Can nursing home be held liable for not taking care of my Father's teeth? - AgingCare.com

Can nursing home be held liable for not taking care of my Father's teeth?

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My father is 86, has dementia, and sleeps a good part of the day. My sister and I are not "allowed" to advocate for my father, as his POA Agent calls it "interfering" (Agent is 20 years younger "Friend" who ingratiated himself onto all of my father's documents after knowing him for only 4 years, Predator). Anyway, he is locked up in an advanced Alzhiemers wing of his retirement community's health care center. We had some legal problems with the Agent, and he banned us from visiting our father for 4 months. So we got a lawyer and got visitation and at the visit a few weeks ago, we noticed that his teeth were completely corroded and disgusting, caked with gunk. My Dad always treated his teeth like gold his whole life, even in his state of dementia, he always said he wanted to go brush his teeth after meals and before bed, always used an electric toothbrush, waterpic, flossing constantly, even the last time we saw him before we were banned, he was brushing and flossing regularly. So clearly the facility has NOT been taking care of his teeth, and the wife nor the POA have been paying attention to my Dad's oral hygiene. We tried to brush them when we were there, because now he can't do it by himself, but his electric toothbrush was no where to be found, and there was so much endless gunk coming out of his mouth every time he spit, we couldn't get hardly any of it cleaned out of there, also, so much plaque! I have never seen so much plaque on anyone's teeth in my life. Anyway, the Agents' response was well, he sleeps 16-20 hours a day (not an excuse!!!) so it's too hard to take care of his teeth and basically said my dad is uncooperative. However, we found him to be extremely cooperative and willing to have his teeth brushed, so....hard to believe this statement. Is the nursing home to be held liable? The POA Agent is defending them. I say they are negligent big time and would never let them get away with it if I was able to advocate for him. His teeth will never recover from the damage that's been done to them and I believe it would be really hard on my dad at this point to try and have them cleaned. But I am worried he could get an infection at this point. I am livid. Is the facility responsible and what should I do?

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It sounds like the entire 'center" is committing absolute abuse. There is no reason except the need fro money and a patient who is 'on the way out' with some type of insurance policy for the maggots to devour. My father was nabbed out of his apt complex - where he lived with my younger brother - simply because my dad was outside at 2am in his shorts trying to cool down. Living in Mesa, Az in the summer w/o A/C tends to cause that reaction by many Arizonans. Anyhow, he was nabbed by the "authorities" and taken to the Christian Center (death camp) where they proceeded to remove his tongue and starve him to death. One day he was fine and wanting out, a week later the had starved and kept water from him for that week and a full three weeks before we could even see him. They somehow grabbed power of attorney over the family and murdered him. His name is L. C. Mealer, and on 11/24/09 DeVille, the crazy woman, (who needs to die in prison), finally had My dad Lee, murdered after his 3 weeks of slow and painful suffering.
It seems that Arizona has some sort of law that not even the Governor can overcome, because at the time, Gov Brewer tried to help but it was a day late.... I believe that cruella Deville knew this and had him injected orally with medication to kill him after his three weeks of torture.

I will never forgive myself for not intervening and doing A.N.Y.T.H.I.N.G. and everything I could possibly do to remove him from that H*LL on earth.

I hope you were able to do something for your dad before they murdered him and called it a natural death.

JL Mealer
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Ps, they probably provide a basin for dad to spit into, which is why he's spitting into his lap.
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In my experience with my mom ( vascular dementia, chf, hip fracture) in a pretty good NH for two years, even with three responsible and diligent adult children looking after her, it takes more or less constant vigilance to spot issues and make sure that what needs to get done is done. Residents don't get automatically get signed up for dental, podiatric, optometry and audio logical care, in my experience; you have to request it. If the elder hasn't been declared legally incompetent, those requests are assumed to come from the patient. We found this out after our mom weeping to us over toenails and teeth, only to find out that when they asked HER if she needed attention, she was saying no. In her mind, we were going to take care of those things, take her to the dentist, podiatrist, etc. It took us 6 months at least for US to figure out how nursing home care works. Some of it is still a mystery to me. (As an employee of a large urban school district, I completely get that bureaucratic organizations have their own mysterious workings).

The underlying issue here seems to be that POA and wife don't seem to be stepping up and doing the job. Even though you don't like them, can you work with them to get dad more services? I'd drop the "liable" thing from your thought process.

In terms of "what dad used to do", you also need to be aware that a couple of months can equal a huge decline in skills in a dementia patient. My mother also used to be fastidious about her teeth. She still brushes on her own, with cueing. But at her most recent care meeting, we asked for staff to do a full assist, because she's not doing an effective job anymore. It's a combination of declining cognition, arthritis and poor sequencing skills. I feel for and understand your frustration.
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Thank you for your comment sherry1. There are 3 nurses for over 20 residents, less at night. They are completely understaffed. And he paid a lot to live there. We got a report back from the nurse director yesterday regarding his teeth, that said, "With regard to their concern that his teeth need further attention, tooth brushing is something that he still maintains control over. He prefers to brush his own teeth and we try to facilitate as much independence as possible. We provide standby assist only when he brushes his teeth. He may not be doing an adequate job. Mobile Dentistry of AZ provides dental care in the facility. It may be a good idea to enroll him as a patient with them. He still maintains a sense of independence when it comes to his dental hygiene and therefore he might enjoy having his teeth cleaned by the dental team."

Okay. He has been in there for over 6 months, and they are just saying this now. His wife sits with him 4 hours a day, never checked his teeth, his doctor, never looked at them. If anyone is "standing by" they didn't notice he might not be doing a good job? His electric toothbrush-missing...Also, he is in a wheelchair and he can't even reach the sink to spit into it bc the counter juts out too far. When we tried to brush his teeth, he kept spitting in his lap when he reached forward to rinse. Is this place for real? Anyway, I am not impressed with their excuses. Also, in 6 months, they have NEVER fostered his independence. They took everything away from him that he had in his independent living life 6 months ago. No computer (he was an avid emailer) none of his musical instruments, he wasn't allowed to leave the building to go to church, no Physical Therapy, so now he's crippled when he was walking previous to being locked up there. I would like a list of all the ways they have "encouraged his independence" since he's been in there. Nurse says, with "regard to his teeth needing further attention" it is obvious she didn't even look at them, they are disgusting, so much caked on gunk, it's not "further attention" they need, they need a total overhaul and I don't know how this dental service, that they SHOULD HAVE OFFERED TO HIM months ago, would even get them clean them. Seems like it would really traumatic at this point.
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Why should it be impossible to do dental hygiene after each meal for every resident. I consider this equal to wiping the bottom after a BM. It's just hygiene and should be done. These places charge enough for their services, if they are understaffed, then they should put on extra help.
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I Can't talk to the nurses about anything as the POA agent has forbidden us to talk to dad's health care workers, and they are forbidden to talk to us. He enjoys gagging everyone and being in full control of my father. Even his social worker can't talk to us. If he actually cared about our dad and took care of him, that would be a different story, but he is completely neglecting him. So, no, I can't speak to the nurse about his teeth. Too late anyway, the damage has been done. I dont expect them to do it after every meal, he doesn't eat anyway, will only drink and only thing they offer are "Mighty Shakes". All sugar. But once a day should be standard in my opinion.
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We know that it would be nearly impossible to brush each resident after meals, but the teeth should be cleaned at least daily. I think oral care is one of the things that get a low priority in many nursing homes.
As for the plaque build-up, I was amazed to see at how quickly this can happen when I had my mom in respite care for a week. One factor that can contribute to this is dysphagia and pocketing of food, something that is common in later dementia. When half their breakfast is still tucked in their cheeks at bed time the teeth suffer.
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Oral hygiene should be part of your dad's daily care. If it's not being done can you speak to the nursing supervisor to ensure that your dad gets his teeth brushed daily? I don't really understand why it would be so difficult on your dad at this point to have his teeth brushed but if that's the case maybe that's why no one's brushed them.
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