We had a full house mtng today, because I called someone on the bd of dir, to ask him the diff between policy and day-to-day activity. I really wanted to know why so many things were falling through the cracks. (Embarrassingly for me, I left a msg on his ofc ph, and he picked up his msgs on vacation. He was in Venice, having a martini and nuts, with-kids underfoot. Arrrgh. He said not to worry, he likes doing it this way so he doesn't get bombarded when he returns from vacation. I just hate bothering people on vacation.) He explained a few things and insisted there wasn't a $ problem, and when I commented on the activity levels during the state inspection, that dropped the day after the state wkrs left, he said that there is a diff of opinion between what the state wants and what the biz wants, and what the biz considers efficiency and how to do it. I could really get into that politically and philosophically, but kept my ph call to the overall picture and how it affected the daily activities, especially in relation to my cousin. Anyway, he called the pres, who showed up at the mtng with-the psychologist, physician's assistant, soc wkr, phys therapist, head nurse, and P, my cousin. This is the first time she's attended one of her own mtngs. We covered the most important things first, such as, has P reached her limit in PT? Yes. This is the best she can get, and she will be on pain medications forever. However, she does need exercise every day, and a lot of mental activity and socializing. Is she ready for assisted living? Maybe. They suggested a smaller conv and rehab ctr that she might like better, and I told them we were on the waiting list. I am also on a waiting list for a really nice assisted living ctr. P is right on the cusp between assisted living and convalescent care. It's a tough call. I'd like her to be in assisted living, and hire in the extra svcs. One of the problems is that there are competing companies, and they all want your biz. Assisted living will tell P that she's doing great since she can walk to the drinking fountain by herself. Conv. care will tell her that she won't get immediate attention or good pain mgmt in assisted living. Both true. How to decide ... Cousin spoke quite a bit and was alert. However, she did digress a lot, and repeated herself. Her idea of what she is capable of and our ideas do not mesh. While the pres was asking her if she could live in her own apt and take her own pain medications, she said yes, plus, she wanted a cat. The head nurse and I are shaking our heads "no," trying not to let her see us. The PT finally said that a cat would be dangerous and she would trip over it, a very well taken point, since I have tripped over my own pets numerous times, and if I were 82 yrs old and weighed 90 lbs and on medications, I'd be toast. After the mtng, I was wheeling P back to her rm, and one of the nurses said to me, softly as we passed by, "Dr K has placed an order for P to be placed on Namenda." Woo hoo! I tried for this b4, but the staff psychiatric only did a cursory Alzheimer's test and I was very unhappy with-it. Anyway, fingers crossed. I don't know which direction this will go but at least we're all on the same page now.