How could one assisted living make a terrible assessment compared to the other assisted living? - AgingCare.com

How could one assisted living make a terrible assessment compared to the other assisted living?

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My husband is retired army vietnam vet with severe multiple sclerosis. I can no longer care for him at home. He was at a rehab nursing home. He went there first week of sept 2013 after 3 days in the hospital for bladder kidney infection and then had enlarged prostate surgery in oct. 2013 so he continued rehab. His multiple sclerosis is severe and when he gets ill he loses all his strength so rehab helps. The end of nov. or first part of dec. i met with Danielle at rehab nursing home. She explained about applying for medicaid and gave me papers to fill out. Then a week later I get a call from a assisted living place . I was told an assessment was done on my husband. (I knew none of this.) They assessed him at level 1 care (helping with bathing and dressing) and if i wanted further information to come and talk to her which i did. . He moved to assisted living middle of dec 2013. After a few days i get a call from the nurse at stating he may need more care than what he was assessed for but it would be okay for him to stay and see how he does after adjusting to moving in plus she would be on vacation christmas week. This past sunday jan. 5, 2014 nurse calls me to inform me that he needs more care that they are unable to do for him what he needs!!!!!!!!!!! Nurse said he needs nursing home care. Also, a couple days after he moves to assisted living i get a call from a different assisted living seeing what decision was made about him. I told her he was accepted him as level 1. She was very surprised then she said she also assessed him but said he needs much more care that level 1. She said she was going to contact nursing home.
""""I was never informed about these 2 assessments.""" I asked nurse nurse to recommend a nursing home. She said the good ones have waiting lists. nurse also said if Terry was approved he could move there one day the week of jan. 13, 2014. I paid assisted living for the month of january 2014. In the contract it says a 30 day notice is to be given if moving. . I have been in shock since the phone call from assisted living nurse on sunday jan. 5, 2014.
I cannot handle the bathroom issues and him falling at a drop at a hat, never know when. His last fall happened in the bathroom. He was standing then just fell backwards headfirst into the bathtub. Didn't hurt himself plus has never hurt himself from all his other falls, maybe just a scrape. The fire dept is 1/2 mile down the street from us. They agreed we could call them to come and lift him back into his power chair if they weren't busy at no charge. Terry has fallen many times. I'm so grateful for them. Normally it's $150.00 each time you call them whether you go to the hospital or not. . I want to know how they could make a terrible assessment compared to the assisted living assessment. Please help with any advice

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I think they had an empty room they wanted filled. You need to advocate for your husband, but maybe you are a little burnt out after years of care giving. Or find an elder care manager, I think that's what they are called.
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Since he is a Viet Nam vet have you checked out the veterans facilities in your area? They actually have some sort of a sliding scale based on service. I don't know about the process personally, but have seen some flyers. Maybe someone here knows something about it.
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Thank you everyone for your replies. I aree with all of you.

I have not heard from the ALF nurse since our conversation jan. 5 when she said what she said nor have I contacted anyone there. I certainly have wanted to but I have to find a place for him first. I am surprised no one has contacted me since then from there. I have kept my mouth shut with all my anger but believe me I will let loose on everyone all of you have mentioned in your replies. I have paid for his care through jan.

I have contacted 2 lawyers and getting him a place needs to be done first. He is retired army and the V A social worker, his nurse and dr. are helping. Hopefully I will have good news for a place for him in a couple days.

I plan to get to the bottom of this plus going to a local TV station or even all 3 stations here that takes complaints!!!. I sure they won't like that a bit plus small claims court for what I paid, I don't care if I lose. My stress level since jan. 5 has been off the chart.This treatment is uncalled for.
Many blessings and hugs to all of you.
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Just wanted to wish you and your husband well. MS is such a treacherous disease.
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I am indignant on your behalf! How could professional screw up the communications so badly?

But, first things first. Have you filled out the Medicaid application? It is probably worth the fee to consult an attorney who specializes in Elder Law to go through the process with you.

Do you agree that he needs skilled nursing care? (Kind of sounds like it, but you know him well and can judge, if someone will explain to you exactly what services are available at each care center you are considering.) Have you picked out a place for him? Is he on a waiting list?

Be sure you have somewhere else for him to go, and give notice where he is.

Take a deep breath!

When you have all this underway, if you have any energy left, do look into how the communications got so screwed up and why you weren't involved in your husband's assessments, etc. Doing so may help the next caregiver and patient. But it probably won't make much difference to your husband, so first direct your energies where they will do him the most good.
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The description you yourself give of his needs is clearly not "Level 1." And you know him best. You are the person who should be making decisions. Have confidence and take a little more charge, here, in pursuing the services that you know he needs, not letting others decide. You can do this! You can certainly do that better than you can take on all the caregiving yourself. Be strong and good luck.
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There are a few things you can/should do; you must first go to that facility and demand (nicely, of course) a meeting with the nurse(s) who completed the assessment, the Director of Nursing, the Administrator and the Social Worker. You have to find out why their communication with you/the family is so horrible, and how they intend to rectify that in the future (if you decide to stay with them). If I were you, I would not pull him out of the facility at this time, as it was THEIR assessment that said he was appropriate in their facility at that level of care. You should keep him there until the end of the month, as you paid for, until you can find a better Assisted Living or nursing home to get him into. Unfortunately, Assisted Living facilities do not have a standard federal requirement of care, as nursing homes do. Most ALF's are only entitled to provide what they say they can provide, and that runs the gamut from barely no assistance (no medication assistance, ADL's, etc.) to heavy duty care (mechanical lifts and the like), so you will often see ALF's that are very different from the other you have heard about. Lastly, I do not think it sounds safe for you to attempt to bring him back home because you may be overwhelmed. That sounds like it may be even worse for you and him, so see if talking to that facility works and in the meantime, take the recommendations of the social worker or friends/family regarding other places for your husband to go. Best of luck.
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The rehab NH and the ALF are both guilty of appalling communication. Are you incredibly difficult to contact during working hours, or something? How come assessments were being carried out without the assistance of either yourself, or someone who knows your husband almost as well? How come they were scheduled without your being informed of it? Who were the people carrying out the assessments, and how do they justify their conclusions? Have you seen the formal reports? What the heck is going on?

I'm not sure where you go from here; but if it were me I'd be writing down names and telephone numbers and requiring explanations.

The week before she was due to have her CRT pacemaker implanted, I telephoned my mother's hospital to confirm dates, times and arrangements; I thought I was being a bit OCD about it but didn't care - better safe than sorry. Good thing I did. Her appointment, in preparation for which she had already had a contrast MRI and two consultations with different cardiac specialists, had been cancelled - if you please - by a nurse who reported that my mother was "asymptomatic," supported by a cardiologist who had never set eyes on my mother. To this day I have no idea how the nurse managed to conclude that my mother was asymptomatic, given her impressive and consistent array of symptoms; or how the cardiologist could put his name to the nurse's conclusion without at least glancing at his colleagues' notes; but that's what happened.

Moral: do not allow your loved one to attend any appointment or be interviewed or assessed on his or her own. Communication is the key, and you need to hold it.
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