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Gramgeen Asked February 2016

Dad is in assisted living facility and is having problems with maintaining colostomy. Advice?

Facility won't keep him if he can't manage. Where do we go next.? Dad also has mild to moderate dementia. Denies that he needs help. Is having accidents almost every day.

gladimhere Oct 2016
Ladyluck, are you his POA? Because of the behavior issues he may need a geriatric psych hospital to get him stabilized. I would think Medicare would pay for that. Is he also on Medicaid? Neither will usually pay for assisted living, only higher levels of care, and Medicare for a limited period of time. See the social worker where he is now for assistance.

Ladyluck61 Oct 2016
My Dad had a stroke , the 2nd day of being admitted to the assisted living . I told them , and no one did anything . I called the doctor at the hospital and they did a brain mri , they called me after , 4 days later and said that the mri did show he's had a stroke . Assisted living says that medicare isn't going to continue to pay because he doesn't require skilled nursing . Are you kidding me ! He is doing chemotherapy and radiation treatment , and his short term memory is gone and he has a feeding tube and is losing weight , down to 138 lbs . Now , they are saying he has behavior issues and they want him to transfer to another facility , which will be a total confusing cluster . I live 2 hours away . ..I'm going to have a nervous breakdown . ..help

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geewiz Feb 2016
Try contacting the Ostomy Nurse organization near you. (You can call the largest hospital in your area and ask for the 'ostomy/wound care nurse.). She/he may be able to direct you to resources. They might even be willing to come to the AL and do a class for the staff. Heck, what happens with diabetics that can't handle the insulin calculations/administration as they decline? Keep us posted.

Gramgeen Feb 2016
I have an appointment with an ostomy nurse at a hospital. Hopefully , she can shed some advice as to what approach to take. Thank you for all the kind advice.

Sasha340 Feb 2016
Hi Gramgee,

I can see you are right in the thick of things caregiving. The problem you describe
is one that can stress even a professional in our world. I see two problems here. One is how to help your father manage a colonoscopy bag. I have no idea what your financial resources are. I can only describe a solution for most people in the medium financial range. It certainly is a solution to find the home visit doctor. Yes they are still out there and this fix can be two fold. First it will allow your father to have some reasonable help with his medical needs. Second It can be introduced to the facility another resource for their use. They can (I have seen the done) use this for staff training (a good way to provide in-house training thus meeting in-service required by DSHS. It is also a cosmetic to advertising to market the facility. This is a win-win for all.

It is also possible to get health insurance to send in a professional to help the staff and your father. After all this is an assisted living by virtual class they must provide some assistance.

The second problem I see here is the amount of stress you are under. Caring for our parents is a situation that most people are not prepared for. At the same time many people are doing this hands on caregiving. Even if you are not living in the area you still provide a necessary resource for your parent. This being said (whether the caregiver being financially very comfortable or the parent being financial able to meet their needs) the caregiver(s) are shouldering a great responsibility. This responsibility can create illness and the inability to work out side the home. Please take care of yourself. You are taking care of the greatest resource your dad has available.

JohnnyJ Feb 2016
An AL facility with a memory care floor could be the answer. They have added, personal care available (for a price, of course). Some take public financing after a period of time for when the money runs out. Sometimes a calming medication helps make them more compliant, but a doctor should be the one prescribing it. A geriatric-psych ward in hospital can be a place for finding the right medication under medical supervision so that the patient can be handled well back in the AL facility and not resist help there. Hope some of this helps!

perseverance64 Feb 2016
My father (rest in peace) had one and would have trouble with the attachment coming loose. He was very fortunate to have a loving and capable woman (Mom) to help. In my fathers case, it was his pride and not dementia that made it hard to ask for help with such a personal issue. For those who may not know, these "accidents" are not a pretty picture and I'm sure it stresses the staff there (and him). Is the problem in managing due to the attachment or his lack of understanding and care this needs?

Eyerishlass Feb 2016
Is your father having problems with the bag because of his dementia?

I agree that he might need a higher level of care than the Assisted Living provides.

Rainmom Feb 2016
What is your father having issue with, changing the bag?

pamstegma Feb 2016
Move him to a skilled nursing facility. By law the ALF is limited to what services they provide. If the family does not act on his behalf, the ALF is required to call in APS, who will take protective custody of the patient.

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