

    My impression from comments from others is that strapping someone into a wheelchair is illegal in many states. But I remember at my wife's ALF them building a sort of cage for a woman who wandered around a lot. this would allow her to walk around but minimized the chances of falling.
    • CommentAuthormyrtle*
    • CommentTimeJul 27th 2017
    Hi One wife, I have never heard of this but paulc's comment raises a good question. What level of care is your husband getting? Is he in assisted living or is he in skilled nursing?.
    • CommentAuthorOnewife
    • CommentTimeJul 27th 2017
    Thank you all for your response. Dh is in a secure memory care unit. He was admitted in April by the end of May he was put on hospice. In June hospice advised me to call priest for last rites and contact family, in July he rebounded and was eating drinking again. He is considered a level 2 out of 4. He has a wheel chair but will get out of it so it is more of a fall risk and it's illegal to restrain him. Family and myself stayed with Dh so much that hospice and I felt staff was relying on his having help. I was cutting back and started only going once a day for a couple hrs and not going back in the evening. Than I got the flu and did not go for 3 days but others popped in on him. Hospice was at the meeting w director of nursing, floor director and myself. I felt like everyone was pushing back including myself. In my observation they have 2 more patients since Dh was admitted and the existing population has patients who are worsening. They are asking for 7 -11 in Am and 4-8 pm. In other words when Dh is likely to be awake they want a aid. I think I could compromise but want them to meet me half way. I think the facility should hire more aids.
    • CommentAuthorCharlotte
    • CommentTimeJul 27th 2017
    I think with my mom they got around it by attaching desktops to their wheelchair. It had a cup holder for her sports bottle of water. She moved around with her legs as did many others.
    Where are you located, Onewife? If you don't mind saying. (In very vague terms.) I have never seen the family asked to pay for an aide once the patient was placed. It is their responsibility to maintain him safely, not yours. At least, as far as I know--but I've only ever worked under U.S. regulations.
    • CommentAuthormyrtle*
    • CommentTimeJul 27th 2017
    I've never heard of it, either.

    The reason I asked what level of care your husband was at (whether assisted living or nursing home/skilled nursing) was that paulc assumed it was assisted living, which a person can get kicked out of because they need a higher level of care. (My understanding is that "memory care" just means a dementia unit, without reference to level of care.) I think you need to get some help in finding out what your rights are in this situation. Is there an ombudsman or other patient advocate associated with this place?
    • CommentAuthorOnewife
    • CommentTimeJul 27th 2017
    I went to my early onset support group and asked others who have spouse in a facility if they had any advice. Only 1 member was asked to hire a aid, after behavior issue and needing Med adjustment. This aid was needed 24 hr for a wk. I might have yrs ahead to pay for aid and facility. I'm wondering if by telling me this they are safe guarding themselves from a lawsuit. I live in suburb outside of Chicago il.
    • CommentTimeJul 27th 2017
    Onewife, I live in Vancouver, Canada and had my husband in two different care facilities on the "Intermediate Care" unit and was billed accordingly.
    In the first facility, the actual care give was minimal and resulted in a skin infection, for example. I was told by the Director of Nursing that according to the B.C.medical Plan each patient was allowed no more than x number of minutes(?) hours(?) of nursing care in a 24-hour period. After that, if more was required, I had to hire someone from an agency.
    The second Care Facility was not much better. I finally had to pay around-the-clock care aides to stay with him —he was at high risk for falling. This supervision was in addition to my regular visits when I relieved the care aides for their lunch. Even then, with all that money and time going out to ensure good care for him, when I put on the call light for an emergency shot to ease his choking, no one came. I would run down to the nurses' station to find the staff had turned of his call light and were sitting around chatting. I want to the top brass about that, but three days later, went through the whole experience again. Going to stop writing. It's too painful to remember.
    Onewife, if he needs more care than that facility can provide, he may need to be moved to a different facility, where he can get a higher level of care. (Like from assisted living level to nursing home level.) If there is a social worker's office in the facility, they should be coordinating this--not asking you to pay for a private aide to go in. Again--he is placed. He is their responsibility, not terms of care. What would they do if he had no family? If you disappeared in a puff of smoke?

    There are many ways to deal with demented patients at risk for falls--maybe a geri chair with a tray in front, or a chair alarm on his wheelchair. They should be keeping him in his wheelchair very close to the nurses' station. When my DH was in Rehab. he was always getting up, had some falls, etc. The charge nurse used to take him with her, pulling his chair behind her med cart like a train, as she made rounds and did the med. pass--so she could always have her eye on him. But they never asked me to pay for extra help for them. I think you are being skunked by that facility.