Getting Old, Infirm and Feeble—Plan

Many of you may have wondered what happened to me over 2014. The answer is, my mother. In late 2013 my 86 year old mother fell and broke her hip. She has had a form of alzheimers for many years and I have taken care of her in her home for the last 10 years or so prior to this fall. I had been concerned that we might have reached the end of her being able to stay at home, and that day, November 21, 2013, it came home to roost.

Finding her in that condition laying on the floor early one morning, cold, soiled and in pain, with no memory of what happened was an emotional time but dare not let it show.  Adrenaline ensued and I acted quickly but calmly beginning with checking her and cleaning her and calling for an ambulence.  I did not want her embarrassed in the condition I found her.  She was okay but had obviously broken her hip.

So began our journey that has lasted through this day. Staying awake for 37 hours straight through wintry, snowy, icy weather, sleeping on the floor of a cold hospital room so my mother would not be scared and I could help her through the night. Running back and forth bringing things, food as well as clothing. Keeping her calm and making sure the care was adequate.  All in all I could not have been happier with the medical staff at Harris Hospital downtown Fort Worth. There were RN’s at her side 2 and 3 at a time throughout the entire ordeal.  She was in for surgery the first evening admitted to the hospital. Up on her feet in a day and half. Doctors orders for rehabilitation and long term care.

Scarey words “long term care” otherwise mostly known as a nursing home. All the plans we had made to have her stay in her new home 2 miles from me until she died had faded. She was no longer safe there. This is my mother. The one that listens to me day and night and has been my constant friend. This is my mother. We will get through this together.

Each day runs into each night and days and nights start blending together where I do not know what day it is any longer.

Searching for a place for mother to go to rehab and nursing care was daunting. I took the advice of a surgical nurse and went to visit one place I had not heard about. When I got there I was amazed. Looked like the Hilton Hotel for older folks. bright colors, beautiful decorations, large carpeted hallways, music playing, nicely dressed staff walking about, a private salon that was “free” to patients, 9 doctors available for care on staff, large rooms with showers in them, a beautiful dining room with steam cleaned kitchen and very nice staff. So, after speaking with the sales rep I decided this would be a fantastic place for her if our pocket books would afford it.  Surprisingly it was not too expensive.  On we go. She was delighted. I took an overnight blow up bed to stay beside her there the first night and make sure she was comfortable and the staff could learn how to work with her, post hip surgery patient.

She did well. I did pretty well also. So days would turn into weeks and weeks into months and I would find myself daily going to see her and check on her. First few weeks were okay. After that, a constant struggle to keep her clean, fed, given water and not neglected. We made as many friends as we could. But, the negligence grew and before I knew it what was only a 2 month stay felt like a year. Two major incidents dislocating her hip and ending up in the hospital emergency room with her praying God would take her to stop the pain. First time, 7 hours in the ER giving her 9 rounds of pain meds. Finally, 3 doctors came in and stood on the bed, literally with nurses around her and they had put her out so she would not feel the pain as they pulled the prosthetic hip back into its joint.

This happened twice.

The 2nd time was the ending of that nursing home. She had 2 E-coli bladder infections and the last one made her so delirious she fell again at 4:00 a.m. and dislocated that hip again. I was called and they did not know what happened, she was just in her bed. The first time was trying to get off the potty with help and it dislocated.
Finding out at the ER room that she was supposed to have had a tall potty, strong flat seat on her wheel chair, never cross her legs, never sit in a low place and try to get up and perhaps a few others. The nursing home was not doing any of these things.

There were many meetings with the “executives” of the facility, Dean of nurses, Administrator, LVN’s, RN’s, and anyone who would listen. They would seem sympathetic and for a few days things would be better, then back to the same. No real response was ever made.

So, advised by my mother’s elder attorney to always go several times a day to visit and monitor and help and I did that. I was on top of any meds they wanted to administer, any therapy she was supposed to have, all cleanliness issues, bath issues, food issues, sickness issues. The E-coli bladder infection was caused by leaving her in soiled underpants. This happened more than once. I would see the symptoms of bladder infection, the odor, her mood change, lack of energy and lack of appetite and they would ignore me. Refuse to give her a urine test, lie about giving her a test and start her on meds before I knew about it.

My experience has been that it is absolutely nothing to be lied to by a worker in a nursing home. It is all about the money and lack of genuine care.  In our area of Texas, nursing homes take in approximately 5000 per month per person, for one half a room and little to no care, at least in our area of Texas (DFW).  The turnover rate is a disaster.  I would just get the certified nurse assistants trained on how to handle mother and they would leave.

So, after two months of an unending story of negligence, even with my presence, there every single day and doing as much as I could physically do and hold a job at the same time, she was losing the battle.

The night I was called at 4:00 a.m. I drove to the nursing care center and told them she had to go to Harris downtown and met them there. This time she was being treated a lot better at this downtown hospital. The first dislocation she was at a local new satellite hospital near the home. This time she was attended to immediately with pain meds and attention and got the dislocation fixed and many tests made on her immediately.

A four day ordeal with her on a drip to get rid of the E-coli and then they fitted her for a body brace. Because she had 2 dislocations, the only way her body could heal is with a body brace. . . .for 3 months!

Three months is a long time in the life of anyone, but especially an elderly woman with not much memory left.

I was with her more than ever now. We had a meeting with the hospital RN case manager and found a better place for her to go to. I went to the place and checked it out and was pleased with what I saw, heard and did not smell. It was 15 minutes from my work and home. This seemed like a good fit and off she went.

Better, but still requiring my attention every single day and night. I am there perhaps 2 to 3 times per day and especially at meal times to make sure she is clean and eating. Simple things like offering a drink of water to make sure she is hydrated—never.

Another good looking place, some better practices and a lot of good things about it, but still have to stand over them every day.

The bad things are daytime help. You have 1 person called CNA (certified nurse assistant) who is assigned to 15 people for the day from 6:00 to 2:00 p.m. Then 1 person from 2:00 p.m. until 10:00 p.m. then 1 person from 10:00 p.m. until 6:00 a.m. The best staff is at night at this place. I was there one night when she was ill and saw them going with a cart room to room changing people’s underpants and making sure they were clean and dry. They do that well. They also clean down all the wheel chairs, sanitizing them. The nurses on staff periodically checking on the patients to see if allright. I am pleased with that. They had a great SPA with one person designated for each shift to bathe the patients. Very nicely done, warm environment with hot towels and lotion, dress them and wheel them back to each of their rooms. The food is also good.

I have only heard of 1 CNA or other personnel getting fired in this entire year–it was extreme negligence.  Then, there was the incident with the CNA.  There was one that had forced my mother to put on pajamas and my mother fought with her and the next day I found bruises all up and down her arms, bloody looking.  I had already put her to bed and given the nurse instructions to be gentle with her because her hip was hurting.  I let her sleep in her clothing–she was clean.  She did not want to be moved.  Then, next morning I found her with bruising all up and down her arms.  I investigated it and found who did it and she admitted she forced my mother to put on pajamas but accused my mother of hitting herself.  That simply is not true.  My mother does not hit herself.  But that person was not fired–even though they filed an abuse report with the State of Texas agency that oversees these homes.  I received a letter in the mail that it was dismissed.  They never called me and asked me what I found.  I was the main witness along with the nurses that saw her condition and heard the CNA admit.  I called the State agency and asked about it and they stated that it was not unusual that the CNA was not fired, they allow them to rehabilitate.

So, what do I do each day? Visit in the morning before work, sometime around lunch before, during or after. Come back at dinner time and get her to bathroom and dining hall and make sure she eats, get her ready for bed, brush teeth, give water, change clothing, see to it the bed linens are clean, set out clothing for next day and take home her dirty laundry. Wash each night and bring back clean in the morning. Why? because if I didn’t, she is likely (and has) missed meals, not enough water, no one brushes teeth, would make her wait until very late to get help. She has to go to bed at 5:00 or 6:00 p.m. each night. Wants to go to bed as soon as she is finished eating.

I am relating this to you because I never dreamed this would or could happen. Everyone I talk to says the same thing. Every nursing home I ever hear about does the same thing. When I ask the attorney about changing it to home care I was advised the same kind of things happen at home.   If you are thinking about doing it yourself?  Its too much on one person. She needs 24 hour care.  So, at least I know one thing, she is likely to eat breakfast and be dressed by the time I get to work. She is “likely” to eat lunch, but may not if I do not come by and see to it she goes and eats. She is not likely to get dinner unless I go by there myself and do it all, a-z.

I am not alone with these problems, but dare to say there are but a few–8 to 10 families out of 120 at this nursing center that do what that attorney said you MUST do and come by and see to their care every single day. Most of them do not come at all. There are some that come on special occasions. So the ones that are there suffering through the same episodes day after day lean on each other to keep alerted about their loved ones when they are not there.

Meetings about the level of care happen once per month between those on the “family council” which are basically the 8 to 10 that are there every day,  but nothing seems to change. Example, an ice and water machine out of service for a month now. All the patients love ice water at their bedside. No one brings it to them. They have to get it themselves or a friend or family member gets it for them.  So, their answer to that is having ice chests where patients can grab a scoop with their hands, get the ice and dump the scoop back into the ice.   Then fill up with water from a sink.  Not sanitary I told them, but still happening.  So I have been bringing my mother ice and water from my home each day.  Simple thing, water. No one seems to care.

So, I am seeing to it that she is getting food, water, cleanliness all day long, bathroom visits, some exercise, do not want her laying in the bed all day when she is able to be up. Basically, the family must be a “watch dog” and nurse assistant for the duration of the stay in order to insure the family member’s well being, safety and health. If you are one of the lucky ones and do not have to work when your loved one is needing you, you “could” try this at home, but let me tell you its not advised. Its too much on one person and if you are like me, there just is no back up. I am the only one that can or will care for my mother.

I have mentioned only a few items here. Its unbelievable to me that this industry is so lacking, no genuine apologies, and the worst thing—when you are in the middle of this there are no more choices. I have heard families that have moved their loved ones 6 and 8 times trying to get better care. Does not exist in the normal realm.

Before this all happened, I was looking.  I did found one nursing center that was good.  It was called Christian Care Center. It was very good and had a good reputation. I missed out on it because I did not know they had a wait list, 2 years long.  It has lots of Christian volunteers to help in many ways so patients get what they need. The atmosphere is good, food is good and people are well cared for.  This is an exception and is rare.

So, this is the best I can do for now and finally deciding that has taken some time. I have explored every possible option. Its now been a full year at the new place. Same things, but still better than before.

This time in my life and my mother’s is surely the most difficult. But every day when I see her smiling at me and telling me how glad she is to see me, I just forget about all the trouble for a while and enjoy just being with my mother. I have made many friends at the home both the patients and their families. I have learned to love many different kinds of people there and try to bring light to those that have no one to visit them or look over them.

I wanted to write about this in order to bring this very important subject to the surface. What are we doing for our elderly? How are these nursing facilities getting by with mistreatment and neglect over and over and rake in huge dollars at the same time?

I am urging those that are reading this to start researching early and try to make a difference so that you and those you love may have a comfortable and trustworthy experience should you live a long life and need nursing care. We never know what will happen, but its a good thing to plan, investigate, get knowledgeable, and perhaps volunteer.

Thanks for reading this short story about a very difficult, long enduring subject. Be smart. Be prepared. Be aware and try to make a difference in your town. Make your plans and help others live better lives in their old age. God Bless.

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