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Respected Contributor
Posts: 3,112
Registered: ‎03-16-2010

My brother who is in a nursing home. I need advice please!

[ Edited ]

My 59 year old brother, is in a nursing home, disabled. He neglected his health and as a consequence, suffered the effects of uncontrolled Diabetes and hypertension. He suffered 5 strokes in 2019 and 2020. 

His overall mental affect and health has started to decline. He has a pressure ulcer on his heel now. That is pretty significant. Recently, he has not been eating and lost 5 pounds in a month. No one addressed the problem. I observed him trying to eat and it seemed like he could not see the tray. I asked for an Occupational Therapy evaluation to help identify strategies that would help him be able to find his food and eat it. Maybe adaptive utensils and or bowls that he can pick-up.  I also made took him to an eye appointment. 

He was evaluated this week by 2 eye doctors and we received the tragic news that he is blind in one eye, and nearly blind in the other eye. The blindness is not fixable.

My sister and I had a care planning meeting with the nursing and social services director. At that meeting, we found out that the Occupational Therapist never saw my brother. I asked that she see him. 

The occupational therapist has a long history of blowing my brother off because "he is lazy.". I called her to relay my observations and she totally blew me off, telling me he eats fine, etc. I disagreed and relayed my concerns to her and she was so mad. Then I told her I am a Mastered Prepared RN and I work closely with therapy, so I do know somewhat about deficits such as my brothers. I also told her that he was just diagnosed with blindness. She did not realize that he was blind.  

Yesterday, my sister went to see him and he was sleeping and the lunch tray was in front of him. No one was helping him. He needs tray set-up and cuing throughout his meal. I know he can eat with the spoon and the bowls. That is in place now, but he needs someone to come around a few times during the meal and cue him to eat. 

I am very, very upset. I wrote the administrator, but not heard back yet. I am particularly angry at the therapy department, and nursing for not assisting him. I cannot be there all of the time to watch this situation. My sister is leaving to go back up North on Wednesday. I have another brother locally and between he and I we visit a few times per week. 

I also wrote a complaint yesterday to the Department of Elder Affairs, Long-term care Ombudsman. 

I have so much anxiety over my brothers lack of care. He cannot speak for himself. The entire situation is so tragic.

Please take care of your health, don't try to self-diagnose and treat. Get your labs done at least yearly. Don't delay your mammograms and Colonoscopy.  The silent killers are Diabetes, Hypertension, and High Cholesterol. All treatable illnesses. My brother was afraid of  doctors and now is paying a very high price for his decisions. 

Respected Contributor
Posts: 4,322
Registered: ‎04-30-2012

Re: My brother who is in a nursing home. I need advice please!

So sorry for what your brother is going through and for you and your family having to deal with the Nursing home issues. I am a retired nurse and I have a sister in a nursing home with dementia but her daughter handles everything and has had no issues with the nursing home. With your background as a RN familiar with therapy have you considered looking into another facility and their therapy program that may fit your brother's needs better ? Just a thought while reading your post. Best wishes for a resolution so that your brother gets the best care.

Respected Contributor
Posts: 4,746
Registered: ‎03-20-2010

Re: My brother who is in a nursing home. I need advice please!

[ Edited ]

I'm so sorry about the poor situation. I'd bet there is a reason, but can you try to move him to another facility? They vary in quality quite a bit and his facility is not helping him- 


My Mom was recently hospitalized and is now is a " rehab" facility- the new name for a nursing home...At first they were not caring for her, but I have been there practically daily and at one poin escalated the issues to the nursing supervisor, and the care has gotten better- 

 

Have you tried going to the management? Best wishes and totally agree, foolish to ignore our own health-

Find peace in that you are doing what you can for him - since he did not help himself...

 

 

 

Respected Contributor
Posts: 3,755
Registered: ‎05-01-2020

Re: My brother who is in a nursing home. I need advice please!

You didn't mention what advice you're looking for but I'd check ratings of other facilities and get him moved. I would also see if there's a state agency you can report the current facility to. Other residents may be having similar issues and families may not be aware there's a lack of attention happening. Someone needs to get the ball rolling with getting things straightened out with this place.

Esteemed Contributor
Posts: 7,035
Registered: ‎07-26-2019

Re: My brother who is in a nursing home. I need advice please!

  No matter a facilities reputation, it takes family to be there almost every day to see that a loved one gets care that they need  and  encouragement to engage  in therapy  .

 No facility is 100%  safe or perfect . If your family is a DNR , they are most often  ignored

Regular Contributor
Posts: 183
Registered: ‎05-19-2010

Re: My brother who is in a nursing home. I need advice please!

My mom was in a nursing home in Pennsylvania and was blind from shingles.  Don't know if it was just from staff shortage or what but she was basically ignored.  My dad and brother took turns coming in at mealtime to feed her.

I'm guessing if we need mealtime help at nursing homes we won't ever get it.

The physical therapist my mom had also said mom was lazy.  Don't know where these professionals come from, but I am very fearful about what the future looks like.

 

You're in my thoughts, 

Seannie

Honored Contributor
Posts: 13,434
Registered: ‎11-16-2014

Re: My brother who is in a nursing home. I need advice please!


@conlt wrote:

My 59 year old brother, is in a nursing home, disabled. He neglected his health and as a consequence, suffered the effects of uncontrolled Diabetes and hypertension. He suffered 5 strokes in 2019 and 2020. 

His overall mental affect and health has started to decline. He has a pressure ulcer on his heel now. That is pretty significant. Recently, he has not been eating and lost 5 pounds in a month. No one addressed the problem. I observed him trying to eat and it seemed like he could not see the tray. I asked for an Occupational Therapy evaluation to help identify strategies that would help him be able to find his food and eat it. Maybe adaptive utensils and or bowls that he can pick-up.  I also made took him to an eye appointment. 

He was evaluated this week by 2 eye doctors and we received the tragic news that he is blind in one eye, and nearly blind in the other eye. The blindness is not fixable.

My sister and I had a care planning meeting with the nursing and social services director. At that meeting, we found out that the Occupational Therapist never saw my brother. I asked that she see him. 

The occupational therapist has a long history of blowing my brother off because "he is lazy.". I called her to relay my observations and she totally blew me off, telling me he eats fine, etc. I disagreed and relayed my concerns to her and she was so mad. Then I told her I am a Mastered Prepared RN and I work closely with therapy, so I do know somewhat about deficits such as my brothers. I also told her that he was just diagnosed with blindness. She did not realize that he was blind.  

Yesterday, my sister went to see him and he was sleeping and the lunch tray was in front of him. No one was helping him. He needs tray set-up and cuing throughout his meal. I know he can eat with the spoon and the bowls. That is in place now, but he needs someone to come around a few times during the meal and cue him to eat. 

I am very, very upset. I wrote the administrator, but not heard back yet. I am particularly angry at the therapy department, and nursing for not assisting him. I cannot be there all of the time to watch this situation. My sister is leaving to go back up North on Wednesday. I have another brother locally and between he and I we visit a few times per week. 

I also wrote a complaint yesterday to the Department of Elder Affairs, Long-term care Ombudsman. 

I have so much anxiety over my brothers lack of care. He cannot speak for himself. The entire situation is so tragic.

Please take care of your health, don't try to self-diagnose and treat. Get your labs done at least yearly. Don't delay your mammograms and Colonoscopy.  The silent killers are Diabetes, Hypertension, and High Cholesterol. All treatable illnesses. My brother was afraid of  doctors and now is paying a very high price for his decisions. 


I am so sorry for this tragic result from your brother having had to deal with uncontrolled diabetes and hypertension. As a Type 1 diabetic for nearly 54 years I have experienced the ravages of diabetes. Even with excellent A1C's and controlled hypertension, I have had a stroke, heart attacks, and numerous other co-morbidities. So your brother is probably not guilty of not caring for himself rather the disease process itself is showing its damaging effects to the human body. 

Is your brother getting labs for 3 month A1C's? Does he have adequate nutrition? Have you seen what they are feeding him? Nutrition is first and foremost for end stage diabetes. Hyperglycemia and hypertension is a recipe for disaster. 

When you visit him, bring a glucometer and test 1 hour after he has eaten. That will tell you whether he is running high. Nursing homes are notorious for leaving patients with hyperglycemia. It is easier for the staff not needing to deal with hypoglycemia and treating it.

Please do not blame your brother for his poor health. I, too, have a brother that has been in a nursing home since he was 52 years old. I advocate for him and when I felt his care was being neglected I went through the necessary steps to have him transferred to another facility. He is about to turn 75 this April.

 

My heart goes out to you @conlt . I know the stress this can cause. 

Esteemed Contributor
Posts: 5,798
Registered: ‎05-24-2010

Re: My brother who is in a nursing home. I need advice please!

I have spent a lot of my career in nursing homes. This falls on the therapy department, until he can eat on his own. They should be giving him adaptive spoons etc.... the therapist should be with him doing the cuing while he eats.  She either goes into the main dining room or in his room. Wherever he eats.

 

Once they establish he can be independent, and he will, with the proper intervention, only then will he be left alone to eat.

 

It is up to the nursing dept to log his food consumption every day, to make sure he is eating the adequate amount.

 

Don’t wait for a call back. Go in and see the social worker. It is her job to intervene and get everything in place.

Honored Contributor
Posts: 15,735
Registered: ‎01-02-2011

Re: My brother who is in a nursing home. I need advice please!

First off I sympathize with your brother for not wanting to see doctors.  When I was first diagnosed with type 2, I was scolded and lectured to, with no meaningful help, and I would put off getting help.  That behavior from care providers has changed for me.  

Secondly, I would contact the ombudsman  that represents the nursing home.  That person should help you run interference with the staff.  I had to do that with my mother.

 

Honored Contributor
Posts: 32,390
Registered: ‎05-10-2010

Re: My brother who is in a nursing home. I need advice please!

So sorry you are going this.  It sounds like you are doing everything you can do.  He isn't receiving adequate care at all,  that bed sore alone is proof of that.  Try being the Squeaky Wheel with the nursing staff on his floor.  Complain loudly and often.  Change up the times you visit so they never know when to expect you.  Complain in writing to the physicians that are treating him.  You didn't say where he is cognitively.  Is he able to work with OT?  Does he have the mental capacity for that?  It is indeed very hard because nursing homes and extended care facilities are all understaffed and not adequately reimbursement by insurers, Medicare, Medicaid.