I'm afraid my dad will get my mother kicked out of a nursing home.

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My dad keeps arguing with the staff at the nursing home about my mother's care. It's always something physical therapy or getting her on the toilet. The physical therapist told him if you didn't like it maybe he should look into going somewhere else. I know the director of nursing is fed up with him for constantly insisting she be on the toilet. She can't stand she can't communicate she's a handful to try to get on the toilet or into bed or to do anything. Can the nursing home tell us to take her somewhere else?

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Louise, the physical therapist's response to your father's concerns was very unprofessional. We are finding here in our part of Michigan that nursing homes are seriously understaffed. We rarely see family visiting residents at the place my grandfather is at now, but when we do, they are almost always in the process of trying to track down staff and advocating for their family member.

The compassionate and competent staff members are on the same side as their patients and their families. The people that are most likely to snap and be rude are ones that should not be working with infirm and dependent people. The fact is that these places do not have enough people to do the work, and the workers who bear the brunt of the work -- the CNAs -- are often working a second job because this work pays so little. It is truly heartbreaking that both the patients and aides are treated so poorly.

Is your dad being abusive to the staff or is he just distressed because he feels your mom's needs are not being met? As you know, it is really a loss to see a loved one in that setting and it takes awhile for everyone to adjust. If this is out of character for your dad, he might be burnt out and the stress of seeing your mom in that setting might be too much. If he is there everyday, it might help to encourage him to take a day off and let him see your mom will be all right if someone else takes a turn visiting.
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I wish health care personnel were/could be on a 1:1 ratio so we could accommodate each patient at the moment they need assistance. As an RN that previously worked in Geri/psych, I had 10 patients and one CRNA. I would be changing a diaper/toileting a patient and hear a patient in other room call/scream for help. I physically couldn't be in 2 places at once. I'm sure for the family member of loved one yelling for help and not immediately being assisted is frustrating. It happens a lot so I understand why your dad is angry. Sometimes it takes more than one staff member to help toilet a patient. Patients can be assaultive and I've been hit and kicked while attempting to care for a patient. Although family members need a break, if at all possible we always allowed family members stay even off visiting hours if they wished to always have a person to constantly be in same room to immediately tend to needs. Another option is if your dad could hire private duty aid to sit and help with toileting. If your mom is a two person lift/assist that aid sitting with your mom may have to wait for a staff member to be free from tending to other patients to help. Nurses have other responsibilities, passing meds, wound/skin care, arranging for tests, entering labs into computer system, calling doctors for medication/admission orders, admitting new patients interviewing family/patient during admission, monitoring behavioral changes, documentation of all of the above and more. We generally try to do our best but we can't immediately be there if we are involved with caring for another. I personally avoided the complaining family member but continued to do best I could. Your dad could make appointment with social worker to discuss a transfer to another facility. Sorry to say, but if complains and is abrupt and demanding to staff, staff will be relieved to not deal with complaints if your mom is discharged. The phone would ring sometimes and secretary would answer it would be a family member known to be difficult. I sometimes told secretary I could not take call because it would take up time that was better served taking care of my patients. Your dad is angry because he loves your mom. That's beautiful. This won't last forever. Good luck.
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You should contact your local Ombudsman to advocate for your mother and strongly encourage Dad to back off. Ombudsman are trained advocates. That's what they do - try and get the best possible care for residents in long-term care. Their services are free. Please contact them.
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I believe she could be asked to leave. But I imagine they would take other measures first. They would bar him from visiting. They would talk to him and tell him to cool it. Most likely if they have a resident who is paying in some way they will try to keep them. Money talks whether it is my medicaid or self pay, they will put up with a lot. Did your family sign a contract and see any rules when mom was admitted. Surely they have rules that have to be followed.
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It sounds like a meeting would help. Between the PT staff and the staff of the rehab facility. It should probably include the nurses, CNA's if possible and a Social worker. Your Dad and at least one other family member so you can get the whole picture as well as potential outcome and what your Dad is doing to hinder progress if there is any.
I understand what your Dad is going through I went through the same thing with my husband a few years ago. It took me 2 months to get a seat riser for the toilet rather than a small rickety commode that had been placed over the toilet for the resident in the next room. Difference was the resident next door was about 5'5" and 100 pounds soaking wet my husband was 6'4" and 260 pounds. While the commode was stable for the next guy it shook like a leaf when my husband tried to use it. I won't get into the 100's of other problems. But there is a difference in advocating and being obnoxious or belligerent.
Tell your Dad the old adage is right...You catch more flies with honey than vinegar.
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''we don't see things how they are; we see things as we are''..Meaning we all have our own opinions.and feelings..the patient; the partner; other family ;doctors...and ALL must be heard by someone who is actually not involved with that particular patient..and feelings and situations can change on a minute to minute..so it is an ongoing process
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I complain all the time about things I am not happy with at my husbands NH....no one has ever told me to go somewhere else...on the contrary they look into the problem and it gets corrected. However I go to the administrators, not the workers....if a CNA is not properly taking care of him I first talk to his nurse, if that doesn't correct the problem I go to administrator....they always assure me I have every reason to complain if there is something that I don't like or agree with ....I don't scream and holler..I just go in with a humble attitude....they are extremely good at addressing the problem...even have opened their eyes to some that needed to be let go.
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A valid reason apart from having every right to see his wife, and his wife having every right to see her husband, do you mean?

If he is violent or abusive, then the staff could take steps to have him banned from the facility, yes. But they are more likely to ask him to remove his wife, and that indeed is the primary concern of the original poster. In any case all the poor man is doing is questioning the care his wife is receiving, and the correct response to that is to explain and reassure - not to chuck him out on his ear for his temerity.
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unless he has a valid reason, yes he can get kicked out. not only can he get kicked out but they can ban him from the entire facility.
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Yes, that's the sort of lift I had in mind. You can adjust the angle of tilt because there are three sets of loops at the back, so the person can be more upright or more reclining. There are also two different ways to fix the thigh straps to keep the person's knees together or not, according to a) what you're using the hoist for and b) how much muscle tone the person has (knees not together is safer if the person is prone to slipping or tipping forward).

I suppose from wheelchair to room to bed to commode to bed to wheelchair and back again would take that time, yes, on reflection. I guess I hadn't really added up in that way before. I used to transfer my mother last thing before "bed-time", and in the whole performance of that, washing, teeth-cleaning, bed-making and the rest of it I lost track of time.

I also ignored the two-person rule. This was partly to do with reality - there weren't two of me, and if you think transferring somebody on your own is heavy going all I can say is try changing the bed on your own with the person still in it - but also because of at least two occasions when the frankly dangerous actions of professional aides, trained and qualified, made me insist they stop what they were doing immediately (I very rarely challenged our HCAs, or felt the need to). One of them would have had the hoist tip over - she was yanking on it to get it over a bed cable - and the other hadn't got the sling straight and my mother's torso was heading for a 45 degree angle to the right. I consulted the government's Health and Safety Executive's reports on the use of hoists in care settings to check what the main causes of serious accidents were so that I'd know what to be neurotic about. And although these reports are in Civil Service speak and therefore don't call anyone a moron, when you dig down accidents are caused by people not paying attention, not using the equipment properly and in one case having the spatial intelligence of a woodlouse. I suspect, too, that quite a lot of the inattention comes from pairs of aides chatting to each other instead of concentrating on what they're doing.

With practice you should get good at it, like a choreographed routine. What matters though is whether your mother is aware of continence issues or not. If she is at all concerned by it and is willing to persist with transferring, then the benefits to her sense of self, skin integrity, infection prevention and just simple hygiene make it worth the effort.
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