Saundra

I feel for your patient, because the progression of the disease is inevitable. After having cared for three of them, what you described is pretty typical. They become uncontrollable, the family can't deal with them, and the periods of lucidity make them miserable. Also, self-flagellation appears to be a common denominator. We had one that presented on admission as claiming to be Satan. It makes you wonder how many of the possession cases treated by the church over the centuries may have been this disorder. But the best you can hope for is to keep adjusting the meds, lots of patience, and try to keep them happy and distracted when they're having a good day. Two of our families went to the support group meetings and found it very helpful and informative. Good Luck.

Having been down that road with my company twice now, you had a team that was in a good mood, or else you fed them well. The last fed review I had to go bail out had 45 pages of citations, 43 of which were on nutrition and dietary. WHAT A MESS!!!! (So was the kitchen) Sandy

Are you doing a chart for the measurement and grading of existing wounds, or are you working on a chart for WOUND RISK ASSESSMENT? I've been hands on and hands in with my staff for the last six years, and would be glad to give you a rather well-developed list of either if you'll let me know what you need. One of my favorite topics. Drop me a line at [email protected]. SandyCDM

No, that's not what it's supposed to be like. I feel for you--Regs on medicaid reimbursement plainly allocate no more than 13 patients to 1 staff member doing primary care with low level function patients. You're BEYOND overloaded. At the load of 13, you gotta hustle, but it's do-able. Don't they have agency there? Or. let me guess, it's a chain and the administrator is being creative to get their annual bonus? What you're describing should not happen, ever. You're not only flirting with major skin problems, you're looking at possible abuse/neglect charges that sound like they'd probably be justified. Toileting / changing should occur at least every two hours, and double diapering is only for heavy wetters during the sleep periods. Towels??

Elderly gentleman, mid 80-s, explained to the writer that he really hasn't been quite right since the doctor Dx him with "Cancer of the Prosthesis" several years ago...Yes, he had an aritificial limb. Should we call a tree surgeon for this one?

Welcome (soon) to NC!! I am a CDM/CFPP working in NC, and am employed by a NC based company that has buildings throughout the state. It's a solid company, LTC, steady work. We have buildings from the coast to the mountains, and we're always ready for a nurse or two or five. If you think you might be interested, please drop me a [email protected].