Among Friends

[hyacinth003]

---

@bikerbabe wrote:

@hyacinth003 

I am so sorry about the loss of your father. 

Did he have a bed alarm?

---

@bikerbabe 

No, he didn't.  He spend much of his day in a motorized recliner.  It was one of those that would lift up to help the person stand.  I suppose there could have been an alarm on that.  When he was in bed, he had an aide in the room.  She was there 8pm-8am.

They knew he was not compliant about calling for help.  Many of the residents there had various stages of dementia. 

Thank you.

Hyacinth

[hyacinth003]

---

@tiny 2 wrote:

---

@hyacinth003 wrote:

---

@DottieBlue wrote:

---

@hyacinth003 wrote:

Some hours later, his oxygen level dropped and he had difficulty breathing.  Tests showed a heart attack and pulmonary embolism.  Took him between 3-4 days to die as we followed his advanced wishes.  These are all risks for fractured hips, and it killed him.

Hyacinth003, I am very sorry for your loss.

You posted that you followed his advanced directive and he died 4 days later.  Would it have been possible for him to have survived this fall if the hospital had performed procedures to save him if the advanced directive had not been followed?  The Care Facility's lawyers will look into this possibility.

Again, my deepest sympathy for your loss.

---

No, he would not have survived.  He developed complications from the fall less than a day afterward.  They were planning to do surgery to repair the hip when he threw multiple clots, the deadliest complication from this.  This resulted in a heart attack and blood clots to the lungs and perhaps brain.  He was never conscious after that.

That's when the advanced directive was put into place.  So my husband and I left him awake and in pain, and never were able to communicate with him again.  It took 3-4 days for all his body functions to completely cease.  I wish it had taken less time.  It feels surreal to wait for your dad's body to shut down completely.

I know others have experienced this also.

Hyacinth

---

@hyacinth003, When my 94 year old mother fell and broke her hip the hospital ER called an orthopedic surgeon right then and they took her to surgery right away to repair the hip. The next day they had physical therapy walking her by 11 am. It sounds to me that the hospital needed to act faster on the hip repair.

---

@tiny 2 

My dad's situation was a bit different.  He was on warfarin (blood thinner) for atrial fibrillation.  They had to try to lessen its effect before going to surgery.  Makes it a little more surprising he suffered a heart attack and pulmonary embolism.  Sometimes fractures cause other substances to be released into the blood though.

That sounds fabulous that they were able to repair your mother's fracture like that.

Hyacinth

[hyacinth003]

---

@tansy wrote:

I had a similar situation with my mother in a care home because of her dementia.  She refused to use her walker, call for help or wear a diaper at night.  She fell off the toilet in the middle of the night, fracturing her hip and dislocating her shoulder.  She died two weeks after the surgery.  I considered a lawsuit but didn't want the stress.  We'd been through hell caring for her for several years.  Is your husband supportive?   

---

@tansy 

Yes, he is.  I've kept my thoughts to myself mostly, but when talking to him, he said he understands.  He loved my Dad.

Hyacinth

[tiny 2]

---

@hyacinth003 wrote:

---

@tiny 2 wrote:

---

@hyacinth003 wrote:

---

@DottieBlue wrote:

---

@hyacinth003 wrote:

Some hours later, his oxygen level dropped and he had difficulty breathing.  Tests showed a heart attack and pulmonary embolism.  Took him between 3-4 days to die as we followed his advanced wishes.  These are all risks for fractured hips, and it killed him.

Hyacinth003, I am very sorry for your loss.

You posted that you followed his advanced directive and he died 4 days later.  Would it have been possible for him to have survived this fall if the hospital had performed procedures to save him if the advanced directive had not been followed?  The Care Facility's lawyers will look into this possibility.

Again, my deepest sympathy for your loss.

---

No, he would not have survived.  He developed complications from the fall less than a day afterward.  They were planning to do surgery to repair the hip when he threw multiple clots, the deadliest complication from this.  This resulted in a heart attack and blood clots to the lungs and perhaps brain.  He was never conscious after that.

That's when the advanced directive was put into place.  So my husband and I left him awake and in pain, and never were able to communicate with him again.  It took 3-4 days for all his body functions to completely cease.  I wish it had taken less time.  It feels surreal to wait for your dad's body to shut down completely.

I know others have experienced this also.

Hyacinth

---

@hyacinth003, When my 94 year old mother fell and broke her hip the hospital ER called an orthopedic surgeon right then and they took her to surgery right away to repair the hip. The next day they had physical therapy walking her by 11 am. It sounds to me that the hospital needed to act faster on the hip repair.

---

@tiny 2 

My dad's situation was a bit different.  He was on warfarin (blood thinner) for atrial fibrillation.  They had to try to lessen its effect before going to surgery.  Makes it a little more surprising he suffered a heart attack and pulmonary embolism.  Sometimes fractures cause other substances to be released into the blood though.

That sounds fabulous that they were able to repair your mother's fracture like that.

Hyacinth

---

@hyacinth003, Oh yes, I see. I am a former critical care RN mostly with heart surgery patients. Orthopedics was definitely not my thing and I was so afraid for her. She was very healthy and on no meds at the time. She lived to be 98 and 1/2 to the day. I do think the fast action that night made a difference in her recovery.

[pitdakota]

---

@hyacinth003 wrote:

---

@Bri369 wrote:

People have a right to sue for what they believe to be negligence.  Ethical attorneys will take the case if it's worth pursuing.  Hopefully, they'll be honest with you regarding the merits of your suit. 

---

@Bri369 

That's all I am after.  If they don't see negligence, I will accept that. 

Hyacinth

---

____________________________________________________---

@hyacinth003, If you decide to follow through with talking with an attorney, I would totally support your effort .  Falls in long term care have increasingly become a frequent cause of death in this country for older adults.    https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a10.htm    

If an attorney thinks there is a case, at least in discovery you would be able to find out what type of falls risk assessment the facility conducted & what plan of care they had determined needed to be followed for your father based on that risk assessment.  It might also reveal that after your father had a fall (I believe you said he had fallen before this particular incident)  if they ammended the falls risk assessment and his plan of care after that fall.  Obviously they are required by standards of care to do so.

I believe in assisted living with falls, going to the bathroom is the number one reason for a fall.  You might want to check that information.  At any rate, most people don't use the call light which is why the plan of care in that situation is to develop a toileting schedule to actuallly assist the patient to the bathroom at certain times, after having conducted an assessment for the most common times of day and night that the patient needs to go to the bathroom, etc.   

You at least might be able to determine if they had insituted any type of toileting program and if they were trying to assist him to the bathroom at certain times of the day.  Not that this is the only thing that most probably should have been included in your father's plan of care, but that would answer an important question for you. 

One never knows if the lawsuit they file will finally be the one that changes practice in a facility.  I have seen that multiple times in a hospital setting.  Many times it takes one last law suit for a facility to make changes that should have been undertaken some time previously.

In the end, since you are a nurse you are aware there are different strategies to put into a plan of care for various situations according to the falls risk assessment.and they are to incorporate those into the plan of care and adhere to that plan of care.  The question with your father is whether they adhered to that plan of care or not.  

There are some long term care facilities out there that have been really inventive and serious about falls risk reduction to come up with really great plans of care.  Those same agencies also have developed policies to promote adherence to the plan of care also.  So it can be done. And it should be done.  Whatever you decide, I wish you luck.  

[pitdakota]

---

@hyacinth003 wrote:

---

@bikerbabe wrote:

@hyacinth003 

I am so sorry about the loss of your father. 

Did he have a bed alarm?

---

@bikerbabe 

No, he didn't.  He spend much of his day in a motorized recliner.  It was one of those that would lift up to help the person stand.  I suppose there could have been an alarm on that.  When he was in bed, he had an aide in the room.  She was there 8pm-8am.

They knew he was not compliant about calling for help.  Many of the residents there had various stages of dementia. 

Thank you.

Hyacinth

---

___________________________________________________

@hyacinth003, as bikerbabe also would know, they can place a bed alarm in a chair.  

[hyacinth003]

---

@pitdakota wrote:

---

@hyacinth003 wrote:

---

@Bri369 wrote:

People have a right to sue for what they believe to be negligence.  Ethical attorneys will take the case if it's worth pursuing.  Hopefully, they'll be honest with you regarding the merits of your suit. 

---

@Bri369 

That's all I am after.  If they don't see negligence, I will accept that. 

Hyacinth

---

____________________________________________________---

@hyacinth003, If you decide to follow through with talking with an attorney, I would totally support your effort .  Falls in long term care have increasingly become a frequent cause of death in this country for older adults.    https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a10.htm    

If an attorney thinks there is a case, at least in discovery you would be able to find out what type of falls risk assessment the facility conducted & what plan of care they had determined needed to be followed for your father based on that risk assessment.  It might also reveal that after your father had a fall (I believe you said he had fallen before this particular incident)  if they ammended the falls risk assessment and his plan of care after that fall.  Obviously they are required by standards of care to do so.

I believe in assisted living with falls, going to the bathroom is the number one reason for a fall.  You might want to check that information.  At any rate, most people don't use the call light which is why the plan of care in that situation is to develop a toileting schedule to actuallly assist the patient to the bathroom at certain times, after having conducted an assessment for the most common times of day and night that the patient needs to go to the bathroom, etc.   

You at least might be able to determine if they had insituted any type of toileting program and if they were trying to assist him to the bathroom at certain times of the day.  Not that this is the only thing that most probably should have been included in your father's plan of care, but that would answer an important question for you. 

One never knows if the lawsuit they file will finally be the one that changes practice in a facility.  I have seen that multiple times in a hospital setting.  Many times it takes one last law suit for a facility to make changes that should have been undertaken some time previously.

In the end, since you are a nurse you are aware there are different strategies to put into a plan of care for various situations according to the falls risk assessment.and they are to incorporate those into the plan of care and adhere to that plan of care.  The question with your father is whether they adhered to that plan of care or not.  

There are some long term care facilities out there that have been really inventive and serious about falls risk reduction to come up with really great plans of care.  Those same agencies also have developed policies to promote adherence to the plan of care also.  So it can be done. And it should be done.  Whatever you decide, I wish you luck.  

---

@pitdakota 

Yes, he had falls before, and was just dumb luck something bad didn't happen before.  And they knew he was not compliant with using the call device. And I am aware they are supposed to modify a plan of care to address things like that.  I think what pushed me over the edge was the concept that the facility only had 12 hours a day to really monitor him.  We provided an aide for the time we thought he would be most vulnerable.  Thousands of dollars to try to keep him safe in addition to the price per month.  It's why I feel negligence went on.  And how about an alarm on his chair?  His family was available any time they wanted us in person or by phone to run anything by us.

People are in assisted living because they need supervision, monitoring, and help from others.  I guess one could look at it as "stuff happens," but he DIED.  We trusted them and paid for their care, and he died.

Most of the residents were frail, had some level of dementia, and had many needs.  It was not like apartment living for seniors!  It was a nice place overall, but I think they let him down.

Hyacinth

[panda1234]

---

@hyacinth003 wrote:

@panda1234 

I wouldn't do this just as a "nuisance."

My dad had fallen before as they were well aware.  He was alone in that bathroom to fall on a tile floor.  If we were there, we stayed right outside the bathroom door.  It was dinner time and I think they were busy.  I believe that is negligence.  We provided private paid help for 12 hours of the evening, night.  And he paid $7,000 a month to this facility - they owed him a duty. 

That is not the way he should have died.  He deserved and was entitled to better.

Hyacinth

---

@hyacinth003  You are absolutely right, you pay good money and they should be held accountable. Being on the otherside of things staff is overworked and underpaid which is no excuse. Not your concern, you paid them plus private care because they could not provide the care he really needed.  Don't know if you have experienced this at your job but either people don't want to work, show no pride in a job well done or can not pass a drug test. Just sad. I hope you are successful in pursuing this, best of luck. 

[CrazyDaisy]

When a person living in an assisted living facility refuses to call when they need assistance who us responsible?  

[depglass]

You have to prove negligence and I don't see any in your story.