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The Care in the Care Homes

June 16th, 2006, 05:21 PM
As many of you are quite young, (nice pics! you may not have had much personal experience with nursing homes.

But for those who have, or who have worked in them.. I wonder what your views are on the level of care provided today?

We have all heard horror stories that make the blood run cold, particularly if you have a loved one residing in one of these facilities, and one who cannot speak for themselves.

These shocking incidents are very rare, though, but they grab the news headlines and instill fear.

My sisters and I screened almost every single nursing home in this entire area before selecting the one our elderly mother now resides in. She suffers dementia.. now severe, sadly, and is completely dependent on others for her needs.

I have always found the staff caring and kind,..the residents and the facility always clean and looking well cared for. We visit often, have always felt confident in this home, and the staff who care for our precious mom.

Until now.

Two incidents this week have prompted me to contact the Director of Care with concerns.

In the dining room - a staff member ( casual worker) gave my mother's meds..(Dilantin, an anti-seizure drug) to the lady at the next table, confusing their identiies.
Luckily this was noticed by another worker, at which point the woman became flustered and complained.."Well.. they all look alike!
Mistakes can happen, but this is a serious error. Some meds administered to the wrong resident could result in tragic consequences, and would always be a health risk for both the one who got them... and the one who didnt.

Compounding things, I called this morning to doublecheck on all the meds my mom receives, and was given the medical information of another - a lady who has a similiar name. I was baffled at first - finally asking her... are we talking about the same person??

This was not a harmful mixup, but its yet another case of mistaken identity, and leaves me with a very unsettling feeling.:sad:

I'm left wondering how often these sort of things happen.:confused:
There is no doubt there are less staff in place now than what there was before.

Nursing home staff have an extremely difficult job, most have my admiration and respect for their caring commitment to the residents, and to their work. As with any job... there are always exceptions however.

Do funding cutbacks, staff reductions compromise the level of care and safety that can be offered in nursing homes today?

As I dont have any experience with any other care homes, I wondered if you had any thoughts to share on this?

June 16th, 2006, 07:13 PM
great subject!!

I think we should applaud those nusing homes that are doing a great job..

My father screaned almost every home in the West Island (montreal) before placing my grand mother who has Dimentia (alzhimers we think) some times she is 50% some times memory lasts only seconds. He deamed most places unsutable.

After almost 4 months placed her with regret in Chateau Dollard, we worried about her transition. After 2 days she made many friends and the staff has made the transition a great success and there are now no regrets.

when we go in all the staff reffers to her by name.

June 16th, 2006, 07:13 PM
please excuse me some how it posted twice can't seem to delete it.

June 16th, 2006, 07:22 PM
My grandmother is in an Alzheimers care home, she has been there for almost 5 years now and they are excellent there! I really applaud the wonderful staff that works there. She has recieved the best care that I could immagine. Aside from her glasses and teeth getting stolen repetedly,there has been no bad news from there.
If my gramma so much as bumps into something they call the entire family to tell us. She fell off her bed once too, ( she behaves like a child now, so jumping on the bed is her new hobby.) they called my dad and his brothers in to the home and had a big discussion on which methods would be best to deter her from doing this. ( Needless to say nothing has worked, she still jumps on her bed, having fun i guess)
They built an outdoor enclosure for them too, so now they can go out and sit on a bench under a small tree with a lovely garden with beautiful flowers and such.
I am sure there are less than acceptable places, however i am so happy that where my gramma is she is happy and safe.
It definately must be a hard and scary descision for people to make, you are trusting the staff with your most cherished family members. You definately have to be VERY careful.

June 16th, 2006, 08:00 PM
My father and Uncles spent countless hours choosing a nursing home for my (now deceased) grandmother, who had severe dementia. The place she ended up in was wonderful, but I think that one of the reasons it was so good was that she had three nurses (who alternated) that only treated her. undoubtedly this costs more money, but if it is in the budget, I think it makes a huge difference, as the nurses grow a strong raport with the individual, and those little (but grave) mix ups don't happen.

June 16th, 2006, 09:24 PM
Last year there was a series of articles on 'those who couldn't speak for themselves' all about horror stories in Canadian nursing homes in the toronto star.

If I ever needed to place another loved one (my great grandmother was in one when I was small enough that I barely remember) I'd have a terrible time trying to see how things really are when the prying public isn't around. I'm pretty scared and wary. The articles were heartwrenching.

June 17th, 2006, 01:34 AM
Several years ago I did most of the legwork in finding a place for my (now deceased) grandma to live. The absolute best place was a private care home, a house converted a bit to care for elderly people. It was run by a family who had 3 of these homes right next to each other. They, too, had staff problems at times, but we were welcome to come and help out with grandma`s care or just to sit and visit any time. They really cared about their residents and after having some experience with traditional nursing homes, it was for her the best thing when she couldn`t live on her own or move in with any of us.

I doubt this is just a Canadian or US problem, having poor care in nursing homes. The turnover rate of staff is so high and their compensation so low, its really hard to attract competent staff. It certainly doesn`t seem a 'fun' job either, but I know a lot of people get satisfaction and enjoy caring for the residents even though they are overworked and underpaid.

The only bad thing about the private care home was that it couldn`t accept government payments (something about cerification) and ate through grandma`s savings fairly swiftly. They didn`t kick her out though. They accepted her income, although it was less than their rates and we helped as we could in buying supplies for her. Their residents became more like family members and we were all so grateful to have such a place for grandma to spend her last years.

Sorry for writing a book, but I`d strongly suggest looking at private care homes when searching for a good place to care for a loved one.

June 17th, 2006, 07:50 AM
I got to know a lady through work,a marathon-runner,curler,golfer and a breastcancer-survivor in her early 60's.
I met a very close friend of hers,who told me she is now in a nursinghome with Alzheimers,I could not believe it:eek:
She's one of the"lucky"ones,has a large bank-account,can easily afford to spend the $4.500/month the nursing-home charges,hence she gets very good care,I think.
My oldest sons girlfriend is a 'home-care'worker,currently on staff at a nursing-home in Burlington.
It is not a $4.500/month nursing-home and most care-workers make $10-$12/hour,her hours were recently cut to very part-time.
I am sure many people are hardworking,caring individuals,but staff-cuts and very low wages,does not guarantee the residents will get good care...
Getting breakfast at noon and lunch at 4pm is not an uncommon scenario:sad:
I just hope,when and if my time comes,I don't know what is happening around me.

June 17th, 2006, 04:32 PM
The place she ended up in was wonderful, but I think that one of the reasons it was so good was that she had three nurses (who alternated) that only treated her. undoubtedly this costs more money, but if it is in the budget, I think it makes a huge difference, as the nurses grow a strong raport with the individual, and those little (but grave) mix ups don't happen.My grandfather ended up in a pretty large sort of retirement hospital, and the nurses all knew him really quickly. Even when he was in the long term care ward at the hospital, they all knew him and our family. I think regardless of the size of the facility, if the staff members' heart is in their work, they just don't screw up like that.

There's a lot of money to be made with elderly care, so you have to be so careful.

I know one retirement home outside of Montreal where the owner is just in it for the money. They have very minimal freedom, crap meals, no respect, etc, but pay a fortune every month for this "service".

If you're unsure if the fit is right and the staff is right for your mom, I'd check around for a new home. You have to follow your instincts, IMO.

June 17th, 2006, 06:17 PM
Prin, my mom turned 85 last week, has been on a slow but steady decline since last Dec... and is now very frail.
At this point, relocating her to a new home wouldnt really be advisable, unless there were further concerns about care and safety. The meds mixup was certainly one red flag.. and I will be on the lookout for more.

The director of care assured me there was a report on this incident, and that a followup would be done with regards to this staff member.
I suggested plastic ID bracelets, such as hospitals use, as a quick and fool-proof way of identifying residents. The high-elopement risks wear them.. perhaps they all should, or in the special care unit, at least.

I just hope,when and if my time comes,I don't know what is happening around me.

My sentiments too, Chico!
Unfortunately, most do, initially at least..and many resist highly, making it even harder for all concerned.

I cared for my mother here in my home when she could no longer manage on her own. After a year, it became more than I could handle, and as there was no other siblings who were able (willing) :rolleyes: to take over the responsibility for her care... a nursing home was the only option.
Fearful of strangers, and rejecting of all outside help, I knew she would hate it, and that it cause her much upheavahal and stress in adjusting.

Taking her there was one of the hardest things I've ever had to do. I had to trick her into the car on a ruse, or she would simply have refused to go. I felt like I was leading a lamb to the slaughter.
When the time came for me to go, I had to explain that she was staying here.. for now..The crestfallen look on her face as she realized she'd been duped.. it was heartwrenching.
Every day when I visited, she would plead with me to take her home.. sometimes promising not to be " too much trouble".:sad:
There were days I just sat outside in my car and cried.. I felt llike I'd abandoned her. So confused and vulnerable... at the mercy of strangers.

But.. she adjusted, and I adjusted to this harsh reality of life. She slowly forgot she ever had any other home. The staff were kind and caring to my mother. My fears receded.

Five years later, she lives in the moment only.
She doesnt even know her family anymore, but I believe she will always feel our love. She responds to a smile, a tender touch, a hug and a kiss, as all people surely do.
She's been robbed of so much,.. everything really... but that is one thing I believe that never can be taken away from her.

Whew! Sorry...wrote a book here, didnt I?:D:o

June 17th, 2006, 06:39 PM
Ahh Shamrock! I wish I could give you a big hug. :grouphug: I miss my mom terribly; it's been 6 months. The one thing I've been grateful for is that we never had to go through what you've had to. We had just consolidated households and moved in together in a new home when she died unexpectedly. I was prepared to be her caregiver when needed, but I dreaded and feared how our close relationship might change and that she might begin to consider me the "bad guy". Then again, my pop gave my mom such a hard time before he died that it was almost a relief. I think the whole key here is that you take an active part in your mom's care. You look out for her and take action when you feel things aren't right. That, if nothing else, will keep people on their toes when they know someone is looking out for her and will make waves if necessary. So many are just abandoned and forgotten. You sound like a caring daughter.

June 17th, 2006, 07:19 PM
Your mother is lucky to have such a loving advocate. So many people in care homes and hospitals don't have anyone looking out for them. I wonder how many are short-changed as a result, just because they can be and the staff is maybe not as well trained as they should be.
There's been a couple of cases here in Quebec where patient's families hid video equipment in their rooms and have been able to film actual abuse (slapping, shaking, verbal stuff). Really heartbreaking.
My mother is in a good situation, living with my sister, who takes tender care of her. Happily she still has her wits (too many, some would say :))

June 18th, 2006, 07:43 AM
Shamrock,wonderfully written story about your mom:love:
I believe,like Badger says,people often forget,are too busy,have more important things to do,than visiting poor old,feeble mom or dad.
My 93yr old former neighbor,who died in the hospitals geriatric ward,had 2 "kids",the daughters excuse for not visiting was"can't handle seeing mom like that!"
The son,who was indirectly responsible for her condition,was a no show,probably from guilt:sad:
We had gotten really close to her and her husband,having been neighbors for many years and after her husband died,I would go and visit with her about one hour every night.
She was funny,kind and very Irish and I loved her:love:
It's too long to tell about all the times she encouraged me and made me feel good about happy she was when I took care of her pretty garden.
Her son,broke her heart,by stealing all her money out of her account,having Power of Attorney.
When she found out,she simply stopped eating and eventually died painfully,from organ-failure in the hospital.
The care she got in the hospital was not the best,she had horrible bed-sores,did not get enough pain-meds,her boney little hand would grasp mine every time a rush of pain went through her..
Boy,writing this brings back sad memories,she finally mercifully died in august 1989..RIP Mary.
Sorry,got off the Topic,but I believe, if the children do not check up on their parents,visit and show an interest,the care he/she will recieve might become less.

June 18th, 2006, 11:08 AM
That is so sad! I want to believe what goes around comes around, but then when you hear about good people having things like this happen . . . . I only hope those "kids" eventually get theirs.

June 18th, 2006, 12:20 PM
Aw, Shamrock. :( You can only try to remember that you brought her there for the good of everybody. With all you have been through this year, her care may have suffered if she had stayed with you. And frankly, it's really hard to constantly care for a parent, even without other things going on.

The staff is hired and trained only to be there for her and care for her all day and night and you can visit her more refreshed, more patient and ready for as much quality time as is possible.:)

June 18th, 2006, 04:02 PM
Glasslass,not that I wish anybody ill,but the daughter died about ten years later,spending 5 of those years in a nursinghome.
The son,who gambled away his moms money(about $400.000),is now blind and looks like a living dead,living on social assistance...

June 18th, 2006, 07:52 PM
Since I work at the opposite end of the spectrum (pediatrics), I am not expert in geriatric care. I simply refused to place my grandmother in one even when she was dying of breast cancer. That said, there are many good places and some not so good ones and the trick is finding out which ones are rated best. Each province has an association for these nursing homes tho I am well aware the regulations across the country vary widely. More and more, it is increasingly difficult even to gain entry to a nursing home and the senior has to be very ill to be admitted, In NB and NS, there are special care homes - which are less medically well equipped - who care for seniors. NB just released a new Disability Framework to try to get younger ppl out of nursing homes where they in fact do not belong.

I guess as someone who is a proponent of inclusion - for children and adults - I abhor the notion of special homes for anyone but do realize there are times when families can no longer cope. And as it is, our hospitals (across Canada) are filled with seniors waiting beds in nursing homes or somewhere. How do we address that?

Lately, I have been wondering about applying inclusion to seniors. And it also annoys me as a medical professional that seniors do not always get the respect and care they deserve. When my own grandfather developed Hodgkin's Disease at the age of 83, the best "adult" (lol) oncologist in the province did not treat anyone over 80 but between his doctor and myself, we managed to get him admitted and into a chemo protocol. He lived for three more yrs but gave it a masterful fight!

My grandmother was so thnkful she donated money to the hospital (for which I now have to attend more Godforsaken events!!) but really, it irked me that I had to do that. Now, as boomers age and 50 is the new 30 and 80 is the new 60 (so I hear), most oncologists - to cite one example - are changing their views. The same is true for other illnesses - I sit on an ethics committee and the VAST majority of cases we encounter are about the very old and the very young. It can be very distressing!

As for mistakes, in medical speak, they are called a variety of nice sounding names (incidents, medication errors - which a database in NS is supposed to help (yeah, right!) but they occur at every level of the health care system.

I am both a health care provider and a health care consumer and the advice I give every parent of my patients or the patients themselves if they are teenagers with mega questions is to have an advocate with them in the hospital.

That said, we truly do have an excellent health care system. How seniors' care facilities measure up against it is another issue.

NB has a program called the Extra Mural hospital and with technology, a family - with home care workers, visiting nurses, physiptehrapists, etc., etc - can care for their loved one. I have been there and it is not easy. When my grandmother was with me, worrying about her never left me for long. But I had always promised her that I would care for her and I can honestly say I did. I still have trouble passing the card section for grandparents, sigh!!

To reply to your question directly tho - I would talk to someone in charge and express your concerns. If the facility has a nurse or social worker whose role includes patient relations, talk to that person as well. It really helps to continually advocate for your loved one!!!

June 20th, 2006, 05:13 PM
Just wanted to say thanks for your input into this thread.. and for sharing your own thoughts and experiences. I was very interested to read these.

Chico,that is just the saddest story about your neighbour! How awful.:sad: This happens more often than one would think.:sad: Kudos to you for being there to visit her, and offer her company and cheer. Aging can be cruel, lonelieness is too, you offered her warmth and kindness.
I'm a big believe in Karma, Chico. The kids were not there for their mom.. they did wrong by her..

CK.. kudos to you also for being there to proving loving care for your grandmother. While many of the elderly are faced with both physical and mental decline, the strain of caring for one whose lucidity and ability to apply logic is greatly diminished is both heartbreaking and highly taxing. One has to know when the personal toll is too great...and act accordingly. Even though I regretted that it had "come' to this.. I felt confident that I had given it my all.

My mother was very mobile at that time, sometimes agitated and uncooperative. I had no help from outside sources, and due to her fear issues..couldnt bring any in. With the rapid decline of her condition.. it was clear this was no longer workable.. or advisable

One of the many stressful issues was surrounding my pets, actually.

She'd always liked animals...but now was bothered greatly by mine. She complained frequently about the dog's barking and the cats scratching "her' furniture, confusion about where she lived commonplace,
I had to deadbolt the doors, and watch her closely as she often would try to put them outside.. 'where they belonged". This scared and stressed me.
Every so often she'd announce that she was calling the SPCA to pick them all up.:) I just humoured her this, as she couldnt have managed this task at all.

But aside from the emotional strain..when health, hygiene and safety issues become too pressing, home care for the elderly can be impossible to keep on with..and that is how it evolved for us, as it does in many cases.

June 20th, 2006, 05:34 PM
I absolutely understand Shamrock - it does take a toll and until you are faced with it, no one can explain it to you!! There were days I questioned my own sanity. While my grandmother was for the most part cogent and aware of her surroundings, she hated to leave her home (But was ill, had difficulty walking, glaucoma -a myriad of problems actually) and so many of her own friends were deceased or elderly so I'd make arrangements to have her visit them or they come and see her. She even refused to attend Church because "someone might think I'm crippled" (After 86, some ppl are not politically correct if they ever were) and she had always been active in her Church.

It was a chore to get her to sometimes do the most basic things. She did not get along with my mom so thus, she lived with me. But I never knew what I'd come home to. Sure, I had home care workers and nurses who would drop in but it was still something that was with me 24/7!! And there were more than one emergency!

So I do not envy any family making those difficulty decisions - they are not easy. I well believe you have done everything you could and more!!! I wish you the best in meeting with the care facility.