The nurse checked said she was fine. I called 911. 2 fractured ribs, hospital kept her. She is not properly being taken care of.. She is in hospital tonight.. I'm afraid to let her go back to Brandywine in the NJ area. I don't know what to do. Please help

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As CM points out, hospital visits, especially entering via ER, are very traumatic for most old folk, especially if they have any degree of cognitive decline. They are definitely sometimes necessary, of course. I think in some cases care facilities over-react and send residents just on a cya basis, so families can't accuse them of neglect.

(My husband's geriatrician shared that outlook and wanted to keep him out of the hospital. So if she suggested it, I knew it was necessary. When he returned home I figured on another week or two to finish recovering from whatever he'd been in the hospital for, and a few months to recover from the hospital experience.)

Which is not to say the AL did the right thing in your mother's case. Too many variables that are unknown to us to make that call. I'd suggest looking at the overall picture of the care your mother has been getting. Do talk over your concerns at the ALF, but don't let this one incident drive your decision.
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I can quite see why your confidence in the ALF must have been shaken.

What prompted you to override the nurse's judgement and call 911, though? Was it just because your mother had fallen and you wanted her checked out, or were there clear signs of injury that you felt hadn't been addressed properly?

If it's the first, and you just wanted to be on the safe side, then you got lucky - so to speak. The thing about trips to ER is that they are an ordeal in themselves and it's a good policy to avoid them if possible. And although you must feel that you dodged a bullet on your mother's behalf, the thing about ribs is that you can't treat them anyway: there's nothing to be done except put up with the discomfort until they gradually heal over several weeks, I'm afraid. The hospital will have kept her in for two reasons: one, to check that there's no damage to any of the lung or surrounding tissues; and two, probably, to reassure you. Don't worry about the first - it would almost certainly have shown on x-ray and you'd already know about it. They're just erring on the side of caution.

If, however, you felt that the nurse didn't examine or handle your mother properly then take it up with the ALF. When you do that, it's a good idea to be very clear about what you expect them to do and where you felt the standard of care fell short - then both you and the ALF will know what needs to be worked on.

So, I wouldn't be fearful of your mother's returning to the ALF just for this reason. But have there been other worrying incidents too? And, just as importantly, do you have an alternative place for her, one that is definitely better?
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My MIL was carted off to the ER 8 times in 15 months. She was a non-compliant patient even in the hospital. The AL finally refused to take her back and she went to a nursing home. The NH had to lower her bed all the way to the floor so she could not get up and fall down again.
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Darcy, did you witness this fall? Wonder if there was more than one fall and it was the second fall that caused the fractured ribs but your Mom was able to get up on her own and the facility didn't even know about that second fall. Or is it possible the fractured ribs fractured on their own without a fall, that can also happen with elders.

Regarding falls, you could have a room full of Nurses/Aides and an elderly will find a way to fall in a split second.
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Sadly, the elders do fall on a regular basis. If you aren't happy with the current AL, use the time she is hospitalized to identify an alternative. However, I'd suggest you first meet wtih the Executive Director (ED) and voice your concerns. Since ALs in NJ do not require a registered nurse at the location 24/7 I suspect that the person who checked your Mom was either an LPN or an aide. If this is the only concern you have (and I am not minimizing it) speak to the ED about a plan of action. NJ requires an incident report be prepared and sent to the state. Ask for a copy of it. Good luck and check back and let us know what happens.
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