Care agency dropped mothers care Help!!

vinm134

I was getting help for over 3 years with this agency.  It started out great.  24 hour care and the day lady was great.  Now i am in hell.  The agency dropped care after i demanded they hire ladies who can follow the care plan of the nurse and the pt.  The ladies all complained of back problems or said they did not want to hurt their back.  They did not know the correct way how to get a person out of the chair.  They say my mother at 130 lbs is too heavy.  The lady who runs the agency takes the side of her employees.  She said i do not understand and she is doing this for 20 years.  The pt and the nurse wanted my mother moved from the wheel chair every 2 hours and stand for 10 seconds 4 times a day.  The day lady said she could not do it and quit.  I fired the night ladies for sleeping while my mother was awake and moving around in the reclining chair.  I can watch her but its not fun.  Now i have to find someone to watch my mother in the day who can do the job.  My mother has dimentia and it progressed but she still has the ability to stand.  Walking is not the same as it was more than a year ago.  Sitting here at night i think i made a big mistake.  But i am trying to get my mother cared for correctly.  The ladies do not want my mother to fall but they were leaving her in the reclining chair or wheel chair too long.  The pt and me believed they could prevent her from falling and have her follow the care plan at the same time if they do it correctly.  I do not believe the agency lady cares for my mother.  It was a mean thing to do to leave me hanging without help of any kind.

M1

This may not be the answer you are looking for, but have you considered a hospice evaluation?

Sounds like the agency thinks your expectations are unrealistic. I can understand wanting to do everything you can to maintain your mother's function for as long as possible, but if she's lost the ability to walk perhaps it's time to change the focus to comfort. That's what hospice would do-and I don't see any harm in asking for an evaluation. You can call more than one agency and see what they say. Good luck-

harshedbuzz

vinm-

I am sorry you are facing this but not surprised.

While moving your mom every 2 hours is best for her skin and circulation, it is a risky maneuver for a single caregiver (and the person being cared for) and many would refuse to do it. You might be able to find a caregiver who could follow the protocol using a Hoyer lift but not all are trained on these.

At dad's MCF, all residents are considered a 2-person lift. Moving your mom to a MCF (or SNF if she doesn't meet the entry criteria for MC because she's no longer ambulatory) would be one option. Another might be to hire a caregiving team privately. My neighbor had live in caregivers for his MIL with ALZ; the wife did most of the care and the husband or one of her sons assisted for lifts and transfers. He and his wife covered the couples' days off. 

I hope you can find an answer that works for you and your mom.

HB

ETA: I do feel your pain. But agencies are fiercely protective of their best people and will make the choice to retain them. I had a dear friend who hired a specific caregiver through an agency who was a perfect fit for her mom in the middle stages of dementia- the woman could converse in German, would do puzzles, take walks and bake with her mom. But when mom's disease progressed to the point she could not longer do these things, the caregiver asked to be reassigned as she felt her skills were better suited to people she could still engage. I broke my friend's heart.

dayn2nite2

You’ve learned a lesson.  You can push only so far and they will push back.  Now you’ll have to find people that will care for her to your exacting standards.  Pick your battles better next time.  You may have trouble finding another agency because agencies warn each other when they drop a client with demanding family.

LaurenB

I would add that I would look for a home health company that is affiliated with a hospital system.  Not all caregivers are allowed to do all tasks.  CNAs are able to do most things, but home health aids may not be allowed to move patients from one location to another.  I agree that the agency should stick to the plan.  If the plan remained the same AND they are no longer able to meet the outlined plan then they need to be up front about it.

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blanch

In my experience with my LO in MC facility, they don't do one person lifts. If a person is falling even, they will do an assisted fall if there's only one person (helping to guide the patient safely to the ground) rather than risk injuring the aide.  My LO's in a wheelchair most of the day and will scoot along with her feet but won't stand on her own.  At night she's transferred to her bed.  Otherwise, that's it.  

Are you willing to scale back your expectations or possibly pay for a second aide to assist?  I think those may be your only options here.

vinm134

Thanks for all the tips. 

The agency had a change of heart and sent an aid for 2 hours in the beginning and 2 hours in the end of the shift.  It is a mother and daughter team.  But on the weekend i have a problem because the lady will not move my mother.  I am waiting for the regular weekend lady to return from overseas.  I am helping my mother from 8pm to 8am.  It was not fun last night.  My mother kept on moving around in the recliner until 1am then slept.  I layed down on the floor and watched her until i dosed off.  She threw her leg lift pillow on me at 7am.  I will do my best.  I will ask about hospice.

Thanks everyone

jfkoc

Have you looked into a Hoyer lift?  That might solve the problem. I also suggest that you get back with the pt and see what eh/she can come up with. They may suggest a chair lift in addition to the Hoyer.

vinm134

I am told that the Hoya lift requires 2 people anyway.  I used the Hoya lift for my father but he was seriously sick with brain cancer.  My mother can stand with assistance but she cannot walk a few steps before stopping.  The nurse told me my mother is not ready for hospice either. 

I arranged for the day lady to stay on until the agency finds someone stronger.  I do not know if they will find anyone though.  I really need these ladies helping me because my mother prefers a lady and I need the break to go out for my mother and myself.  I aim to ask the doctor or nurse for a bed downstairs.  I am watching my mother for 4 nights a week and 3 nights a lady gives me a break.  For me it is hard to switch to another agency because my mother likes these ladies.  And i trust them enough to leave them alone in the house without something being stolen.  It is hard working with new ladies because you do not know who you will get.  You do not know what will happen.  In the past my mother did not like some of the ladies.  And the ladies would do the things these ladies do.  They clean, cook, do laundry, and sit next to my mother.  

M1

Not sure I'd trust their judgement about hospice, they may have an ulterior motive of wanting to keep your business especially if you are private pay. I'd ask for an independent evaluation-don't see a downside to asking.

towhee

I'm not surprised your home caregivers didn't want to take this on. I have seen CNAs in rehab facilities who had to be trained how to do transfers. I have a couple of suggestions but make sure to pass everything I suggest by your PT. 1--If your mother can bear weight and walk a few steps she doesn't need a Hoyer lift which does indeed need two people. One thing you might try is a bathroom safety bar securely attached to studs. Your mother might be able to use this bar to pull herself up from a wheelchair to a standing position and be able to hold on to the bar for balance. The aide could be trained to use a gait belt to give her a boost. This is a set up sometimes used in assisted living and is safer for the aide and your mom. 2-- Another possibility is a sit to stand lift. These can be manual or powered and are designed to be operated by one person. Problem here is that because of liability issues your caregiver company might only let CNAs operate one. I think manual ones can be paid for by Medicare if you have a doctor or PT order. These are incredibly useful in transferring from chair to bed to chair and even in toileting. Your PT would need to advise you on which ones would work. Sometimes a PT who is trying to restore function doesn't like to use mechanical assistance, but some movement is better than none. 3-Try not to be upset if your mother does not cooperate as much as you would like. 4--If you can get a hospital bed for your mother she might sleep better, but it is harder to get Medicare to pay for one these days. You can ask the PT to check  your mother's wheelchair cushion to see if it needs replacing and check to see if the wheelchair wheelchair height is correct. Wrong sized and ill fitting wheelchairs cause our LOs a lot of pain. Hope things get better.l

jfkoc

 Lumex Stand Assist Patient Transport Unit, LF1600

Patient Aid Gait Belt with Padded Handles & Quick Release Buckle, Long Strap Easy Transfer Lift Assist Aid for Elderly,

Carex Premium Power 17 inch Chair Lift for Stand Assist - Chair Lift Assist Devices for Easy Lift Assist - Fully Electric Power Seat for 100% Sit to these are all on Amazon so you can look at them and more I agree.....call Hospice yourself...if they agree to get on board they will be an enormous help. If not they may give you some good suggestions to help you. I would also talk again with the therapist for some additional instruction. Please let us know.

ebplionis

If you are worried about bed sores on top of being dropped (that is so hard, its happened to me as well) ask the PT or your mother's doctor for a prescription for a roho cushion for her wheelchair.  It is a special type of cushion to help prevent bedsores.  She still needs to be moved, but maybe while you are looking for better care it'll help mitigate some of the damage.  You can buy them online too, but if you are looking to reimburse from medicare/ medicaid you will need a prescription.    Good luck!

(=Meow=)

They say my mother at 130 lbs is too heavy.  The lady who runs the agency takes the side of her employees.  She said i do not understand and she is doing this for 20 years.  The pt and the nurse wanted my mother moved from the wheel chair every 2 hours and stand for 10 seconds 4 times a day.

+++
I stand about 6 feet and weigh 170lbs, and *was* in good physical shape.  My mother is 4'9 about 135 has multiple health issues, including dementia.  Over the past 4 years I have destroyed my body moving her around by myself.  Ripped a tendon in my right ankle that will never heal, I'm too old, never going to run long distances again.  My spine is shot after years of lifting her off a bed that's knee high to me, had to put the box springs and matress flat on the floor so she could climb into, and sometime out of, bed by herself.

These injuries will never heal, I *chose* to do this to myself as she's my mother, agencies and employees do not have the same type of motivation, who will take care of them after their bodies are destroyed?   It's not like the US has world class universal health care now does it?  CNAs are considered low skilled/low payed disposable workers, they have to look out for their best intrests as nobody else will. 

(=Meow=)

Carex Premium Power 17 inch Chair Lift for Stand Assist

+++++++
Many medical supply companies have made the deliberate choice to NOT carry such devices, many more doctors/surgeons will tell you they are NOT safe.  If I'm helping my mother out of a chair and her legs refuse to support her weight, I can put her back down, a powered springboard device can/will not - It's putting them on their feet, that's what they do.