Assisted living questions UPDATE

[ZipaDeeDooDah]

I work in LTC and we have an AL unit. Our AL staff are to be able to assist with transfers, and there is a nurse for 8 hrs/day exclusive to AL and for 16 hrs there is a nurse on site but she has Nursing home also. I will say that our admission person has brought in/relocated people not right for AL but yet they stay. I know in our policy manual it's says something to effect of you must be able to perform job duties while preg. or take leave.
I refer to our AL as NH Jr. as some of residents in NH would be better suited to AL than some that are there.

What does LTC mean?
Long-term care, I think?

 

[ZipaDeeDooDah]

8 hrs/day exclusive to AL

How many AL patients are there?

 

[RitaE]

I know, I will simply never, ever, click upon any of those tracking ads, there ya go, problem solved, I think?

Glad you feel happier about it now.

 

[sha_lyn]

You had to fill the syringes yourself? wow, I am really shocked at that, the person administrating the injections, should have been able to fill them as well, that just does not make any sense to me, or did you have to do that too? why would that be o.k.? unless you are a Lvn or RN, or MD.

They couldn't admister the shots, do finger pokes for the blood sugar readings etc. They couldn't even open a pill bottle or touch a pill if a patent dropped one. That's why they had to have all meds in blister packs.

Forgot to mention Sha lyn, I love your tag line! it is so very true for me, as well, and it sure is humorous, too, and I love your kitty avatar, he or she is just so cute and rolly polly, reminds me of my Tommy kitty and Happy Birthday to your daughter, I hope that she has a really great birthday!

Thanks....The tag line is from my fav Jimmy Buffet song
The kitty is our Martha. We had her for gosh, 12 yrs. She died last yr from cancer. She was a tough kitty. Fought right till the end even when the tumor paralized her remaining hind leg. The tumor had started in her right hind leg. The vet thought he could get all the cancer by amputating but it turns out that it had already started spreading. She had an amazing recovery form the surgery for a cat her age (we estimated she was 14 based on the guess that she was 2 when we adopted her) but the cancer was stronger.

Thanks for the B-day wishes too. We are taking the easy road this yr. Just meeting her girlscout troop for brownies and a playdate at the park, then one of her best friends is spending the night.

 

[sha_lyn]

Honestly, what the heck are you talking about. Could you please explain?

The google adds at the top of the page. Google uses some type of "intelligent" tracking on the web page so that the adds match the subject being discussed.

 

[MushyMushy]

MushyMushy:

Did your mom know what she was being evaluated for in the hospital?

Is there any chance that she thought she was being evaluated so that she would be able to go back to her home or somewhere she wanted to go?

She knew. They came in with a bunch of literature about the place (which she promptly set aside and never looked at) and talked to her about it, then had her doing the things she'd need to do in the home. They didn't talk to me about it until it was all said and done, which ticks me off since we're not dealing with the 3x a day visits.

Gisele, what are you talking about with the medicare places wanting to know about our finances? That has nothing to do with it, correct? Short of dipping into our own retirement or bankrupting ourselves, we can't care for them financially. I know they really need to get a financial adviser for this because they won't talk to us about finances AT. ALL. They've got retirement money, bonds, and all kinds of assets that we just don't know the extent of.

Also, regarding home care, it's not an option for my mother. We will take my father in and care for him when the time comes, but not my mother. Long, bad history there for one thing. For another, she simply requires too much. Whoever took her in would be waiting on her like a slave all day and night, and would be putting up with abuse. Not happening. It would destroy the health of anyone who tried, and my sister and I both agree on that.

ETA: regarding the mental state of mind, she's just as difficult as she always was, but now we're dealing with (I think) depression. They just put her on Prozac, so we'll see what happens there. Basically she just has it in her mind that she's done with life, period. She's just waiting to die. And if her side of the family is any indication, she will linger like this for many many years.

 

[Disney Doll]

See bolded below and then more at the bottom.

I need advice! My mother was put in an assisted living facility on Friday. They came to the hospital to evaluate her and found her fit enough to be there. She has to be able to stand for long enough to get from bed to wheelchair to toilet.

First of all, they took her in on Friday and she was being difficult and flat out refusing to do ANYthing. She kept threatening to leave and kept telling everybody she couldn't stand up to get to a toilet. If she cannot stand up to get to a toilet, she cannot leave. I always get a kick out of people who can't take care of themselves threatening to leave. Where's she going to go? How's she going to get there? What's she going to do once she does get there? The bottom line is that any patient is required to be safe. That supercedes anything else. They had to call my sister from work, and then us and we weren't even in the state so we had to go rushing back.

Long story short, they brought in a physical therapist, who had her standing up. They had her on the toilet and even had her in the shower for the first time in years. The supervisor assured us that there were always enough employees on staff to assist her, and in fact went on and on and on about this. If this is what they assured you of, then this is what they should be able to provide. If they are not able to provide this, then you need to remove her from that facility and place her elsewhere.

Friday night, we get a phone call to come help my mother into bed. All kinds of major drama because they couldn't get her into bed. Now it's turning out that one woman's pregnant and can't assist, one employee has a bad back and can't assist, one employee is "afraid" and can't assist, and yet another employee hurt her back yesterday and can't assist. Therefore, they've been calling US 3 times a day to help her. Then they have not been able to provide the level of care that they have assured you they can provide. And it's been MY wonderful husband who's been doing it because my sister lives way out in the country and I have a bad back & neck (though I'm not hired in an assisted living facility so I don't need a good back ) plus I have a bad case of tennis elbow.

We can't continue to do this. We have her in "assisted" living for a reason, and if they weren't going to be able to help her in this manner, then they shouldn't have accepted her and they definitely shouldn't have told us that they could! You are correct.

What are our options here and what should we do? For starters, refuse to go help get her into bed or onto the toilet. They'll figure out a way to do it or they will call 911 and return her to the hospital, where it will be much easier to have her placed in a nursing home, which it sounds like she needs, quite frankly. As I've mentioned before, she cannot live with us and we cannot care for her. She won't do anything to try to help herself get more mobility and just wants the world to wait on her hand and foot. Then she is a nursing home candidate, not assisted living.

From what we understand, the local nursing homes have no empty beds and she refuses to even consider going out of town. She may not have a choice of where she goes. Many nursing homes keep an "emergency" bed available...it's not a well-known fact, but it does happen. If she is transferred back to the hospital, and the hospital they can get her in locally.
I'm at a loss here. And also need to vent a little.

May I also recommend a psychiatric evaluation for competency. Pretty much her options need to be presented thusly:

"You have 2 choices. #1 is to be more independent and not expect everyone to wait on you hand and foot so you can remain in assisted living. #2 is to go to a nursing home, and you may or may not get your choice of facility."

There is a Choice #3 - to refuse #1 & #2 and have the hospital deny her stay and therefore she would be responsible for the bill and they will put a lien against her property/estate to collect their money when possible. It's fine to be a "spitfire" but at a certain point the rubber meets the road & she may have to do something she doesn't want to do. You may have to step out of Mom's domain of care if she is not going to cooperate, and let the system handle her as it will. As her child, you are not responsible for any bills etc. that she incurs. May I also recommend starting a Title 19 application, which will make nursing home transfer easier. I know I sound harsh, but based on her "spitfire" personality and lack of desire to help herself, she is effectively limiting her choices and she needs to be told that very clearly. She may not get what she wants.

 

[ZipaDeeDooDah]

The google adds at the top of the page. Google uses some type of "intelligent" tracking on the web page so that the adds match the subject being discussed.

Okay, that makes sense, but we all know what the Google ads are about...don't we??? Hint...they all involve the dollar sign.

If she has some serious discussion about the elderly and why they might be in assisted living or need home care, I hope she will come back to ask.

 

[bigbabyblues]

I'm so sorry, Mushy. Is it possible that she is being difficult thinking they'll kick her out and she'll get to go home? If so, and she's really against a nursing home, I would tell her that she either cooperates or she's going to a nh.

It does sound like they shouldn't have taken her, honestly, unless it's different from the AL facility in our area, which is possible. The one here is a big building with a bunch of "apartments", and the residents have to be able to do everything except cook for themselves. I think the nurses help them with their medicines too, but not the basic care/toilet/shower, etc.

I've read a lot of your posts about your mother, and I'm just sorry you have to face this.

 

[ZipaDeeDooDah]

Does that not tell you anything?

The fact that she:

She knew. They came in with a bunch of literature about the place (which she promptly set aside and never looked at)

??? If she did not look at it, she may have not "wanted" to look at it.

MushyMushy, I am really trying to see your side of things, but I cannot help but put myself in your mom's shoes.

 

[golfgal]

What will happen if you refuse to come help? Sorry, but the AL place is being PAID to do that for your mom. I think it is time to a little tough love with mom, either she cooperates with the nursing staff where she is or she goes home with NO HELP from anyone and then stick by that.

I TOTALLY understand 'sick' moms--trust me, I do. Mine is finally in a nursing home and it has been a great move for her. She 'qualifies' for a lot of care but doesn't need that much so she has a private room, has to walk down the hall to get to things, meals, etc. She is doing MUCH better in a nursing home then she was living at my sister's house.

 

[MushyMushy]

Does that not tell you anything?

The fact that she:



??? If she did not look at it, she may have not "wanted" to look at it.

MushyMushy, I am really trying to see your side of things, but I cannot help but put myself in your mom's shoes.

I'm not denying that she doesn't want to be there.

But what she wants isn't possible. She wants to be home so my dad can change her bedpans and wait on her. She wants us to be at her beck and call.

It's not an option.

 

[ZipaDeeDooDah]

I'm so sorry, Mushy. Is it possible that she is being difficult thinking they'll kick her out and she'll get to go home? If so, and she's really against a nursing home, I would tell her that she either cooperates or she's going to a nh.

I like this, this is a very good option.

 

[lovemygoofy]

Your mother was placed in an assited living facility? To what degree do they assist? I've seen some facilities that are ran like hotels and not like nursing homes and vice versa.

Some states and some places only hire people to "help" with duties like getting dressed, helping with meals, possibly with getting showered and to the bathroom, and with everyday chores.

These kind of 'helpers" can not touch any kind of medication just can point at it or remind the person to take it but not adminster it in anyway.

I don't understand why your mother wasn't placed in a skilled nursing unit at the hospital. Are these not in every hospital? It's like rehab whether for physical therapy or for patients that aren't well enough to go home but not so sick they need to be taking up space on specific hospital floors.

Our skilled nursing unit was hell on wheels on my step dad's father and they had to be. He is a mean SOB. He'd throw things and rip out IVs and just generally abuse them in all ways possible he could after he broke his hip. The physical therapy set up a schedule where family could only come see him for about 2 hours a day, one in the morning and one in the evening. After about 3 days he finally broke and the physical therapy got down to doing what they were supposed to do. It took the family not showing up and taking the phone out of his room before his will would bend.

Honestly lets face it. Until everyone stops running to your mother's side to help when she is being ugly and she has to start doing for herself, it's not going to stop.

 

[ZipaDeeDooDah]

I'm not denying that she doesn't want to be there.

But what she wants isn't possible. She wants to be home so my dad can change her bedpans and wait on her. She wants us to be at her beck and call.

It's not an option.

MushyMushy, I hope you understand that I would hate to be in the position you are in.

Again, I am trying to put myself in your, and your mother's, shoes...

I agree, your dad should not be responsible for your mom's health care. I do not dispute that.

What she wants, and what are feasible are two different things.

I know that what she wants is not possible, I think I get that.

What do you think she needs?

 

[MushyMushy]

The nursing home is a great option! We'd all like that. The problem is, as of right now there's no empty beds in our town and she's refusing to go out of town (though I like DD's idea of seeing about emergency beds). We're looking into forcing the out-of-town idea, but she'd have to get used to only seeing my dad once a week.

Speaking of my dad, oy vey, that's a mess too. You know the whole medicare spend down thing and he's resisting it with every fiber of his being. That's why we need a financial adviser to see what he'd be left with. I can't imagine how it would eat up all their finances caring for her, but then nothing being left when he needs the care.

It's all so murky because we're only getting some of the picture. We don't know what their finances are and they won't tell us. They really need to let us in so we can get some solid advice!

 

[Fire14]

How many AL patients are there?

LTC = Long Term Care
16 IN AL and 36 in NH

 

[Disney Doll]

Does that not tell you anything?

The fact that she:



??? If she did not look at it, she may have not "wanted" to look at it.

MushyMushy, I am really trying to see your side of things, but I cannot help but put myself in your mom's shoes.

Well of course she didn't want to look at it because she wants what she wants, but yet sounds as if she is so nasty and difficult that no one would be able to deal with her.

I know Hallmark has us convinced that all mothers are angelic, sweet and loving. I have been a nurse for 25+ years, and let me tell you, I have seen some parents...mothers and fathers...whose treatment of their family would curl your hair. I have had women as patients who made the statement to me "I expect all 3 of my daughters to be here with me around the clock. I suffered having them and gave up my life for them, now it's their turn and I don't care whether they like it or not". I have had mothers say to me "My son can wait until after I die to get married. I don't need another woman taking time and attention away from me". Paragons of virtue and motherhood??? Hardly. Mushy says there is a long and difficult history with her mother. I believe her. Perhaps her mother is now reaping what she sowed.

She is choosing not to be independent. She is choosing to try and have everyone wait on her hand and foot. Well, the place to get that kind of care is in a nursing home...they have people there who get paid to wait on you.

 

[lovemygoofy]

I'm not denying that she doesn't want to be there.

But what she wants isn't possible. She wants to be home so my dad can change her bedpans and wait on her. She wants us to be at her beck and call.

It's not an option.

Does she have insurance? Do ya'll have home health care where you live?

My granny live on her own until her death this year. She had a home health aide 5 hours a day that would come in make her meals, clean her house, help her shower and get dressed and help her see to day to day acitivities like walking around the neighborhood or even helping granny in her flower bed.

She couldn't adminster meds or even touch them but we got around that as we put all the meds in a weekly pill thing for Monday morning, Monday afernoon, Monday evening thing and then the pill thing was put in a basket out of her reach and the nurse would grab the basket but never touch the meds but could remind her to take her stuff, which was all listed on the cabinet.

A LPN would come every week to check on her, record her vitals, and refill her pill thingy.

Is that sort of service aviable where you live? Would that be an option that would be a compromise?

 

[ZipaDeeDooDah]

The nursing home is a great option! We'd all like that. The problem is, as of right now there's no empty beds in our town and she's refusing to go out of town

How far is out of town???