Wednesday, August 26, 2009

Nurse error nearly cancels Mom's physical therapy

A few days ago I caught a nurse in an error that could have cost Mom a chance at some physical therapy. She really needs some regular PT to keep her as limber as possible and it's also some diverse activities to keep her mind active.

Here's the scenario:

  • Mom's doctor calls the ALF to order some physical therapy but the nurse tells them that the Physical Therapist (PT) won't return because Mom refused it last time.
  • Doctor's office calls me to get Mom to agree to do the PT and tells me she refused it. I tell the Doc's office Mom did NOT refuse it that she was discharged because they could not make any headway since her knee was so bad.
  • NOTE: The doctor was about to cancel his PT order until he heard from me that the ALF was mistaken.
  • So, I call the LPN at the ALF and ask her to check Mom's records. She INSISTS that Mom refused more PT. I had to press her to look in the files and she saw that Mom refused one day because she was ill but that she was discharged from by the PT.
  • The LPN then called the doctor's office to confirm that Mom HAD NOT refused PT so it was ordered and she began this week.

This scenario really got me worked up. This nurses ASSUMPTION based on something she was TOLD nearly cost Mom a chance for some needed physical therapy. The nurse would not have checked unless she had been pressed by ME. The PT is necessary to strengthen her muscles and keep her as limber as possible. It's necessary to keep her mobile under her own power even though that's limited.

What about those residents who don't have pushy family members? What about those who don't have doctors willing to call daughters to get another perspective? I realize that the ALF has budgets to worry about; I realize they are short handed and everyone does more than their share of hard work but..... My concern must be my MOM not their work load. If they can't handle it, they need to hire more people.

2 weeks in town and I'm tired and angry with the ALF...

For the past two weeks I've been in Idaho visiting my Mom and family. I always make a long to do list before I arrive but then something always happens to blow my plans and schedule totally out of the water. It always seems that I spend the last day or two cramming a couple of days worth of work into a few hours. That's one thing that all my friends mention as well - they never get enough done while they're visiting their parents. Whether it's for work or pleasure, they all want to do much more than time, energy and money permit. I like to think it's because we're such good people, we WANT to do too much.

I feel as though I'm doing a half-assed job of everything - visits with Mom, cooking for my husband and I, exercise for myself, visits with family or friends, my job search, my blog.... I don't seem to be able to do anything well... One thing is certain, Mom seems happier when I'm there and I'm rallying the care givers at her assisted living facility to pay her more attention and be more cautious.

This week the administrator asked to speak with me and she outlined what she did to address the 8 or 9 items I brought up to her two weeks ago. She was kind and understanding even when I added a couple of things to the list. I'm really irritated that I feel it's necessary to add to my list of concerns about this ALF! I feel like I must be on guard all the time. That's what we PAY THEM to do but... ... they can't train on common sense I guess. So, I'll just keep raising concerns and getting them addressed.

My latest concerns are these - these seem so very basic to me and I'm really frustrated that I'm forced to complain about something so basic:
  • Make the bed properly: Mom's bed is not placed properly after it's made. Often the top mattress sticks a foot out from the bottom box spring. If she were to fall against it, there would be no support there and she'd hit the floor. Sometimes the box spring and frame protrude out past the top mattress but the frame is hidden by the large comforter. I stubbed my own toes on the frame and cried because it hurt so very bad. If mom had done that with her osteoporosis, she might have broken a foot.
  • Move the commode then empty it: Six times now I've found that her bedside commode was not emptied. The commode is placed near her bed during the night and moved to the bathroom during the day. This is a tactic to keep her moving by getting her to walk to the bathroom. Visiting in the afternoon or early evening, her room reaked of urine so I checked the commode; it was properly moved to the bathroom but it was full, very full. To me it appeared not to have been emptied for a couple of days, not just one day. The first four times (I should've complained after the 2nd but I'm too patient) I noticed this full commode, I emptied it and told an aide what I did because I knew that they were busy. The fifth time, I was mad and told them I was mad. The sixth time, I hit the roof then told the administrator that it was unacceptable to pay more than $3000 a month for Mom to smell piss!!!!!! It seems to happen more on Fri, Sat, Sun and Mon - it makes me wonder if they are short handed for the weekend. Anyway - I'll ask my brother and sis in law to stop by now and then to check on it. When it happens I'll just call the Nursing director or the administrator.
  • Nurses fail to check details on Mom's care: There have been a couple of incidents where the LPNs or RN tell me something - generally negative - about Mom so I press for details. When they look in her file they can't find any information and tell me that they've confused her with another resident. This REALLY concerns me because it means that doctor or his nurse could get incorrect information when they call. Please see the blog entry Nurse error nearly cancels Mom physical therapy.

So - for now I'll continue to stand guard so to speak. I'll return to our home in Indiana soon and hope that Mom will be fine until I can return in November.