Mom has been in the Nursing Home since March 2021 - five months now. I am generally satisified with the care she receives other than the fact that the staff don't communicate well with each other regarding her needs or concerns. She has dementia that is progressing rapidly and she cannot voice concerns or needs such as when she has pain. I feel that staff should be communicating with each other at shift change in regards to falls, denture care and a couple of other issues that seem relevant. I feel like documentation on a communication log should be essential for this in all nursing homes. Does anyone know if a NH is required to keep a Comm. Log? I have participated in Care Plan Meetings and although I have asked for a copy of the Plan have not received it. We have another meeting coming up this week and I would like to make very specific requests regarding written communication/documentation of her status each shift and make sure it is in the plan. Can I do this? I don't know exactly what is required of nursing homes. To give a specific example, mom fell last Monday. She was determined to be ok. They called and let me know. All was good. But by Sunday she was crying yelling and refusing to let staff move her at all. When I asked if she was hurting (perhaps from her fall) when they moved her, they replied that they (the daytime staff) were unaware that she had fallen. It took me an hour to get her calm enough to finally figure out that her arm hurt when they transitioned her from place to place - so yes, she was very sore, just unable to voice that. She just cried and yelled for them not to move her. They thought she was just being contrary (which is normal for mom). I can't understand how they can give adequate care if they don't know what happens from shift to shift.
CNAs, especially in the morning, only have so much time to spend with each resudent. The 3 shifts on the weekday have different CNAs, on the weekend shifts different CNAs. Or, the CNAs stagger days. There are more CNAs than RNs. The RNs may work 8 or 12 hr shifts. There are those that work only on weekends 12 to 16 hour shifts. You have nurses who work 12 hr shifts for 3 days and then aren't there another 3 days. What I am trying to say is that staff does not work a 40 hr week with 3-8 hour shifts. Staff is staggered over many different kinds of shifts. My daughter was lucky and worked 8 hour shifts but when she was starting out she worked every other weekend.
So what I am trying to say is the day Mom fell each shift coming in may have been told. Those nurses may have said something to the CNAs on those shifts but tomorrow is a whole new day with maybe different staff and new problems with the residents. You were called to say Mom fell. She was examined at the time and found just bruised. I would think, without being told Mom fell, that when Mom hollered "that hurts" the aide would be careful. If the resident continues to complain an LPN or RN is called.
I am not saying don't ask the question just trying to explain how a facility works.
I found with my Mother, who suffered from Dementia, overreacted to pain. Like a small child who gets a scrape who reacts to it like they are dying, that's how Mom reacted. Having her blood pressure checked would have her crying out. And as Moms Dementia progressed, she did not want to be touched. She also would act like the aide was hurting her.
I would not go into the meeting "white hot with anger". I would tell them about what happened to Mom and ask your question. Nursing Homes are not perfect. You have too many different personalities working there to be a perfect environment. As my MIL used to say "you attract more bees with honey than vinegar" Don't accuse, ask questions. "Are the aides/nurses made aware from one shift to the next that a resident has had a fall?"
I was lucky. I had my daughter to ask should I complain about this or that? Somethings she said let go, others she told me I should say something. There are things you will need to adjust to. These people are spread thin.
Why in the name of all that is sacred did a shift of nurses NOT know about your mother's fall?
Ask why you shouldn't report this to the Joint Commission on Nursing Home Accredidation, the Ombudsman and CMS.
I asked that once, very quitly, but with fire in my eyes at a care meeting and 2 people were fired that day and my mother got better care from there on in.
I hope it works for you.