Has anyone ever dealt with a NH dumping their parent to another facility because they became too difficult to handle? - AgingCare.com

Has anyone ever dealt with a NH dumping their parent to another facility because they became too difficult to handle?

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Mom fell and broke her hip because of a cord left in an area she was permitted to access. Her only solace was walking and now she is confined to a wheel chair or a "comfy chair". She had to have a plate put in her hip and now she can no longer walk. She is confused and combative because she doesn't understand that she can't just get out of her chair and walk. The nursing home dumped her on the local hospital emergency room and expect them to find a psychiatric geriatric unit to help adjust her meds so she won't be so agitated. The nursing home says, they do not have the staff to watch her constantly so she doesn't get up and fall again. They put her in this situation with their negligence and now they don't want to deal with her issues. No one will take her due to her medical condition. They truly just dumped her. This is heartbreaking, she is so scared and confused. I have no idea how to help her. She is in the hospital and they are trying to find placement for her in a geriatric psych ward. I do not understand how a dementia ward in a nursing home can not deal with a dementia patient!! Would really like to hear if any one else has dealt with this issue.

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My advice as someone who has had some experience with loved ones in NH with dementia is document as much as you can in writing. Always keep copies of records. Document care plan meetings including medication changes and email a copy of what was discussed and agreed to the DON or admin. Try to take a witness with you like a trusted family member or friend to these meetings too. Do not just rely on the Ombudsman. Ombudsmans can many times become too friendly with the lousy staff.
If a serious problem with care of a loved one arises put it writing and document asap and send it to the facility or DON. You will find quickly what type of facility your dealing with if an effort is made to solve the problem when a serious concern is in writing.
Also, a serious well documented complaint with supporting back up documentation stands a better chance of accountability by the States Bureau of Licensure. Don't be afraid to appeal their decisions and expect to appeal. Nurses and DONS who back up lousy care or look the other way are putting their license at risk. True most facilities will rarely shut down. Although, a nursing license can be revoked, criminal liabilities do exist for neglect and abuse and lawsuits can be fought favorably with good supporting documentation.
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Hi, I am an Ombudsman. When I hear "dumping" I think of residents who are taken to a homeless shelter, not to a hospital.
If your mother was injured due to negligence, get a good lawyer. Now.
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I am a registered nurse who previously worked in Psychiatry. No, it is not "completely illegal" to use a restraint on a patient. In fact, as long as the restraint is ordered by the MD with good reason, it is legal. If a patient is assaulting other residents, that patient is a danger to others and it is unfair to allow that resident to continue the behavior. The patient may be physically or chemically restrained by physician order.

I went through this with my late father, who had vascular dementia. He began assaulting the other residents by yanking out their hair deliberately. So, I agreed to a "chemical restraint" of low-dose Ativan. Yes, it made him less functional - but the result was that both he and the other residents were safer.

Not all nursing homes provide the same level of care - and this is regulated by each state. A NH that is licensed as "rest home" basically only provides custodial care - feeding, bathing, light supervision, basic medical care. One needs to be in a "skilled nursing facility" to receive a higher level of care or a NH with several specialized units.

Gero-Psych patients are the most difficult to place anywhere, because they have both dementia and mental illness (e.g. bipolar, schizophrenia).

Finally, another consideration is that NHs that accept a large percentage of Medicaid-only paying patients are woefully understaffed. I think some adult children have the mistaken notion that their elderly parent is going to have some kind of one-on-one supervision 24/7 - which is not possible in a place with just one LPN for every 25 residents and a few aides. Even in one's own home, it is not possible to supervise an elderly parent at every single second of the day and accidents may happen. You might go to stick a load of laundry in the washer, turn your back for one minute, and your parent falls out of their wheelchair and breaks a hip.
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The geriatric psychiatric facility we found for my mother was excellent. They were able to adjust her meds and she was able to go to a memory care unit. Please give the psychiatric units a chance, I was reluctant initially but it was the best thing for our mother. You can take legal action against the facility if you really feel they were negligent but you do want to find a facility that welcomes your mother and will care for her the best way possible. It doesn't sound like the facility she was in was doing that.

However, a facility can place a client in psychiatric facility if their behavior warrants (i.e. hitting, yelling, screaming, verbally abusive (cussing), grabbing and scratching staff would all be included in behavior issues in addition to sexually inappropriate behavior.
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I agree with Lolli about the Ombudsman - a great resource.

Here is something else to consider when your mom gets settled into where she will be living. It helped my mom, and therefore me, to hire student nurses who had done their "clinicals" at the NH. I could only afford to do that a few times a week, but my mom was much calmer and happier when she had that companionship.
Best wishes to you.
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Christine73: Thank you! It was horrible. They tell her "maam, you're too well to stay here." LESS THAN 48 HOURS LATER, SHE SUFFERED A STROKE THERE! What is wrong with these people? I suppose that we could have sued, but my brother generally doesn't have the time of day for much of anything. And the NH did a CYA by calling me at the hospital where they had transported my mother asking if I wanted to do a bed hold. That would have been @ $410 a day!
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We had this happen with my mom. The NH gave us no choice but to send her to a geri-psych unit for medication adjustment and while there they discharged her and would not take her back. I did get an Ombudsman involved and The State Board of Health. It was a very stressful time as the geri-psych unit was like "One Flew Over the Cuckoos's Nest" and it took several days to find another nursing home for her. Although the first home definitely broke the law...they were given a "slap on the hand" by the Board of Health and I nearly had a nervous breakdown during the process.
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Llamalover, that stinks! I know first hand how monstrous those people can be.
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$20K/month clarification.
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I have the same fear that this will happen if my mom has to be placed (she is combative with me when she is crossed or doesn't like what I say). Yes, I understand the under staffing. But one-on-one care is often the only answer but very expensive. My friend's upward expenses for the care of their mom her last 1-2 yrs was $20K! She ran through all of her assets very quickly and not much left in the end. For most of us, this expense wouldn't even be possible to sustain for any length of time.

I fear that any kind of NH that is willing to take on such a resident is not going to be too great (just over medicating them to oblivion) and leave them sit in front of a window somewhere scared, lonely, helpless. They will be just as understaffed and what kind of nurses, CNAs, aids want to deal with a NH full of these kind of residents as their everyday job. Very sad situation and I have no answers.

Two helpful answers posted earlier:
1. consult with hospice
2. consult with director and work with them as much as you can to get 30 days or your local hospital/doctor to find alternate NH care.
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