working with a nursing home

[rothlev]

I am mostly venting here. I have an elderly mother with dementia who lives in a nursing home. She isn't happy. I live in Atlanta, she lives in Chgo, my brother is close by. When I visit , I take my mother for walks to various stores, restaurants, and just plain old walks thru the neighborhood. She likes to be kept moving. She is in a wheelchair, she is easily agitated , walking her without a seatbelt annoys me so much. The nursing home is restraint free. ( never mind the locks, never mind the chemical restraints, and never mind the alarms that go off when we walk by an elevator)

The nursing home won't let me have a seatbelt. For obvious reasons, her dementia, the obstacles, the pot holes, the sloped sidewalks, I need her to be secure in the wheelchair. I am tired of arguing with them. I bought a gait belt, left it in her room and use it to belt her in the chair. It was removed from her dresser. They refused to lend me one until I could get another.

When I complained to the DON she told me, ur wheelchairs are for short distances only, and not meant for outdoor use. you should not be using a gait belt for a seatbelt. It is not designed for that.

I sent them information from the joint commission recommending that the dr. write a script. They refused. I sent them information about restraints. Since my mother can unbuckle a seatbelt is is not a restraint.

I bought another belt, verified that they won't stop me from taking her out, but I am very unhappy. I store the belt in an office . I want an attached belt, I don't think it is asking too much.

 

[braumeister]

Have you talked with your brother about this? Being close by, he probably has more interaction with her and might offer suggestions.

 

[rothlev]

Have you talked with your brother about this? Being close by, he probably has more interaction with her and might offer suggestions.

He has no interest in doing battle with them. I am an advocate by nature, he just ignores everything about the home. He does visit her .but doesn't notice or care if they lost her hearing aids, put her compression socks on, dressed her appropriately for the weather.

It is very hard to work with them. Not that I can't bypass some of the rules, but why should I?

 

[Newventurer]

Sorry to hear what you are going through. My mom is in assisted living, going on 4 years now and she struggles with dementia as well, though she is quite able bodied. We moved her to a new home to be closer to my sister and she had a hard firest week acclimating. The new home locks all exit doors and she can’t get out, though there is an internal courtyard she can use to be outside. The old home did not restrict exit which was really a liability with dementia patients but she loved the freedom of going out for a walk on a sidewalk that went around the building. We have definately found that the staff is attentive when they know who you are and you visit often and we hope that translates into better care for mom. I am amazed that they are able to get level of caring staff that they seem to be able to and with everyone’s issues being different trying to keep it all straight must be quite a handful.
Sorry I don’t have any words of wisdom or experience for your specific issue but hope that Over time they get more familiar with you and ‘bend’ the rules to accommodate what you are trying to accomplish.
Good luck

 

[rothlev]

Sorry to hear what you are going through. My mom is in assisted living, going on 4 years now and she struggles with dementia as well, though she is quite able bodied. We moved her to a new home to be closer to my sister and she had a hard firest week acclimating. The new home locks all exit doors and she can’t get out, though there is an internal courtyard she can use to be outside. The old home did not restrict exit which was really a liability with dementia patients but she loved the freedom of going out for a walk on a sidewalk that went around the building. We have definately found that the staff is attentive when they know who you are and you visit often and we hope that translates into better care for mom. I am amazed that they are able to get level of caring staff that they seem to be able to and with everyone’s issues being different trying to keep it all straight must be quite a handful.
Sorry I don’t have any words of wisdom or experience for your specific issue but hope that Over time they get more familiar with you and ‘bend’ the rules to accommodate what you are trying to accomplish.
Good luck

thanks I appreciate your kind words. I hate seeing my mother suffer. Some of those people never see sunlight, it is too hard for the home to even take them outside.

 

[Moemg]

Why not just bring a gait belt with you in a back pack and put it on after you exit the facility ?

 

[ERD50]

" The nursing home is restraint free. " ...

I saw a bit of this with my Mom in Assisted Living. I think (maybe some here knows) much of it is legal bureaucracy. I remember asking if I could get a side rail for her bed, to make sure she didn't slide/fall out, and for the response I got, you'd think I'd asked if I could use a cattle prod on her! They were saying, Oh, we don't use restraints here!

Restraints? I just wanted a railing to keep her from falling out of bed? To keep her safe.

I didn't understand it. Maybe try to talk to someone there, maybe they can explain things.

DD is a hospital nurse, and that was a big thing there too. When she worked nights, she said they just did it anyhow, for the patients benefit, and made sure they were down before the day shift came in!


-ERD50

 

[Texas Proud]

When my mom was at a skilled nursing facility they did not have the rails... we asked if we could have them and they said it was against the law... that the state comes by all the time to look at the facility and it is banned...


I would think that having a seat belt is in the same category... it does not matter if you mom could get out easily on her own, it is probably just banned...


As mentioned, they cannot prevent you from having a belt that you bring and that you take with you...



Now, at my mom's nursing home we did have the option of buying the railing but we decided that she was now less likely to fall and just did not do it... if there is a problem in the future we will...

 

[rothlev]

Why not just bring a gait belt with you in a back pack and put it on after you exit the facility ?

Well, what happened is my brother from Texas came in, since there is no belt attached, he took her out without one, mom, being mom, had a melt down in the parking lot on the way back, she did not want to go "back in there"

Brother was hurt, embarrassed, me I am just angry. Not his fault that mom was beating him up in the parking lot, and falling out of the wheelchair.

we are scattered all over the country.

 

[Bamaman]

Elder care is just such a difficult situation. We moved my aunt from an assisted living apartment into full nursing home care, and she ended up having her happiest times--much happier than in asst. living. To me, meals looked like a sea of white headed women--all in wheelchairs. Few gentlemen were there.

But she still told everyone her nephews kidnapped her and brought her up to this awful town (her hometown). She died 3 mos. short of 100 years old.

 

[joeea]

Well, what happened is my brother from Texas came in, since there is no belt attached, he took her out without one, mom, being mom, had a melt down in the parking lot on the way back, she did not want to go "back in there"

Brother was hurt, embarrassed, me I am just angry. Not his fault that mom was beating him up in the parking lot, and falling out of the wheelchair.

we are scattered all over the country.

It sounds like this is about more than a belt.

It sounds like you want Mom in a nursing home that will provide her care in the manner you would prefer rather than what they are currently doing and what your brother tolerates.

I would suggest you have Mom moved to a nursing home of your choosing within commuting distance of your home. That way you could be her primary advocate and direct her care more easily.

You should first discuss this plan with your siblings.

 

[Newventurer]

It sounds like this is about more than a belt.

It sounds like you want Mom in a nursing home that will provide her care in the manner you would prefer rather than what they are currently doing and what your brother tolerates.

I would suggest you have Mom moved to a nursing home of your choosing within commuting distance of your home. That way you could be her primary advocate and direct her care more easily.

You should first discuss this plan with your siblings.

+1

 

[ncbill]

" The nursing home is restraint free. " ...

I saw a bit of this with my Mom in Assisted Living. I think (maybe some here knows) much of it is legal bureaucracy. I remember asking if I could get a side rail for her bed, to make sure she didn't slide/fall out, and for the response I got, you'd think I'd asked if I could use a cattle prod on her! They were saying, Oh, we don't use restraints here!

Restraints? I just wanted a railing to keep her from falling out of bed? To keep her safe.

I didn't understand it. Maybe try to talk to someone there, maybe they can explain things.

DD is a hospital nurse, and that was a big thing there too. When she worked nights, she said they just did it anyhow, for the patients benefit, and made sure they were down before the day shift came in!


-ERD50

Side rails aren't used anymore because of the risk of the patient climbing up on them and then falling to the floor from a greater height than the bed itself.

If the patient is deemed such a risk the recommendation is that the mattress should be placed directly on the floor but I've found homes don't want to do that because of the extra effort it requires.

 

[Texas Proud]

Side rails aren't used anymore because of the risk of the patient climbing up on them and then falling to the floor from a greater height than the bed itself.

If the patient is deemed such a risk the recommendation is that the mattress should be placed directly on the floor but I've found homes don't want to do that because of the extra effort it requires.

Or get an adjustable bed that adjusts the height... that is what we bought for my mom.... you can lower it to be very close to the floor and then they have mats placed next to the bed....

 

[Texas Proud]

It sounds like this is about more than a belt.

It sounds like you want Mom in a nursing home that will provide her care in the manner you would prefer rather than what they are currently doing and what your brother tolerates.

I would suggest you have Mom moved to a nursing home of your choosing within commuting distance of your home. That way you could be her primary advocate and direct her care more easily.

You should first discuss this plan with your siblings.

The big problem is if someone has legal rights to make the decision... IOW, if brother has 'control' then he cannot move her anywhere....


I have legal right to make decisions for my mom.... the rest of the family can make suggestions and I always listen (and almost all the time we are all in agreement) I make the final decision....

 

[rothlev]

It sounds like this is about more than a belt.

It sounds like you want Mom in a nursing home that will provide her care in the manner you would prefer rather than what they are currently doing and what your brother tolerates.

I would suggest you have Mom moved to a nursing home of your choosing within commuting distance of your home. That way you could be her primary advocate and direct her care more easily.

You should first discuss this plan with your siblings.

I wish that were an option. Mom is out of money. We are currently applying for medicaid. The home she is in is actually one of the better options. The only way to get in is to start on private pay, and then they keep you when you are out of money. So , we choose this home with that in mind. She cannot move without money, she would wind up in a dump.

 

[Scuba]

As others have suggested, I am sure their objection to the belt is a legal issue. They can’t knowingly support something that is against state regulations or federal laws. Elder care is a very highly regulated industry, and inspectors show up regularly from various agencies to make sure everything is being done properly. I think the best solution here is for you to keep the belt with you and use it once your mom is outside, unfortunately.

 

[joeea]

I wish that were an option. Mom is out of money. We are currently applying for medicaid. The home she is in is actually one of the better options. The only way to get in is to start on private pay, and then they keep you when you are out of money. So , we choose this home with that in mind. She cannot move without money, she would wind up in a dump.

Well, you and your siblings could choose to pay for it. There are always options. We each get to decide if the cost is worthwhile or not.

For your specific issue in your initial post, you (along with your siblings perhaps) could purchase your own wheelchair designed for outdoor use with attached belt for when you choose to take Mom out. She will be in your hands, using your equipment. The nursing home won't object to that.

 

[ivinsfan]

I'm sorry your Mom isn't happy, IMO that is often a by product of dementia and there is probably nothing you can do to change that. My MIL was one of the most pleasant people on Earth until dementia took over.


Sounds like the nursing home can't win since you are disdainful of the common things you see in a memory unit such as locks and door alarms. Gait belts have a use and wheelchairs are not one of them.


There is a difference between persistently asking for a change, accommodations for your DM's condition and complaining, every person you asked has said the belts aren't allowed on wheelchairs so don't expect that to change.

My DH had a surgery and due to complications was not supposed to go to the bathroom alone. Being a typical guys he snuck away a couple of times by himself....the nurse told him you know I can see you make it fine on your own, but if you happen to fall you would not believe the pile of paperwork I'm going to have to fill out and how much hassle it will cause.

You're going to fine almost all decent nursing homes follow the same set of guidelines for dementia patients and there are good reasons for them.

 

[Jerry1]

For your specific issue in your initial post, you (along with your siblings perhaps) could purchase your own wheelchair designed for outdoor use with attached belt for when you choose to take Mom out. She will be in your hands, using your equipment. The nursing home won't object to that.

This is what I was thinking. Wondering if they would even let you keep it in her room. Otherwise, if brother is close by, store it there and pick it up on your way to see your mom.

 

[rothlev]

I'm sorry your Mom isn't happy, IMO that is often a by product of dementia and there is probably nothing you can do to change that. My MIL was one of the most pleasant people on Earth until dementia took over.


Sounds like the nursing home can't win since you are disdainful of the common things you see in a memory unit such as locks and door alarms. Gait belts have a use and wheelchairs are not one of them.

I just want to maintain safety for myself and my mother when outside. there has to be a reasonable way of doing so. A gait belt works, Wheelchair belts have bolts for attachments.

 

[rothlev]

Well, you and your siblings could choose to pay for it. There are always options. We each get to decide if the cost is worthwhile or not.

Nursing homes cost $10,000 per month. No, I cannot private pay. for her. just venting.

 

[rothlev]

Well, you and your siblings could choose to pay for it. There are always options. We each get to decide if the cost is worthwhile or not.

For your specific issue in your initial post, you (along with your siblings perhaps) could purchase your own wheelchair designed for outdoor use with attached belt for when you choose to take Mom out. She will be in your hands, using your equipment. The nursing home won't object to that.

I do like this suggestion. I had not thought of it. The home would have to help me transfer mom to the chair thou. I cannot do it.

 

[rothlev]

As others have suggested, I am sure their objection to the belt is a legal issue. They can’t knowingly support something that is against state regulations or federal laws. Elder care is a very highly regulated industry, and inspectors show up regularly from various agencies to make sure everything is being done properly. I think the best solution here is for you to keep the belt with you and use it once your mom is outside, unfortunately.

When I called the state and looked up the applicable federal laws, the answer is clear, the dr. can write a script for the designated purpose. And the federal definition of a restraint is clear that if you can unbuckle a belt it is not a restraint.

Mom fortunately or unfortunately still has her fine motor skills. She is a bit cagey and sneaky. She has set off fire alarm. Unbuckle a seatbelt, no problem whatsoever for her. That does not concern me overmuch, I am pretty sure once she is buckled in it won't occur to her to unbuckle it.