was holding a meeting with him at 10AM regarding mother's care. I
drove up and attended the meeting. Before we entered the facility Dad
shared the rest of the conversation and indicated it was his belief
that the facility was going to ask him to "move mother again."
The meeting was attended by, myself, Dad, the head Nurse, the
admitting/admissions manager (lady), and the facility owner. The head
nurse started the session with a review of the past three weeks and
the changes in Mom's behavior, including...
Over some, non-specific period of time there have been six or seven
incidents where mother and her wheel chair have bumped, passed,
rubbed, touched or otherwise impacted another patient and that other
patient has reacted aggressively to Mother (the victim) with a push,
slap, grab or shove.
Three days ago, or "last Friday", mother "struck" or hit a staff aid
who was assisting her with some need (unspecified). This staff person
was "hit hard enough in the head that we needed to drive him/her to
the doctor for evaluation."
Mom continues to be one of the most active wheel chair movers in the
facility. She has a vertical pole attached to the back of her chair
to prevent her chair from passing through doors and hall way
sections. This restricts her movements to the hallway chosen by
staff. Apparently she attempts to enter patient rooms and she has
"figured out a way to tip her chair and get into other rooms."
The admitting person chimed in with..."we are very concerned for your
mother's safety and for her own safety we need to help you find a new
facility for you mother."
The owner added several remarks about, "we want what is best for your
mother, we want her safe, she is disruptive to the facility..."
At this point I asked the admitting person, "so you are saying, if my
mother was removed from your facility, remove this one patient, and
her wing or hallway would be calmer, quieter?"
She responded, with the head nurse, "yes, that is true, except the
improvement would affect the entire facility."
The owner chimed in with a vague remark of..."you know the state is
watching us closely...." I did not follow up on this comment.
Both Dad and I repeated that we were happy with the facility, pleased
that mother is there, we have no desire to move her, there is no
other facility nearby.
The meeting ended with Dad and I asking several questions regarding
availability of beds in other facilities and specifically, was the
staff recommending that Mom be placed in a locked "Alzheimer's unit?"
The answer was YES.
I asked about specific other facilities and "wouldn't it be best if
this was a facility to facility transfer, rather then a "discharge
and new family placement"?". They conceded that a facility search for
a new placement would probably be most effective but would we
"please" start looking for a new placement "as a family".
The meeting was over, they promised to look for a new placement
facility, no timetable was met or mentioned, we made no specific
promises of any kind.
After the meeting, I visited with Mom a few minutes. She physically
looks different. Her face if puffy and round (from medication?) and
she is constantly moving, agitated, rolling her chair, wants to be
with her visitor, but rolling off right away at the same time. No
recognition of me, no idea my name, I asked, pretty constant
repeating, "I just want to go home". Heaven?
What I know and What I am learning...
During the past three weeks the medication used to calm mother has
been changed, increased, on at least two occasions. I was called and
notified several weeks ago that the "evening" dose was being
increased to "morning and evening" to help calm her during the day.
From time to time, probably three times, over the past two months,
the staff has called and notified us that there has been some sort of
"incident" or contact between patients with Mom being the "victim".
It has always sounded very minor and only once, that I recall, was it
ever mentioned that her wrist or arm was grabbed and there was minor
bruising.
Until Monday, I had never heard of the "hitting of staff" incident
mentioned in the meeting.
Dad and I adjourned to his house and we made some calls. Dad called
the facility in Petaluma that Mom was moved to back in June. She had
at first been placed in their ambulatory locked unit after being
transfered from Clearlake on a recommendation that she be placed in a
ambulatory Alzheimer's unit. Dad was told, on Monday, by that
facility, that wheel chair bound patients were NOT allowed in the
locked unit and any wheel chair patient would be placed in "general
population."
I called the highly regarded facility in Williams and spoke with a
helpful lady about placement. She said her facility had no bed and
"had a waiting list". Then she listened to my story a moment and
said, "remember sir, they can not discharge her, even if they want
to. She is a MediCal patient and she can not be discharged. "
Another incident
Last night, the 20th, I received a call from the facility about
8.30pm. The call was to notify me that another "incident" had taken
place where mother's wheel chair had bumped or touched the feet of
another patient and mother had been grabbed "on the arm". There was
no bruising reported but we were being notified, "just like the state
must be notified of any incident of possible "elder abuse"."
Here is what I believe
I believe that the facility is attempting to operate with as few
incidents that need to be reported to the state as possible. I
believe that they believe mother is the cause of many of those
current incidents. They consistently describe mother as the "victim",
they speak of "her safety", yet I believe this is all about the
record of the facility and their attempt to improve their safety
record by asking us to move Mom.
My current research has led me to two information sources.
CANHR, California Advocates for Nursing home reform
http://www.canhr.org/
The Ombudsman Program of Lake and Mendocino Counties
I have learned there is a very short list of reasons a patient can be
discharged from a facility. I have learned that facilities sometimes
"trump up" charges that allow them to discharge a "difficult" patient
without complying with the short list of legal discharge reasons.
I do not yet know what role MediCal plays in all this since mother is
a 100% MediCal pay patient, where would she be discharged to?...
This will take more research.
No comments:
Post a Comment