UTI, friends, hearing aides and referral,

toolbeltexpert

Well just an update on dw. I found out Monday that she has a uti, seems kinda odd,they checked her at the er when she was there?

Maybe they did a culture at the geripsych? I need to ask more about that.

Yesterday another close friend of dw went to visit her. He said she didn't seem medicated?  She knew him and continues to mourn the loss of her best friend, the wife of the visitor. She asked about me and why I hadn't come. He explained that she here to get some help and he mentioned her memory problem which she acknowledged.  He said it was the old dw,but that she would fade back especially towards the end of his visit. Anybody else ever have a visitor that just told the truth to the pwd. I am gonna call today and ask how it went after the visit. 

Dw hearing aides are dead and she continues to wear them, the shift nurse who didn't speak English well said dw wouldn't give them to get them charged! Dw was always very faithful to charge them every night, I just wonder what kinda skills they have, whose in charge?

The sw told me yesterday when I called that he had sent a referral for dw to my first choice. The sw said he was just getting ready to call them back to see what they think, he said he would keep me informed.

I have been on the Medicare site and did a search for mcf in my area. There is lots of data there for each mcf,though I question some of it. I have visited many mcf when I pastored and not just once either, I always keep my eyes open and my nose can pickup urine at a hundred yards. 

So when I saw one particular place have well above average scores I was shocked, also the information wasn't up to date as a local NH that I had visited in the last month and had closed their mc part during covid, was still listed as a mcf, which it is not.

I also found out the my first choice is the cheapest around, which surprised me because of the reputation they have in the area as being the best.

Well that's all I got. Praying for some good news for my wife to feel better and be healed of her uti and that she will be accepted to my first choice. Praying for everyone whose going this.. The list is long and some are in similar situations which for me helps me understand your pain and heartbreak. Love ya all.

dayn2nite2

Regarding the training of the staff.  I'm sure they're well-trained - it's just that they cannot force someone to give them the hearing aids.  She has to give them voluntarily, they are not going to manhandle her or wait for her to sleep and take them out of her ears without her consent.  She has rights as a human being and they are going to respect her rights.

That's part of why I recommended you not replace the hearing aids anymore - just as I explained that a lot of this is her brain's inability to process what she is hearing, her brain is also not letting her be compliant in keeping them in working order.  If she isn't compliant, they cannot force compliance.

Ed1937

I agree that they cannot force her to give them the hearing aids. If they did that, they could be in trouble.

I'm glad they found the UTI. It might be that when treated successfully, some of the negative symptoms will be relieved. The ER probably didn't run a culture.

I don't think it's a good idea to always be truthful when speaking to a PWD. Many times the truth causes distress in them, and should be avoided. Too many people don't want to lie, and they don't understand how kind it would be to bend the truth at times.

You have to take whatever you see on the medicare site with a grain of salt. From what I understand, a lot of the information is put on there by the facility itself, and they are not likely to put anything negative on there.

Hopefully you can  have her transferred to your first choice of facilities. Sending good thoughts and prayers your way.

toolbeltexpert

Dayn2 I do understand about them not being able to take them. I was thinking more in the lines of being able to cope with that behavior, such as couldn't they put the charger in a place she could see it and maybe make a suggestion if they are not working they might need charging in a nice cheery voice. I am not sure the regular floor folks have any dementia training at all. I am sure if she doesn't want to give them,  they won't get them.  I guess if they are junk I will not be doing anything else. 

I guess my first post didn't really sound like I understood about the control thing, when I said whose in control, I was really thinking about the skill sets you would use knowing a pwd isn't in control. Can't you read my mind( I say that jokingly as my post are sometimes not very clear) 

Because I am not sure how clear my previous post about her hearing aides was. Here is the lowdown, the current hearing aides are just over 2 years old, her previous ones where 8 years old which i still have and they work but they are not rechargeable. I haven't done any replacements at all.The first day or 2 after she got in the geripsych  I was told she threw them down and they made it sound like she stomped them, not sure how factual that report was. They may still be working correctly?  But I am tempted to go and get them. Or maybe visit the unit area, I can connect to them via my phone if they have any charge or even if they are in the charger and look at somethings without being in her presence.

It is just frustrating  knowing how much they cost, she could lose them easily.  Maybe I should just quit worrying and pray for Gods help for everyone involved.

Ed that's what I thought about the er as well, they did have a specimen jar and I may have assumed they did a culture. Never assume. Her friend that visited doesn't understand this, I might try to make some suggestions.  But I don't want to not have him visit. His son calls me almost everyday to check on me. They are like family to us.

dayn2nite2

The staff probably is not going to spend a lot of time encouraging her to take care of her items, it is easier and quicker to ask for them and let the staff take care.

She is not the only patient in the facility, so things like this are an adjustment.  While you had time to cajole and encourage and revisit items like this when she was at home, they do not.  It's generally going to be a one-and-done thing.  They ask, she won't, they won't ask again, they will let her walk around with dead hearing aids if that's what she wants.

Medicare ratings.  Look for nothing less than 4 stars and look at the last inspection and also how many citations they have received over the past 3 years.  If the violations are paperwork-related (no documentation of this or that), that is okay.  If a violation is related to a particular resident or group of residents and is abuse or neglect related, then that's what you want to pay attention to.  

For example, I just saw an inspection from March 2022 done on a facility I have driven by that is new, beautiful and I'm sure it has all the bells and whistles - but the inspection contains a citation regarding a resident who told the inspector she had been living there for several months and had no shoes to wear.  I find this concerning, and the facility was cited for denying the resident's right to a dignified existence.  This place would be a hard NO just based on that inspection, and I wouldn't even consider touring that place if this is how they take care of people.  The resident had to tell a state inspector herself what was wrong, imagine if a PWD was living there and they were unable to communicate their needs.

toolbeltexpert

Dayn2 in my searching there is a mcf nearby, our church used to visit precovid but not now. Any way they had a long list of complaints, alot concerning the tubing for o2 supply not being replaced and out of date, one resident didn't have his button within reach and he had complained about not being able to signal for help. They get almost double what my first choice has. They do not have a dedicated mc unit and the front door is locked by code but thats it.And they are a no for me. I appreciate all your posts, I am not beyond learning or change. I have learned so much here. I sincerely hope I do not come across as a know it all. As a mechanic and a pastor I had a saying. Have you read and understood the owners operating manual. I say I don't know everything but I know where to find what I am looking for. This forum is my one of my main sourse of information. 

Sorry if I am rambling. 

dayn2nite2

You do have 2nd and 3rd choices identified, don't you?  Sometimes the first choice doesn't work out due to availability, finances, or other reasons.

Also, please do not get stuck into thinking the facility MUST have a memory care.  "Memory Care" is a marketing/sales term and it means whatever the facility wants it to mean.  There are no legal standards for memory care.  As long as it is a secure/locked facility and they have a good rating and no concerning citations, even a NH can be appropriate, especially if you know eventually she will need long-term Medicaid in your state.

toolbeltexpert

Dayn2 yes and no. My searches are to help me make my 2 or 3 choices. BTW my first choice doesn't have a Medicaid option in that unit but they do have another facility, same name ,that's not to much farther that does have a Medicaid option. And I am behind in that respect, I have a appointment with a cela on August 1. Guess I should have had the Medicaid thing done, but I am dragging my feet. I procrastinate

jfkoc

Regarding the hearing aids. They only "help" and  they are going to get lost so my vote would be to pick them up or charge them when you visit.

 Selecting a facility is no easy task and frankly online ratings would be about the last thing I look at.

I suggest you start by telephoneing. Ask what the training is...both initial and ongoing. If they can not give you a name that you can google strike through their name. Next I would ask to have a copy of their contract and license with the state. Next I would look up any inractions/citations. If all pans out I would make a visit...actually more than one. The first would be scheduled. The next few would not be. 

BTW...you must live somewhere near me. My go to facility has only decent food and has not been decorated since sometime in the 50s...lol. It is wonderful and has the best staff around!

Jo C.

Various explanations re the UTI.  Sometimes what is not there one day can be there with bacteria growing in a short period of time after the initial sample.

Be cautious using the Medicare.gov site.  Sadly and concerningly, the data is self-reported by the facilities themselves and no one at Medicare or any watchdog entity checks to confirm the information.  Some facilities are honest, and others somewhat game the system with others being blatantly dishonest.  (Staffing being a big concern for reliability.)  However; if you see a very low star rating, that is definitely a warning.

One thing that is always good to do AND is totally acceptable, is that by law, the facilities must provide a copy of their most recent inspection report for viewing when requested.  This is done frequently and is not considered a negative by facilities, but as said one has to request to do so. 

NOTE:  Every single facility will have deficiencies that need to be corrected; no exceptions to that.  However, it is a matter of degree.  I always checked the inspection reports for any LO being a potential admission and did the same whenever visiting a facility with my staff to update our viewing as we gave lists of facilities to families at the med center and wanted to ensure things were still the same or what changes positive or negative were present.  Some deficiencies were not severe, but at a few facilities it had my hair standing on end. If a facility received a hefty fine, it means the deficiency was involved with potential and likely patient risk or actual harm.

When there is a deficiency, one can also read what the facility plans to do to correct it or what has already been done.  Good to be able to see the responses.

It is not unusual for a pwd to react differently with different people and at different times.  For many, the ball is always up in the air so to speak and can bounce one way or another at any given time.  Sometimes it is simply a moment in time with behaviors, other times some people are negative triggers for the pwd through no fault of their own; other times as said, it depends on how the pwd's brain is able to process and manage at the time with some times of the day being better than others.

J.