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KristenNC Asked January 2020

Who do we report to when facility is not giving prescribed medical treatment?

My mom lives in a memory care unit. Tonight my sister reported she did not get her bath. She was told the water was turned off. She did not get the dental treatment prescribed by her dentist. Nor did she get cream administered to her bottom for a diarrhea issues.

BarbBrooklyn Jan 2020
No need Grandma! I do that ALL the time!. I'm still curious what the OP found out about this situation

My mom, with the beginnings of dementia once told me, " you know, I have to manage my own meds in here". The nurse was sitting there and had just given my mom her afternoon medications. When I asked mom what she meant by that, she pointed to the water pitcher with a "significant" look.

From that moment on, I verified what had actually happened before I got upset with staff.
ImageIMP Jan 2020
I get that, but... I actually doubted what my Mom told me about several things (she was pretty bright overall, but had "moments" of confusion). She told me her roommate in the nursing home and she didn't get along - that her roommate called her a liar and yelled at her, etc. I discounted her story, because I'd met the lady and couldn't imagine her acting like that. That is, until the lady across the hall took me aside and told me that Mom was being abused by the roomie and she had told the nursing staff but they weren't stopping it... Her story was the same as Mom's, except Mom hadn't told me all of it! The room was set up very poorly, and the roomie had to be disturbed and actually move frequently if someone went to Mom's part (back) of the room, or if Mom wanted to leave the room... She was therefore taking it out on Mom - verbally haranguing her, physically barring her from leaving the room, and - worst of all - hitting her with a wooden back scratcher. I told the staff I knew about the issue(s) and would not tolerate anything further - they had to take care of the lady's behavior or move her away from Mom! A week later, the gal across the hall again filled me in that things were still bad, and I again talked to staff but told them that if she wasn't gone from Mom's room within 24 hours I'd report to Senior Protective Services... She was moved. I really felt bad I'd doubted Mom's original report to me!
Compassionate5 Jan 2020
With concerns, always go to the Director of any facility before calling outside sources. It keeps sanity in the situation and usually brings immediate change.
Be kind to the staff. Rudeness rarely stimulates the behavior you want.
A thank you, a smile, a box of donuts... goes a long way with kindness.
lealonnie1 Jan 2020
Well said & very true. Killing a fly with an elephant gun rarely gets the desired results.

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BarbBrooklyn Jan 2020
Kristen, was the water turned off in the whole facility? It sounds like there was a plumbing emergency of some sort. Unpleasant, but unavoidable. Talk to the DON in the morning about rescheduling mom's missed bath. (I assume that it was your sister who was told the water was turned off, not mom reporting that. We learned to be very cautious about what mom told us about the facility. She told us about big floods, problems in the basement [there was no basement] and also that she wasn't allowed to have showers anymore because she would have to stand. None of these things were true).

The other two issues are more concerning. Having been through this with my mom in a NH for 4 years, my advice is this: ask for a care meeting! Focus on these two issues--why mom is not getting prescribed treatments.

It may be that mom refuses. It may be that mom doesnt remember getting the treatment. It maybe that although the dentist prescribed the treatment, the med was not ordered. It could be that although it was prescribed in his notes, it never made it into the DON's chart.

We found that there multiple ways that mom's treatment could get screwed up. Fixing it remotely never worked. Having a meeting where all the players were in the same room worked every time and helped us understand better how the system worked.

It IS exhausting! Good luck, and let us know how this turns out. We learn from each other.
Grandma1954 Jan 2020
I am looking and I can not find a comment about the water being off? Where did you get that info.
Manson Jan 2020
Oh boy...get used to this! I guess this is your 1st time. There will be many more dysfunctional occurrences... Sorry.
lealonnie1 Jan 2020
My mother has been living in Memory Care (the same ALF for the past 5+ years) and the only thing I've had to 'get used to' is great care by the entire staff the entire time she's been there. Making a generalized across-the-board statement such as you've done here is ridiculous.
cjwilson Jan 2020
The question to ask is "Why is she not getting her bath, her medication (cream) or dental treatment"? You want to ask these questions , see if they tell you "the water was turned off".

If your mom is refusing to take a bath, or have her dental treatment, the staff can not force any treatment on her. That being said they do need to encourage her to take a bath, have her dental work and let them apply the cream. Staff should offer the treatments more than once, have different staff approach her and do everything in their power to get her to allow them to do these things.

The number one refused treatment in nursing homes is baths. Residents refuse to take a bath more than they refuse medication, therapy, diets, doctors orders or anything else. When a resident is refusing to take a bath the staff need to try and figure out why the resident is refusing. Some of the reasons I have seen residents refuse to bathe are the time of day, water temperature, water pressure, personality conflict with staff, a dignity issue, cultural issues. When a resident has dementia they may not understand what the staff are asking them to do, they don't process information like we do.

I would recommend you talk to the Director of Nursing and request a Care Plan to discuss these issues.

lealonnie1 Jan 2020
Call the Executive Director or the Director of Nursing and let him or her know of your concerns and the situation you've learned of. Not getting a bath b/c the water was turned off can't be helped; it will be given at a later date; that happens. Bathing can be postponed for a variety of reasons, as long as she's put back on the schedule for another day in the very near future. The staff should definitely be attending to the application of barrier cream so the situation doesn't get out of hand. I don't know about 'dental treatments'...........there's only so much the staff is permitted to do in a Memory Care ALF situation. Unless your mom is in a Skilled Nursing Facility and even then, make sure such treatments ARE part of her care plan so you'll know for the future.

Always take a gentle approach at first, that's my suggestion. Reporting her care home to the state, the ombudsman, the corporate headquarters, etc, is just a bit of overkill unless there is true negligence or abuse involved, in my opinion. The DON or the ED is usually more than happy to address your concerns and get things handled for you in a professional fashion. If not, THEN you have the option to take things further.

Best of luck!
Lynn105 Jan 2020
It IS NOT OK FOR A HUMAN TO NOT GET A BATH OR DENTAL CARE WHEN EVERYONE STILL IS REQUIRED TO PAY MONTHLY FEE. R U SERIOUS? I'VE DEALT WITH NUMEROUS NURSING HOMES AND REHABS. AGAINST REGULATIONS. THEN THEY, NURSING FACILITY, NEEDS TO CORRECT PROB ASAP OR CALL SOMEONE. B S.
bluefinspirit Jan 2020
Contact your local ombudsman. Should be posted at your mom’s MC facility.
ImageIMP Jan 2020
Sadly - not necessarily...
JoAnn29 Jan 2020
Baths are only given about 2/3 ×s a week. I would talk to the Director of Nursing and find out what is going on.
KristenNC Jan 2020
Yes, tonight was her scheduled bath night. I have reported to the nursing director before, it is getting very frustrating.
NeedHelpWithMom Jan 2020
I’m so sorry that you and your mom are going through this. She deserves to receive good care. They are being paid to do a job. What are their reasons for not doing a satisfactory job? They owe you an apology and an explanation.

Mythmyth Jan 2020
The health system needs changes in NYC ! the culture needs rebirth .... seriously... reporting has no effect .Nursing homes are like murder houses. The staff is usually partially trained, fast trained, un documented on cheap payments ,poorly trained, from various colleges ( no quality ) with non accreditations. There is no in house training, no supervision,no quality controls, no CMEs and no education for staff.
I saw an aide using a towel to clean poo and the same towel to wipe the body and face ! is there any infection control?any hygienical system ? health is wealth. sad status...also the nursing homes employ less staff and they are over worked.

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