Hard to Fathom Where We Are

[Narragansett]

I know we are not in Shaffer City or Marlboro Country. I do believe we are in a world of _ _ _ _ !Yesterday I heard what I consider to be the dumbest explanation for not doing something to help my mother that I can imagine.

My mother is in assisted living, and has fallen out of bed several times. So in talking to the nurse last week, she says to me, that it would be good if my mother had a fall mat on the floor. So, I get on Amazon, and have one delivered the next day. Yesterday, I get a 6AM call that she has fallen out of bed. I said to the night nurse, did the fall mat help? She said there was no mat there.

Well, I did my checking, and it was delivered. So I get the director of the place and the head nurse that asked for the mat on the phone to get to the bottom of why it is not in use.

OK, drum roll please, here is my answer " Her primary doctor has not gotten back to them with an answer as to if it is OK to have a mat on the floor at night. "

Don't even get me started on beds with rails

 

[Breakaway500]

It would seem more prudent to prevent the fall (bed rails) than cushion the fall.I can't imagine why they would not allow rails?

 

[Narragansett]

It would seem more prudent to prevent the fall (bed rails) than cushion the fall.I can't imagine why they would not allow rails?

Rails, if permissible have to be a certain height, and because they are restricting, they go outside of the realm of assisted living, and tend to define the need for skilled nursing home

 

[ralph7]

A mat on the floor could cause someone to trip on it as they wouldn't be expecting it.
I agree with trying to keep her from the fall in the first place.

 

[twodog max]

Insurance companies and government interfering in healthcare. That is all.
My wife and I have been running up against this sort of bureaucracy quite a lot lately.

 

[moralem]

Insurance companies and government interfering in healthcare. That is all.
My wife and I have been running up against this sort of bureaucracy quite a lot lately.

Bureaucratization of healthcare is just around the corner, it’s inevitable. It is our country’s last greatest institution that will fall. Education, transportation, telecommunications, banking, energy, etc., have all fallen to bureaucratization….I have been in healthcare for nearly 40 years as a calling…..but alas it will not abide.

 

[RT44nut]

I’m sorry for you and your Mother and everyone else dealing with similar situations.

 

[StrawHat]

Pete,

So sorry to hear of this. We went through similar nonsense with my eldest brother. It sucks as there really is no way to distance yourself and remain objective.

Thoughts and prayers for you and Mom. (I know that sounds trite, but it is offered with good intentions.)

Kevin

 

[alwslate]

Having been hospitalized numerous times in the past I can assure you that the nurses primary concern is for themselves. They will do nothing for a patient, give them nothing, not one pill or one bite of food unless it is in the doctor's orders. Just the reality of the world we live in today.

 

[robvious]

TOO MANY LAWSUITS...

 

[Ivan the Butcher]

My mom is 91.5, and in assisted living also.

If you talk to the head nurse or facility director on Monday, they never write anything down or place it in an electronic file. Then by Friday when the new person filling that position doesn't know anything about it!

It is getting so bad, my brother and I are about to have all instructions sent by Certified Mail, that way there is proof of instruction. The sad thing is, Having been through this with Dad a few years ago, we know this is probably the best facility in Central Ohio.

Ivan

 

[SteveA]

I had a 96 year old client with bed rails. She lived at home alone, with home health coming by daily. She apparently rolled over in her sleep and trapped herself with head down against her chest against the rail. Died from suffocation in her sleep. Rails aren't the best thing unless there is competent staff keeping a close eye on a patient.

 

[smoothshooter]

Having been hospitalized numerous times in the past I can assure you that the nurses primary concern is for themselves. They will do nothing for a patient, give them nothing, not one pill or one bite of food unless it is in the doctor's orders. Just the reality of the world we live in today.

Everyone is afraid of the legal repercussions if they show initiative.

 

[martyd]

Having been a bedside nurse for 52 years I am sorry to say that patient care has been taking a logarithmic decline over the past 10 years.

Bureaucracy on top of bureaucracy has been the cause of this decline.

As far as the mat goes.
Any item used for any purpose for patient care MUST have a written order from the physician before it can be used.

This is controlled by "Standards of Care" which I touch on below. Any violation of the Standards will result in some sort of penalty, including termination of an employee of the facility and legal action by the facility and or patient - patient's family.

Side rails are considered restraints, Posey Vests are restraints, limb restraints. Must have a physician's order before they can be used and must include a time limit for their use and documented frequent checking the restraint and patient. As frequent as every 10 min in some cases.

Anything that has anything to do with patient care is controlled by State Agencies and Medicare. These agencies use "The Joint Commision" a private company to inspect and establish guidelines for medical facilities. There are a couple of other companies like the JC which basically are competitors. Medical facilities have to pay for the inspection and make the changes recommended by the JC. If they don't then medicare will not pay the facility and the state will send in the goons. Frankly, it is too easy to justify doing or not doing something for a patient in the name of care.

I have to quit this subject rant, it drives me out of my mind and I get very emotional and upset with what has happened to caring for humans in need by our society as determined by idiots and the courts.

This was one of the major reasons I decided not to go for 53.

 

[jeffrefrig]

Teachers and nurses are getting harder to come by every year.
I've never heard of the Joint Commission, but I think I know why they call it that. At least that's what it sounds like.
I lost both of my parents from the same facility, two separate wings, 6 weeks apart almost to the day. My two remaining sisters & I often talk about it, and we've come to the conclusion that was a blessing in disguise because of their particular circumstances. A large part of me went with my dad. I almost want to have DNR tattooed to my forehead, but half of these nitwits don't know what that means; and Heaven forbid they do it in cursive.
I really hope they get their (stuff) together for your mom soon.

 

[mojave30cal]

Yeah, no brains, no headaches. Lights out, nobody home. I
guess it's hard to find good help these days. Your mom deserves
better. Any chance of moving her to another facility?

 

[Alk8944]

I can see both sides of this, but my belief is in a nursing scenario the welfare of the patient should be first and foremost. If the facility is doing this then concern about theoretical possibility of injury to staff, or a lawsuit must just be accepted and handled in the best way possible if either happens. Injury to patients can happen equally through either active or passive negligence!

There is no question that considering moving her to a different facility should be a consideration. The problem with this is that in larger cities several nursing / assisted living facilities may be owned by the same parent corporation and there may be little difference from one to another!

In this case I cannot understand the reasoning behind needing the Doctor's approval before they utilized the pad! What possible downside could there be to protecting the patient! It sounds like the flimsiest of BS excuses for not using the pad!

It sounds like moving her from Assisted Living to a nursing facility may be the best for her at this time!

I wish you luck in finding somewhere that will give her proper care if moving her is what you decide is best.

 

[martyd]

In this case I cannot understand the reasoning behind needing the Doctor's approval before they utilized the pad! What possible downside could there be to protecting the patient! It sounds like the flimsiest of BS excuses for not using the pad!
.

A possible reason, other than liability, for doctors order for the pad is to get reimbursed by medicare. Assisted living and nursing homes can bill for each and everything thing they do/perform. There is a billing code book which all medical facilities use and doctors offices, it has an ungodly number of codes for billing. The person working at the facility/office has to be a certified billing person.

The reason behind billing for every possible thing is the facility/office knows a significant number will be denied, so the more you bill for the better their chances are of getting a higher payment for services.

I could go into deeper explanation and by giving some examples but it would just be a bunch more words which probably are not needed.

 

[IrishFritz]

I'm very sorry for your circumstance. At the same time I'm appalled that your mother has been allowed to continued to fall. Elderly people are fragile and even a fall of only a few feet may have enough force to cause a fracture. The skilled care facility is acting neglegently in my opinion; they have an obligation to keep your mother safe. I would certainly have a blunt conversation with their administration. Better times for your mother.

 

[Onomea]

A mat on the floor could cause someone to trip on it as they wouldn't be expecting it.
I agree with trying to keep her from the fall in the first place.

I bet this is the reason. If, as most of us older folks do, she gets up at night to go to the bathroom this is a danger.

The rails sounded good to me until I read about the lady who got trapped by the rails and suffocated. And I guess another issue would be could the lady lower the rails by herself to get out of bed? I think this method of suffocation is akin to babies tragically, but rarely, suffocating in their cribs. By this I mean tragic, but rare enough so as to not call for stopping the use of bed rails or cribs.

This falling out of bed by the elderly must be a common problem, though, that has a variety of strategies to deal with. E.g., bed rails and adult diapers is one that occurs to me for folks in assisted living.