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My father is 89 and in a nursing home. He is in the rehab. part and is considered short term at this time. He is in a wheelchair right now and has early dementia. I am having a very difficult time with him being in a nursing home and probably having to go long term. I don't know how to get better care for him. I complain about something almost every day and they only respond to requests if I am there. Seems like the care is very poor unless I complain.
Today I had to complain that he had been wearing the same clothes for three days. He was in a polo shirt that was dirty. I would think at night before bed they would take his shirt off. Also I believe three days of the same clothes is not okay. He has an air mattress. They don't put sheets on the mattress and when we said he wanted sheets they said they don't have sheets for this type of bed. Today I complained again and a different nurse made the bed with sheets with no problem. I visited yesterday and he was covered with a king sized quilt that was old and dirty. I told them it wasn't his and he said it was donated to the facility. I asked that they only use the blanket I brought in and hospital blankets. The blanket they had on him looked filthy. They removed the blanket and bought in a hospital blanket. I asked that any new medications be approved by family as I don't want him drugged up. the last two days when I have visited he can barely stay awake and looks very tired and flat. I asked if he was on any new medication and they told me they had been giving him sleeping pills because he can't sleep. The reason he went downhill was because he had delirum then a seizure caused by medication. Ativan and sleep meds. They tell me that he is confused sometimes and needs 24 care because of safety issues and that he shouldn't come to live with me unless I can provide 24 care, yet then they say he is competent to decide if he wants the same meds. that put him in the hospital. I have bought him many new clothes while he is there and they all end up stained and ruined or lost. I have already called the administrator at the hospital to complain that the medicaid director told me that I could afford to place him in a private facility. This is when I went to ask her about medicaid and his options. They think I am a pain at this facility, am I expecting too much and making too much of all this? Do all nursing homes run like this? Each nurse I complain to blames it on the previous shift.

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Ask for a sit-down meeting with the administrator and director of nursing. Be prepared to present a list of the issues, most important ones first as you might be cut off if you try to address all of them. You can also give them a list of concerns, explaining sweetly that you're dissatisfied but felt they should be given an opportunity to address the issues before you start looking for another facility (but say this only if you already have looked and located other facilities that will take him).

You mentioned the "administrator at the hospital" - I'm not sure how this person is involved, assuming you're at a rehab facility, or was it that the hospital administrator recommended this place?

I think you have some legitimate concerns. If you have any family in the area, or even a friend, it would help to have someone else along for the meeting as the staff might try to intimidate you by having several people there, thinking you'll feel uncomfortable if you're the sole advocate for your father.
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My experience with short term rehab for my mom was miserable for me but the physical therapy for 6 weeks did help her - I did hire a private sitter to be with her 4 hrs a day to help her eat dinner and get ready for bed

My recommendation is that if he will go to a nursing home permanently then find the best you can that is near to you as you must visit often and at different times - if you can bring treats for the nurses station and show concern for staff - know their names - yes care is inadequate - personal belongings are stollen - if you can do his laundry yourself do so , if not, -label everything and take pictures - nh has to inventory and if it is on their list and goes missing then they reimburse you

As for meds, Ativan should only be used short term usually in a hospital- who is his attending dr - who ordered sleeping pills ? Nothing should be given without your permission assuming you have health care directive and power of attorney

We all have to accept no one loves our parent and no one knows our parent like we do and while there are some very good hearted people working in these facilities - it is not one on one care - at a minimum he should be bathed 2x a week

I've seen people not able to reach their food tray offered no assistance to eat and others cry for help while the one caregiver on shift is asleep in the hall and this at a five star Medicare rated facility
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is spot on have that list ready and be absolutely certain that from the outset you identify the meeting as THE FIRST OF SEVERAL that you will need to have - if they ask why tell them you must have at least one more as a review meeting - you have drawn up a list for them to which you will also email in case they 'lose' it.

As I have said on hundreds of occasions MH facilities are fantastic ...until your LO is in one that isn't.

I would take a friend with you anyway - one that does not know your Dad and therefore is as impartial as is possible (short of paying someone and arguably payment prevents it being totally impartial anyway)

If however you are concerned re his health and medication then this meeting must formally request a medication review to be held by ....and give a date and express that you wish to be present. Have that ready ion envelopes and give one to friend and one to each of them so everyone has one.

Its belt and braces stuff at this point and they will know by those two very actions you are considering taking this further, are acting in good faith now, and will fight to the death (perhaps not the best choice of words) if need be to ensure Dad's care is the best it can be.

For me care costs should only vary based on one thing - the size and decor of the place. Two care homes in the same street/area should cost the same UNLESS the rooms are bigger, the grounds are bigger, there are more communal rooms or they offer a la carte dining!. Outside that care is care
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NH not MH grrrrrrrr
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Don't complain to the staff " on the floor". To them you say " i noticed dad's clothes are dirty. Can we get them changed?" You pose questions to them, not complaints.

You should be having regular care meetings with the DON and administrator to discuss dad's progress and any complaints. Call the ombudsman if there is no improvement.

If still no improvement, you write to the Joint Commision On Nursing Home Accreditation.

And start shooping now for a new ltc place. Comparison shopping is great, and now you know what to ask.
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