I wonder if you experienced LTC workers think that these demands/observations are unreasonable.
These are some comments I heard (or heard about) the past weekend by several different resident's family members (mostly private pay):
An aide goes to answer the call light and the daughter is standing there tapping her foot and says, "Do I need to go call the administrator and tell him you don't have enough help? Mom has been waiting here almost 3 minutes for someone to take her to the bathroom. And look at how filthy the wheels on her bed are...do they ever bleach these walls???"
A resident's son angrily comes to the nurse and says, "my mother has been needing to go to the bathroom for an hour!"
The nurse asks why the call light was never turned on and the son says, "don't you think you people should make it a point to check on these patients every few minutes or so???"
This happened to me. A family well known for griping about everything came in about 8:30AM to see dear old Mom. I had been in there 30 minutes before to give her meds while she was eating breakfast. The call light goes off a couple of minutes later and I walk in and smell poop. Her husband says, "She tells us she's been sitting here in mess since 5:30 this morning. I tell him that couldn't have been and why and when I leave he immediately turns the light back on. After a couple of minutes (the aides are busy tending to others at the time, I hear him say, "they need to get here TODAY! TODAY! TODAY!" He leaves but makes sure to call back Monday morning and tells the management he came in at 10:30AM and his wife had been sitting in mess since 5:30 that morning.
If I have to deal with much more of this I'm going to lose my job because I'm going to tell them to wheel the car around to the side door so we can roll Mom's or Pop's @$$ out there and they can take them home and do it themselves. Private duty is not included in the price of their bed.
The good residents and families we have are REALLY good, and the bad ones make it unbearable.
I just think these are people who would never be pleased.
Although there will always be those who are completely unreasonable -- no matter what area of life we're looking at -- I think it's important to try to see the situation from the perspective of the family members. I think it's okay to ask family members what part(s) of care they are comfortable and want to participate in. For instance, if my dad was in LTC I would want to participate in assisting with personal care such as washing his face, cutting his hair, shaving his face, brushing his teeth, helping to check his blood sugars (he's diabetic) and those sorts of things. When it comes to peri care or toileting, my father and I would neither one be comfortable with that. This will vary on a family-by-family basis of course.
We must also remember that in many cases there is a tremendous amount of guilt involved with placing a parent or other significant family member into LTC. It's someone many see as a last-resort, necessary evil and I think people "hover" because they have heard horror stories of abuse/neglect which may or may not be grounded in any sort of reality.
So we may have to take some hovering, questioning, lack of trust from patients and/or family members. Now if they're abusive to staff, that's a whole different story.
I think it's pretty rotten to call up administration and tell a lie, like the old creep who called up and said he came in at 10:30am (when it was 8:30) because it would add drama to his assertion that his wife had been sitting in poop since 5:30am.
Your comments are one of the reasons why it can be somewhat easier to work on night shift. Family members normally are gone from the facility. One facility I worked at though, encouraged family to come whenever they wanted, so one got to dread dragging in at 11 to find the worst complainers with their mouths in gear.
I know that it does cost a good deal of money to have a parent in LTC. the only reason that someone is a resident is because the family is unable to provide the care needed 24hour a day. We go back to the money. People assume in LTC that their loved one will essentially be receiving 1:1 nursing support 24/7. I have to fault the Admissions coordinators for not explaining the care to be provided (wait, I did this for a couple of years, & I am guilty as well). Usually a person admitted has been in a hospital where the nurse to patient ratio is a great deat smaller, & admissions coordinators must keep the beds full. We are in competition with other facilites for the same residents. We have 1 nurse for 49 residents in my facility. She has a MED AIDE, & 4 CNA'S. Our LTC unit has residents with a varied degree of assist needs. Most need extensive support with ADL's in one way or another. These CNA's are running their collective butts off and give excellent care. We also have families who are overbearing to the point that they will enter a closed room where the CNA or nurse is providing care to tell them that their loved on has to go to the toilet (usually the most incontinent resident there, thats why they are there). NO matter what, you just can't please them. We also have residents who lay guilt on their family, "They neve come when I put on the light for help" When the family isn't there they are the nicest folks, but they have to punish their kids because, "they put me in a home". I just keep smiling & tell them as soon as I can, I will be in there, but please don't impede the work I am doing right now. It is a "me first" mentality, nothing will ever change this.
Its not limited to LTC but I do feel very bad for LTC nurses when I have to deal with difficult families on a long term basis. Like the one I had in acute care this weekend who called everyone in administration (I mean everyone) over a small issue that really was being resolved in the best possible manner. But it just wasn't enough. And this patient was a nursing home patient, so I just am glad that I get to send them back, lol. But I did think, geez I hope this person's LTC facility has some kind of respite or rules for this family to prevent having to deal with them like we did. Yikes.
Specializes in LTC,Hospice/palliative care,acute care.
Bless my DON-she will not hesitate to offer the offending family member the list of LTC facilities in our area and any assistance they may need with transferring their loved one. This is her last resort after all attempts to solve the problems have been tried and have failed and she uses the DOH frequently for advice. This approach works every time-the stooopid and un-realistic demands always stop after that meeting (things like trimming momma's "down there" hair or q 30 minute incontinence care on a 42 bed unit)
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i hate to say it, but this problem is not limited to ltc. i work in peds, and we get crazy, unreasonably demanding families all the time. families that seem to think that they've checked into a 5-star hotel and are mad that the service doesn't meet their expectations. families that will let their kid sit in their own poop rather than changing them or putting the call light on, and who are then upset when the kid gets a diaper rash. families that expect you to read their minds. families that are upset that their kid got their dose of tylenol 15 minutes "late". i could go on, but you get the picture.
thankfully, most of our families are not like that. as for the demanding families, i do what they want as much as i can (e.g., make sure the tylenol is on time or early, as long as i don't have another patient with a higher priority need), but when i can't meet their (unreasonable) expectations, i pretty much just ignore the complaints and just give their family member the care that they actually need to the best of my ability.
these families are everywhere! we get them in the icu as well. and they're becoming more and more prevalent.
mammac5
727 Posts
Although there will always be those who are completely unreasonable -- no matter what area of life we're looking at -- I think it's important to try to see the situation from the perspective of the family members. I think it's okay to ask family members what part(s) of care they are comfortable and want to participate in. For instance, if my dad was in LTC I would want to participate in assisting with personal care such as washing his face, cutting his hair, shaving his face, brushing his teeth, helping to check his blood sugars (he's diabetic) and those sorts of things. When it comes to peri care or toileting, my father and I would neither one be comfortable with that. This will vary on a family-by-family basis of course.
We must also remember that in many cases there is a tremendous amount of guilt involved with placing a parent or other significant family member into LTC. It's someone many see as a last-resort, necessary evil and I think people "hover" because they have heard horror stories of abuse/neglect which may or may not be grounded in any sort of reality.
So we may have to take some hovering, questioning, lack of trust from patients and/or family members. Now if they're abusive to staff, that's a whole different story.