Question:
Dear Karen, I believe i've spoken to you in the past, and just have two questions: My mom is in Aaron manor nursing home.She is 88 and has advanced alzheimers. (mentally, about 3-4 years old.) she broke her hip last summer, and is now in a wheelchair, (bad rehab!). before the hip, she had problems with ankle/feet edema, but now it's terrible, all the way up her legs, to the hip area. we've tried and tried to ask if they'll increase her lasix, walk her more,etc. Last weekend I went to visit her and she was crying, because her knees hurt so bad. They said they had given her tylenol and bengay, but it obviously wasn't helping. Sunday wasn't much better. Today, my sister called the nurse manager, who is NOT very helpful or caring, and he said he'd look into it. To me, this answer is not very acceptable. I am a nurse, and i would call the Dr. and get a better pain med. for her, and then call the family back. We had a meeting with this man about two months ago, and he told us he'd set up an aptm't. with the PA, (we've never even met her doctor!) . We're still waiting. My mom is in a lot of pain, and they just don't care. we don't know who to call. the other question: We just completed the whole process of getting mom on medicaid. Would it be impossible to have her moved, now that that's in place? We'd really like to look at the Fairport Baptist Home. Is this a realistic dream? thank you soo much for any help you can provide. I've never felt so helpless in my life! Sincerely, Linda Snyder
crab.legs2@yahoo.com
Karen's Answer:
Dear Linda,
I'm so sorry the situation has continued in this abusive manner. If she has been accepted for medicaid (which means an acceptance letter in hand), or, if the County medicaid worker can assure you and the social worker that she is eligible now, but it's just a matter of time for the paperwork to get through, it is possible to move her. Most nursing homes do not accept "Medicaid Pending" residents. In an extreme situation she might get in. When she definitely has the medicaid, she can be moved to a different place more easily. The Fairport Baptist Home is a possibility. I would call them immediately to check into it. Talk to the director of admissions and explain the situation. Tell her of the medical danger. Go in person if you can.
If you have not yet met with the Nursing Director of Aaron Manor, make an appointment right away to see her in your mother's room so she can see for herself what mom's condition is. If this doesn't work either email or write me back and I may be able to help.
You could also call her doctor or PA yourself, if you can find out their names, and tell them about the lack of care and concern. Demand immediate assistance. If all else fails, pack her up and take her to the emergency room yourself. Don't let anyone stop you. You are getting the medical care your mother needs. Your mother has a right to leave if she so chooses. (both for a medical exam and to go to another home). Even with her Alzheimer's, she may be able to give consent if you say you want to take her there to relieve some of her suffering. The Health Care Proxy can give consent and sometimes the POA can as well.
It's also time to call the NYS Nursing Home Complaint Hotline at 1-888-201-4563. If you would like to hire me to help, I would be happy to step in. Either way, please email or write back. I care.
Question:
Dear Karen, I believe i've spoken to you in the past, and just have two questions: My mom is in Aaron manor nursing home.She is 88 and has advanced alzheimers. (mentally, about 3-4 years old.) she broke her hip last summer, and is now in a wheelchair, (bad rehab!). before the hip, she had problems with ankle/feet edema, but now it's terrible, all the way up her legs, to the hip area. we've tried and tried to ask if they'll increase her lasix, walk her more,etc. Last weekend I went to visit her and she was crying, because her knees hurt so bad. They said they had given her tylenol and bengay, but it obviously wasn't helping. Sunday wasn't much better. Today, my sister called the nurse manager, who is NOT very helpful or caring, and he said he'd look into it. To me, this answer is not very acceptable. I am a nurse, and i would call the Dr. and get a better pain med. for her, and then call the family back. We had a meeting with this man about two months ago, and he told us he'd set up an aptm't. with the PA, (we've never even met her doctor!) . We're still waiting. My mom is in a lot of pain, and they just don't care. we don't know who to call. the other question: We just completed the whole process of getting mom on medicaid. Would it be impossible to have her moved, now that that's in place? We'd really like to look at the Fairport Baptist Home. Is this a realistic dream? thank you soo much for any help you can provide. I've never felt so helpless in my life! Sincerely, Linda Snyder
crab.legs2@yahoo.com
Karen's Answer:
Dear Linda,
I was sorry to read about the shoddy care your mother in receiving in the nursing home. This is a difficult and very traumatic situation. There are several things you could try. At first, you could ask for a care conference that includes all the staff that work with her. Be sure the head nurse on her unit and the social worker are there. Call and ask her doctor to come. If he won't do this, make an appointment with him to explain your mother's medical condition. Also make an appointment for the PA to visit her on follow-up. It is important to get the doctor on your side. If you go this route, get someone else to go with you. In the past I have taken a tape recorder to these meetings when I thought it was necessary.
You could also call the NYS long term care hotline to lodge a complaint against the home. The number is 1-800-697-7582. Your name is kept confidential by NYS. These complaints are investigated fairly quickly - I don't know the exact amount of time it takes.
Moving her to another home is an option. This is sometimes a difficult process, but can be done. Since she is on medicaid, it might take a little longer. You would have to have another Patient Review Instrument done by one of the nurses at the Home and them fill out application forms to other places.
If you want or need my services, I am certainly willing to become involved in this process.
Sincerely,
Karen
Question:
My 92 year old Grandmother refuses to leave her home, but we are worried about her sleeping alone. She is unsteady on her feet and we fear she will fall when she gets up at night to use the bathroom. We have gotten a quote of $150 per sleepover visit, which we certainly can't afford. Any suggestion would be welcome. Thanks much
Karen's Answer:
This is not an uncommon problem. None of my clients want to leave home and do so only when "forced to" by medical necessity. The first thing I would do would be an evaluation of the situation. Safety is the paramount concern. A trip to the doctor would be a good idea to find out why she is falling. Perhaps a walker or other assistive device could help her. An emergency health call system where the push of a button can bring emergency help can be part of the care plan.
Unfortunately, finances come into the picture when talkng about hiring home care. In terms of someone coming to sleep over, check with senior companion agencies in your area. You may be able to get a better price using a senior companion (a senior companion cannot do "hands on care" or give medicines but can reassure the person and direct him/her back to bed) rather than a more expensive home health aide. Another alternative is to privately hire someone you know and trust for this job. Maybe adult children and grandchildren could take turns staying overnight. I've had cases where volunteers from church and friends have stayed for an occasional overnight. Family could fill in the gaps.
Question:
What's a PRI and why does my mother need one to get in a nursing home?
Karen's Answer:
A PRI stands for Patient Review Instrument. This is a standard state form used to assess whether a person is medically eligible to live in a nursing home, which is considered the highest level of care. This form must be completed by a nursed trained in using this tool.
PRI's are not covered by most health insurance programs. However, if the person needing assessment is currently hospitalized, a hospital staff nurse would do one as part of hospital care. Home health organizations have nurses that specialize in this type of assessment. There are also nurses that work for private agencies that can do this. The general cost in the Rochester area ranges from $75 - $90. It is good for 3 months. If a suitable nursing home is not found within this time period, another PRI must be done.
Question:
We are starting to look at nursing homes for my father. I am trying to assess the relative merits of the facilities we have visited. What a bewildering process! Any suggestions?
Karen's Answer:
Assessing nursing homes for a loved one is difficult, especially if you have not been exposed to doing this kind of thing. I have produced a booklet called "Nursing Home Checklists" for consumers in this situation. It is a rating system that lets you compare 3 nursing homes at a time, has space for you to make notes and makes you aware of what questions to ask. I will gladly send you one free of charge. Please go to the contact part of my home page and type in your address and your email address. You will receive one in at least one week. Thank you for your question.
Question:
My 85 year old mother is starting to lose her memory. She can't remember where the bathroom is in the house. She goes outside and can't remember how to get back in the house. She keeps asking me the same questions over and over. What should I do?
Karen's Answer:
First you need to make an appointment with your mother's physician. You need to accompany her and make the doctor aware of her memory problems. Oftentimes, the doctor will refer her to a clinic for testing to determine what is causing her memory loss. There may be a physical condition or a neurological condition. After you know what medical conditions exist, you need to make yourself aware of resources in the community that can help you. Often memory clinics are associated with major hospitals and your mother would be seen on an outpatient basis. Most insurance companies (in New York state) will cover this evaluation. The Alzheimer's Association in your area would be a good resource if there is a possibility that she has Alzheimer's Disease or another memory related dementia.This would be a good way to get started on getting your mother the care she needs.
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