Related to complaints about nursing homes I've heard arguments like "If they really loved her, they wouldn't have put her in a home. They'd take care of her themselves, nothing is more important than family."
Also, "What do you expect when you go to the cheapest possible nursing home/whatever medicare will pay for. If they really cared they'd put her in a more expensive/better nursing home".
for me. I won't work at a LTC/nursing home that I feel gives substandard care AND that I can't make a positive change for the better.
Plenty give substandard care...just because of staffing issues not because they intend to. I think they get caught up in "it's the way it's always been done" as opposed to thinking of new ideas about patient care, selective hiring practices and setting schedules, timetables and consequences for substandard care.
I do think that many bad nursing homes could be changed...but it's just apathy. The feeling you can't make the change alone. Mgmt who is too interested in the bottom line ($$$) than overall positive change is a problem. I understand they need $ to operate but how about not skimping on the little things...hand sanitizer, gloves, GOOD personnel who like and want to do their jobs, administrators who are not just good at pushing papers but can actually lend a hand if needed..not just call in people who can...at time and a half or agency prices.
I may be a new grad. A jobless new grad ...and maybe I'm a bit eccentric in my thinking that team nursing really means having an adequate team to work with. From administrators on down...I also think everyone who works in a LTC/nursing home...in ANY capacity should have CPR training and emergancy training.
So instead of me watching over 65 residents in the dining room...just in case one chokes or needs cpr...I can do what I should be doing...caring for the ones not well enough to even GET to the dining room. Instead I'm getting paid to be a cafeteria lady? Get an administrator in there....let us nurses actually NURSE.
Just to attempt to set the tone of my "voice"- I'm not angry or attempting to be hostile :) Just sad that people feel LTCs are represented by a very few they may have heard about- but not worked in one :heartbeat
I'm sorry this is your view of LTCs The vast majority do well by the residents. The state monitors any problems that are called in by the families or residents. SOME are bad- but they don't generally last all that long. CPR is required of direct care staff. Some others have CPR training by choice. Like in a hospital.
If you haven't worked LTC, (nothing said you had- just going by that), please don't assume they're generally horrible places. Many of my favorite jobs were in LTCs because of how much they did care..... not judging you for not wanting to work LTC- that's no different than me loathing the idea of working OB - But one or two heard about on the news over 5-10 years doesn't represent the 1-2 HUNDRED that are doing just fine
I never said that everyone should care for their loved one at home. I specifically said that some people can handle the stress and some people cannot. I specifically said that everyone is different. I totally understand that some people do need to be in nursing homes. I am being attacked for no reason.
For several pages of posts, you are the only one bringing YOU up at all :)
No we don't throw out their wishes. Which is why I said I can respect that. I don't know what my decision would be if one of my parents decided they wanted to be in one place while I was in another far off area. I think that if they were demented enough, I would find a way to move them closer to me and the family. I would want to be with them on holidays and be actively involved with their care. So I would probably find a way to move them. I would see how well they could adjust to the new environment. But if they are so distraught and depressed then I have no other choice but to bring them back to where they belong. Can't say I didn't try. I just hope I never have to make a decision like that. But if i do, I would HOPE that I am always able to visit, near or far.
No, we respect peoples wishes period. It doesn't matter how demented they get. JMHO. That's like saying someone is a DNR, until they pass out and then we can code them. It's disrepectful.
Yes this is true, but all bad parents aside, what about those who were good to their children and don't get any visits. If distance is an issue, why not bring her to a closer nursing home. Some of our residents have been moved for that reason.
For some (not all, obviously :)), THEY have friends in the area- and/or it's where they feel the most at home, or changes (in the case of some phases of dementia) would cause more harm. There are a lot of reasons, just as there are a lot of situations. Maybe the family calls as often as possible? Maybe they don't..... bottom line, it's between the family and resident. :)
I have a personal experience about placing a loved one in a nursing home. My grandmother started showing s/s/ of dementia and Alzheimers. She lived way out in the sticks on a huge farm. For a few years since we had a very large extended family, we would take turns staying with her. She would wonder the house at night, and sleep all day.
My aunt who was my grandma's power of attorney (made while she was still lucid) decided to go on a Paula Dean cruise and just didnt want to be bothered. She against all of our wishes put my grandma in a nursing home. My grandma was being taken care of at the farm she had lived on for over 60 years. All of us grandchildren and great grandkids and aunts and uncles took turns staying with her. That was the only reason why my grandma was placed in a home. My aunt thought of her as a bother. But she sure did spend the money in the trust though without a second thought.
My grandmother died about a year after placement. Even though she no longer remembered her grandchildren, she knew she wasnt at home. Fortunately the place she went to, was actually on of the good ones.
I see both sides of this debate. As a nurse who did geriatrics I considered my "patients" part of my family and tried to do the best I could for them. This isnt a easy decison.
I work in a memory support unit in a LTC facility. Our place is INCREDIBLY nice, but there are those that aren't.
My opinion is that most of the time, obviously its not that the families do not want to take care of the person, its that they know someone else can do it better than they can. If they choose a nice facility, it IS because they love them and they chose a nice place to do it for them when they cant. Whether its due to they have very busy lives, and it would be a strain on their family, or that they just cant take it emotionally. If they didnt love that person, they could just throw them in any old place. Unfortunately, the "cheaper" nursing homes also tend to be the worst ones. Not always, but most of the time.
SO I would agree with the second statement. If you really care about them, you will find somewhere nice where you dont have to worry about them all the time. Somewhere you trust.
We have one little lady that is exit-seeking all the time, and every day she packs up everything in her room and puts it in trash bags because she thinks she needs to move out. She is worried her parents and husband dont know where she is. She has been there for a year and her husband just died last month. Sometimes we are honest with her, and you see this look of realization come over her face. And sometimes we try to re-direct her behavior. Those times when she remembers everything weve told her, this look of sadness comes over her. You think she not all with it, but then she sits there and says "Well, this isnt living. This is just existing". She definitely understands the impact of where she is and how much it has changed her life.
The debate is whether or not they are really happy where they are, and some of them cannot tell you. Or they dont have anywhere else to go.
I agree. if you ever loved your mom or dad you won't let others took care of them. Other caregiver (I'm not saying all) don't care on what your moms feeling right now or let's say they having some pain or something that makes them uncomfortable. But the caregiver just ignored it. why? because they had a lot of patient to take care if and yet it is not their mom or dad they taking of so they don't even care about them. They just care about the money they care on that facility. So if you do really love your parents you won't send them to nursing homes. You must care for them as they cared for you like you were in your developmental stage.. :redbeathe
So by your reasoning I should have gone against my mother's expressed wishes that I not bring her into my home when she was imminently terminal rather than placing her in the SNF where she had worked for 15 years and was loved by the staff, as she verbally requested, repeatedly.
Or how about my father? He and my stepmother abused me and my (older) stepsibiling so severely that CPS told my mother they would place me in foster care if she allowed me to go back and placed my stepsibs with their biological father, in the 70s. I made an attempt at reconciliation when I was 20 because my step-mother had run off with another man and he seemed to have changed. He abducted my 2 year old daughter and hid her for 6 weeks because he didn't approve of my husband.
You know nothing of which you speak, nothing.
I had my back broken by a 48 year old man who was a big, strong, healthy steelmill worker until 4 weeks before he was admitted to my facility due to Lewy body disease. His wife had 3 young children at home, do you honestly think taking him home would have been the "right" thing for his wife to do? How about his elderly parents, should they have taken him home to care for him? Or maybe his siblings with young children?
This is a totally separate issue, but when somebody gets really really bad, why isn't it more routine to discontinue their regular meds (like BP, anticoags, etc) so they won't live as long? Withdrawing treatment is not euthanasia but it seems pretty taboo.
I don't think enough people talk about that.
Because withdrawing those meds is far more likely to cause more pain and suffering than not. It may shorten their lives expectancy but could destroy any comfort or quality of what life remains.
Because withdrawing those meds is far more likely to cause more pain and suffering than not. It may shorten their lives expectancy but could destroy any comfort or quality of what life remains.
Heh. I always like when the family agrees to "comfort care" - that very withhlding of medication except for comfort - and the resident promptly perks up and goes for another few years. It's almost magic.
And we don't do it because it is, for many, tantamount to murder. Do you want someone to decide that your mom is no longer worth keeping alive and discontinuing her Coumadin?
I've seen family members who decide to DC all of their parent's meds because they're the POA and mom and dad simply aren't dying fast enough, get them put on hospice, and repeatedly ask us to "hurry things along." They're always so disappointed when we put the patient on comfort care and they actually do better and live longer than they would have if they'd been being dragged from doctor to doctor and having invasive procedure after procedure. That's been proven in studies from 2004, 2007, and recently in 2010.
Where did I say everyone has to take care of their loved ones at home? I never said it.
Don't save a bed for me. I will not be going to LTC. I will go live on the streets with the homeless.
Blackcat, I totally support your decision to do what was right for you and your mother. It's the way you worded your first post, it was very condeming of people who don't make the same choices you did.
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xtxrn, ASN, RN
4,267 Posts
Just to attempt to set the tone of my "voice"- I'm not angry or attempting to be hostile :) Just sad that people feel LTCs are represented by a very few they may have heard about- but not worked in one :heartbeat
I'm sorry this is your view of LTCs
The vast majority do well by the residents. The state monitors any problems that are called in by the families or residents. SOME are bad- but they don't generally last all that long. CPR is required of direct care staff. Some others have CPR training by choice. Like in a hospital.
If you haven't worked LTC, (nothing said you had- just going by that), please don't assume they're generally horrible places. Many of my favorite jobs were in LTCs because of how much they did care..... not judging you for not wanting to work LTC- that's no different than me loathing the idea of working OB -
But one or two heard about on the news over 5-10 years doesn't represent the 1-2 HUNDRED that are doing just fine 