Dental Hygiene - Mom has been at the home for 3 years now and has gone through only 2 six ounce tubes of toothpaste. I know because I supply her toothpaste and if I don’t bring it in she doesn’t have any. The 2nd tube was recently finished and she has been using a 1 ounce sample tube from the dentist for a full 2 weeks now. I don’t know how that is possible if she brushes 4 times a day as promised - in the morning when washed and dressed and then after each meal. Also her partial is still occasionally not in her mouth and only Hema will replenish the cleaning tablets for her partial. If Hema is not working when they run out her partial does not get cleaned and is probably not removed from her mouth.
When taking Mom to the dentist in early August I reviewed the paperwork supplied to the dentist and looked over her list of medications. There were 3 items that I was not familiar with. The first was Zantac for heartburn and acid reflux. She had been on another medication for this and I was not told of the change. The second was Xyzal for allergy symptoms and the third was Singulair which is usually prescribed for asthma. Mom has no history of breathing problems. When asked about the changes the Xyzal and Singulair were discontinued and I still do not have a complete explanation of why Singulair was prescribed in the first place. In any event, had I not brought this to your attention she would still be taking unnecessary medication. It troubles me that I was not made aware of these medications and that I have to be so proactive to ensure proper care for Mom.
Safety Issue, Training for the standing lift - As you may know Mom uses a specific belt or sling which provides a little more back support. On four separate occasions staff members did not know the proper procedure for use and I had to show them how the belt is fitted around Mom and attached to the lift – it is not complicated. The first time this happened nobody in the building knew the proper procedure. A meeting to train the staff was hastily arranged and I was told a physical therapist was to conduct the training. I was deeply troubled to learn that in reality the RN on duty actually conducted the meeting. She had admitted to me when I left for the day about an hour prior to the meeting that she, too, had not been trained as to how this new belt was to be used. This happened on a weekend and not surprisingly the following weekend the same problem occurred. Equally disturbing is that I left a voicemail explaining the situation to the chief executive on both occasions and he never returned the call. The four instances that I am aware of happened when I was there and could correct the situation. How many times did it happen when I was not there?
Weight issues - As you know it was me who alerted the staff to Mom’s weight gain from about 115 to 150 pounds (apparently she never gained more than 5 pounds in a single week and thus no red flag was raised) and it was me who requested smaller portion sizes for Mom and a special breakfast and lunch menu. And it is me who monitors that it is being adhered to. I had been told that under this new diet Mom had lost about 1 pound per month and had gotten down into the 130+ range. At the most recent care meeting I was told that was not accurate and Mom has been between 145 and 150 for the last 2 years. I do not believe that is true. I also have reason to believe that Mom’s method of being weighed has changed from being weighed without her leg extensions to having her leg extensions included which adds approximately 8 pounds. I do not understand why there is a discrepancy in the numbers and why I have to chase someone down to be told what those numbers are.
Wet pants - Not just wet pants but wet chair and even a puddle underneath the chair. Historically, Mom accidentally wet her pants about once or twice a month. Recently this has increased to 2 or 3 times a week. Although it is possible that a urinary infection may be partly to blame I am having difficulty believing the accidents would be this severe if Mom were indeed being taken to the bathroom every 2 hours as promised and is specified in her care plan. Also alarming is the fact that on 3 occasions I was told that Mom spilled something at breakfast or lunch and the wet pants was not a urine stain. My nose knows otherwise.
Known and recurring issues - Care on the weekends had been improving but has regressed to previously unsatisfactory levels. If a regular staffer is not scheduled for the weekend shift wait times are routinely 20 minutes or more for an aid to respond and in Mom’s case (she does not use the call bell) who knows when or if an aid will check in on her when I am not there to act on her behalf.
It seems to me that the home is a wonderful place to leave a loved one if you plan to visit infrequently or for short periods of time. The grounds are nice, the facility is well maintained and the staff seems willing to please and conscientious. Its only when you look closer do you see the reality. It is for that reason that I asked to have the daily activity sheet reinstated and I’ve told Bobbie repeatedly that management must be involved and enforce its use. The sheet should be for all staff and not just the aids and there should be consequences for misuse. There has to be accountability at all levels for this to be effective otherwise it will continue to be the joke that it currently is.
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Accountability is required at all levels at this facility. Communication and quality of care needs to be improved.
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