*VENT* Resident being sent back to the one who put her here!!

[pj_marie]

I can not believe this. I have a resident in my group that is going home Sunday to live with her grandaughter. My problem is this "grand"-daughter is the reason she came in in the first place. How can this happen?? This resident came to us with severe burns reaching across her thighs and groin from a heating pad... the scars are horrible!! She also had a stage IV decube on her coccyx that you could easily put your fist in. It took months and months for her to even begin healing. I don't understand why it was never reported or better yet, how the same person that put her here can now take her home. We are all so afraid that she will come back to us in far worse shape than when she came in a few years ago. We are all just sick about the whole situation. Thanks for letting me vent though. Have any of you ever had things like this? How do you cope with it??

On a lighter note,

Here's a question for ya..... Is it just me or can you also tell when it is a full moon without looking at the sky? LOL. I knew tonight was a full moon before I ever saw it. The residents were all completely LOOPY!!!!!!!! Some of my best memories are from full moon nights though, really makes you laugh and picks you up on those nights when you need it. I have been reading all of the ER threads about "the funniest/wierdest/scariest things you have ever seen in the ED" and I tell ya, LTC has those moments too, with/without a full moon! LOL.

PJ *Proud CNA*

[Blackcat99]

Perhaps you could contact the aging and long term care agency in your area and ask them for advice. It sounds like she may indeed come back to you in the future with more problems.

[leslie :-D]

every ltc facility has an ombudsman and their number should be clearly posted.

and yes, i recall a few times that i've had concerns about someone going home. i did what i did and left the rest to the powers that be. it is difficult in letting it go.

and finally, i often knew when it was a full moon. predictably every month when my residents were 'off' (including my hospice pts which weren't elderly) i would later find out it was a full moon, give or take a day.

a very strange phenemonon, for sure.

[CoffeeRTC, BSN, RN]

Who is doing the discharge planning for her? Why would your facility discharger her to such a bad environment?? Is it payment related? Was a home eval done? Was the department of aging involved with the case in the begining? Sounds like there is more involved. I wouldn't want to be the nurse signing the discharge papers.

Yep about the full moon. The yelllers yell more, the fallers seem to fall or wander more. I'd like to do a study on the number of incident reports in relation to the lunar cycle. Think it would be interesting!

[pj_marie]

Who is doing the discharge planning for her? Why would your facility discharger her to such a bad environment?? Is it payment related? Was a home eval done? Was the department of aging involved with the case in the begining? Sounds like there is more involved. I wouldn't want to be the nurse signing the discharge papers.

Yep about the full moon. The yelllers yell more, the fallers seem to fall or wander more. I'd like to do a study on the number of incident reports in relation to the lunar cycle. Think it would be interesting!

Now, that's a study I would love to be a part of!! LOL. I am sure the results would be interesting to say the least.

The facility has been doing anything and everything to ensure that she is going home to the best environment possible. The MD even ordered that she hire HHAs to come in at least once a day to check on her and do what they do. That met with some resistance from the granddaughter though, was quite interesting to watch that little pow-wow. On paper, everything is in place and looks good, we are all still quite concerned though, I guess that is there with every resident that goes home though. I just hope it goes smooth and she does just fine. We had a resident that was on his way out the door to the parking lot a few months ago to go home for good when he fell, breaking his hip and busting his head open. Not a good outcome on that one, I hope to not ever see that again. It was so sad. Thanks for the support though, I appreciate it.

PJ *Proud CNA*

[obeyacts2]

I think in a case like this I would have some notes made up about things you saw/noted about this resident. If something happens, God forbid, Im sure people are going to say why was she discharged to that situation. I have a case I am keeping my own notes on, an elderly 87 yr old who is think is being financially exploited.(She is supporting several able bodied unemployed male relatives) The loving daughter (sarcasm) got annoyed that I brought it up to her, and I foll0wed proper reporting channels for my agency. I did what I could, but if something happens......no one will be able to balme me for not reporting.

Laura

[kathy_79]

i would advice to talk to social worker, don, other family member to get involve and to see what can be done in such bad situation. i think like most of you that pt should not be placed under her grandmother care if she was the reason of what happened to pt. there should be taken some help steps to avoid the same situation in future and to stop suffer for your pt also.

[meownsmile, BSN, RN]

The discharge planner for your facility should be working with the department of aging and community services about monitoring the situation. Im sure that is probly the case and although i know you are concerned about the situation you have to remember it is family, they have ultimate control unless the court is willing to step in and appoint a guardian. It may very well be that this person may reappear in a couple years with the same situation but unfortunately it is your job to take care of her within your facility not at home. About all you can do is hope social services/discharge planning do their job and pray that she remains in a safe environment.

[CardioTrans, BSN, RN]

The discharge planners at your facility could arrange for home care to come in and help with her care. If she has Medicare and a qualifying skill, and is homebound, Medicare will pay 100%.

Also, what about teaching the caregiver how to care for this lady. Nutrition to prevent or help heal the decubitus, proper skin care, and lets not forget about the proper way to apply a heating pad.

Also, if DHR is given a report of an unsafe home environment and find it to be true they can ask the physician to sign a letter stating she is unsafe. However, from yrs of home care experience most MDs will not do this. They dont want to get involved in court.

Heres hoping the lady will be ok.

[Mister Chris, MSN, NP]

The discharge planners at your facility could arrange for home care to come in and help with her care. If she has Medicare and a qualifying skill, and is homebound, Medicare will pay 100%.

Also, what about teaching the caregiver how to care for this lady. Nutrition to prevent or help heal the decubitus, proper skin care, and lets not forget about the proper way to apply a heating pad.

Also, if DHR is given a report of an unsafe home environment and find it to be true they can ask the physician to sign a letter stating she is unsafe. However, from yrs of home care experience most MDs will not do this. They dont want to get involved in court.

Heres hoping the lady will be ok.

Yes Yes Yes - get the 'message' to the community nurses and her own doctor and don't hold back on missgivings (but don't get yourself sued!). Stick to only the facts that are documented at your department - from the day she was admitted. And you do not have to inform the caregiver of all the details that you send to the community nurse and doctor. But you must stick to the facts only.

Been there a few times and have been very upset about the 'lack of care' once the client had left our establishment. I do not want to live through that again, and do not think that any nurse should have that on their conscience.

Mr.C.