Need advice about nursing home placement for my grandfather

[swirlygirl]

My grandfather is 90 years old and has severe dementia. My mom took care of him at home for the past 10 years, but he's gotten to be too much to take care of at home, so they decided to permanently put him in a locked alzheimers unit in an assisted living facility about 2 weeks ago. He's become incontinent and started falling a lot in the past few years. He's been in different facilities for short respite stays during those few years just so my parents could have a break. They've also had home care nurses come to their home for a while, but that didn't work out.

Well, since this past Friday night, he's had 2 bad falls at this current facility - both falls have landed him in the ER. First on Friday night for a broken rib, and yesterday my mom went to visit him and found him in his bathtub with his head cracked open and bleeding. The staff actually had no idea he had fallen, they told my mom that he was in his room sleeping and that was how she found him. We have no idea how long he laid there. So he had another trip to the ER to have a head CT and to have his scalp stapled. So, now he's in the hospital for a day or two just to try to give my parents some time to find a new facility since he obviously can't go back to the one he's been in.

I really have no idea what to tell my parents to do with him, because he apparently doesn't qualify for a nursing home. The social workers keep telling them that he would do fine in an assisted living facility - but obviously he hasn't done well there! I was just wondering if any of you guys had some ideas about placement for this kind of patient that I could pass on some info to my parents? They're pretty much at their wits end and don't know which way is up at this point! Any help would be greatly appreciated!!

[litbitblack, ASN, RN]

I currently work in a private alz./dem certified facility. We have 60 beds and 4 suites that consist of 15 rooms each. Each suite has a dining area and a living area and each room has a bathroom and closet and comes with a bed. family can bring personal items, some furniture, momentos. Each suite is secured and our main goal is to assist each resident in their daily living while they are living with thier alz/dem. Its really seems like assisted living as we allow them to do what they are able and assist them or do for them what they can't. Each suite is designed with the stage of alz dem they are in and they are moved dependin g on the stages they are in. That sounds like something you need for your granpa. I know here in texas there are only a few, but with 1 nurse and 2 cna for 15 residents and they have personal alarms and motion sensors if needed, we really don't have many falls. We know when the unsteady ones get up cause they have alarms on. You need to look for a place that definately is as up to date on alz as poss and takes into account the safety factors and nutritional factors that affect alz dem residents. Good luck.

[travel50]

I am the DON at a nsg home, and he most certainly does qualify for nsg home care. Anyone as confused as he is will qualify by the time I get through with their paperwork. I don't mean I lie on the paperwork b/c I don't. I mean, if the person doing his paperwork takes the time to do it correctly, he will qualify. He is confused, therefore could not take his own meds, cannot properly toilet, bathe and do his own personal care, cannot go outside unattended, etc. Assisted living facilities do like the money. Having been in the hospital, he will qualify for skilled care if he has medicare (as long as he is in the hosp for 3 consecutive midnites).

The best facility will be one with around the clock RNs, in addition to the LPNs and the aides. Find out what the ratio of nurse to patient is. The facility will need a locked unit, but would help if there was an outside area (locked and protected) where he could still go outside and walk around. Ask to see the results of their last survey. Some tags are okay, but you'd rather not see any IJs (those are bad tags), although a facility can have them and still be good. Go look at the residents. Are they clean, do they all look drugged up, does the facility have a bad odor. Tour the building. Meet with the administrator and the DON. Make sure you can visit him whenever you want to. Do they allow pets. Pets are a good thing...residents respond well to them. Do the workers look happy, or do they look exhausted and just too plain tired to care.

Good luck, and keep us posted.