It's like family members automatically assume nursing homes are out to harm their family members. Do they understand the hardwork and dedication it takes to caring for their loved ones?? I think they think it's easy. There are those family members that are thankful. But the ones that are negative and ANNOYING take the cake.
If your 80 something year old mother falls out of the bed, how is that the facility fault??
If your 96 year old mother dies, how is that the facility fault?
If your 80 something year old wife is treated like everyone else, how is the nurse racist?
I understand that everyone needs a place to vent thier frustrations, but the distrust in LTC personnel is not unfounded. Many of the reasons that are given as to why you are frustrated would make me uneasy to have you take care of my family member. I have had many experiences with LTC centers and have never been impressed. The nurse to pt. ratio stated in an earlier post in itself leaves a very bad taste in my mouth......
There are techniques to building trust with families so that when you cant solve all their problems, they know you have done all that is humanly possible. I learnt some from my husbands seminars and they really help.
It's a matter of knowing what to say and when.
It starts with the admission,: explain from the start " There are hours when I cant be accessible for explanations as I will be providing essential care and cant be distracted, the doctor as well. But here is my personal cellphone number and I will call back as soon as I can". Follow this up with investing time when you can and repeating as often as possible,: " Your mother (or whatever) is important to us, it is in our best interest to keep her healthy and happy so you can depend on that.." or something of the sort. And mean it.
It is showing the families from the start that we are doing all we really can to make this part of their mother's life as good as it can be.
A nice touch is when you do something good ( e.g. like remembering that the pt loves the tomato soup and bringing her seconds of it ) and the patient is happy you should follow it up and say to her/him "You know we love you". and mean it.
Then when you dont have the time to talk you can briefly say " I am busy right now we can talk in half an hour(or tomorrow)"- and keep your promises.
If the doctor cant be available to sign off a discharge, apologize and explain nicely to the patient and her/his family. Not everything is in our hands.
If you have built trust, they will understand- they will be disappointed but so would I be in that situation.
Try to remember that from their perspective, we dont spend enough time with each patient, we are not gentle enough, the food we serve (mind you they blame us not the cook or facility) is garbage, it is our fault that the beds are not as comfortable as those at home, we are to blame it the TV is not set to their mothers favorite soap opera even though we gave the family the option of bringing their own TV and THEY said it was enough for Mom to watch on the public one in the Dayroom where the majority decide what channel is turned on etc.
Don't be afraid of referring appropriate complaints to your DON or SW or MD or Administrator. Or approaching them for help with extremely difficult patients or families. In such a case it is good to have a unit meeting and decide uniformly how to deal with a particularly difficult case.
This doesn't have to be a problem, and complaining here is a good outlet but trust me , we can do better!!
I agree wholeheartedly. My grandmother is in severe chronic pain due to numerous issues, none of which are severe enough to end her life. She is on a dozen meds and has asked me many times if she can just stop taking them as she is truly 'done living'. I never know what to say. She is in her 90's, had a great life and is now lying in total misery in a bed in a small room in a facility. She has lost her mobility, her independence, her home, her belongings, her husband...she has a strong faith and she is ready to cash in!
I had to fight to get her her salt shaker...she super salts her food and so they took it away...if she wants salt - give her salt! And the PT started coming in..it was agony for her as the sessions were very painful..the PT kind of said no pain no gain...ridiculous...they stopped that too! I know they are trying to be 'helpful' but still, common sense. Thankfully they haven't taken away her walker even though she falls...and somehow never manages to break anything! They'd have a battle on their hands taking that walker!
You could always tell her the truth: She has the right to determine her quality of life. As a resident, she isn't required to take her meds. The facility can't *force* her to do anything. She (or her representative) could always advocate her MD to discontinue her meds. That way, the facility won't nag her anymore. Same thing with the salt shaker. Is she DNR? That's important too.
Bottom line, there still is a lot she can do to advocate for her care.
I understand that everyone needs a place to vent thier frustrations, but the distrust in LTC personnel is not unfounded. Many of the reasons that are given as to why you are frustrated would make me uneasy to have you take care of my family member. I have had many experiences with LTC centers and have never been impressed. The nurse to pt. ratio stated in an earlier post in itself leaves a very bad taste in my mouth......
I have thought for a long time now that there should be a ratio of how many patients a person can care for in LTC where most people are fully dependant. I'm not just talking nurse ratios either seeing as CNAs do most of the hands on care. Day care centers for young children have strict ratios and infants count as 2 seeing as they need more care. LTC should be the same way and then all of our family members could get the time and care they need and deserve. I've worked as a CNA in LTC and no matter how hard you work and how much you give the workload is almost unbearable when you have 10... 12... sometimes 14 patients. That should be illegal really! :angryfire
I agree wholeheartedly. My grandmother is in severe chronic pain due to numerous issues, none of which are severe enough to end her life. She is on a dozen meds and has asked me many times if she can just stop taking them as she is truly 'done living'. I never know what to say. She is in her 90's, had a great life and is now lying in total misery in a bed in a small room in a facility. She has lost her mobility, her independence, her home, her belongings, her husband...she has a strong faith and she is ready to cash in!
I had to fight to get her her salt shaker...she super salts her food and so they took it away...if she wants salt - give her salt! And the PT started coming in..it was agony for her as the sessions were very painful..the PT kind of said no pain no gain...ridiculous...they stopped that too! I know they are trying to be 'helpful' but still, common sense. Thankfully they haven't taken away her walker even though she falls...and somehow never manages to break anything! They'd have a battle on their hands taking that walker"
Have you tried approaching the DON and SW? Who is the POA? Have you signed a DNR?
The nurses cant give her her meds by force and if she wants salt and understands that her doctor recommends against, but wants it anyway- they have to give it to her.
HOWEVER Please try to understand the staff whose jobs it is to encourage her and give her the meds as per MD order.
You can call the state and report the facility ( even anonymously).
I still think when we have the "grandma's gonna live forever" types who would make a corpse a full code that they should have to watch a video of a real code -- not a TV code, the real one that goes on for 30, 40 minutes, with ribs cracking, the occasional decayed tooth flying, suctioning flash edema, stomach contents coming out around a PEG tube, with real shocks not the TV version. And they should be told that there's on average only a 30% chance of reces nationwide -- that's the Emorys and the Johns Hopkins and the Level One trauma centers, of which my facility is not one.
People need to learn the meaning of the word "futile."
I was accused of murdering a 98 year old. I know it was in the grief stages, Grandma had just died but I got a mouthful of "You were supposed to do X Y & Z and you didn't and now you killed her!" The staff were all hoping they were not on shift when this poor woman died - she was really suffering, CHF, renal failure and a bunch of other things. We knew her death would be the fault of whoever happened to be on shift at the time.
Never mentioned the four or five times we had saved Grandma from the jaws of death. Or the amount of times we had tried offering hospice and grief counselling or the amount of MDs who had told her that Grandma was a goner.
Specializes in Peds Critical Care, Dialysis, General.
It is truly difficult to accept that your parent(s) are getting older and their time is getting shorter.
My sweet MIL was in a LTC/Rehab center before she died in 2007. We got an order for her not to do the rehab part - too painful for her. She was well cared for by their staff. The Wednesday before she died, she waited to get her hair done - I was with her and she made sure I didn't forget. She died 3 days later. The staff grieved with us - they made her last few weeks pleasant as it could be. They put up with us very graciously.
We had to accept the fact my mother was dying and honored her wishes. We did shade the truth about the nurses who were coming out to see her. Hospice was wonderful to her and to us. We stopped giving her the meds she couldn't take and weren't going to make any difference in her outcome. She was able to die on her own terms.
Can't say enough good about about Hospice. They are not the enemy, but your very best friends. And to all the LTC nurses - you are totally awesome and you really, really rock! My utmost respect to you.
It starts with the admission,: explain from the start " There are hours when I cant be accessible for explanations as I will be providing essential care and cant be distracted, the doctor as well. But here is my personal cellphone number and I will call back as soon as I can".
I would NOT be giving my personal cell phone number out. No way.
123rn456
3 Posts
I understand that everyone needs a place to vent thier frustrations, but the distrust in LTC personnel is not unfounded. Many of the reasons that are given as to why you are frustrated would make me uneasy to have you take care of my family member. I have had many experiences with LTC centers and have never been impressed. The nurse to pt. ratio stated in an earlier post in itself leaves a very bad taste in my mouth......