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Goldercare Asked July 2019

CNA Responsibility - Opinions please?

My 95 year old mother is living in a SNL. She has been a resident of this particular facility since early 2018. I came across a situation last night when I made my daily rounds after work to check on her. On entering room, she was sitting in a wheelchair with her back to the door, but laying forward face first on the hospital bed. The wheels of the wheelchair were not locked, and her call button was completely out of her reach. She has been immobile due to muscle atrophy from waist down for the last two years and requires help when moving around, or adjusting herself in a chair or in a bed. I believe they must have had her down to the cafeteria for lunch and maybe an activity, then brought her back to her room. At some point she had either fallen asleep or possibly fainted (happens sometimes when her BP drops). She was difficult to wake up. Of course, it scared me. No aides were anywhere in the hallways or rooms. Family was finally able to wake her, and were talking with her. She was very spacey though. I pushed the button for help. Help did not show up for 45 min. The excuse was they were short handed yesterday and aids were helping with dinner feeding in another area.


I'm trying not to over-react, however, should I report this to administration? My gut says yes, but I've seen aids purposely ignore patients after conflict with families as retaliation. I can't afford that. Her age and dementia is such that anyone can easily take advantage of my Mother. I did take a picture of my Mother in that state just because it seemed so odd, and I knew from previous events in last several years, that pictures & date/time stamp do help when trying to prove anything to these administrators and staff, and especially after hours, when administration has left for day. I've experienced a lot of excuses from the aides in the past as well as the LVN's on duty. Is this negligence on their part? I would think a patient must have access to a call button for help and an unattended patient should have the wheels locked. Her chair could have rolled away from the bed, and if so, she would have fallen flat face first to floor. Last fall, we had an experience where she fell face first out of the wheel chair in a hallway because it wasn't locked and hit her forehead on the metal foot rest. That event caused an ER visit, 12 stitches, a broken wrist and 10 weeks in cast, then further PT to be able to regain use of that hand.


So opinions anyone?

katydid1 Jul 2019
You have every right to be angry. There should have been a CNA on the floor while the others were in the dining room. In my state, the MAXIMUM wait time for a call light to be answered is 5 minutes. I understand it could be a little longer, but 45 minutes is unacceptable!! What if someone were having a heart attack or other emergency in which time could be what determines if that person lives or dies??? When I was a DON and got a complaint about excessive waiting times for call lights, I would do random "call light audits". That is, I would go into a residents room and push the call light button, then wait to see how long it took for it to be answered. I would make sure that I or my ADON covered all shifts over the next few days. Not right away, because I knew that THEY would know it was coming and I wanted to see the response when they weren't expecting me! Any response over 5 minutes was a discussion and they better have had a good reason!!

JoAnn29 Jul 2019
There should be an RN on duty at all times. If Mom had fallen out of that wheelchair again, you would have a right to sue. An incident report needs to be filed and the CNA reprimanded for leaving Mom alone.

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AlvaDeer Jul 2019
I believe you need to speak with an ombudsman as this is serious endangerment of your loved one, and you are likely not the only one experiencing you. You have voiced a very real concern that makes me think that this reporting should be done with privacy concerns in place to prevent retaliation against your elder. The place should now be investigated would be my belief and this investigation should be quietly done under cover to prevent retaliation. If you like, report this incident to administration WITH OMBUDSMAN present, and include your concerns. Keep the report. Then I would, to be frank, speak with family members visiting other elders here. Is that possible? Can be done perhaps as easily as going to coffee together. Start a diary now.

Goldercare Jul 2019
This was exactly what I thought. The LVN was passing out meds in another hall. I tried to catch him between patients, but was unable to get his attention without raising my voice and a real stink. We were trying to remain calm. When an aid did show up, it was an aid I did not recognize. She was kind to my Mom, and helped me get her diaper changed, and into nightwear, and helped me locate her dinner too. I don't believe she was normally assigned to our hall, as none of the residents or family member knew her name. It was 7pm when I left, and since no one with half a brain was around, I decided to wait for my own temper to calm, and get a second opinion of the members on the forum. I did have another patients daughter who witnessed the situation. She was pretty mad too, as her Mother is a stroke patient and told me there seems to be no common sense from most of the aids recently. She has troubles with call buttons and wait time also. She told me someone comes to help her Mom from the family 3 times per day. More often than not, the call button is laying on the floor, or laying in a chair next to her bed. This call button situation I had thought was kind of CNA 101 as far as training, and is a big no-no with the State if they catch it. However, I'm beginning to think moving the call button out of reach is purposeful, so the lights and buzzer isn't going off. Trying not to be suspicious, but I've noticed it too, and last night was an instance where my mother needed it fastened within her reach.

rocketjcat Jul 2019
Oh boy, you can bet I would have raised holy hell if I had found my Mom left alone like that. Yes it should be brought up to the charge nurse. If they give you a weasly answer, then up the ladder. They knew in no uncertain terms that my Mom was not to be left in her room unsupervised. She was never to be left where she couldn’t be seen from the nurses station, and that was on her care plan. I think you have to take that tactic. And 45 minutes to wait for a call bell is completely unacceptable. But if I had to wait more than 10 minutes I’d be out tracking somebody down. And not happy. I sometimes did have to fetch an aide from the dining room. Oh well. Your Mom sounded unresponsive. This is not good and must be communicated to her doctor. I would also speak to the ombudsman.

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