I'm going to strangle everyone at P's assisted living

Discussion in 'The Watercooler' started by TerryJ2, Sep 5, 2012.

  1. TerryJ2

    TerryJ2 Well-Known Member

    They raised the rates again, plus, I pay extra for them to check on her every hour, and get her dressed and cleaned up every day.

    Sat. I went (I also called and went in Thur and Fri, because the staff kept telling me that the dr was coming in and I checked in person, as I am doing with-difficult child's school) and P was in her Pjs but covered in chocolate, coffee, urine and who knows what else.

    I called this a.m. because P was confused and upset and thought she had to leave the bldg. I calmed her down and told her that I would send in someone to help her get dressed, no matter what the circumstances because we pay for it. She was fine with-that.

    The head nurse today just called me and told me that someone went in, and P told her that she never gets dressed until 11 unless she's leaving the bldg.
    I responded, "P has dementia."
    "Right. We'll send someone back in at 11, then."
    "Good. by the way, I was in the other day and P was in her Pjs but covered in chocolate, coffee, urine and who knows what else."
    "Oh, no, that's terrible. What day was that?"
    "That wasn't on my shift" (of course) "But I'll make a note of it. and make sure she gets dressed."
    "She can be changed into another pair of pajamas if necessary," I said.
    "Yes, she can. I'll make a note of it and put it on my 24-hour report."


    This is the same thing that my little sister went through with Dad. The SAME THING. That's in Minn. This is VA. Doesn't matter. You have to breathe down their necks to see action. You have to call Every. Single. Day.

    You learn which staffers are good and who just punches the clock.

    I have to go for a walk. I'm getting a headache. (And yes, I have a call in to meet with-the director.)
  2. Rabbit

    Rabbit Member

    sending hugs
  3. Hound dog

    Hound dog Nana's are Beautiful


    I've never worked assisted living. We had no such issues in the one mother in law used, it truly was a really good one. But yes, it was very expensive regardless.

    I'm going to assume to some extent that staffing works like a nursing home. You're going to get those who love their job (regardless of pay) , those who don't mind their job but need the money, and those that hate the job and are only there to pick up a paycheck. All these places try to keep the latter group down as low as possible. But let's face it, these are not popular jobs for a wide variety of reasons, top one being that eventually all your clients are going to die. Emotionally that takes it's toll after a while.

    I have worked in nursing homes and spent lots and lots of time in them even when not working in them. Even with a good Director who is working hard to keep staff at the highest quality, you're probably not going to see the issues like this get resolved this way. While those that love their job and those that don't mind their job would understand why you chose that route (because it would tick them off as much as you) the ones in it for a paycheck are going to be resentful as hades because odd are they're the one who left her in that condition (and they know it even if others only suspect) so will feel like you're personally attacking them and making trouble.

    I have had families of clients come to me with similar issues over the years of varying degrees. Best advice I could give them from my point of view was to first try to at the very least warm up to every single direct caregiver their family member has. Thank them whenever you get a chance. Talk to them with a smile and respect. Maybe bring in an inexpensive treat for staff to enjoy once in a while or on holidays. Praise the hard work of staff that take good care of P, and I mean lavish it on.

    I say this because in both assisted living and nursing homes, they're usually terribly understaffed. Staff often find themselves at a running pace for 8-12 hrs because there are so many clients and only one of them, if it is a bad day, it's even worse. It gets to the first two types of workers, but that last group only in it for the money......well they don't bother to try to keep up with the pace. But I've found time and again that even with the ones in the last group, if they are treated well by family and happen to like them, that individual client will get better care even from them.

    I did this with mother in law when she was in assisted living. Shoot, there were times we visited with her care givers as much as her when they had the time. lol And I tried hard not to assume they were in the wrong when mother in law had a complaint. I listened to both sides and then made a decision. Often it was simply the case of one worker and too many clients and it took longer to either get mother in law whatever she wanted than she thought it should or whatever. Believe it or not, the way P was found that day can happen on a really bad day with not enough staff. In a good facility, it's a rare event, but it does happen. I also did this with mother in law in the nursing home, and really went the extra effort to do so because her level of care had gone up. Know what I mean?? On one hall mother in law's quality of care had gone down because the DON has switched some of the good staff to another hall to cover vacancies. After a few incidents I was not pleased with at all, I spoke to not only good members of staff that were still there, but also some of the ones that had moved (because I wanted to know why it had suddenly gone down)......and next thing I knew, mother in law was moved to where several of her (and my) favorite workers had gone. I doubt seriously this would've happened had I gone and officially complained. The staff had gone through their own channels because they really cared for mother in law and wanted her quality of care to go back up.

    I'm not saying you should never go to the Director and complain. But this is a good route to try first if you can. (I can't recall if you're close to this facility or not)

    I know when I was working in such places, I loved family that took the time to get to know staff and ask questions instead of assuming the worst. The places I worked, although I know the DON was working her tail off trying to keep staff, were always terribly short staffed. Far too often I'd have 20 (or more) clients all by myself. On a good day if I could find someone to help lift those I couldn't lift alone, this was fine and I could handle it. I often had, and did, take the time to do clients hair up extra special or paint finger nails and even sit and chat. On a bad day or a really bad day.........well let's just say they had to wait their turn to get to the bathroom because I couldn't split myself into parts and get them all there at the same time. (which is often how it goes) It wasn't often I didn't get to someone in time, but it did happen. I loved my job but it was utterly exhausting due to the under staffing.

    Whomever you spoke to, well, that is the typical response. 1. because they're not going to admit to wrong doing until they investigate. She'll find out who had P that day and try to find out why she would be found by you in that condition. If the explanation is reasonable, the staff will be told to make more effort in their care. If the explanation is not reasonable, the staff will be reamed. It will depend on the situation and the staff members workload that day. (and if staff had help ect) But assisted living "appear" to have less staff available for those clients who are more able bodied. At least where mother in law did, and that is my only up close experience with them. They had more staff on the side that was more full care, like a nursing home. But only 2 staff per shift, plus a medication nurse, for heaven only knows how many clients in the assisted living part of the facility. I was a little surprised, but then I've noticed they have a constant ad for staff both online and in the paper, so guessing that is part of the issue.
  4. TerryJ2

    TerryJ2 Well-Known Member

    Lisa, I used to drop off more gifts and I have to get back to that. One thing that bugged me was that I'd put a note with the gift, and place it at the nurses' station, and chat a minute, and I'd find out later that no one knew who the gift was from, and two staffers ate the entire thing.

    So, I guess I have to buy stuff for each shift and PLANT myself there, lol!

    Mostly, what I have done, is cut flowers from my yard (I actually like to do that) and put them in medication. sized vases that I pick up at yard sales ea yr, so I can drop them off at ea nurses station.

    I forgot to mention that THREE staffers I did not like are no longer there. :) I have no idea why but they had a big shakeup in June, about the time my life was falling apart and I spent more time on an airplane than anywhere else, and things started to get worse, then level off.
    Just as people were being trained in, the staff dr got a better job and was replaced.

    You BET I know which ones are the good one! And more important, P knows. :)
  5. Hound dog

    Hound dog Nana's are Beautiful

    For a while at least, just until staff knows who likes to bring them little things to brighten up their days. :) I used to love it on the rare occasions we were brought fresh cut flowers from someone's garden. Sometimes it felt like I never got a chance to be outside.......and to me that was the next best thing. :)

  6. Marcie Mac

    Marcie Mac Just Plain Ole Tired

    Terry, SO's mom is now in a home and that stuff goes on everywhere. SO goes up every day to check on her, and ends up helping in the cafeteria, arts and crafts and during bingo. The day people all know him and there is hardly a problem - its the night staff that are the absolute pitts. She will ring to have the bed pan, and if the guy is busy, he will just go in and turn off the light, or put her button where she cant reach it, he has thrown the bed pan on the bed and left, or put the bed pan under her without taking off her diaper, or if he does get it right, just never goes back. SO has complained, she has complained, and am sure the guy by this time cannot stand him or her so goes out of his way to be a pita. She does have a room mate but she has had a severe stroke and can't talk.

    Right now she is there on a short term basis and we are waiting for medi cal to make it permanent. I keep telling him not to make too many waves as they can and will ask her to leave - its bad enough she is going thru a difficult time herself and is causing problems. You are sort of at their mercy with these homes.

  7. TerryJ2

    TerryJ2 Well-Known Member

    Ugh, Marcie, that is horrible!

    Last night, the early evening shift head nurse made sure that the night shift checked P every two hrs and made her go to the bathroom. (Her underwear was missing and I said, "Oh, she's going to wet the bed. Sounds like she already had an accident.)

    This a.m., I spoke to the head nurse after the shift change, and she reported that the midnight shift said that P was really mad that they got her up every two hrs to go to the bathroom so that confirmed that they checked on her. Usually I hear, "They didn't say that anything out of the ordinary happened."

    But we can't keep this up every day. Once all the tests are done at the end of next wk, depending upon the results, I suspect I will have to move her.
  8. Marcie Mac

    Marcie Mac Just Plain Ole Tired

    Doesn't it make you start to think Terry the OMG, what am I going to do when I get up there and am in the same situation? LOL I do, and its a concern.

    Yesterday they were having an outing to eat and shop at Walmart, so SO took the day off (and lost a day's pay) to help them and mom was just a total PITA and nasty to him all day. Before they even left the facility, they were all in the lunch room playing a game waiting for the van, it got noisy and SO couldn't hear what mom was saying and asked her to hold on and she started yelling at him not to tell her to shut up. Went downhill from there - she didn't want to eat with everyone else when they got to the mall, so he took her into Walmart. She picked up some Fixadent for her dentures, then yelled at him she only used Polydent, why would he pick up fixodent (he didn't, she did), then wanted to buy about 8 outfits and got really mad that he told her she had no room (not to mention she has way outgrown Walmart sizes), then started picking up stuff to eat and was mad when he said no, she can't buy like she has an apartment, a few snacks were ok, but there was no room for anything else. Then she wanted to eat, soon as they got the food she started yelling at him they were going to miss the van (which was 2 and a half hours late to pick them up so that was more fodder for her anger). She refused to talk to anyone and was downright rude the rest of the day. Poor guy goes out of his way for her to make sure everything is ok, misses a whole days pay to help them on this trip. Now she has lost her knight in shining armor for the next few days cause he is so peeved with her he is not going to go up there LOL And he told her he was cancelling her trip to IHOP next week because he wasn't going to deal with her if she is going to be nasty and she told him to get out.

    At least P seems to be a lot more mellow. Its a good idea of hiring someone to go visit with her -I never thought of that and it would give him a break so am going to see if he would be agreeable to that. Her main nurse Raffe dotes on her and we make sure he is taken care of -its just too bad he doesn't work 24 hours a day :) I just wish she would get resigned to being where she is at and would stop working so hard to get herself out of there and back home. Am afraid the next place she would end up at would be worse than where she is now.

  9. DaisyFace

    DaisyFace Love me...Love me not

    I have worked in an assisted-living facility and everything that Hound said is true for the place that I worked. There was not a ton of staff because the idea was that this was only "assisted" living and most things the residents should be able to handle for themselves. But sadly - there was a lot of neglect. Not big things....but little things that constantly got pushed down the priority list because of being short-staffed. Nail trims, fresh clothes, returning items to residents, that sort of thing. It DID make me worry about someday needing to live in such a place myself...

    I think Hound's idea about being extra nice to the staff is a good one. They'll want to make sure that you think highly of them - so they will put in that extra effort with P's care...
  10. DDD

    DDD Well-Known Member

    I follow your posts very closely and with great compassion. My experience is quite limited with the exception of on nursing home in our community where my next door neighbor lived for two years prior to her passing. I visited her twice a week during that time as she had no family. She was of sound mind and a fiesty woman. She made notes of any and every time she was not treated completely appropriately and then called the Director herself. But, of course, she was the exception to the rule because of sustained mental health.

    Alas, truth be told, most residents are not able to consistently advocate for their own needs. In fact I found it was very stressful when I was hospitalized recently because the level of care was, in my humble opinion, not what it was twenty years ago plus when I was last inpatient. Somehow it shocked me. It also made me think of P. Sigh.

    I have asked my daughter to hire someone to visit me daily if/when I end up in assisted living. Whether it is a college student or a young Mom wanting a few extra bucks it doesn't matter. I just want someone there for me every day. DDD
  11. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Having been inpatient in a rehab hospital I can tell you there are good staff and not so good staff. I had people who absolutely were great with me and treated me with the utmost respect and then I had some of them who talked to each other as they changed my sheets or bathed me as if I wasnt even there and they were just moving around some whale in a bed. The only time they paid attention to me was to tell me I had to stop sliding down the bed and work with them to push myself up to the top of the bed. I used to hear some of them being exasperated with me if had an accident in the bed. I cant really blame them but that was in the beginning and I didnt quite understand what they were telling me.

    I still know I am headed for a nursing home...most likely. I dont want to live with my kids. Actually I dont think I will get that far to be honest. I know my mom got better care because her nursing home felt sorry for her because I didnt show up and they thought I was an awful person for that. The DON hated me and she made my mom her special pet. Whatever.
  12. TerryJ2

    TerryJ2 Well-Known Member

    Argh, Marcie Mac, what an ordeal! She is clearly miserable and needs to know that she's making others miserable. Don't know how to accomplish that, though. Her memory issues are clear, so maybe that's what agitates her and she's just taking it all out on everyone else.

    Thank you all.

    I noticed that when my dad was in hospice, when people came in to change his sheets, they just started to pull at the sheets and not even warn him. I told them repeatedly to stroke his arm and say hello first. Did they listen? Nope. Then he'd grab them by the wrist and not let go. To his last day, he was strong.
    I just don't understand people.

    Good idea to make your wishes known NOW, DDD. I am going to tell my kids the same thing ... a daily visitor. It makes a huge difference.
  13. TerryJ2

    TerryJ2 Well-Known Member

    Aha! Ran into the new head nurse last night at 8:00 p. m. We knew one another from when P first came to the convalescent ctr before she "graduated" to assisted living.
    Turns out that the dr I had to practically sit on is going to get the boot. He's made a lot of mistakes. Also, he drew P's blood and got the results AUG 5, over a mo ago, and her sodium was low. Among other things!!!!
    Still, it was a good call to lower her dose of Ativan.
    So long, farewell, ....
    I wonder who the new dr will be?
    They also have 3 new staffers.
  14. DDD

    DDD Well-Known Member

    Lord, Terry, you just triggered a bad memory. I had actually forgotten walking into my Mom's room at the hospital and observing two nurses aides chit chatting away and suddenly rolling my Mom from one side to the other to change the sheets...no warning! I was so shocked I couldn't speak. Yikes. DDD
  15. susiestar

    susiestar Roll With It

    I am sorry for P and you, Terry. I would be reporting that night nurse to the state elder abuse line and make sure his nursing credentials note this because it is abuse and neglect and is NOT acceptable. A friend here was terrified that her gma would be kicked out if she made any complaints but she finally had to after finding shoe shaped bruises all over her gma, even on her FACE and a big bedpan shaped sore from being left on a bedpan for most of a weekend. Infection from the sore actually killed her gma but it was an exceptionally long and painful death and the entire staff ended up getting canned over this. Don't let this night time abuse/neglect go on. You are NOT responsible if the facility chooses to not employ enough night time staff - that is their CHOICE and does NOT change their RESPONSIBILITIES to P.
  16. TerryJ2

    TerryJ2 Well-Known Member


    by the way, my little sister is still involved with-Dad's place, even though he's gone. She has been fighting to add ONE more caregiver to the dementia section.
    They had no money.
    But they are remodeling the restaurant for the third time.
    husband pointed out that in marketing, it's all about bringing in new clients.
    True. How to keep the clients, though, should be an issue. These orgs have no clue how expensive it is to constantly hire and train new staffers because of the high turnover.
  17. Marcie Mac

    Marcie Mac Just Plain Ole Tired

    I was telling SO about P yesterday when we were on our way to see Mom. We had gone out to eat, and brought her a treat of Strawberry Shortcake - a no no with her diabetes, but once in a blue moon treat. We got there about 4:30 and she was in bed, in PJs sleeping and had to shake her more than a few times for her to open her eyes. Turns out she was up playing bingo, but then a preacher turned up out of the blue and they ended the game so he could preach and she wanted to go back to her room till he was done. Guess because she didn't want to stay, the put her pj's on and left her there in bed for the afternoon (guess to show her what happens when you buck the system).

    As she was eating her cake, the nurse came in to take her sugar reading, started to give us a lecture about bringing her that kind of stuff, and then looking at the machine, said oops, Jean, its ok for you to eat that. Turns out her reading was 90 - which explained why we had a problem waking her up.

    Looking at those brochures, I still maintain that "for profit" health care should be banned as the bottom line figures mean a lot more than the patients do. Its all about the money

  18. DaisyFace

    DaisyFace Love me...Love me not

    Well said.