My father's hospice provider, Sangre de Cristo in Pueblo, Colorado, has been disgraceful. When we got him enrolled in it I really thought it would be a huge relief for me and my mother, but for me it has been one headache after another.
This hospice is fully accredited and has a good reputation, but for me as a caregiver it's been like driving a six horse draft horse hitch that's gone out of control near the edge of a cliff.
All of the siblings and I were together this week, with our parents at their home, to meet with the nurse, social worker, medical director and COO of the facility. I facilitated the meeting. My siblings and I discussed our concerns in the days and weeks leading up to the meeting. I've done a pretty good job of documenting the problems. We, the sibs, introduced ourselves and included information about our educational and professional experience, which includes a total of six Master's Degrees, two RNs, two retired ministers (one of whom was a head chaplain as well), and little old me, the social worker with the Master's in Counseling.
My parents were extremely anxious about this meeting. My mom told me she wasn't going to be able to sleep the night before and she was just going to get in her car and leave before the meeting starts. My father said he was just going to get out of hospice care because (his words), "It's tearing the family apart." I don't think I can even begin to describe the toll this took on me. I couldn't understand why my parents were upset with ME! I'm trying to protect them!
So we had the meeting. It went really well. My father's nurse lied about a couple of details regarding the multiple screw ups with my father's warfarin dose and testing, and I could see it was quickly going to turn into pissing match between me and him. So I brought up the last screw up, which required ME to call the hospice and ask them to tell me EXACTLY what was prescribed for my father. This was on July 6th. Turns out a LAB TECH a few days prior told my dad how many pills to take on which days instead of leaving it up to a qualified health care provider. Actually, I suspect my father's nurse told this lab tech to tell my father how many pills to take on which days because he was too f*****g lazy to take five minutes to stop by my parents' house and go over it with my dad. This lab tech gave my father a post in note that told him to take one pill on Sunday, Tuesday, Thursday and Friday, and take two pills on Monday, Wednesday and Friday. Didn't take into account how many milligrams were in each pill. I asked my father to tell me the name of the person who gave him that post it note and wrote down that person's name.
Consequently this meant my father had been taking half of what he'd been been prescribed for who knows how long. The nurse thought my father was receiving 5mg tablets, but the tablets were/are 2.5. The nurse tried blaming it on the pharmacy, but the pharmacy dispensed the medication correctly.
Previously, the hospice doctor had overprescribed the warfarin and my father's INR was jacked up to 7.1. But that's a whole other story.
So once I confirmed how many milligrams per day my father should be taking, I wrote it down for him day by day...take two pills on these days/dates, take one pill on these days/dates. Finally, I left a lengthy message about all of this in my father's progress notes and told his nurse to be sure to do an INR sometime during the week of July 8th.
Fast forward to the 15th. At the meeting I brought up this issue. I made sure I was holding the binder that contains the progress notes. The nurse made an entry under the notes I left, so it was proof he'd seen my father after this most recent screw up and seen my notes. I asked him if he'd made arrangements for an INR during his most recent visit. He said no because they're only doing the INRs every other week. I asked him WHY, after clearly being told there was a significant error with the directions given to my father about how many pills he should be taking, he didn't make arrangements for an INR that week. I asked all hospice staff present why one of their lab techs believed it appropriate to tell my father how many pills he should be taking. I asked my father's nurse if he directed the lab tech to write that note and he said he didn't, but I know he did.
It was evident (and understandable) that the medical director, COO, nurse and social worker met prior to our meeting to discuss their strategy. The COO and medical director were dumbfounded by what I just told them. They apologized profusely and told us they had no idea this had occurred.
They also had no idea they were dealing with a family that has the background to do their jobs and analyze the quality of their work.
They know they are on notice. One more screw up and I am hiring an attorney to sue them out of business.