Need a little help from my friends....

[mickeysaver]

First an update, they ended up calling EMS out at some point in the night to check her and thankfully, all they felt that they needed to do for her was give her some glucose to even out her sugars. I haven't heard an update on how things are going this morning.

Gabby's hands look bad, but she refused to go to the ER last night to get X-rays. We have come up with an excuse to why she looks like she was in a bar room brawl in case anyone asks.

I understand the medical need for this and the need for the caregivers too. I am a CMA and I while I work in pediatrics, I have worked in adult medicine and seen a few situations that were similar in many aspects. I have talked with Gabby, but she still refuses to consider the idea. Gabby's dad, who divorced Pati about 30 years ago, agrees with me that an ALF is the right way to go. My own father agreed that if he were in similar shape and single that he thought that an ALF would be the kindest thing to do for him, and he has never wanted to end up in an ALF himself.

Honestly, Gabby is leaving in a few minutes to go to the airport. She has enough guilt and "I don't wanna" going on in her head as it is, I can't even talk to her about this again until she comes home Wednesday night. I will try to talk to her again. I will try to talk to the good sister too. Something needs to be done here.

 

[mickeysaver]

Ok, Gabby is out the door and on her way to the airport.

I did not take any offense to what you said. I appreciate the way that you put it and I will attempt to use some of that language when I again try to make the case for putting Pati in an ALF.

As to us not leading boring lives, we usually do, but the past 7 months have just been crazy. I fear that it's just going to get worse. Gabby found out last week that her mom has no written Will. Pati has told the girls what her intentions are and that Gabby is to be the executor of the estate, but nothing is on paper. I told Gabby that in the end, the house, the stuff in it, and the money is not worth the sanity that will be robbed from her if the sisters decided to show their butts about it. The good sister just wants to move up to North GA or North Carolina, mostly to be there closer to her dad when he will eventually need help, plus she loves the area and the alpacs would be much cooler there than they are in Florida. Gabby used to want the house and claimed for many years that when her mom died that she wanted to buy the other two sisters out and move down there. Last night, she told me that the house is actually in her grandmother's name, so there is nothing that can be done about the house until her grandma dies anyway and I have no idea if her Will, which does exists, has anything in it about the house that Pati lives in, so this could be a huge mess in the end too.

As with all things in life, it's one day at a time.

 

[jackskellingtonsgirl]

Maggie, hopefully Gabby will come to terms with what needs to be done after she has some time to clear her head. I agree that the kindest thing for her mom is to make sure she is being cared for with some consistency. Having her blood sugar yo-yoing up and down can't be good for her. And she sounds like she needs skilled nursing help, not just the sisters taking turns.

Thinking of you girls, and sending lots of hugs.

 

[DVC~OKW~96]

It's right to give Gabby some room with this too. Pushing can sound like nagging and that won't work at all, as we know with anything.

I hope her poor hands don't hurt too much. Geez.

Gabby may want to look into a springing power of attorney. It's specifically meant for someone with dementia. She'll need to move a little quickly though. Out run the decrease in cognitive ability so to speak.

Take care now. I sure wish there were more to do than send cyber hugs.

 

[mickeysaver]

So the blood sugars are still bouncing around and big surprise, the good sister went from "I will be ok if you don't come back for a month" to "Can you come back now".

I am hoping that they cave on the ALF issue soon.

ETA @7:13pm: Now Gabby and I are texting about the ALF's. She thinks that if they get a nurse to train them that it will be just as good.

ETA: On the phone with Gabby, I think there she's coming around. Finally!

 

[DVC~OKW~96]

One step at a time Maggie. One step at a time.

 

[mickeysaver]

Gabby is seeing the light! ​

However, she is still hesitant because she is scared of leaving her mom's care to strangers that are just there to get a paycheck.

First of all, I explained that no paycheck that any of those folks that work in ALF's receives is sufficient to cover the value of the service they provide in doing the work that they do. Those folks are there because they are dedicated. I explained to her that just because her mom is in an ALF that doesn't mean that family can't make themselves known to the staff. I explained that it would still be the right thing to do to be present in her life as much as possible there, but it would be better for there to be a coordination of care by professionals that know what to do for all of the things that are happening to her health. I told her that her mother deserves this level of healthcare and that to deny her that is cruel. Pati deserves to be treated with the dignity and respect that she deserves and that would happen in an ALF.

In the end, I told her that she should think about it. I told her that she and the good sister should talk about it, but she is scared to bring it up. I offered to talk to her sister, but I told her to think about it and let me know what she wants me to do after thinking about it. I also told Gabby that they should ask all sorts of questions about the care and services offered at the ALF and to interview several before making a decision. I told her that she should still plan on going down once a month as she is hoping to do once work approves her desired plans. I think by appealing to her sense of doing the best thing for her mom's care because it's the right thing to do vs doing what she felt like her mom wanted is working.

The ball is in her court. I am praying that we are about to see an end to a large part of the drama in our lives.

Thanks again. Trust me, the old is so not sufficient to convey my appreciation, but anyway!

 

[DVC~OKW~96]

OK, here is some basic info.

In Florida, all ALFs are required to have their most recent COMPLETE survey posted for public view (not just the check off that they've corrected previously discovered problems, the entire survey). Gabby should ask for that at each ALF she's interested in visiting. And go ahead and visit some even before things are resolved. It will take easing into.

The vast majority of people who work in an ALF do so for the love of the residents, not for the paycheck. Sure, there are some who are in it for the money, there always are but they don't last. The work is too hard and the money too little to do it for anything other than love.


Here is a link to the AHCA (Agency for Healthcare Administration) facility locator. It lists every licensed ALF in Florida and will link to any problems (like moratoriums, ect). The licenses are, standard (all have to have this) ECC - extended congregate care (allows for a higher level of care to be provided) and LNS-limited nursing service (allows for mid level care, but is close to being abolished). LMH is Limited Mental Health, not meant for those with dementia, rather chronic and persistent mental illness.

Gabby needs to use her nose, and all her senses when touring. How are the residents dressed? Are the active or slumped over... is the memory care unit markedly less clean, less nice, less involved/active than the regular AL care side? If so, walk away.

ALFs will go out of their way to promise the earth. Request a copy of the contract. Each ALF is required to have an individual contract between the ALF and the individual resident. Read the contract COMPLETELY and BE CERTAIN to understand ALL the requirements before siging, or saying yes.


http://www.floridahealthfinder.gov/facilitylocator/facloc.aspx

Gabby can also call the Long Term Care Ombudsman for the county in which the ALF is licensed and as if there are any founded complaints against the ALF. They won't tell you much, but they will have to reveal if there is a complaint.

If Medicaid is ever going to be a consideration, be certain that the ALF will work with Medicaid. Not all do. There are two basic programs that pay for care in and ALF, the Assisted Living for the Elderly Medicaid Waiver (ALE Waiver) and the Long Term Care Diversion Medicaid Waiver (LTCD Waiver of which there are many providers).

So! That's the bare bones basics and enough to get started with. I hope it helps a bit, and if you have any other questions don't hesitate to let me know.

Take care now!

 

[mickeysaver]

Update time....the drama continues....

So, Gabby talked with her sister about their mom's needs and I think that they both are really leaning towards finding the right facility for her mother rather than waiting much longer.

I took it upon myself to have a conversation with the healthcare provider that Gabby and I both use and she has agreed that with Gabby's meltdown on Saturday night that she would be glad to give her a script to help get her through her mom's passing, which we both agree is going to be super hard on Gabby.

I also took it upon myself to request info from most of the ALF's in the area close around where Gabby's family lives in FL. Some calls have come in today, but I was mostly trying to get general facility info via email, not over the phone. We shall see.

Just now, I got a text from Gabby. The good sister had said yesterday that if Pati's sugars had not evened out that she was going to take Pati to the ER today. Well, it's a darn good thing that she did because her platelet level dropped from 220,000 to 120,000, because the hospital screwed up her dose of the methotrexate and if she had remained at home, she would have been dead in 24 hours due to this. Pati is getting transfused right now and hopefully will be stabilized soon. I have no idea if she is being admitted, but I bet she will be.

Of course, this has totally ticked off the sisters and they all want to sue the hospital for this error that almost killed their mom.

Never a dull moment with those girls for sure.

 

[mickeysaver]

Ok, correction on the details on Pati and her ER experience....it's amazing how the stories change.

Ok Pati was to have outpatient labs done today and when they went, she had critical values and was directed to go to the ER for a transfusion. She did end up admitted. The good sister and the other sister were both at the hospital for a little while. The good sister encouraged the other sister to leave because she was obviously stoned.

I understand more medicine changes are happening. Lord only knows how long she will be in this time.

 

[DVC~OKW~96]

GET A GERIATRICIAN!

Dr. Salagubang, I'm telling you.

 

[mickeysaver]

I know, I gave Gabby the info, but she didn't have enough free time while she was down there to get to it. I will bring it up again tonight.

As to her mom, unfortunately, halfway through the transfussion, the vein collapsed. I don't know if they are going to put in yet another PIC line or what. Gabby is in the air right now, so no additional info is getting to her at this time.

 

[DVC~OKW~96]

Ah no. I sure hope things turn around for her Mom!