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My 91 year old mother with dementia and wheel chair bound has been in a nursing home since September 2014. I am constantly having to ask that her hair be combed and not left standing on her head like a cat's hair stands up when they are mad. I am also concerned about the shortage of help especially in the dining hall during mealtimes. Not only is there a shortage but new faces constantly in the dining hall. My mom eats very slowly and drops a lot of her food I am afraid she may not get all her nutrients. At first I tried to go over at least 3 times a week at dinner time to make sure she had help. The facility is 30 minutes away and with the increase in gas prices I can not go as often as I would like. Recently they changed both my mom's roommates and gave her new ones. I don't understand why they did this. Also, when mom entered the NH she had her own wheelchair with the leg extensions on it since, she has been in the NH they have removed the leg extensions. When my brother asked about them because he wanted to push my mom outside no one could find them. Also, because my mom has a history of constipation I would like for them to give her a probiotic which I would furnish. The first time I asked about this they said, "no". How can I address these issues without angering the staff?

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Hollar - write all your concerns down and take them with you to mom's next scheduled care plan meeting. Mom should be having these every 90 days - for my mom's first NH only the 1st one was a formal sit down the rest were more of a phone call (sigh); for mom's NH # 2 which was solar systems better, it was scheduled with a letter sent on it 3 weeks in advance for me to schedule a time within a 3 day window.

If this NH isn't doing this, then I'd send a request for a formal CPM to be done and this request goes in writing to the DON - Director of Nursing with a CC to the medical director. At her care plan meeting there should be a rep from all departments (MD though is rarely at a CPM). You can bring up digestive issues & meals as dietary & nursing should have someone there for it. If mom can hold a sandwich, 1 meal a day can be done as a sandwich - got that done for my mom.

About help with meals, the medical director can write orders for "assisted feeding". My mom had this & "mechanized food" for the full 18 mos she was on hospice at her NH. During the week a CNA would come in an sit either aside in a chair or on the mattress and help her eat. At night or weekends, it would be the dietary staff who helped mom eat. Hospice ordered these big feeding bibs too as assisted feeding is messy. When I went in to visit, I would try to be there for dinner as a long feeding is easier at night as dietary tend to leave the Cambro/meal racks in the hallways longer. When you finish the meal, you do need to take the tray and put it into the Cambro; do what you can so that staff finds you to be an ally.

Doing things for staff pays off in huge ways. I would pretty often stop & buy a box of those mini-birthday party size sherbets at the grocery store to bring in for a dessert for mom and leave the rest at the nursing station - happiness all around.
Extreme good will for a small price!

About her hair, is mom on a schedule for the beauty salon? If not, perhaps try it so that mom goes once a week or twice a month to get her hair done. Make sure that mom has enough in her NH trust fund to pay for the salon too. If mom needs extra help - like for us, she did as mom was bedfast once she went onto hospice so beautician had to go to her room to do her hair twice a mo. - you probably need to tip heavily from your own purse. Mom had already been a weekly client so beauty salon had a relationship with her.

hollar - got a ? for you, just how did it go for the appeal?
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Thanks for the answers. Most of the things you all have suggested I have already done. I haven't taken the staff any treats since Christmas,so maybe I will do that again. Also, someone asked how did I know mom was constipated. The answer is I have been there twice when mom's stomach became very hard and she was groaning. The nurse's did response to my request for a suppository which is noted on my mom's chart. I guess I will just keep my eyes open and start back visiting 3-4 times a week.
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I seriously doubt you can furnish medication for the NH to administer. Too great a liability for them. Ask her doc to prescribe a stool softener or a laxative or both. If you're not there that much, though, how do you know she's constipated?

I don't see a nursing home hand feeding mom. Maybe you could furnish a protein drink for her in the early evening.

As to the extensions on her wheelchair, talk to the supervisor on the floor about their being missing. When they find them, clearly mark them so they don't get misplaced again. Talk to her every time you come in until they locate them.

If mom's hair isn't cut short, make an appointment for her. Ask the Director of Nursing to make sure her hair is combed every day.

Once a month, bring the staff a treat from your mom...a few dozen donuts, big box of candy, big bowl of in-season fruit...a big bowl of Halloween candy type bars in her room.

When you come to visit mom, come around mealtime so you can help her yourself. AND! Help staff in the dining room clean tables, help OTHERS with their condiment requests, refills on coffee, etc etc. Bec a little worker bee they're glad to have around.
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You can arrange a Care Plan Meeting through the Director of Nursing. You'll sit down with several staff members (Dir. of Nursing and maybe the social worker) and you can address your concerns in this meeting. Passing along your concerns in a meeting such as this is much more efficient than trying to get these individual concerns taken care of on your own.

I can tell you why they took off your mom's foot rests: they take up too much room and with the foot rests the staff can't slide your mom into her spot during meal times. Also, with the foot rests your mom has to be pushed around in her wheelchair by a staff member. Without them your mom may be able to propel herself around without any help. I'm not saying it's right but that's why her foot rests are gone.

Your concerns are valid and deserved to be addressed.
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Hollerfatgirl i think you are just seeing the tip of the iceberg. This does not sound like a very well run nursing home. Constant change of staff is a good indication that all is not right. Is your Mom properly washed and dressed in clean clothes. if she is incontinent does she smell, check and see if her diaper is wet and really soaked. if you take her to the bathroom see if she has any sores or redness on her butt. look at her heels and elbows for sores. Does she look as though she is loosing weight? never mind upsetting anyone - they are upsetting you so demand those leg extensions be found or replaced. Ask nicely twice then send a letter to the administrator. It sounds as though you are new to having a loved on in a NH. Do you know anyone more knowledgeable like a nurse or an aide that would visit with you to get the feel of the place. Be friendly towards the staff and sympathize with them. "You look tired today are you short staffed again" someone will open up and give you the dope. Keep a journal of your visits and make notes of the things you have told us. If you see bruises take a photograph. check the bed and make sure the sheets are clean. If you see serious wrongdoing make a report to your States Health Dept and they will visit and investigate. You really do have to advocate for your loved one and visit at different times of the day. You can ask to speak to the Director of nursing or the homes administrator with your concerns and don't be put off with limp excuses. Almost forgot the probiotic, they are not allowed to give anything like that without the Dr's order so ask for that
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At least a my mom's nh, I have found it useful to funnel requests through the social worker. I email her with any concerns and questions and she either calls or emails back. Your mother should have her hair combed every morning, certainly. The foot and leg rests are off my mom's wheelchair so that she can use her ft to propel herself around. Any medication, even an over the counter one must be ordered by a doctor. I hope this helps.
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