I work as a PCA at a ALF, yesterday the daughter of a family member called and was extremely upset, she said that NOONE has washed, dressed, showered, or changed the linens of her father in OVER A MONTH. He is Very HOH and can barly see at all, but he is capable of getting himself dressed, and in AL thats what I was advised to do. We are suppose to let the patient do as much as they can for themselves. As for his shower, we have been low on staffing, and my boss is just finding random PCAs to come in a cover the 7 to 3 shift (i work 3 to 11) Well this random PCA said that he gave this man a shower, signed it in the ADLs, and on our report. I know I gave the man a shower two weeks ago, because the fill in PCA didnt say they did, so I did it when I came in. However, 2 weeks ago, I didnt change his linens, I didnt have time because he is scheduled shower on the 7 to 3 shift. He is a very aggitated patient, might I add, and why I am 'talking' to him I have to scream so he can hear me. I find myself being very short when trying to talk to him, because he cant understand ANYTHING. Also, I went in last night to help him into his PJs, and 'wash' him up, etc, etc. He was already in bed, not in his Pajamas. I tried to get him to change into his pajamas, he got irritated and started yelling at me! I'm not going to FORCE someone who REFUSES. Do you think this could be considered neglect or abuse?? If he blantley refuses to get into his pajamas?
I think the daughter might try to put a hidden camera in the room. Is this legal? We have cameras pretty much everywhere else except in the residents room. It just makes me feel weird knowing someone can see me all the time like picking my wedgie or my nose or something lol.
Yeah he mind is definately going, he is a a wandering resident too, with dementia. He definately doesnt remember showering, or anything. I feel horrible, because hes at the hospital now, but they will bring him back in skilled and then back to AL, like they do WITH EVERYONE I SWEAR. its all about the $
I know when people 'move in' they tell them 24/7 nurse supervision!! HAHAH. BS. We are combined with a nursing home, where the nursing home is 2 floors as AL is 2 floors, we have a LPN for AL on duty Mon - Fri 7 to 3. Other than that we are on our own.. We do have a charge nurse (in the nursing home) if we were to need anything, but shes busy ALL the time, its pretty much impossible for her to come to AL, one time a lady fell and gashed her head open had blood everywhere, I called for charge nurse, and she never came up so I called 911 and family and did everything on my own...probably shouldnt have but i thought it was best at the time, because when the charge nurse finally came up 45 minutes later she wasnt too happy, but the lady prob would have been dead by then!
Right. ALF's will take the money as long as they can, even though there are no licensed nurses in those facilities--usually.
Exactly. My former resident service director said that since we are a small alf (max capicity is 64) and since our census drops all the time, that they were forced to start letting in people who are ltc candidates (and even accepting people who came from ltc). Why? Because of the economy.
don't alfs have any liability when a resident is injured?
i wouldn't think they'd want to keep the census filled, with high-risk, medically-needy people...
unless there isn't any liability?
i've 'heard' that alfs are loosely regulated.
if true, that is just too darned scary.
leslie
They are very loosely regulated and VERY EXPENSIVE. Who would tell a paying son or daughter that there loved one is too frail for AL? I think the family takes the liability.
I think the issue is (at least at my work) is that they have Level 4(highest level of care) people living in AL, so they are more vulnerable to falls, etc. Well, these people fall, get sick, and stuff, so they send them to the hospital. While they are still in the hospital, the family is still paying for their apartment in AL (about 6000 a month) then they come back from hospital, they put them in skilled nursing for a few weeks, so the family has to pay for the skilled nursing room PLUS the AL apartment. Its just a circle of events, because these people keep getting sent to the hospital, then to skilled, then back to AL, and so on. So the facility is making BANK. and the residents i take care of are REALLY SUPER RICH people so i dont think they care that they are blowing their money. but its still not right.
I think the issue is (at least at my work) is that they have Level 4(highest level of care) people living in AL, so they are more vulnerable to falls, etc. Well, these people fall, get sick, and stuff, so they send them to the hospital. While they are still in the hospital, the family is still paying for their apartment in AL (about 6000 a month) then they come back from hospital, they put them in skilled nursing for a few weeks, so the family has to pay for the skilled nursing room PLUS the AL apartment. Its just a circle of events, because these people keep getting sent to the hospital, then to skilled, then back to AL, and so on. So the facility is making BANK. and the residents i take care of are REALLY SUPER RICH people so i dont think they care that they are blowing their money. but its still not right.
As I have said many times on this forum, it's all about MONEY.
The family definately does take the liability... I think a lot of famalies are in denial, and that having their loved one in AL, means their not going to die soon. I think they see a 'nursing home' as "counting down the days" kind of tatic. Its completely untrue...but i swear they all think that way!!
Document, document, document! Document if the gentleman refuses a bath. Document the words he uses when he refuses. Document what he's doing and where he's going.
I also hope that he will end up in a LTC facility because it sounds like he is way too complex for an ALF. But others are right. Facilities often admit people for whom they cannot adequately or safely care because they can get by with it and it's all about the money.
Sorry to sound so cynical---this sort of thing makes me angry.
Oh, and start applying for another job. You sound like a good worker, caring and observant, but most places will throw someone like you under the bus if something goes wrong. Get out of Dodge NOW.
I know, I hate the way the place is run. I really want to look for a new job, but I have completely fallen in love with all the residents. I wouldnt want them to feel as though I am abandoning them=( I am completely caught between 2 worlds.
Document, document, document! Document if the gentleman refuses a bath. Document the words he uses when he refuses. Document what he's doing and where he's going.
I also hope that he will end up in a LTC facility because it sounds like he is way too complex for an ALF. But others are right. Facilities often admit people for whom they cannot adequately or safely care because they can get by with it and it's all about the money.
Sorry to sound so cynical---this sort of thing makes me angry.
Oh, and start applying for another job. You sound like a good worker, caring and observant, but most places will throw someone like you under the bus if something goes wrong. Get out of Dodge NOW.
OldNurseEducator
290 Posts
You are soooo right!! It's all about the MONEY!!!