08 Jul Something for families to think about in advocating for their loved ones in long term care: The more care they need the less likely they are to get it
Families of heavy needs residents need to go to their facility as often as possible and be unpredictable in doing so.
One of the crueler realities about long term care we have gleaned from extensive experience suing nursing homes and assisted living facilities is the axiom that the more care your loved one needs the less likely they are to receive it.
For families whose members have more than typical cookie cutter standard care needs, it is even more important to be present at the buildings. This is true for all residents, but especially the more dependent ones. You need to really know what your loved ones needs and politely but firmly demand it be provided. By regulation, facilities are not supposed to admit or keep people whose needs they cannot meet, but in reality they do so all the time.
To just give an example, residents at high risk for falling frequently do not receive anything like the supervision or care plan interventions they obviously need. Care plans call for dementia patients who cannot remember or follow instructions to use call lights when they need to go to the bathroom. This predictably leads to residents getting up on their own and falling. Falls are much too often fatal. Be proactive in demanding real care planning. Don’t accept any facility assertions that falls are inevitable. They rarely are and facilities accepting them as inevitable and not care planning is very negligent. Demand progressive care planning. Demand real assessments that include physical therapy type persons who understand the dynamics of ambulation issues ranging from gait instability to balance problems. Make sure the nursing team is on board at the CNA level. Demand accountability when you see near misses. Near misses recur.
We are also seeing an increase in calls from families who have lost family members to resident on resident violence. Demand to know who poses such threats and how they are addressed, especially in dementia units but in any facility.
Look under the sheets. See the wounds under any dressings. Be involved with staff and be present with eyes towards understanding whether your family members conditions are worsening. If you think your loved one is getting worse get them to doctors you know and trust or to hospitals.
You have the right to call 911. We have often heard stories of staff telling family members they need a doctors order to send your loved one out. They do not. You decide. You are the ones who love and care the most. Make a call to 911 yourselves if you are being blown off. We have heard of facilities trying to scare people with the costs associated with a hospital visit. Medicare usually pays transport bills and hospital care provided in good faith.