Making a tough decision - Page 8

Isobel Archer · ‎04-04-2015

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

That's what I'm wondering too. Unless someone is restrained - in bed or chair - even an alarm sounding is probably too late if they've already gotten up and taken a couple of steps. The attendant would have to be right outside the door to get to them before they could fall. And it's the fall, not the immediate attention after the fall, that causes the damage of broken hips etc.

Another possibility is medication so that they can't or don't have the energy to get up - but what quality of life is that?

And I'm all for persuasion and trying to get them on a bathroom schedule etc., but I think the same resistence to using the call button applies in those cases too.

As I said before, it is heartbreaking when your family member acts against their own interest, but I'm just not sure what the answer is here.

vsm · ‎05-08-2010

@hyacinth003 wrote:
@Trinity11 wrote:
I feel for you @hyacinth003 . You have had a lot on your plate with relatives behaving irresponsibly. I remember the fiasco you went through with your FIL's estate. Now you are dealing with an assisted living situation that clearly was not up to par.

Personally, I would not engage in a long, arduous law suit but I would flood the internet with reviews of the facility. I would also report the facility to the State. I had to pursue this route with an incident my brother endured and the facility ended up being closed from numerous complaints and was purchased by another owner. It resolved a lot of issues and thankfully he is very safe now.

One thing to also consider is the stress this will put on you. I know you have diabetes and from previous posts you were caring for your daughter? Remember we all have our limits and this will take a toll on you. Please take care of yourself...
@Trinity11

The attorney who is investigating the situation asked me to report the facility, but I have not done that. I am not looking for a vendetta. Maybe I'll change my mind, but for now, I haven't done that.

Yes, the situation with my daughter is not getting better. This issue has tugged at me for some time, and I want it looked into. Thanks.

Hyacinth

@hyacinth003 So you spoke with an attorney and chose not to take his very sensible advice. He understood what you do not: that reporting the facility has nothing to do with waging a "vendetta," but everything to do with taking the first appropriate step toward a lawsuit, should you ulltimately decide to bring one. I'm getting the sense that you feel you'll be honoring your father by pursuing this in a court of law. But given the kind of man you said he was, it seems unlikely that he would want you to do that. Have you considered grief counseling? That is far more likely to ease your heart than a lawsuit will.

bikerbabe · ‎03-09-2010

@CrazyDaisy
@Isobel Archer

In the hospital, we (the hospital, the nurse) are responsible if a patient falls, regardless of whether they disregarded instructions to call for help before getting out of bed. It’s not different in assisted care, in particular where many patients are cognitively impaired and unable to reliably follow or remember or even understand instructions.

It’s a struggle to find creative ways to monitor and protect patients when you don’t have staffing to have sitters for everyone who probably needs one. We don’t even have enough RNs let alone CNAs. You put patients in rooms near the nurses station so you can keep an eye on them. We also have TV monitors that can be brought in so the patient is on camera with a tech at a remote location monitoring the room.

CrazyDaisy · ‎03-20-2010

@bikerbabe wrote:
@CrazyDaisy
@Isobel Archer

In the hospital, we (the hospital, the nurse) are responsible if a patient falls, regardless of whether they disregarded instructions to call for help before getting out of bed. It’s not different in assisted care, in particular where many patients are cognitively impaired and unable to reliably follow or remember or even understand instructions.

It’s a struggle to find creative ways to monitor and protect patients when you don’t have staffing to have sitters for everyone who probably needs one. We don’t even have enough RNs let alone CNAs. You put patients in rooms near the nurses station so you can keep an eye on them. We also have TV monitors that can be brought in so the patient is on camera with a tech at a remote location monitoring the room.

There are expectations of different levels of care at different facilities. Hospitals and skilled nursing homes have a higher level of care than an assisted living facility. If a resident is unable to follow or understand these instructions then they probably should be moved to a facility to better suit their needs.

Someday, when scientists discover the center of the Universe....some people will be disappointed it is not them.

qbetzforreal · ‎08-28-2010

The attorney told you to make a report against the facility which makes sense since you are bring forward legal action. The question would be why the lawsuit, if there is no complaint? No complaint is like you were please with the care your father was receiving. I would follow the attorney's advisement and lodge a formal complaint of neglience.

bikerbabe · ‎03-09-2010

@CrazyDaisy

Yes, there are different levels of care in different facilities. The OP mentioned that this facility has many dementia patients so I am assuming that this home is not for individuals needing minimal support. Perhaps that is an error on my part. If he was not in the correct level of care, that is the responsibility of the facility to notify family.

@pitdakota is correct in mentioning we need to know his Plan of Care POC and any adjustments that were made based on his fall history, becasue it there weren't any that is a huge red flag. He certainly needed an alarm on his recliner if that is where he spent most of his time during the day.

I do not know that there was negligence but facilities are generally responsible for patient falls.

Isobel Archer · ‎04-04-2015

@bikerbabe wrote:
@CrazyDaisy
@Isobel Archer

In the hospital, we (the hospital, the nurse) are responsible if a patient falls, regardless of whether they disregarded instructions to call for help before getting out of bed. It’s not different in assisted care, in particular where many patients are cognitively impaired and unable to reliably follow or remember or even understand instructions.

It’s a struggle to find creative ways to monitor and protect patients when you don’t have staffing to have sitters for everyone who probably needs one. We don’t even have enough RNs let alone CNAs. You put patients in rooms near the nurses station so you can keep an eye on them. We also have TV monitors that can be brought in so the patient is on camera with a tech at a remote location monitoring the room.

OK if you are "responsible" how does this work? In an Assisted Living facility, if the patient is not restrained, even if you have someone 24/7 monitoring them on TV - how do they get there fast enough to prevent a fall when the person gets up?

pitdakota · ‎03-16-2010

@bikerbabe wrote:
@CrazyDaisy
@Isobel Archer

In the hospital, we (the hospital, the nurse) are responsible if a patient falls, regardless of whether they disregarded instructions to call for help before getting out of bed. It’s not different in assisted care, in particular where many patients are cognitively impaired and unable to reliably follow or remember or even understand instructions.

It’s a struggle to find creative ways to monitor and protect patients when you don’t have staffing to have sitters for everyone who probably needs one. We don’t even have enough RNs let alone CNAs. You put patients in rooms near the nurses station so you can keep an eye on them. We also have TV monitors that can be brought in so the patient is on camera with a tech at a remote location monitoring the room.

_____________________________________________________

Hi @bikerbabe! First I want to take a moment to give a BIG THANK YOU for your work and being out there today taking care of covid patients and all other patients too! Kudos to you!

We have a care facility here that has assisted living, memory care, and a long term care division for requiring higher levels of care. They have really made some inroads in decreasing their falls with the implementation of several strategies.

One is that they now have beds in all the assisted living and memory care areas that actually go all the way to the floor. No more letting a resident bring their own bed in. Theory is that it is easy to sit up in bed, swing the legs over, and then stand up for many people in those areas. It is a whole nother thing to roll out of bed on the floor and then have to get up from the floor. As we know, that gets harder and harder with age. LOL They change the plan of care to lower the bed to the floor for those on falls precautions that also are at risk of getting up without assistance.

They pad the area around the bed with non skid pads and have instituted policies that these patients must be checked on every 30 minutes when they are in their bed (day or night).

They have also invested in pajama bottoms for men and women that are padded arounded the hip area for those on falls precautions at night. Of course, that only works when they put the pajama bottoms on at night, but they are routinely using them now for the appropriate patients.

Just a couple of strategies this facility has been using with really good success. Hopefully the ones that prove to be beneficial and evidence-based will catch on in other places out there.

It is so hard in a hospital especially to keep your eyes on that patient or patients along with doing everything else. And it is Murphy's Law that of course when something else on the unit happens, that is when that person will try to get up and fall.

* Freedom has a taste the protected will never know *

Isobel Archer · ‎04-04-2015

@bikerbabe wrote:
@CrazyDaisy

Yes, there are different levels of care in different facilities. The OP mentioned that this facility has many dementia patients so I am assuming that this home is not for individuals needing minimal support. Perhaps that is an error on my part. If he was not in the correct level of care, that is the responsibility of the facility to notify family.

@pitdakota is correct in mentioning we need to know his Plan of Care POC and any adjustments that were made based on his fall history, becasue it there weren't any that is a huge red flag. He certainly needed an alarm on his recliner if that is where he spent most of his time during the day.

I do not know that there was negligence but facilities are generally responsible for patient falls.

Again if he is not restrained, what good is an alarm when someone hearing it can't get there fast enough to prevent a fall when he gets up?

Isobel Archer · ‎04-04-2015

Sorry if I am not understanding these responses. But in my mother's case, she fell immediately upon rising from her chair and taking a step.

Are you saying most people who fall walk around for several minutes before they fall - enabling someone watching them on TV or hearing an alarm to get there in time to pevent this?