Skip to main content

View Diary: Elder Advocacy and Being a Detective (74 comments)

Comment Preferences

  •  I'm all ears on the advice part. Reinventing the (14+ / 0-)

    wheel isn't really one of my goals:)

    202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

    by cany on Fri Dec 09, 2011 at 12:58:50 AM PST

    [ Parent ]

    •  OK. Not tonight/this morning, but (15+ / 0-)

      I will try tomorrow. I don't have medical expertise to share, but experience with many of the other aspects. I was lucky to have an out of town sibling I could call with medical questions, though, so if there's anyone you can count on for that function, that would be ideal. Yes, you will have to be involved much more often and more deeply than they represented when you signed up.

      Do not count on the nurses at these facilities. They are often skilled at the interpersonal issues with geriatric populations but abysmal when it comes to knowledge of medications and related issues. Several of them did not seem able to take an accurate blood pressure, so keep that in mind. I would not assume they know what "prn" means, necessarily. Most likely they do, but if it is easier for them to dope someone up, it is not hard for them to say "do you need something to help you relax, dear?" and have the resident express a "need." (Sorry if I'm offending anyone, and yes I met exceptions.)

      We're in California, and used a facility that began as a Sunrise property but then turned over. Is your mom in a well known chain or a standalone? (Again, pluses and minuses.) Is your mom otherwise healthy, or just on the edge between nursing home and assisted living? Is she continent? Ambulatory? etc. ... whatever you want to reveal, and if that's nothing, that's fine. Or if you want to ask by kosmail, that's ok too. Do check out Greyhawk's writings here -- there's a whole book that may be useful to you, and I think their situation involved dementia as well.

      More later.

      •  I am heading to bed, but will respond in the morn. (11+ / 0-)

        Thank you for helping me.  I sure appreciate it.  I have no clue what I am doing.

        202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

        by cany on Fri Dec 09, 2011 at 01:40:05 AM PST

        [ Parent ]

        •  Most people don't know what they (11+ / 0-)

          need to do and the more people you ask, the more completely different answers you get.

          A couple of things I did  that really
          helped when my mother first went to a nursing home is 1) hired an agency to provide around the clock care for the first month, and then tapered off as she adjusted to her meds and settled into her new environment and 2) talked to my own PCP and told her about my mother's problems and my problems.  I visited her every day (still do) and got to know the aides from the agency.  They know so much, and since they are separate from the nursing home, they gave an honest appraisal of how things were going at the home.  Some of the  staff at the nursing home weren't always pleased with the arrangement, but we've gotten past that and they know I'm very involved in my mother's care.  My doctor talked to me about medications for my mother and was very supportive of my needs, too.  My mother was pretty naive about legal issues, and I was fortunate to find a lawyer who helped out with so many issues.

          My mother really needed the 24-hour care at first because she was psychotic and her medications needed to be monitored to get her settled down.  It sounds like your mother wouldn't need extra care for as long as my mother did.  I asked the owner of the nursing home about providing extra, agency staff at first and he said he wished more people would consider that.  

          A couple of other small things I do - I always make an effort to look well-groomed when I visit.  I also visit every day, unless there's a crisis and I just can't.  And I do my mother's laundry instead of relying on the staff.  

          •  Well, that saved me a few paragraphs! (7+ / 0-)

            Good advice. Usually the paperwork includes what the deal is with bringing in outside care. Good places welcome the extra hands as long as they have the requisite credentials and check in at the nurses' station. Be wary of relying only on the facility's recommendations, though, until you know whose opinion you can trust. If they are strongly negative on the agency, take that seriously, but strongly positive recommendations often suggest kickbacks at a minimum. Home health care agencies and facilities seem to be rife with mutual backscratching relationships (ditto nursing homes and hospital social workers). Ask other resident families if you can.

            (Obviously, this is for cany, but I want to reinforce the comment.)

            •  My mother had agency aides (7+ / 0-)

              in rehab before she went to a nursing home, so I was familiar with the aides and the agency.  The home kind of wanted me to use an agency they were affiliated with, but I wanted to keep things as familiar as possible for Mom so stuck with the people she knew.  The agency was absolutely wonderful and helped deal with problems at the home.  I don't think the agency the home recommended would have been as responsive.  And in Michigan, it's the law that we can hire qualified people from any agency.

          •  According to the contract, I CAN bring in someone (6+ / 0-)

            as long as they are licensed, etc.  I am going to wait until mid next week and see if she is better.  If not, I am going to get someone in there.  Thank you for these recommendations, both of you!

            202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

            by cany on Fri Dec 09, 2011 at 05:10:09 PM PST

            [ Parent ]

    •  Your mom is so lucky! (15+ / 0-)

      It sounds like you are such a caring and loving daughter. I'm a volunteer state ombudsman in my area. We advocate for the resident in nursing homes and assisted living facilities. If you aren't getting your questions answered, call your state Aging and Long Term Services department. They will assign an ombudsman to help you get your mom's needs addressed (they may already be at your facility). If necessary, a supervisor will assist is well. There are many resources available, and federal law mandates that there are ombudsmen in every state. Best wishes!

    •  Every state (2+ / 0-)
      Recommended by:
      cany, Villanova Rhodes

      has regional offices for Eldercare Ombudsman.

      Find yours.

      They can tell you exactly what a nursing home can and cannot do, what influence outside doctors can have, etc., etc.

      I found out the hard way that nursing homes' in-house doctors are VERY prescription happy. You may be able to arrange for your Mom's doctor, or someone from his/her office, to come to the to check on your Mom.

      "No one earns $100 million. You steal $100 million." --Fran Lebowitz

      by SNFinVA on Sat Dec 10, 2011 at 10:31:39 AM PST

      [ Parent ]

      •  Incredibly, the Ombudsmen introduced herself (2+ / 0-)
        Recommended by:
        SNFinVA, Villanova Rhodes

        to me today at the party! She was very nice! Had some good advice for me including this (roughly):

        The more you are here to see to your mom, the better care she will get. That's just the reality of it. And while this care home does pretty well, no one is perfect. These people work very hard and some are better than others, but your presence will let everyone know they are being watched.  It helps.

        This is much what everyone here has told me, but boy, after discovering only in this diary (per comments) that there even WAS an ombudsmen then to have her come right up to me was the best luck I have had in a long, long time!

        202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

        by cany on Sat Dec 10, 2011 at 04:07:57 PM PST

        [ Parent ]

        •  That's great! (2+ / 0-)
          Recommended by:
          Villanova Rhodes, cany

          Yes, being a regular visitor is very helpful, and being 'hands on' is important too: cultivating good relationships with some of the staff that care for your mom can also result in better outcomes.

          The ombudsman's office here in my town provided invaluable assistance to me when my father went in to nursing care.

          "No one earns $100 million. You steal $100 million." --Fran Lebowitz

          by SNFinVA on Sat Dec 10, 2011 at 04:48:57 PM PST

          [ Parent ]

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site