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My Grandfather is in a rehabilitation center is smells like urine when u walk through the door. They are always late with his medication because of under staff. It takes about 30 minutes to answer when he calls for a nurse. He takes a shower only twice a week. There is a really bad bug problem. I killed a spider on his pillow and many others in his room also waterbugs. What can I do? No one in the family goes to see him but me and my aunt sometimes and she controls everything so I can't move him.

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You and your aunt should sit down with the director and talk about the problems. Be open and expect the director to be open, too. I would make the medication issue the main focus of the talk. That could have serious consequences for your grandfather and needs to be addressed. The other issues are unpleasant for you to see, but may have explanations behind them. Maybe they are addressing the bug problem, etc.
How does your grandfather feel about the place? Is the staff kind to him? How does he feel about the frequency of showers? Twice a week (with wash-ups on other days) is pretty normal for the elderly. In fact, left to his own preferences he, like many older people, may choose to not bathe at all. Bathing becomes a very vulnerable experience when you're old. And, their skin can't handle frequent baths.
Ask the director what's up with the pee smell. My thought would be that people are sitting in their soiled Depends, but maybe there's a disposal issue. Staff may be leaving the door of the trash room open.
My advice is don't go in with guns blazing, certain of your impressions about the place. Be open-minded, expect answers to your concerns and expect to walk out of the office with a plan for addressing the ones that impact your grandfather's care.
It's often a family's first response - "let's get him out of here". Sometimes it's warranted, but other times it may be the family's first experience with a nursing home and they'd do better to work with where they are before upsetting the situation entirely. It should be kept in mind that a frail person doesn't make transitions easily.
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Here in Maryland, we have a Office of Health Care Quality, and it should be listed on the wall somewhere by the front door in case you have complaints, you can call or write them. I wrote them for my husband, and they have cited the Nursing home with 3 citations that will stay with them as long as they are open. I suggest you look for that as well. They helped me more than the Ombudsman did.
JAD711
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By Federal law, there is an ombudsman in your state who can assist with this. Go to your favorite search engine and search "long term care ombudsman" and your state or visit the National Long Term Care Ombudsman Resources Center (I cannot post the link here). From their website: an ombudsman can address "Poor quality of care, including inadequate personal hygiene and slow response to requests for assistance"
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You'll have to tell the Aunt who has control about the problems. If she CARES, she will find another rehab center that is not as poor as this one. But, from what I've seen in the last 6 years, there's not much difference in any of them. You can also report it to your state's elder care hotline. There should be a hotline number to report things such as this, there is in KS. I've used it and then they investigate and get back with you. You don't need the aunt to call them.
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