Saturday, June 04, 2011

Is Your Loved One In Long-Term-Care?

Cleaning up paperwork on my desk, I ran into notes and information that I thought instead of filing away, I could share on my blog hoping that some of it might be useful for anyone having their loved one in a long-term-care facility.

I spent a year as an Ombudsman for the State of Oregon until my mother required my full-time presence if she was to stay at home with us. I am grateful to the State of Oregon for my experience and training. I encourage others to seek out this opportunity as a way of possibly helping our residents of long-term-care for the better and maybe help you personally in years to surely come way before you are ready! I can speak from experience of both having my mother in long-term-care for a year; along with my Ombudsman experience and now as a caregiver myself.

I found scribbled on a yellow note pad some notes that I must have written down during one of frequent training meetings while serving the state as a volunteer regarding meetings for a Care Plan or maintenance of a Care Plan.

When you have a loved one in long-term-care, you should consider yourself their best and strongest advocate to make sure their care is top notch along with protecting their rights. One cannot assume that care facilities have an interest in following the best laid plans for care. They often find themselves short staffed, unwilling to train help to high expectations and/or simply in the business of making money without willing to spend money or time improving and making life and health a top priority for their residents.

When my mother was in a local facility, I found that I could not assume that she was being well cared for. I wrote an article at the time so that I would not forget what she and I experienced. Reading this over, I find myself still angry about her care. I cared. I asked questions and I persisted and still with little or no improvement. I ended up taking her home. My article written in 2008, speaks volumes describing my frustration and my mother's lack of proper care with little dignity.

Back to the yellow pad notes:

Making sure you have the legal rights to sit in on a Care Plan Meeting and to look over facility medical notes either by a Power of Attorney or Guardianship and possibly a note from the resident saying you have this right, attend a meeting of her caregivers in the facility where they are a resident.

  • You can state that you are there to act as your resident's advocate. Keep it informal as you can telling them that you have written permission or rights to access medical records prepared to show them your permission.

  • When you look at the nurses notes, look for problem notes from day 1 and if there are missing dates with nothing written. If nothing written ask for the shift log. Remember getting nasty will not get you what you are looking for.

  • The Care Plan should not have omissions and inconsistencies.

  • Flow Sheets will see what portion of each meal is eaten by your loved one or possibly tracking diabetes issues. Keep in mind that I have had caregivers in facilities report to me that they have been asked to fudge on these reports by reporting a shower given even when they did not shower the resident. Imagine one worker showering 17 residents. Common sense says that this is nearly impossible especially in a Memory Care Unit where full assist is needed.

You might be very disappointed knowing the records could be incomplete or just plain wrong showing you the need for an advocate.

  • Now, you have the added task of feeling the hair of the resident. Is it oily? Does it smell bad? Keep a log for yourself on what you experience. Are their clothing soiled. Is it even their own clothing?

  • Can you smell urine when you walk into a unit? If you can, what else is not being taken care of?

I took an inventory of what my mother brought into the facility and actually took pictures of each and every item. It is amazing to see what is mixed up. I even insisted on washing my mother's clothes hoping to keep this problem at bay. It did not work. Clothes would show up and clothes would go away.

  • Does your loved one have a hearing aid or glasses and false teeth? Note this on her entry forms. Keep a copy for yourself with signatures. The facility is libel to replace lost items. It is hard to convince anyone that she lost what they don't have written down.

We should be irritated and even angry that we have to do all this when we are paying 4-10 thousand dollars a month to house our loved ones in a facility. Keep those notes. Call your local Ombudsman when you have any problems and attend any support meetings the facility has for residents and family. We cannot expect improvements if we do not participate as an advocate watching out for those we love and care for.

Now, is your loved one even wearing the hearing aid or the glasses? Is someone helping them see and hear? My mother was left in silence most of the time.

As disjointed this blog is today, I am hopeful that it will help someone that has someone in long-term-care or is thinking that it will be necessary sooner than later. Feel free to give comments and/or ask questions.

Wednesday, June 01, 2011

A Singular Woman by Janny Scott

I received the book, A Singular Woman by Janny Scott for a Mother's Day gift from my daughter-in-law and son. It was an excellent choice! A review is in the link above and also here -- written by the Indianapolis Star; which so happens to be where both my children were born.

I found myself intrigued and sympathetic to the mother of our President, Mr. Obama. Ann was born one year after me in the Midwest of America where I am also from. Civil Rights came in our early adulthood along with a war many did not believe in fighting. Our world view was similar and our experiences very much the same.

Unlike this remarkable woman, I chose to marry and raise children loosing dreams to explore the world trying to understand what makes us who we are. I would have been in some far off land living in the unknown, if I had been braver and much brighter. I let my insecurities rule my life instead. I failed to give my children a more inclusive view of the world they live in.

I know Mr. Obama's mother failed him by her choices to live separated from him. I know moving to strange places is not a child's dream of the perfect childhood. As she failed her children, I failed mine. I did not follow my dreams. I settled for less and did not grow either mentally or spiritually for years letting my children know that their mother was not important. I was always last on a list to respect. I doubt that Mr. Obama disrespects his mother or finds her incomplete. I found myself rooting for Ann as she struggled living the life I would have loved to join in.

She made a brave and risky choice marrying a black man from Africa. My parents would have died if I had done the same. I had an urge to be someone who could buck the system in order to make our world better. I wanted to stand up with my beliefs holding me steady, but I chose a man who matched the list of who I should marry. How strange it is that even using the list, he turned out to be so much less than I wanted. I was not happy with the traditional role of a married woman of the time. I was always fighting against my limited world. I refused to believe my perfect man would not allow me to have independent thoughts if he did not agree with them.

So, our President had an example of a brave and determined woman. She might have given him instability, but she gave him the world as his place of occupancy instead of only a small area in a safe place here in the United States. I gave my children a sense of constant motion in their childhood by not being firm in my belief of who and what I was.

If I would be Ann's friend today I would remind her of the wonderful choices she freely gave herself. Her children learned from her example. No man of history is discounted for his lack of staying home with his children. Our President would not be the man he is without his mother's example of following her heart doing what she loved and found valuable to give the world. I wish that I had been that woman for my children.

I often wonder what my life purpose is. I'm not sure I even have a purpose. I try to appease myself with thoughts of tolerance and love as purpose. Never the less, I think I gave my children nothing that I consider valuable. It is a sad thought. My children suffer from this inability on my part. They see my tolerance and love ideas nothing to respect or to be emulated.

Needless to say, A Singular Woman, was a hard read for me. It woke me up to what I did not do in life and what I did not give my children. My most important parts will not live on as Ann's do. Thank you, Ann, for giving the world a great man. Thank you, Ann, for being strong and singular in mind. Thank you, Ann, for loving across lines of shoulds that were part of our times. I wish I had said to someone that my son could be President. I did not dream that large. It is my son's loss and my failure.

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We blog about our rural area in the Pacific Northwest . This blog is all about my life and the places where my mind wonders from day to day. Have fun reading and looking at pictures. We welcome comments.

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We moved to our current home on the Wild River Coast of Southern Oregon from San Jose, CA. Our family consist of Jim and Karen, two dogs and two cats. Karen's passion is gardening. Jim's obsession is building electric powered fishing kayaks and fishing.