Thursday, June 14, 2012
Dad stayed in bed all day and night yesterday. That's happened once before, and hospice says it's normal at the end of life. Today Dad is up again, but barely. His teeth aren't in his mouth and he's not wearing his hearing aid. I'm fed up to my ears with the Assisted Living facility. Yesterday I left him in a fetal position facing the wall and when I came back three and a half hours later, he was in the same position and badly in need of a diaper change. "I just came on," said the caregiver in charge of the floor for the day, absolutely exempting from any blame on the current situation. I was the one that initiated the help. He didn't come into Dad's apartment on his own, and I waited quite a while to see if someone would come in. The caregiver goes to get the plastic liners that protect the sheets from excessive moisture and discovers that he's out of them. He says he'll borrow some for Dad "later." "Hospice is supposed to supply them," he says. "Hospice says Dad should be turned every two hours. Will you be back in two hours?" I inquire. I am leaving at 5:15 and the private caregiver I now hire to get Dad through the night doesn't come until 7:30. "I'll change him in two hours," he promises. "How will you remember?" I ask. "Oh, I'll remember," he says. "Sure," I think to myself. "If I make a special request, he'll accommodate me, but what about the others?" "I'll write it in the book," he says. The book is for one day. I'm fed up to my ears. I've had incident after incident and I'm over it. I call hospice to find out what needs to be done and that it's not being done. Today I e-mailed the head nurse at the AL facility with a copy to the Hospice director to sort out what should be done and when it should be done including toileting, "repositioning," and hydrating. Then I called up Hospice and asked them to deliver some new plastic bed sheets. Now the Hospice director is going to call a "meeting" to straighten it all out. I hope Dad is still around when they decide to schedule something. Really, it makes you wonder what you did. Not only that, my some-time care manager has checked up with Hospice periodically on her own to see how Dad is doing. I wonder why she doesn't call me. I think that's really more appropriate. Bottom line is that it's always about money. The care manager wants more business, Hospice is getting more business faster than they know how to manage it, the assisted living facility keeps its costs down by hiring way less help than they really need to be a full service institution and besides that they wouldn't know how to manage if they did hire someone. In my up coming book, I'm going to factor out the costs of staying in a home with full time care as opposed to staying in a nursing home as opposed to staying in an assisted living facility and supplementing the nursing care. Bottom line is that the people you hire are your responsibility. It's an art to figure out how to have the best quality. You could leave the assisted living facility (at this point that would be totally traumatic for Dad which I told the head nurse last week when Dad fell out of bed and they were considering sending him to the emergency room) and go to a worse nursing home. I mean, you really take your chances on your choice and once you've made the choice you have to try your hardest to make it work.