Anyone here faced with placing a parent in LTC?

TracyB,RN, RN · Feb 2, 2005

My hubby's grandmother had almost the identical problem your mom does....the scenario you described regarding your mom is soooo similar it's scary. She also went down at 5:30am... Eerie.... ANYWAY........

We did briefly have her in a SNF for rehab, but pulled her out after a week d/t constantly finding her wet with her own urine, often left alone in her room without call light in reach, she unfortunately was slightly confused, so of course, her room was as far away from the nurse's station as it could get. The day we pulled her out, we walked into the room, had we not arrived when we did, she was probably just minutes away from falling out of her w/c onto the floor.... We did the visits at various times throughout the day, as this particular SNF had open visit from 8a - 8pm & boy, did we switch it up alot. This poor quality of care from the "highly regarded SNF therapy" ughghgh. We brought her home & after PT/OT/ Speech at home for a few weeks, she was strong enough for the inpatient rehab... Did very well, the first few days, until she had a GI bleed & ended up in ICU. While there, she developed numerous pressure ulcers & had a few more strokes, leaving her totally dependant for the slightest of care. When she was finally discharged we opted to care for her at home. My hubby quit his job & has been her primary care giver, ever since, while I work outside of the home. It took me 6 months plus LOTS of dressing changes & debridements from the mobile doc that comes to the home to get that heel ulcer healed. Funny, how in the last 3 1/2 years, she has not had ONE skin break down. She requires total care & is on bolus GT feeds. She had 2 wishes... one to die at home, & the 2nd to not starve to death, thus the GT placement. She has her good & bad days, as far as memory goes, & we have had to sacrifice ALOT to be able to do this, but she was a FANTASTIC woman prior to the strokes (yes STROKES.... 4 total). She was more like a mother to my hubby & cared for him throughout most of his childhood. I swear, if my hubby had to pick between saving her or saving me, it would be me going down, lol... But I consider myself fortunate to be married to such a caring man & wonderful father. I don't have to worry about daycare, cooking, cleaning, or laundry. He takes care of her, plus all household duties. Of course, before I got laid up with my back surgery, I worked alot of overtime, to help make up for his lost income, BUT, on the flipside, we live in her house & don't have a mortgage to worry about, which is nice, but, I would be lying if I said it was easy. I miss the days, when we could just get the kids in the car & go, but now EVERYTHING has to be planned in advance, so we have someone to watch over gram if we go out to dinner or to one of my daughter's tumbling meets. It's rough on the kids (15 & 7) but they are old enough to understand, sometimes, too, b/c if we are busy bathing gram or tending to her in some other fashion & we can't always just stop in the middle of what we are doing, feeding, bathing, etc, etc.... BUT it is alllll worth it, b/c we know that she is getting the BEST possible care. And hopefully teaching my kids the importance of "family sticking together to get things done." Gram will be 87 in June, & we laugh about how she will probably outlive all of us. But at least we can sleep easy, knowing we did the best we could with what we had. Sure, free time is a total luxury, but feel that we will have a pretty good chance of getting into heaven. Plus, if I ever pull OT, I NEVER have to worry about who is going to take care of the kids, or junk like that.

I know this probably isn't a very encouraging reply, but totally understand what you are going through & send prayers your way. I guess, that if you do decide on a SNF for rehab, check it out from ceiling to baseboards, go at all hours, shift change, meal times, etc. It will give you good insight as to the type of facility they "claim" to be.

Good luck to you & your mom. I used to work inpatient rehab & feel that as soon as she can handle the rigorous therapy, get her in there ASAP, as long is she is clinically stable. You will be amazed at the progress such intense therapy can do for a stroke patient.

Please feel free to PM me, if you ever need to vent, b/c I sure know what you are going through & if I can offer any other suggestions, I will do the best I can.

Sorry, can't help with the baby question... no clue on that one, & hope your hubby is feeling better sooooon :)

lmcnabbkv · Feb 2, 2005

my father is in an long term care facility and the only thing that keeps him going each day is that my mother can be there nearly all of the time (which is unhealthy for her, but that is what she feels she needs to do). However, I must say that if she was not there, my father would be untended to like many of the other patients whose families are not able to visit. Because the staff does not know when my mother will come but they know that she will be there, it keeps them on their toes. So sad that this happens in facilities, although I'm sure not all of them are this way but we did not have a choice as to placement as the VA was responsible for payment they found a VA contracted facility. Good luck, my prayers are with you and your family!!

oramar · Feb 2, 2005

My hubby's grandmother had almost the identical problem your mom does....the scenario you described regarding your mom is soooo similar it's scary. She also went down at 5:30am... Eerie :)

First let me say you have sympathy for all of your problems. Second let me say that current studies have shown the early morning hours are the time of day when platelets are most sticky and strokes and heart attacks are most likely to occur. Just thought I would mention it.

CoffeeRTC, BSN, RN · Feb 3, 2005

Wow...we placed my DH's dear aunt in a SNF 2 years ago...very hard decision. I've been a LTC nurse for 10 years and never wanted to have a family member in one. Well things happen and we had to look for one. What complicated things was that she was getting peritoneal dialysis. No one took them in our area. Finally found one and they had a private room and accepted her (and her private pay funds!)

Yep...I know what to look for/ expect, but what really matters is do you trust the staff? If not why...definalty bring these issue up with the unit manager/ supervisor/ DON as they happen. Offer to assist or help when you are there (just small stuff...feeding, getting water, etc) but don't feel like you have to do it all. That is why she is in the facility...for more help. YOu need to care for yourself and your family so that you can be healthy and be there for your mom. Do not settle for substandard care.

It was hard to get used to the fact that we couldn't care for our aunt at home, but in the end..we knew that she was getting the care she needed.

TracyB,RN, RN · Feb 3, 2005

Oramar, you know, I had never heard that, but thinking back to when I worked nocs & all the codes that were called in the early am hours, sure is interesting. Do you have any links to any of those studies? I would love to read some of that info.

Midwest4me · Feb 3, 2005

My hubby's grandmother had almost the identical problem your mom does....the scenario you described regarding your mom is soooo similar it's scary. She also went down at 5:30am... Eerie.... ANYWAY........
We did briefly have her in a SNF for rehab, but pulled her out after a week d/t constantly finding her wet with her own urine, often left alone in her room without call light in reach, she unfortunately was slightly confused, so of course, her room was as far away from the nurse's station as it could get. The day we pulled her out, we walked into the room, had we not arrived when we did, she was probably just minutes away from falling out of her w/c onto the floor.... We did the visits at various times throughout the day, as this particular SNF had open visit from 8a - 8pm & boy, did we switch it up alot. This poor quality of care from the "highly regarded SNF therapy" ughghgh. We brought her home & after PT/OT/ Speech at home for a few weeks, she was strong enough for the inpatient rehab... Did very well, the first few days, until she had a GI bleed & ended up in ICU. While there, she developed numerous pressure ulcers & had a few more strokes, leaving her totally dependant for the slightest of care. When she was finally discharged we opted to care for her at home. My hubby quit his job & has been her primary care giver, ever since, while I work outside of the home. It took me 6 months plus LOTS of dressing changes & debridements from the mobile doc that comes to the home to get that heel ulcer healed. Funny, how in the last 3 1/2 years, she has not had ONE skin break down. She requires total care & is on bolus GT feeds. She had 2 wishes... one to die at home, & the 2nd to not starve to death, thus the GT placement. She has her good & bad days, as far as memory goes, & we have had to sacrifice ALOT to be able to do this, but she was a FANTASTIC woman prior to the strokes (yes STROKES.... 4 total). She was more like a mother to my hubby & cared for him throughout most of his childhood. I swear, if my hubby had to pick between saving her or saving me, it would be me going down, lol... But I consider myself fortunate to be married to such a caring man & wonderful father. I don't have to worry about daycare, cooking, cleaning, or laundry. He takes care of her, plus all household duties. Of course, before I got laid up with my back surgery, I worked alot of overtime, to help make up for his lost income, BUT, on the flipside, we live in her house & don't have a mortgage to worry about, which is nice, but, I would be lying if I said it was easy. I miss the days, when we could just get the kids in the car & go, but now EVERYTHING has to be planned in advance, so we have someone to watch over gram if we go out to dinner or to one of my daughter's tumbling meets. It's rough on the kids (15 & 7) but they are old enough to understand, sometimes, too, b/c if we are busy bathing gram or tending to her in some other fashion & we can't always just stop in the middle of what we are doing, feeding, bathing, etc, etc.... BUT it is alllll worth it, b/c we know that she is getting the BEST possible care. And hopefully teaching my kids the importance of "family sticking together to get things done." Gram will be 87 in June, & we laugh about how she will probably outlive all of us. But at least we can sleep easy, knowing we did the best we could with what we had. Sure, free time is a total luxury, but feel that we will have a pretty good chance of getting into heaven. Plus, if I ever pull OT, I NEVER have to worry about who is going to take care of the kids, or junk like that.
I know this probably isn't a very encouraging reply, but totally understand what you are going through & send prayers your way. I guess, that if you do decide on a SNF for rehab, check it out from ceiling to baseboards, go at all hours, shift change, meal times, etc. It will give you good insight as to the type of facility they "claim" to be.
Good luck to you & your mom. I used to work inpatient rehab & feel that as soon as she can handle the rigorous therapy, get her in there ASAP, as long is she is clinically stable. You will be amazed at the progress such intense therapy can do for a stroke patient.
Please feel free to PM me, if you ever need to vent, b/c I sure know what you are going through & if I can offer any other suggestions, I will do the best I can.
Sorry, can't help with the baby question... no clue on that one, & hope your hubby is feeling better sooooon :)

Hi--Hey thanks for the response--I thought I mentioned I'd already decided and placed her in an SNF--one I used to work in years ago--5 staff still work there I knew from back in the 90's---an RCM I worked with is again there after leaving for a couple of years--I was impressed with her back then so that helped my decision. I was again frustrated tonight though when I went in and she was sitting for 20 mins in w/c waiting for chance to get up and stand for a bit. Had to get an aide to help. I find I am doing a lot of the care myself when I go in. The aide tonight mentioned "shift wars" and how "this place is going downhill" from when she first started working there. Oh THAT's just what a family member/nurse wants to hear!!!! She confided in me the following: "since you're a nurse I thought you might want to know that I found her foley back in her drawer last night with 300cc urine still in it. Maybe you might want to mention that to the nurse--I know I am going to mention a few things to some people higher up". I left in tears....again!

blondebritbrat · Feb 3, 2005

Wow, I totally feel for you. My mom was in a really bad motorcycle wreck almost two years ago and nearly died despite having a helmet on. She almost lost her leg too since it was basically severed at the accident site. We had to consider putting her in a nursing home/rehab home for the physical and cognitive therapy she would need due to a severe head injury. But the closest facilty that had all the proper equipment was like four hours away plus it was a private facility as far as I know. It was really expensive and she wasn't even going to be able to start therapy right away if she decided to take that route. She was going to have to recover first because she had other problems and internal injuries. So we decided that I would take care of her and drive her to therapy. We finally found a facility in Dallas that had the proper equipment just no residential domains. So I took care of her and my mom also had a nurse friend that would come and help me A LOT. My grandmother helped me a lot too. So did my boyfriend whom I later married. I had to quit college to do it though. Sometimes it is easier to take care of your family at home when possible due to the bad care that people seem to get in a nursing home. I have a grandmother who is a social worker and I used to volunteer at the nursing home quite a bit when she worked there and some of the things I saw were just amazing. But not all nursing homes are the same for all you people that work in LTC or nursing homes or whatever I commend you!!

CoffeeRTC, BSN, RN · Feb 4, 2005

Please just don't let them use "short staffing" as an excuse. Yep it might take them 20+ minutes to come and walk or repostition mom, but hopefully they are prioritizing their care. Even when we work short, we get basic care done. No excuses. The foley thing is carelessness and ignorance on the staff part that could cause actual harm (infection). My staff is to never mention "how short we are..etc" Yep staffing is a problem, but do you as a family or resident really need to hear our problems? NO. Every facility is required to post the number of staff on per shift per unit. Look at it, count the staff. If not enough they could get cited. (I do remind some of our families when the ask...to speak with the DON/ ADM about this)

I'm lucky that most of our residents are called Gramma (by their request) and treated like our Gramma, Grandpap, aunt or uncles... :) I tell all my new orientees....You wouldn't treat your mom/ dad etc bad...so take care of these like family