Making a tough decision - Page 10

Isobel Archer · ‎04-04-2015

I'm still hung up on the liability concerning standard of care. What should it have been?

Let's say it should have been 24/7 TV monitoring for fall risks. OK so then EVERY time he got up someone should have rushed to his room. As I noted, that would NOT have worked for my mother who fell immediately upon rising - but MIGHT have worked in this case depending on how long it took him to get to the bathroom.

I'm sure he wasn't the only fall risk so that would mean that there would have to be probably more than one person monitoring the various TVs and several people on standby to rush to rooms because most people in AL don't just stay in bed or sit in chairs all day even if they are fall risks.

If being "too busy" is no excuse, then apparently not getting there in time wouldn't be either. Since this would be impossible in some situations, then is the answer with patients who refuse to use their call buttons to decide they cannot be properly cared for in AL and move them to Skilled Nursing where they have limited opportunities to move around (and which is much more expensive than AL)?

And even in Skilled Nursing, alarms may not be sufficient - since again, as noted, some people will fall immediately upon trying to stand (and I'm not sure you can conclusively assure that isn't anyone who is a fall risk) - would restraints also be necessary?

I know I'm painting a very grim picture, but other than stationing someone in the room 24/7 - which is also intrusive in itself, I'm just not sure how you can completely assure that a person will not fall if they insist they don't need to use a walker in their room or to call anyone for help (as with my mother) or are incapable of understanding the need to do the former.

Edited to add: Additionally what constitutes a "fall risk" in the first place? My mother fell at home - which led to rehab and then AL. She was in AL 3 years before she fell again (and for the final time). So when do these responsibilities and liabilities for a higher standard of care kick in?

Calcgirl · ‎03-10-2010

I am sorry for your loss. Was living in a assisted living quarters your dads idea or yours? The reason I ask is it doesn't appear the place was derelict in their duties since it wasn't a nursing home, ( even they do not gaurantee 24/7 surveillance) but that you may deep down feel guilty that your dad was there and you were not with him to help keep him safe. So this guilt is being transferred onto someone else. This is not untypical of how a person feels when they lose a loved one and it isn't your fault or the place your dad lived that he fell or died. It is what it is in life, at some point our name comes up to pass on. Let it go, forgive your brother and family, the place your dad lived and above all yourself. Peace be with you dear lady, you need a big hug and a deep cry to let it go.

God Bless you.

hyacinth003 · ‎03-12-2010

@Isobel Archer wrote:
I'm still hung up on the liability concerning standard of care. What should it have been?

Let's say it should have been 24/7 TV monitoring for fall risks. OK so then EVERY time he got up someone should have rushed to his room. As I noted, that would NOT have worked for my mother who fell immediately upon rising - but MIGHT have worked in this case depending on how long it took him to get to the bathroom.

I'm sure he wasn't the only fall risk so that would mean that there would have to be probably more than one person monitoring the various TVs and several people on standby to rush to rooms because most people in AL don't just stay in bed or sit in chairs all day even if they are fall risks.

If being "too busy" is no excuse, then apparently not getting there in time wouldn't be either. Since this would be impossible in some situations, then is the answer with patients who refuse to use their call buttons to decide they cannot be properly cared for in AL and move them to Skilled Nursing where they have limited opportunities to move around (and which is much more expensive than AL)?

And even in Skilled Nursing, alarms may not be sufficient - since again, as noted, some people will fall immediately upon trying to stand (and I'm not sure you can conclusively assure that isn't anyone who is a fall risk) - would restraints also be necessary?

I know I'm painting a very grim picture, but other than stationing someone in the room 24/7 - which is also intrusive in itself, I'm just not sure how you can completely assure that a person will not fall if they insist they don't need to use a walker in their room or to call anyone for help (as with my mother) or are incapable of understanding the need to do the former.

Edited to add: Additionally what constitutes a "fall risk" in the first place? My mother fell at home - which led to rehab and then AL. She was in AL 3 years before she fell again (and for the final time). So when do these responsibilities and liabilities for a higher standard of care kick in?

@Isobel Archer

In the case of my Dad, he was a KNOWN fall risk because he had done it before. They knew he was not always compliant in calling for assistance. That would top anyone's list of "fall risks." Others can be more theoretical - known dementia, certain medications, etc. We the family tried to mitigate it by hiring extra caregivers from 8pm-8am. Meal times are especially risky because residents seem to use a bathroom before or after. If he was going to use the bathroom, with his history, someone needed to stay outside the door to ask him if he was done (as he wasn't reliable to report it). If that had been done, he would not have DIED. Most of the residents are frail, and they need adequate help and supervison. They have paid a lot for it.

Death makes for serious issues.

Hyacinth

qbetzforreal · ‎08-28-2010

Was there an agreement that the facility would cover having an attendant for your father outside of the hours of 8pm-8am?

hyacinth003 · ‎03-12-2010

@Calcgirl wrote:
I am sorry for your loss. Was living in a assisted living quarters your dads idea or yours? The reason I ask is it doesn't appear the place was derelict in their duties since it wasn't a nursing home, ( even they do not gaurantee 24/7 surveillance) but that you may deep down feel guilty that your dad was there and you were not with him to help keep him safe. So this guilt is being transferred onto someone else. This is not untypical of how a person feels when they lose a loved one and it isn't your fault or the place your dad lived that he fell or died. It is what it is in life, at some point our name comes up to pass on. Let it go, forgive your brother and family, the place your dad lived and above all yourself. Peace be with you dear lady, you need a big hug and a deep cry to let it go.
God Bless you.

@Calcgirl

The decision was definitely mutual. There wasn't guilt about it. We discussed ways for him to stay at his home, but it wasn't doable. He needed the assistance that such a facility provided. And care has to be modified as the resident's needs changed. We changed by hiring individual help for half the day. So they had only half the day to be adequately attentive, and mealtimes were especially in need of extra attention.

I have never felt really angry. More time has led to the feeling he was let down, and I want to know by experts who know if that is true or not. I know the medical end of liability and I want the legal input. He died in terrible pain and I want to know if it was an "act of God" or something else. I don't know how else to explain it.

Hyacinth

hyacinth003 · ‎03-12-2010

@qbetzforreal wrote:
Was there an agreement that the facility would cover having an attendant for your father outside of the hours of 8pm-8am?

@qbetzforreal

No, that was our choice for our peace of mind. We thought the night hours might be less supervised, so we TRIED to help it out. Private care is very expensive in addition to at least $7,000 a month just to live there. We paid extra for his medication to be given by a nurse as he became unreliable.

So much for our try at peace of mind!

Hyacinth

Anonymous032819 · ‎03-29-2019

So, you are suing because they didn't provide the level of care that a skilled nursing facility would have.

That is not the fault of the assisted living facility, which provides more autonomy for the residents.

It's clear that you want to sue out of revenge, but even if you were to win, that is not going to erase the knowledge of what happened.

You may think that it will erase the pain, but it won't.

You say that someone should have been standing outside of the door.

Let's say that there had been.

That means that the fall would have still happened, because he fell inside of the bathroom where he was by himself, and he would have still broken his hip, and still had the complications.

The Sky looks different when you have someone you love up there.

qbetzforreal · ‎08-28-2010

@hyacinth003 wrote:
@qbetzforreal wrote:
Was there an agreement that the facility would cover having an attendant for your father outside of the hours of 8pm-8am?

@qbetzforreal

No, that was our choice for our peace of mind. We thought the night hours might be less supervised, so we TRIED to help it out. Private care is very expensive in addition to at least $7,000 a month just to live there. We paid extra for his medication to be given by a nurse as he became unreliable.

So much for our try at peace of mind!

Hyacinth

@hyacinth003- Yes, private care is expensive. My father saved all his life and wanted to leave us something but it had to be used for his long term care.

Just my opinion, if there was no agreement to have someone there when the paid attendant wasn't and your father wasn't compliant with using his call button. It may be difficult to prove negligence. Yes, if someone had been there to assist him to the bathroom then he may or may not have fallen. But there was no agreement.

Good luck to you. Losing our parents is so, so difficult.

Sooner · ‎03-10-2010

One thing I have learned early in life is that legal actions are expensive and no matter what the lawyer always wins and gets money.

Another thing is that no matter what the outcome, it has nothing to do with what you think and know in your own mind. It usually never changes one iota for the plaintiff in a case except to make money for someone--and you never know who.

But as far as how someone feels, nothing much will change no matter what the verdict, except maybe more anger coming out of the court room than in.

mom2four0418 · ‎04-23-2010

The decision was definitely mutual. There wasn't guilt about it. We discussed ways for him to stay at his home, but it wasn't doable. He needed the assistance that such a facility provided. And care has to be modified as the resident's needs changed. We changed by hiring individual help for half the day. So they had only half the day to be adequately attentive, and mealtimes were especially in need of extra attention.

I have never felt really angry. More time has led to the feeling he was let down, and I want to know by experts who know if that is true or not. I know the medical end of liability and I want the legal input. He died in terrible pain and I want to know if it was an "act of God" or something else. I don't know how else to explain it.

You said that your father was in the hospital for 3-4 days. Were they not giving him pain medication?

“The soul is healed by being with children.”
— Fyodor Dostoyevsky