They sent a letter for me to go to a care plan meeting with the wrong date and then they called me short notice if I was going to be there. My sister is incapacitated, paralyzed from her left side due to stroke. But they never do anything to improve her well being no restorative therapy, speech, or take her to activities or just to move her around/ reposition her so she does not get so constipated or bloated. They get very upset if I tell them to do things, but today I went there because the DON told me they did the care plan because they were up for review. And social worker told me I didn’t have to be present for them to do the plan. Also there have been many issues there. The ombudsman is now apparently getting involved because of all the violations they continue to do under the HIPAA rules. And she tells the social worker about things I discuss with her but the social worker is new, she already tries to cover up and make excuses for the LVNs or CNAs and the DON and A D O N S. So it’s just a very hostile environment because it’s all about a power struggle there. Sometimes I feel like I’m also employed there because we’re always competing about certain issues. And they don’t like to be told if they do something wrong they can really retaliate.
Perhaps you could ask why she does not get "restorative therapy". In my experience, many family members expect this when it is not indicated (or covered by insurance), as an example, if a patient is "incapacitated" as you say your sister is, she would need to be able to follow directions, show progress and be able to participate fully in therapy in order for her to get picked up for therapy, and the goal needs to be to be discharged to a home or home-like environment like an assisted living or residential care facility. If these things don't apply, then they would do RNA or "restorative nursing activities", or passively moving the limbs, but not therapeutic. This is most often done during times of personal care, such as changing diapers, so family doesn't always see it happening. I would ask what she is getting, why, and when. She is lucky to have you advocating for her!
You can change facilities too. May be a little involved with Medicaid being transferred but it can be done. Really sorry this all falls on you and it has for so long.
Sorry, I know this sounds condescending, but what did you think being a POA entailed. No, you don't have to do the hands on care. But you do need to "be" there. You need to ask questions. If the staff isn't doing the job then go to the Administrator, talk to the doctor.
If if I wanted to reschedule, I had to request in writing.
Moms 2nd NH ran great CPMs and very accommodating if given a heads up for changing time. I did abt half as conference calls as I live in another state.
I’d be careful about your being nonresponsive to going to the meetings. CPM really are an opportunity to actually be face to face with a rep from each of the departments of a facility, like dietary, social work, activities in addition to nursing staff. And at the end of the meeting - at least for us - you had to sign off on their status & determinations made at the CPM. This is important CAUSE you can write in your concerns or come all prepared with a typed litany of concerns and it HAS to be put into the chart. Whether the place likes it or not. It becomes part of their health chart & this is a way to get your concerns down in writing & has to be dealt with. The DON will see it and that’s what imho needs to happen in order for anything to truly change in how care is done. Your speaking with floor nurse or CNA or SW won’t accomplish it, it’s gotta be the DON (director of nursing) & who in turn gets the MD medical director of the place to sign off on orders, prescriptions, therapies etc. DON is the goddess and power center for the place.
if you are nonresponsive to CPM, a facility may seek to become MPOA for the resident. Then they determine what the care plan is. If your already at odds with the facility, it’s not gonna get prettier if this happens. You don’t want it always to be adversarial. Why?....well If need be they can find cause to have her go via EMS to the ER and then refuse readmission back. What then........? Another facility will review her record and may turn her down for admission. Please please try to work as a team for care.
If its totally private pay, great insurance and $ not an issue, for that scenario you can be quite determinedly demanding. But if it’s Medicaid & Medicare paying, you have to work with the place imho.
For mom’s 2nd place, I brought snacks to the CPMs, like mandarin oranges, lil apples, kids birthday party prepacked goodies. Everybody showed up for mom’s CPM once it was established & extras went to DON to distribute as she saw fit. Minimal investment but major payoff. I’m not at all the social chair sorority type by nature but I gotta tell you, this was well worth time & $.