Thank you. But was his family responsible for finding a place for him when the Memory Care place rejected him? I’m asking because I have no family at all to help if a situation like that arises.
Hospitals don’t just discharge people without any consideration for the care they require. Although I didn’t work in either a hospital or nursing home , I spent a fair amount of time working with people who no longer needed hospital care but needed too much care to go home on their own and they stayed in the hospital until an appropriate placement was found. It’s possible that it’s a Medicaid/Medicare rule or it just may be an across-the-board legal responsibility - I don’t know.
This is the right answer. I’m a nursing home doctor, including medical director at two SNF / long term care facilities as well as attending at two assisted living facilities. It’s all about the staff at the facilities and how seriously they take their responsibilities. The focus of the administration is also important. The best ones are not necessarily the fanciest or most expensive. The worst ones are the ones where administration only cares about filling the beds rather than the quality of care.
ETA. One thing that is apparent to me is that the longer the nursing staff have been there, the better the facility. The places where the nurses have been there for years and recognize all the patients and are familiar with their health problems, even those patients for whom they aren’t the attending nurse, are usually the best places. Those places where the longest tenured nurse has only been there a few months and most of the staff are agency tend to be the worst.
ETA 2. Which is not to disparage agency nurses. The issue is that if a facility is in a position to have to use agency nurses on a large scale, it’s almost certainly because administration was treating the nurses poorly, likely by overworking them and having unsafe nurse to patient ratios.
That’s interesting. It’s surprising how often “tenure of staff” is predictive. When we had kids in preschool, we learned that places with high turnover were worse for the kids. (We got lucky.) My employer (a large insurance company) has looked at how to predict which trucking companies will have fewer accidents and injuries, and “tenure of truckers” turned out to be one of the most predictive variables.
It’s almost as if people like to do good work, and are more likely to stay at a place that lets them do that.
But, but, but … what about our profits??? We have to flog the workers or we won’t make quota. Waah! Workers are so selfish & lazy! Waah!
My dad’s got dementia. Had a stroke in the spring which accelerated things and made him less mobile. We were told he needed in-home care, so my step-mom and step-siblings and I (all of them live in SC, I live in MI) arranged through the VA to get a person to come in overnight and for a few hours during the day a couple days a week so my step-mom could shop/shower/etc. My wife went down there when they were getting the help set up, and she said he became so unbelievably nasty, that they decided that it wasn’t worth it. He accused my step-mom of cheating, accused my wife of plotting to rob/kill him with this stranger, called my step-mom a “fucking bitch” for bringing this person into their home, etc. Then the next day he remembered none of it. My step-mom refuses to move into a senior facility, so they muddle along in their big home, where he needs constant supervision. If my step-mom leaves the room for too long, he freaks out. I honestly don’t know what the best solution is as a “place to end up” for him. I guess until my step-mom says “enough!” and decides to move them/him into a place where she can get some assistance once in a while, there’s not much I can do.
@Newtosite My sister was handling it, having power of attorney. I want to say she also had to get a medical power of attorney separately, as well but I could be wrong.
I am pretty sure she would have followed whatever the doctors suggested. Sorry I cannot answer you better than that. My sister tried her best for him and luckily he had great insurance from working for the Department of Defense all his life.
I have read that people with no one to take care of things- sometimes write a living will that will kick in with solutions to various scenarios. But I could be wrong about that too. Anyway you go, it will take a boatload of money.
Thanks, by-tor.
She could move him without moving herself, if she can afford to. I have a friend whose parents were in two different facilities, one a regular retirement home and the other a memory care facility. (Sadly, they both died of covid within a few months of each other when covid was hitting aggregate care facilities.)
The problem is, though, he just gets so dang nasty. I can’t imagine the things he would say to her, or anyone of us, if she moved him into a home. It really is an absolutely horrible condition to have Three of his four brothers all died from it already- oldest on down the line. My dad’s going through it now, and I’m pretty sure his younger brother is looking on in horror. Frankly, so am I. The men on my dad’s side all seem to get this.
No worse would be not mentally impaired but to be stuck in that damaged incommunicative shell of a body with a full awake mind that has no way of communicating outside it.
That happened to my friend’s mother recently. She had a devastating stroke that left her paralyzed, unable to speak, and incontinent. She could communicate by blinking, but that was pretty much it. She was still in there, as best as anyone could tell.
She refused food and water until she died. My friend said that when she tried to clean her mother’s mouth (necessary if you can’t do it yourself) her mother would clamp her jaw shut, and my friend had to reassure her that it was just mouth care, and they weren’t slipping any water in there.
It was horrible.
I’ve got more experience with this than I’d ever wish to. My FIL had Alziemer’s and we took care of him until he had a stroke. My husband with great reservation allowed them to put a feeding tube in. FIL apparently had another stroke during the procedure and ended in a shitty nursing home. This place’s social worker assured us they never used Morphine (long story regarding my husbands feelings about Morpine) any way the guy was lying.
My daughter worked at the nursing home in town. I have many issues with my daughter, but she worked hard there and had great compassion for her ladies. She was an activities associate. She was often made to do CNA duties. Some CNAs there one day told this poor woman who thought she’d killed someone that the cops were coming. My daughter called them out and they told her, “Oh she’ll forget it in and hour.” They threatened to fire her when she was sick and had a doctor’s note, and the last straw was when she found out some teen boy she was training was making $2 an hour more than she was. There was much more, but that says most of it. And predictably the turnover there is ridiculous.
Last, my husband, as I’ve mentioned, has Parkinson’s. So far he has not had any cognitive failure. He remembers stuff a lot better than I do. He always has. However, he fell in the bathroom one day, and his doctor said next time there was an issue like that to call an ambulance and get him into a rehab situation. Unfortunately, the only place his insurance covered was a place about 25 min. away. He was there over night. I called to see how he was and he said, “Come and get me out of here.” It seems that as the night shift came in, he told the nurse he had to use the restroom. She left the room and never came back. He rang the buzzer off and on all night and no one answered. He ended up getting out of bed himself. Now remember he was in there because he had fallen in the bathroom he managed to get to the bathroom on your typical tile over concrete institutional floors, but he didn’t make before he wet himself. I was LIVID. The director tried to talk me out of it and told me she knew those night nurses and they were good girls. No, no they weren’t. My sister came and got me and we went and got him. I will NEVER put him in a place like that again. Ever.
@Happy_Lendervedder your step-mom is going to need a lot of support, possibly later, but more likely now as well. She is being abused by your dad, even though he can’t help it. Something similar happened to my mother, though Dad wasn’t abusive, instead she became abusive to him. She couldn’t see it and we didn’t press home the issue because she was doing what she thought she had to do. Still, when he eventually landed in a nursing home, she was very depressed and withdrawn and it took a long time to come back to who she used to be, even with help.
Of course, I don’t have a crystal ball to say what will happen with step-mom. All I can say is support her in any way you can. She took on a tough, tough job.
That’s true for ALL kinds of companies, whether you’re an employee or a client.
The wonderful book and movie “The Diving Bell and the Butterfly” is about someone who did indeed experience locked-in syndrome, although he was able to communicate on very primitive levels, which was how he managed to write the book.
And our late board poster here, @blinkie.
I wish all senior care homes were like my parents’. They got their own apartment, and when one of them would need more help, say, recovering from surgery, they could move to the rehab floor, or stay in their apartment and get regular visits from the nursing staff.
And when my dad’s dementia got bad, he just moved to their memory care unit (“around the bend”, which meant that when my mom visited him, she only had to walk down the corridor and turn left).
^^^ My mom is currently living in such a place, which makes me very happy.
A major problem is that they decided to move to South Carolina from Michigan almost 30 years ago to be near her kids. That was fine, until my dad’s memory started to go and then he had the stroke last year. I still live in Michigan (only child), and have been telling my dad and step-mom for years that if they need help as they get older, I’m happy to be there for them, but I can’t leave Michigan. They both have siblings/nephews/nieces within 30 minutes of where I live, so it’s not like I’m in some foreign land to them. I’ve said multiple times to both my step-mom and her kids to get my dad into a place where he can have actual professionals caring for him. She refuses.
So my wife, kids and I went down there (to SC) four times last year, for just over three weeks total to help out. I run my own business, and am the only employee, so can’t just take time off like most people could. It costs us thousands to go down there each time (in lost work, car/flight/hotel/etc). I honestly don’t know how often my step-siblings spend over at our parents’ house helping, but I suspect it probably isn’t that much. It’s also getting harder to talk to my dad on the phone; at times he forgets how to even use it in the middle of a conversation.
On the flip side, my mother and my in-laws all moved within 10 minutes of my wife and me within the past few years, knowing that my wife and I would be there in their golden years when they needed it. We see them each multiple times a week.
There’s definite guilt of not being able to do more for my dad (and step-mom). Everyone I’ve talked to, though, about the situation with my dad and step-mom has told me not to stress over not being down there more, and not to go broke travelling down there; they say it’s on my step-siblings to step up and help their mom right now, as they’re the ones my dad and step-mom chose to live by 30 years ago. People tell me I can only do so much, and that I can extend an offer to take care of them if they move back to Michigan, but I can’t make them do it. It still doesn’t make it feel less crappy knowing what my dad and step-mom are going through. And I also constantly wonder if my step-siblings are expecting me to do more.
(Incidentally, everyone thought my dad would outlast my stepmom, including him, and he planned on moving back to Michigan after she died. Her heart health remarkably improved while his mental health declined, and so that plan never materialized.)
If you have elderly relatives that you need to keep in touch with, you may want to use video chat if possible. If they can see you, they may have an easier time staying in the conversation. While there’s a huge variety of ways to do video chat, it’s probably best to use a device designed with elderly people in mind, like this GrandPad.
These devices try to make it as simple as possible so that people with limited abilities or tech knowledge can use it. Some will have a subscription cost, but if you need a higher level of service, that may be worth it over a free solution.