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I received a call this afternoon from my sister who went to visit my mother this morning at the personal care home/dementia unit where she was placed in August. The morning aide informed my sister that my mother sustained a black eye last night and no one seems to know how it happened. First of all I have POA for my mom and no one notified me from the personal care home about my mom's black eye! To say the least I am upset about hearing this and not sure how to handle. I have a call into the executive director to find out the details. From what my sister was told the night time aides said my mother walked to her home and when she came back to the community room she had a black eye and no one can seems to know how it happened! My mother is 79 years old and suffers from stage 6 alzheimer she walks fairly well with out a walker or cane so I'm not convinced she might have fallen! I live 100 miles away but on my last 2 visits I was not pleased with how I saw the night shift aides sit around texting on their phones and not paying attention to the residents. When I helped the one resident walk from the dining table to the TV area her pants were clearly soiled from urine and she was wet down to her knees! I will be turning 55 in 2 months and feel like take early retirement and moving my mom back home for me to take care of her. I welcome your advice.

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MJ:

Although my mother was such a pain and had her placed in a senior citizens' home, I'd never allow her to live in a place where the staff seem to have better things to do.

Sounds like you've almost made up your mind to take her home. Trust your instincts.
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mjl, if I had a dime every time I saw a bruise or scratch or bump on my mother-in-law's head, I'd be rich. With her dementia, she forgets where they came from. But I know she did it to herself, because even when she lived alone before moving into asst. living, she would complain that her head hurt. Only to find a bump on it where she banged her head into who knows what.
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Thanks Jeanne for your reply and insight. I did send an email to the executive director asking her to explain the protocol and to inquire as to why I was not notified of my mom's injury. Your right it's possible that my mother may have tripped or walked into something, maybe she got dizzy or got agitated by something. I just feel that the facility should have contacted me or communicated the incident to me instead of having to hear about it from my sister. Most of the aides are caring and attentive but there are a few aides working there who are only their for a paycheck and should not be working in the dementia unit.
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I'm sorry that you are having this experience.

Some observations:

1) Even people without any impairments at all can trip and fall or bump into something. I don't think you can rule out this kind of accident even though your mom is mobile.
2) POA gives you authority to make legal and financial decisions/transactions for your mother. Since neither kind of decision was needed perhaps the facility did not think it necessary to call you at night. The fact that your sister visited in the morning may have seemed adequate notification of the family. Maybe the facility was negligent in not informing someone sooner, or maybe this is a matter of misunderstanding the routine protocol. It would be good for you and your sister to sit down with the director of nursing and talk about when family normally gets called, when you want to get called, etc. If you are expecting one thing and it is their policy to do something else that is bound to lead to hard feelings.
3) You saw aides sitting around texting. More than one aide at a time? More than once? Unlike us 24/7 caregivers at home, facility staff do get breaks. It is quite different for an aide to be texting on her scheduled break and another to be doing it instead of making rounds. It would be good if you could go to the director with names and times and get to the bottom of this. One of the caregivers in my support group did this and the end result was a night aide was fired. Responsible administrators want to know when staff are not doing their jobs. Just be careful not to jump to conclusions -- gather evidence and report it.
4) It is very sad to see residents in soiled clothing. Without knowing whether it had just happened or whether the poor dear had been sitting like that for hours it is hard to know how responsible to hold the staff. I hope you immediately reported the problem to someone on duty.
5) Maybe this is not a good facility, and it would be best to move your mother to another one or to bring her to your home. But since change is generally disruptive to someone with dementia I suggest more close observation and working with the people in charge to see if this can be made to work for your mother. Try to sort out what might be misunderstandings, what might be a single poor employee, what can be improved if the directors know about it, and what is just sign of a poorly run facility.

Where was mom before August?

I'm afraid that no matter where she is, your mother is going to experience some problems. She could lean down into the edge of an open dresser drawer at your house or in her care center room. A person with late stage dementia takes 24/7 care, ideally by people who come on to their shift well rested and who have breaks throughout their shift. It is also good to be able to call for immediate help when something unusual comes up. If you do decide to bring Mom home, I hope you will arrange plenty of in-home help and also think ahead about respite.

I hate to admit this, but even though I usually had someone else with me in the house while I was caring for my husband with dementia, he still fell from time to time. The scrapes on his elbows and legs made him look like an 11-year-old learning to skateboard! I don't think this was a reflection on the level of care he was getting, but rather on the nature of his disease. One minute he'd be sound asleep. The next he'd be awake and in desperate need of getting to the bathroom and totally forgetting that he needs help to walk. The aide and I could bathe him, shave him, dress him nicely, take him to the bathroom, and a half an hour later his pants could be soiled where the disposable undies were not in place just right. Dementia is a very, very difficult disease for the person who has it and for the people taking care of him or her.

I hope you can come up with a good resolution to the concerns you have about your mother's care. Bless you for being so conscientious.
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