Showing posts with label elderly care. Show all posts
Showing posts with label elderly care. Show all posts

Thursday, February 2, 2017

I am old lady

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Yes, I will admit I'm not a spring chick anymore.  When I arose this morning, I was able to wander around my house at five in the morning.  I turned on my computer, made a pot of coffee and played with my cats.  I was able to look out my window to see what kind of a day it was going to be and I pretty much was able to 'do my own thing,' as they say.

It may not sound like such a big deal, but if you are living in a traditional nursing home, believe me, this kind of freedom is as 'big of a deal' as you're going to get.  I wasn't made to get out of bed at six in the morning, I chose to get up at five and if I didn't want to get up, I didn't have to.  In a nursing home you will be forced to get out of bed for breakfast at six in the morning. Why?  Well it's always, always for staff convenience.  

When I was a nurse aide, I was told:  'We have to get them up and ready because the day shift will get mad if we don't.'  So screw the day shift is my response.  The day shift has 'so much to do already.'  So?  They get paid for their efforts. (Even though I know nurse aids don't get paid near enough for all they do)  I have worked the day shift and yes, people have appointments, they need breakfast and it's pretty busy.  But that still doesn't warrant dragging my old ass out of bed at that god awful hour, especially since all night I've probably already been poked and prodded, so now I've had very little sleep.  No wonder I'd be groggy and upset at being drug from my warm bed. The night shift people would hurriedly dress those old people, all the while saying: "Come on, we have to be in the dining room shortly."  Many elderly balk at being hurried.  Hell, you'd think they had some damned job to get to, instead of paying big bucks to be hurried and shuffled to the dining room like so much cattle.  Traditional nursing homes are full of damned rules.  Rules that, for the most part, are quite meaningless in my book. 

Once they do get into the dining room, they are greeted by nurses with med carts.  Now nowhere on any prescription bottles I've ever gotten, does it say: 'To be takes in a large group at times convenient only to nursing staff.'  My bottles say: 'To be taken at XYZ time of day.'  That medication is supposed to be individualized, for that particular patient.  But, remember, all of this is for staff convenience only.  Which pretty much assures that I'm no longer an individual.  Just part of a herd of cattle.  Kind of like when a farmer milks cows the same time, all at once, in a big group, every day. 

When it's time to shower, also for staff convenience, you will be wheeled into a stall, and the experience?  Well more akin to a car wash than any showers I take in my home.  That Big shower wand, it gets lifted from its holder and a waterfall of water is washed over your head, your face,your eyes, your body.  I'm sure this might be how water boarding feels like.  Getting old and showering, equals torture.  Now imagine, if you will, you have dementia and have no idea what's going on.  I'm sure you would be combative too.

Today I'm going to the local store to pick up some things I need.  In a nursing home, especially the one I worked at as a Social Worker, a place that doesn't even own a van for such trips; that is also a big deal.  That nursing home feels it's too big of an expense to have a van to take people to the stores.  Too expensive to own, even though that facility, as all nursing homes, rake in billions of dollars.  But, gosh, don't spend any of those big bucks on people living there.  

So as you go about your day, just think of all the little freedoms you are enjoying.  Remember, those freedoms will evaporate if you have to ever live in a traditional nursing home. 


Friday, September 16, 2016

For elderly, the vultures will hover



This past summer, a person dear to me, was admitted to one of the hospitals here in Lafayette, Indiana.  It is significant to mention the city and state because hospitals here that were small and cozy have been bought up by corporations.  Most all of the nursing homes here have too.  The once small, cozy, city hospitals, are now equipped with big machines, staff that try to act caring and the names have changed too.  They once had pleasant names like: Home Hospital and St. Elizabeth, names that made you feel warm and fuzzy.  Now hospitals, and nursing homes have big, inflated (like their budgets), names to impress people.  In my book, those names may as well be: We're big, impersonal, and just want your money.  Cities aren't the only places, even small town hospitals have merged in order to make big bucks.  Corporations don't buy any hospitals or nursing homes and spend a lot of money to build all new buildings unless they stand to gain an obscene amount of money.  Like my book states: These places, especially nursing homes, are a billion dollar industry, make no mistake about it.  

The person in this episode went to a doctor here with an infection.  Well, well, the doctors here all work under the umbrella of those corporations.  I suppose if they don't then they are out of business.  Problem here is: Since they are under that umbrella, they, of course, refer as many as possible to the hospital they are affiliated with.  Due to the person's infection, there was a procedure that could have easily been performed in the doctor's office.  Since the actual doctor was 'all booked up' for over two months, this patient had to see the nurse practitioner to be examined.  Well, the procedure required inserting a catheter into a person who happened to be male.  I sat in the waiting room that day and I observed many, many male patients.  The stupid nurse practitioner stated: "I've never done this procedure on a male before."  Not to mention this doctor's office wasn't even equipped with the proper catheter.  Are you kidding me?  What in hell kind of college did this dunce attend?  The whole incident reminded me of the part in Gone With the Wind where Prissy says: "I ain't never birthed no babies, Miss Scarlett."  I know it takes pretty extensive training (or is supposed to) in order to obtain nurse practitioner status.  But since she had a problem, guess what?  Yep, the patient was handed a paper and told to go to the emergency room of the impersonal hospital the office was in cahoots with.  Surprise, surprise. 

I went too, this whole trip was quite an adventure.  Once in the emergency room, your sick ass gets to wait hours for an examining room to open up, once it finally does, you, as a patient, get a needle stuck in your arm only to wait another several hours to see a doctor.  Finally someone comes in saying: "Dr So and So has ordered a million tests."  Well how in hell do you think the hospital pays for machines that cost a fortune?  How in hell do you think they pay for the entire hospital?  By inflating your bills.  So once the patient is wheeled back and forth for tests ( a nice bumpy ride would make me feel a whole lot better) then they get to wait several more hours for test results.  Let me add here that those tests produced nothing unusual and the doctor was sadly disappointed.  This patient is over the age of 65 so, in the medical profession's eyes, there damned well is supposed to be more wrong than the infection.  A person over 65 who is otherwise healthy, unheard of. These massive hospitals are in the business of 'filling every room with asses' so my person went to the emergency room at four in the afternoon and it was after ten at night (six hours later) that a room finally became free.  Oh, before being admitted, the doctor came in and said they'd 'like to admit' this person to the hospital.  Ok, I inquired whether the person could go home with a hefty prescription of antibiotics and be able to rest in their own bed.  I was told that of course a patient could go home, after all it's not a prison.  Since we didn't just say, sure,  admit him to the hospital to inflate his bill, the doctor resorted to scare tactics.  Having worked nursing homes for a number of years, I'm familiar with those tactics.  They went something like this:  "I'm not going to say he might have a heart attack if he went home, (I think he already did say exactly that.0  But he will get better care in the hospital."  Better care?  Seriously.

It played out like this:  He had nothing to eat since lunch.  Was admitted to the hospital at ten at night and not one person on staff ever once asked him if he would like a sandwich, a nutritious drink, not even a lousy package of crackers and some juice.  He got such better care that a nurse came in almost every hour on the hour and woke him to take his pulse, poke and prod and of course this patient rested well.  

Finally the next morning, after all of this indignation, the patient asked if he could go home.  I walked in his room about that time and said: "I'm a certified nursing assistant and I'm sure he would get much better care at home in his own room as long as his tests were negative."  Gee, his battery of tests did come out negative.  Imagine that.  Number one, never ask if you can go home.  Remember you are a paying customer in charge of your own body, even though courts are trying hard to stop you from having those rights.  But for now for the most part......you can call the shots concerning your own body.  Too many people think doctors are God and they think the doctor always knows best.  Not so, you have to be your own champion in health care.  When you are not, this is what big pharma counts on, hoping you will take every pill that is prescribed to you, whether that medicine is good for you or not.  I've noticed, over the years, simple things many of us experience, have been turned into an affliction in order to sell you a bill of goods so they can make money.  Doctors have become the biggest drug pushers in America. Even our televisions are trying to sell us drugs in commercial after commercial.  Just be aware and do your own research because I assure you the drug companies are doing theirs. 

When asked what type of antibiotic was administered, we were told which one.  I said: "Oh yeah, the sort that can cause c-diff."  The nurse immediately looked up, almost shocked I knew this.  She tried to do damage control saying there were other factors that cause c-diff with these very heavy drugs.  No, Folks, these heavy antibiotics can and do cause c-diff on their own quite well.  Now, c-diff can cause harsh symptoms for people over 60 years of age and in some cases, can cause life-threatening inflammation. Leave it to the medical professions to try and cure one ailment and then cause ten more for you to deal with. The patient finally did go home that day, after several hours of being ignored when discharged and waiting for assistance to the front door.  When we went into the hallway, several people who could be helping, were milling around the nurse's station chit chatting.  Nice.

But I think the biggest thing that pissed me off most happened just before I arrived in the patient's room the day he was discharged.  A damned vulture had entered his room and said: "Do you have someone at home to take care of you?"  You want to know why I was pissed?  He is over sixty and I can assure you that if he were twenty, thirty, forty and even fifty, this vulture would have never come into his room to ask that question.  For one thing this vulture saw his age and never bothered to check and see if he was capable of getting around on his own.  It was an infection, which 24 hours of antibiotics will make you start to feel better.  He is ambulatory, able to walk on his own and care for himself.  But the vultures (stupid ones anyway) simply see the age and try their best to drum up business.  Business for whom, you might ask.  For nursing homes and those pesky in-home services that cost a fortune.  Simply because, after all, over sixty spells fresh meat and fresh big bucks.  All I can say is that vulture can count herself lucky I missed that little visit because she would have been put in her place pretty darned fast.  The vultures (maybe even hospitals these days) get kick backs for every elderly person they can prey upon and convince they need help just because they are over a certain age.  Nursing homes don't make money either unless they are filled to capacity.  So, as I said, they all are trying to fill those beds with asses,their main objective, priority number one.  


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Wednesday, April 16, 2014

Pissing me off about the elderly in nursing homes

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I keep hearing and reading about a nursing home that brought in male strippers for the entertainment of the elderly, mostly the elderly women.  Now I hear that some damned adult kid is suing the nursing home on behalf of his mother stating: "She has been defiled."  Get the hell over it Kid!!!!!!!!!!!!

In another news bit I hear: "A nursing home held a Senior Prom for their residents.  To me the strippers is treating the elderly as adults, that Senior Prom is a mockery in my book.  Why?  Well Senior Prom assumes the elderly give a crap about some stupid high school type dance.  Yuck!  While the strippers is giving the elderly the respect they deserve as adults.

Too many damned adult kids think Mom and Dad  or Grandma and Grandpa must be shielded from anything sexual.  Oh my, are the elderly adults now some sort of teenagers who must be protected from sex?  Did the elderly Never have sex?  How do the adult kids figure how They came into this world?  No sex?  Yes, adult elderly have likely had more sex than those cheeky adult kids have ever had.  Grow up!!!!!!!!!!!!!!  Too many people think elderly adults are dead from the waist down.  Stop it!!!!!!!!

For that stupid adult guy who thinks 'Mom was defiled' by joining in the fun.  I was an Activity Director and I can assure you No One is Forced to attend any activity in a nursing home.  They are asked and apparently Mom said: "Yes."  to attending.  You want to talk stupid lawsuits with me?  

I've seen the pictures of his mom on the news, she is stuffing money into the shorts of a male stripper and she is smiling from ear to ear.  I just want to slap that adult child.  

Stop pissing me off over the elderly in nursing homes.  I have an entire section in my book concerning sex and the elderly. 

 

Friday, November 1, 2013

Activity director in a nursing home




It's really hard to cheer people up in a nursing home.  Everyone knows they do not have the freedom they once did when living in their own homes.  They cannot go shop whenever they like, they cannot just decide to go have lunch or coffee out in the community whenever they like.

Activity Directors in nursing homes have their work cut out for them.  Before I was a Social Services Director, I was the Activity Director in a nursing home.  Corporations are so cheap, they do not see activities for seniors as anything useful, nor do they like to allocate much money for activities.  It's also very difficult to recruit volunteers to come in and provide entertainment for free.

It's kind of a myth that all seniors love to play bingo and as Boomers age, well, most of them have little interest in bingo.

There are good Activity Directors and there are mediocre ones and then of course, there are bad ones.  The one nursing home I worked at thought that Garfield cartoon movies appealed to the elderly, when in reality they liked things like The Notebook and such.  You know, real movies for adults.

I have to say the Senior Prom was another idea I disliked very much.  Most seniors liked working on quilts, having bake sales, interacting with animals and gardening.  

The Activity Director at one home, didn't see any reason to work with Social Services either in helping to alleviate what staff liked to label behaviors.  It takes all staff to help find residents things to do, meaningful things to do.

We had one lady who had worked at a department store since she was 16 years old, at 90, she missed feeling useful.  I begged activities to find her something meaningful to do, to no avail.  Hence this poor lady was pegged as having behaviors because she complained about being idle. 

If you become an Activity Director, or are one, remember all the useful and meaningful activities in your life that make your life worthwhile.

Sunday, September 15, 2013

Social work in a nursing home

This is how I kind of view some new social workers

I know this is really not a nice thing to say, but I do view new social workers as being 'by the book and inexperienced' which, in turn, makes me question their empathy when dealing with people.  

For example:  I had an interview at a nursing home in my small town of Penn Yan a couple of years ago.  I was grilled for 4 hours, one would think I was applying for a job and was in front of the senate ethics committee.  So I figured, gee they must be really careful and choosy about their social workers, that is, until I met the social worker in their employ at the time.  She showed me around, even though I'd been a nurse aide in this nursing home before, and she said to me: "Nursing home social work is not a difficult job at all."  I, in turn, wanted to reply: "Then you aren't doing the job right."

Why would I want to say that?  Because while there are social workers in all packages, some are good, some not so much.  Yes, one can put in their 8 hours a day, doing what the big wigs want in any agency, or, they can actually do their jobs right and work for the client's best interest.  The first type of social worker is a dime a dozen, the second kind is hard to find.

Personally I found it exhausting to do a good job when everyone in a nursing home is a social worker, or at least they think they are.  We had a Social Services sign on the door, but it might as well have read: Complaint Department.  Now I know the director of nursing thought her department got lots of complaints, but then, nursing ignored them all and nothing got better.



Social work in a nursing home is draining because we got all kinds of things dumped on us.  We'd get 'behavior complaints' concerning an elderly person's behavior even if it consisted of the person complaining about no one answering call lights in a timely manner. 

 Now, personally, I think call light issues were a nursing problem, but everyone else thought it was a social work problem.  I'd direct the complaint to nursing, just to be ignored, have it tossed back to me, telling me it was a flaw in the elderly person's character.  I guess no one has a right to complain about nursing in a nursing home.  That is the main problem with nursing homes run on the medical model.  Nurses just do as they please.  

Social Services also got an office full of things residents left behind when they died or went home, WE had to call, call, call and find out if they or the relatives wanted the items.  Social Services was asked, by maintenance, to call and tell families if their loved one's chair needed steam cleaning, we also were asked to call and tell relatives if the resident's closet was too full.  Just busy work junk on top of the regular jobs we had to complete.   Much of our work consisted of the MDS (minimum data set) this minimum data is supposed to show we knew the resident by asking stupid questions.  Much like a job application where the interviewer does not know you at all, but they attempt to know you by reading a five minute piece of paper.  Just can't be done.



Nursing and therapists are the little darlings of a medical model nursing home.  I see, even now, in our local paper, the nursing home here lauds the medical people with special, huge ads.  While those are needed, never mind the social worker who: set up in home care, when needed, set up your oxygen tank services so you can breathe, set up meals on wheels so you won't starve and set up your link to life so if you have an emergency you can call for help easily.

Most times, families would send a thank you note to the nursing home thanking only nurses and therapists.

If you have a loved one in a nursing home, remember, as long as it is run on the medical model, it's NOT a good nursing home.  It's NOT home, it is a damned hospital disguised as a nursing 'home.'   If your loved one has meals on wheels, or any in home services, don't forget to thank a social worker. 

If you are a person going into nursing home social work, remember that you work for the resident's rights, not the rights of the nursing home. 



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Saturday, August 24, 2013

Nursing home diaries

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I was recently reading a book which is 'a social worker's guide to nursing homes' by Elise Beaulieu, not the entire title, but a link is here.  She tells of the rules and new regulations but doesn't seem to touch on the reality of the career, or short time in those places.  I say short time because it's such a stressful job that most social workers quit after year one.

What makes it a stressful job?  Well when owners and corporations want you to knuckle under to their regulations and rules, plus federal and state rules and regulations, it's hard because all those often conflict with each other.

Owners and corporations want you to think 'don't bite the hand that feeds you' meaning them.  In reality, the hands that fee you and them are the people living there, paying to be there and lining everyone's pockets.  But the First pockets to be lined are the owners of the facilities. Make no mistake about that fact.

Institutions have become such big business that they spring up all over, from prisons for adults (both state and federal), county jails, group homes (which are nothing more than kid prisons or prisons for people with developmental disabilities).  These are billion dollar industries.

The book I mentioned also says nursing home social workers get a salary of $37,000 to $70,000...........Boy oh Boy, I'd like to work where she works.  Sorry, but usually if a social worker breaks $30,000 in one of those places, they are doing well.  She also mentions it's a predominately women's field.  Know why?  The pay is so damned crappy.

Don't believe everything you read. 

Saturday, March 23, 2013

Nursing home diaries

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Today I am hit with a barrage of requests to open the door to the garden area.  I approach the person at the front desk and ask for the key.  I'm met with: "Well let me see what the temperature is outside."  I inquire as to what that has to do with anything.  Desk person informs me that if the temperature is above 80 degrees or below 40 degrees, the residents are 'not allowed' outside.  I ask her who made that stupid rule.  She informs me the nursing home owner did.  

The nursing home owner is over 70 himself.  I ask desk person is the owner is outside today and about town.  Desk person is also over 65 so I ask her if she plans to go outside today after work.  I get a glare and a reply: "I fail to see the correlation to any of this."  I inform her that these residents are also adults, able to decide if they want to go outside and able to decide to come inside if the weather is uncomfortable.  I also inform her we are not a prison offering inmates recreation time.  She asks what if they get dehydrated.  I inform her maybe the aides and (heaven forbid) the nurses and even myself, can take them water or juices to be sure they stay hydrated.  She reluctantly hands me the key.  I open the door and a rush to go outside begins.  One lady immediately tilts her head to the warmth of the sun, allowing it to warm her face.  Many remind me of inmates who are allowed out of solitary to feel the breeze on their skin, smell the fragrant flowers and bask in the sun's warmth.  

Later on I get a call from the, yes, you guessed it, Administrator.  She summons me to her office.  Gosh, I cannot imagine why.  But I do know I bucked the system and their rules.  I once again expected the residents' rights as adults, to be honored.  I'm such a trouble maker.  But I don't care.  They have as much right to bask in the sun or the cold, as any other adult has. 

Thursday, December 6, 2012

A fear of growing older


 The biggest fear most people have of living in a nursing home, other than having to be uprooted from their present home, is losing the important things that contribute to our quality of life. The basic day to day decisions we all take for granted living on our own in the community. 

 People also have a fear being placed out of sight when they go to a nursing home and no longer being a part of a community. Having and being able to make our own choices is what keeps our quality of life in tact and people have come to understand nursing homes usually mean adhering to their rules and having someone else make our decisions without consulting us, or worse yet, making decisions for us entirely. 

 Maybe nursing homes have improved a bit since the 1930’s when, before then, no elderly people were well taken care of in any programs. As late as the 1960’s I recall my parents talking about the ‘poor houses’ for older people and how it was a place to be avoided because apparently it meant people were destitute who had to go there and the treatment of older people in those dreaded places was awful.

Still to this day, many conventional nursing homes resemble large hospitals and for many elderly, seem more like a prison where rules abound, not like any home they have ever known. These places make elderly people feel they are now being punished for not having a lot of money to afford help in their own home, and they feel like they have committed the crime of daring to grow old, and worse yet, being punished for needing help in their daily lives.   

 The older nursing homes where people are housed two, or more to a room in order to make even more money for the owners, represent to residents not only being uprooted from their long time home, but now having to share a small space with a virtual stranger.  

People are not paired up in those facilities according to compatibility but paired up according to the space available and for the staffs’ convenience, especially if they have similar medical conditions. Homes that do pair more than one person to a room, all of them say they want people to bring furniture and personal belongings from home, yet do little or nothing to really encourage this in reality. 

 In other words, when entering one of those facilities, people now have to give up everything they owned, be uprooted from their homes and have the added insult of getting used to a new living environment and a room mate they may or may not like. The possibility of getting a room mate who has a TV or radio they want to blare late into the evening or having habits they find hard to deal with is very high.

It is safe to say that approximately 90% of people who enter a nursing home for therapy, did not ever plan to live there long term. Having lived in denial, as most of us do, it did not occur to them that it may be deemed as unsafe by the therapists for them to be able to live safely in their own homes anymore. This can be a big blow to many elderly, especially those who are used to being very independent, to now have to face the reality of living in a nursing home. With many hospitals discharging elderly patients early to nursing homes for therapy, it can be difficult to convince elderly patients to go to places for needed therapy. As one lady once said; “you tend to go to one of those places and never come back.’

Nursing homes have to absolutely change and change quickly and steadily begin moving towards a more home like atmosphere. I see no reason why the really good, caring facilities should only be a luxury for those elderly who can afford to pay out of pocket for the good treatment.

 Culture change and good treatment should and must be available to all residents in every nursing home in America, regardless of their pay source. Every elderly person has worked hard all of their life and all deserve to be treated with compassion and respect, regardless of their source of pay to the facility.
It is my belief that all nursing homes, for profit, not for profit, those of sole proprietorship and those owned by corporations, can move in the direction of culture change without losing money, and without having to tear down their existing buildings. It is also my belief that all people living in nursing homes are owed this change and deserve this change because it creates a home like atmosphere, not a hospital one, for people to live their lives in dignity. I believe every person is entitled to be treated as an individual and with respect.