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My mom lives in a memory care unit. Tonight my sister reported she did not get her bath. She was told the water was turned off. She did not get the dental treatment prescribed by her dentist. Nor did she get cream administered to her bottom for a diarrhea issues.

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Baths are only given about 2/3 ×s a week. I would talk to the Director of Nursing and find out what is going on.
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KristenNC Jan 2020
Yes, tonight was her scheduled bath night. I have reported to the nursing director before, it is getting very frustrating.
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Contact your local ombudsman. Should be posted at your mom’s MC facility.
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ImageIMP Jan 2020
Sadly - not necessarily...
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I’m so sorry that you and your mom are going through this. She deserves to receive good care. They are being paid to do a job. What are their reasons for not doing a satisfactory job? They owe you an apology and an explanation.
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Kristen, was the water turned off in the whole facility? It sounds like there was a plumbing emergency of some sort. Unpleasant, but unavoidable. Talk to the DON in the morning about rescheduling mom's missed bath. (I assume that it was your sister who was told the water was turned off, not mom reporting that. We learned to be very cautious about what mom told us about the facility. She told us about big floods, problems in the basement [there was no basement] and also that she wasn't allowed to have showers anymore because she would have to stand. None of these things were true).

The other two issues are more concerning. Having been through this with my mom in a NH for 4 years, my advice is this: ask for a care meeting! Focus on these two issues--why mom is not getting prescribed treatments.

It may be that mom refuses. It may be that mom doesnt remember getting the treatment. It maybe that although the dentist prescribed the treatment, the med was not ordered. It could be that although it was prescribed in his notes, it never made it into the DON's chart.

We found that there multiple ways that mom's treatment could get screwed up. Fixing it remotely never worked. Having a meeting where all the players were in the same room worked every time and helped us understand better how the system worked.

It IS exhausting! Good luck, and let us know how this turns out. We learn from each other.
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Grandma1954 Jan 2020
I am looking and I can not find a comment about the water being off? Where did you get that info.
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The starting point is your county Ombudsman. Also report to any state agency that deals with the Aging. Neglect can rise to the level of abuse, and allegations of abuse usually get the attention of the powers that be. You must let them see that you will not sit by silently while your mom is neglected/abused. Good luck.
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It's in the original post. "She was told the water was turned off". 3rd sentence.
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Grandma1954 Jan 2020
I saw that just after I hit "post answer" I did several head slaps and posted a "sorry" to you
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No need Grandma! I do that ALL the time!. I'm still curious what the OP found out about this situation

My mom, with the beginnings of dementia once told me, " you know, I have to manage my own meds in here". The nurse was sitting there and had just given my mom her afternoon medications. When I asked mom what she meant by that, she pointed to the water pitcher with a "significant" look.

From that moment on, I verified what had actually happened before I got upset with staff.
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ImageIMP Jan 2020
I get that, but... I actually doubted what my Mom told me about several things (she was pretty bright overall, but had "moments" of confusion). She told me her roommate in the nursing home and she didn't get along - that her roommate called her a liar and yelled at her, etc. I discounted her story, because I'd met the lady and couldn't imagine her acting like that. That is, until the lady across the hall took me aside and told me that Mom was being abused by the roomie and she had told the nursing staff but they weren't stopping it... Her story was the same as Mom's, except Mom hadn't told me all of it! The room was set up very poorly, and the roomie had to be disturbed and actually move frequently if someone went to Mom's part (back) of the room, or if Mom wanted to leave the room... She was therefore taking it out on Mom - verbally haranguing her, physically barring her from leaving the room, and - worst of all - hitting her with a wooden back scratcher. I told the staff I knew about the issue(s) and would not tolerate anything further - they had to take care of the lady's behavior or move her away from Mom! A week later, the gal across the hall again filled me in that things were still bad, and I again talked to staff but told them that if she wasn't gone from Mom's room within 24 hours I'd report to Senior Protective Services... She was moved. I really felt bad I'd doubted Mom's original report to me!
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The health system needs changes in NYC ! the culture needs rebirth .... seriously... reporting has no effect .Nursing homes are like murder houses. The staff is usually partially trained, fast trained, un documented on cheap payments ,poorly trained, from various colleges ( no quality ) with non accreditations. There is no in house training, no supervision,no quality controls, no CMEs and no education for staff.
I saw an aide using a towel to clean poo and the same towel to wipe the body and face ! is there any infection control?any hygienical system ? health is wealth. sad status...also the nursing homes employ less staff and they are over worked.
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With concerns, always go to the Director of any facility before calling outside sources. It keeps sanity in the situation and usually brings immediate change.
Be kind to the staff. Rudeness rarely stimulates the behavior you want.
A thank you, a smile, a box of donuts... goes a long way with kindness.
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lealonnie1 Jan 2020
Well said & very true. Killing a fly with an elephant gun rarely gets the desired results.
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Medicare & Medicaid Services is the contact and they have an Ombudsmen who will contact you. The Ombudsmen is the go-between the patient or family member and the nursing facility. You file your complaint with them and they are suppose to check it out. Google Medicare & Medicaid Services and you will find the link. You can also call Medicare or Medicaid and ask for the local Ombudsman's name and phone number. That is where you start.
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ImageIMP Jan 2020
Sadly, there really is not an Ombudsman easily available everywhere... I live in Oregon, and tried several times to find an ombudsman without luck. The only contact I finally had officially - was with overworked/bored/disinterested case workers with DSS when Mom went on Medicaid. Prior to that, I couldn't get any help either when the first facility she was in injured her... I followed through with an official complaint with the State of Oregon, but the whole thing - after "investigation and discussions with staff and witnesses" - got swept under the rug. (There were no other witnesses but me, and of course the staff were going to be open and honest about what they and and were doing to her? They rigged up reports, and although I had irrefutable evidence, written and photographic, ignored all.) Sorry - I'm just reacting to the many suggestions people have to call the Ombudsman when that isn't really always an available option.
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1 - Talk to the nurse on duty when you notice a problem. He/she can address the issue on their shift. The nurse is responsible for the care the CNAs give.

2 - If the nurse can not resolve the issue, contact the director of the facility. Be specific about the issues that need to be addressed. Give them a reasonable amount of time to address the issues, but you should see improvement within the week.

3 - If no improvement within 3 weeks, report it to the state. I would also consider placing LO into another facility at this point.
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Write a letter to facility to report all of these things now. A phone call is not addressed in the same manner as written document. Trust me on that. If she missed bath one night due to water off (why was it off?), did she get one the next day/night? No excuse on the cream/medication.

What sister witnessed may be a more common occurrence than what any of you were aware of and is a good indicator someone needs to be visiting daily to see what is really going on. Patients who do not have visitors are recognized early on and it is very easy to put their care on the back burner.
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Oh boy...get used to this! I guess this is your 1st time. There will be many more dysfunctional occurrences... Sorry.
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lealonnie1 Jan 2020
My mother has been living in Memory Care (the same ALF for the past 5+ years) and the only thing I've had to 'get used to' is great care by the entire staff the entire time she's been there. Making a generalized across-the-board statement such as you've done here is ridiculous.
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I would report the facility to the state department of health as well as the area agency on aging's ombudsmen. I would also speak with the director of nursing as well as the administrator of the facility. Lastly, if the facility is part of a corporation of facilities I would report them to that level as well.
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Call the Executive Director or the Director of Nursing and let him or her know of your concerns and the situation you've learned of. Not getting a bath b/c the water was turned off can't be helped; it will be given at a later date; that happens. Bathing can be postponed for a variety of reasons, as long as she's put back on the schedule for another day in the very near future. The staff should definitely be attending to the application of barrier cream so the situation doesn't get out of hand. I don't know about 'dental treatments'...........there's only so much the staff is permitted to do in a Memory Care ALF situation. Unless your mom is in a Skilled Nursing Facility and even then, make sure such treatments ARE part of her care plan so you'll know for the future.

Always take a gentle approach at first, that's my suggestion. Reporting her care home to the state, the ombudsman, the corporate headquarters, etc, is just a bit of overkill unless there is true negligence or abuse involved, in my opinion. The DON or the ED is usually more than happy to address your concerns and get things handled for you in a professional fashion. If not, THEN you have the option to take things further.

Best of luck!
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Lynn105 Jan 2020
It IS NOT OK FOR A HUMAN TO NOT GET A BATH OR DENTAL CARE WHEN EVERYONE STILL IS REQUIRED TO PAY MONTHLY FEE. R U SERIOUS? I'VE DEALT WITH NUMEROUS NURSING HOMES AND REHABS. AGAINST REGULATIONS. THEN THEY, NURSING FACILITY, NEEDS TO CORRECT PROB ASAP OR CALL SOMEONE. B S.
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Im very sensitive to elder care. Call Directive of Nursing. The Dr in care of ur Mother at Facility. An threaten to call Board of Nursing an Ombudsmen an H.H.S. thats bull. Report.
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The question to ask is "Why is she not getting her bath, her medication (cream) or dental treatment"? You want to ask these questions , see if they tell you "the water was turned off".

If your mom is refusing to take a bath, or have her dental treatment, the staff can not force any treatment on her. That being said they do need to encourage her to take a bath, have her dental work and let them apply the cream. Staff should offer the treatments more than once, have different staff approach her and do everything in their power to get her to allow them to do these things.

The number one refused treatment in nursing homes is baths. Residents refuse to take a bath more than they refuse medication, therapy, diets, doctors orders or anything else. When a resident is refusing to take a bath the staff need to try and figure out why the resident is refusing. Some of the reasons I have seen residents refuse to bathe are the time of day, water temperature, water pressure, personality conflict with staff, a dignity issue, cultural issues. When a resident has dementia they may not understand what the staff are asking them to do, they don't process information like we do.

I would recommend you talk to the Director of Nursing and request a Care Plan to discuss these issues.
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What kind of dental treatment is she supposed to have? Can't imagine a CNA or what have you has the training for dental work beyond the very basics, like brushing and flossing.
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Speak to the Director of Nursing.
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elaineSC Jan 2020
Oh my, when you said Director of Nursing, it brought back memories. That would make the most sense but the facility my mother was in had a Director of Nursing that was in a circle of co-workers or “gang” is what I called them that believed the bad egg LPNs who were slackers and lied about my mother’s meds. I filed a formal complaint when I witnessed it myself and another patient’s family member saw too that some patients we were familiar with were not getting their meds. They all lied and covered for each other and I took it to the Administrator and got mother moved onto another unit there away from those lying people. Unbelievable! It was like a nightmare. They covered for each other because when one was out, they needed the others to cover their jobs so they took up for them.
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Everyone deserves to be heard, residents, families of residents and the staff.

I sincerely hope that all of your issues will be resolved. Don’t give up. Sometimes there are protocols that must be followed and it takes a bit of time to follow through with procedures. Reports have to be made and so forth. They will investigate the facts. It helps to know as much as possible before filling a report.

There are always going to be issues in facilities due to one reason or another. I think you have to feel good about what is being handled well and address issues as they arise.

When my mom was in rehab in a nursing home a few issues came up. One serious, an overdose of meds, the others I would consider not quite as bad. One was gross, my mom freaked out about her roommate using her toothbrush and water cup. Usual stuff, clothes missing, staff taking awhile to respond to call button, roommate’s television blaring, etc.
It’s awkward for the residents and family. I am sure it’s hard for the staff as well.

My mom did not want to be viewed as a troublemaker so she was hesitant to even tell me about the circumstances. I was like you. I was cautious.

I think it’s good to be cautious instead of a hot head that flies off the handle quickly. I showed appreciation for what had been handled correctly and then I went forward in filling a complaint about mom being over medicated due to an LPN not wanting to make another trip back to mom’s room for her final dosage of her Parkinson’s meds.

I was really surprised that the nurse told my mom, “Here, take two pills now so I don’t have to make a second trip back to your room.” Crazy, huh? Mom is sharp! She immediately told her, “That is twice the amount and might hurt me. Will taking two pills at once hurt me?” The nurse replied, “No, won’t hurt you. Take them both.” As I said, mom not wanting to be a troublemaker did as she requested. I was so upset with that nurse.

I realize they are short handed but they shouldn’t modify a resident’s meds!
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CaregiverL Jan 2020
NeedHelp, tomorrow morning I would have a meeting with the Nursing Supervisor or Director. medicine should be taken as prescribed on bottle by dr. ..not changed by lazy nurse not wanting to make 2 trips! I would be so incensed that the whole building would hear me. ..When my mother was in SNF, a Nurse left my mother’s meds on her food tray for her to take herself! My mother has dementia & doesn’t know what she takes or when. If that tray was taken away ...mother would not have gotten meds & it would go recorded as dispensed. When I saw pills on her tray, I immediately called over nurse who was passing meds & pointed it out to her....& she apologized saying she was distracted by another patient....& next morning I went to Nursing Director to discuss....
Hugs 🤗
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Call your local ombudsman. They are available to assist resident with issues.
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I am seeing several replies stating that your mom isn't reporting things accurately because of her memory. While that may be the case, I would definitely look into things. I have personally experienced being told things that sound like they may have been exaggerated or not correct, but then had them confirmed by staff. I have also been present for medication mismanagement (missing, wrong time) and my grandmother is in an extremely nice facility. My family had to make sure these issues were quickly resolved and we know not to brush anything off that sounds like it may not be accurate. Don't get me wrong, there are many statements that aren't correct, but some have been. Talk to the staff. In particular the head nurse and the director. It also doesn't hurt to make friends with the caretakers and housekeeping. Best of luck to you and your mom.
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