geriNurse1

Talk to her about her past, school, job, sisters, brothers, parents. Try to find out at what age she is at in her mind. Maybe that will help. If her family has any pictures of her when she was a teenager or child, that might help getting her talking. Does she recognize her daughters, as her daughters? Maybe her wedding pictures would help. Remember Alzheimers is child development in reverse! Short term memory is gone, but long term is still hanging on. Good Luck!

I also went from working 6 yrs in ICU and 12 yrs in ER to a Skilled Nursing Facility. It was hard at first, thinking more of chronic long term problems rather than acute, emergent ones. Also the lack of equipment, IV's, meds, etc. being right at hand was hard to get used to. But you do get a chance to keep your assessment skills up and you get to know your residents. Talk with them. Some can really open your eyes as to what life was like when they were growing up. I really enjoy it now. It did take me awhile though. And by all means, listen to your CNA's. They are your eyes and ears. They know their residents better than anyone else and they will notice changes in them first. You will get frustrated at times, not enough time, not enough help, etc. But hang in there.! LTC is a great place to work.

Definitely, report him!! Hospice is a great thing for the patients, family and the staff of the facility. This Dr. should not be practicing if he has that attitude! Be the patients advocate.

In Missouri the regs say that there has to be a RN in the Building on the day shift, after that the facility can be staffed with LPN's and CNA's with an RN available 24/7 and that's usually the DON or someone she designates. Good luck,:wink2:

Thanks for all the replies. We have packages of pre moistened wipes that the aides are to use for peri care, so they do not have the excuse of not enough linens. The State AND the Feds were just at our facility for the yearly survey. The Feds were watching the State, so the State really got picky. We didn't do too bad though. Nothing major, just a lot of little things. Don't ever wish for the Feds to come in though!

I am so sorry! You are in my prayers! Have you tried the home health agencies? private duty? Factories? Doctors offices? Public Health? You did the right thing! But if you haven't reported to facility to the State yet, it needs to be - or call the Elder Abuse Hot line. They need to be investigated and possibly closed!

Our aids are instructed on giving good peri care in orientation, their certification classes, and in inservices during the year. Still they do not do it, possibly because they feel they don't have time. But if they would take the time they would save time in the long run. Does anybody have any suggestions on how to motivate them to give good peri care? When you ask them to describe good peri care they have all the right answers. Help!

We do not consider a fall onto the mat from a low bed a "fall" unless they roll off the mat. But yes, if a resident does not have freedom of movement anything can be a restraint. I believe side rails were considered a restraint after several residents strangled themselves by getting caught between the side rail and mattress. It is quite a challenge to think of some way to keep them safe.