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A lot of people who are employed in care facilities have chimed in- I was not expecting that- that people who work in these places are just as much victims as those they care for.....So damned hard to get by and survive..my old wife mentioned the other day that instead of us evolving into a caring culture..That things are getting worse. The only thing that I can think of and suggest is that we all realize that we must take care of each other and it it better to be a bit more poor than betray our elders - who in time we will be ourselves- WE have to stick together...and take care of each other...forget the money issue- and be aware.............that time makes us the same- We will all be vulnerable in the end...so please do not let those in control of the buck- force us to betray each other.
Very difficult to accept the idea that human beings are always commodities - My mother in law gets past around from one specialist to another. There really is not much left of her. She is aware and she dose get around but not without help. Here in Canada where we have universal health care there is a problem. When a person is doing their last lap in life they perform medical procedures that extend life by a month...or two..
It gets to a point where specialist pass around a patient like a piece of meat - each doctor taking a little bit of profit..and billing the tax payer. You have a woman with no kidneys to speak of- just had a heart by pass operation-hip replacement- knee replacement...drug costs of over 2000 dollars a month (payed for through the public purse)....a support worker that visits her home...also paid for...
Now they insist on opening up a vein in her leg to increase blood flow to her numb foot..she has open sores that will not heal..also- she has a walker - a push wheel chair - a high tech electric chair worth 30 thousand bucks...all paid for- and there is transport (pick up and drop off) again paid for...To take her shopping- dialysis a few times a week...So I am talking hundreds of thousands of dollars per year being spent on her--- The latest surgery regarding improving circulation is on hold...The new specialist refuses to do the procedure because the old lady is a heavy cigarette smoker...
Suddenly all this expensive treatment is going to come to an end because of political correctness- The fact that she smokes really bothers this doctor- His rationale is that the procedure will not be effective for as LONG...The woman is a walking zombie over 75 years old..smoked all her life - I don't believe that it makes much difference at this point if she smokes or not- This doctor is being a jerk...as if this surgery is so important- for one thing the incision probably will never heal anyway...
I guess what I am saying is that universal health care allows for experimentation in life extension..These curious doctors place a burden on family and stain the system because they have the luxury to toy with a dying person out of scientific curiosity...and greed.
Oh I forgot to mention she had her eyes repaired restoring her sight to perfect - she wore glasses all her life now she does not...You can wheel her off to the casino and she sees exactly how to waste her personal money while costing everyone a few million buck buy the time she leaves this world... okay that is my personal dislike of the old lady... back to the issue of tax dollars being paid to keep what is a corpse alive.
My own mother never got all these fancy treatments - in the alternative they did everything to speed her demise along...On once my mother was dead- I was approached by the doctors who were amazed at her will to live and they were curious on why she lasted so long...They asked me- "We want to perform an autopsy"---I looked at the clowns and said _"No ...you know what killed her find someone else to cut up"- They frowned and turned and walked away.
This fight with nature to extend life at all cost literally...that is funded by the public is one of the great defects in public health care and what in the end will make it unsustainable.
If I was put in the same position as my mother in law...I would take my chances and bypass being used as some money making device for some guy who needs a new Porche.
The latest news flash- our government wants to start restricting the earning power of doctors in Canada- There is great resistance by the medical profession.
Thank you for saying that. It's the thing I notice most, that this culture has become less cohesive, and more distant, when what we need is to help one another.
Quote:
Originally Posted by Oleg Bach
A lot of people who are employed in care facilities have chimed in- I was not expecting that- that people who work in these places are just as much victims as those they care for.....So damned hard to get by and survive..my old wife mentioned the other day that instead of us evolving into a caring culture..That things are getting worse. The only thing that I can think of and suggest is that we all realize that we must take care of each other and it it better to be a bit more poor than betray our elders - who in time we will be ourselves- WE have to stick together...and take care of each other...forget the money issue- and be aware.............that time makes us the same- We will all be vulnerable in the end...so please do not let those in control of the buck- force us to betray each other.
I think that while allopathic (in other words, non-natural) medicine has many good treatments and medicines, it also has some horrible ones, not to mention that not every treatment is good for everyone.
Here are 2 examples. I developed high blood pressure and was prescribed a medication. It made me sick and gave me asthma. I went back to the doctor and he changed my medication. My asthma worsened with the new medication. I decided to go off all medication and my asthma disappeared but my hbp returned. Frustrated, I began to do some googling and research the topic of high blood pressure. I found some herbs, researched, and began to experiment with them on myself. Why not? Hell, I'd read the risks on the inserts of the hbp meds I'd been given, and oh my God, it had a list of risks, precautions and side effects that were pretty horrific. Anyway, I found something that worked for me, and I now have normal hbp and without taking meds.
I'll give another example, my dad is 81 and has 2 calcified heart valves. He's been seen by several doctors (at my request). Many of those doctors say that to perform surgery on him in his condition, would endanger his life. He could die in surgery or directly after it, or soon after it. Still, a few doctors (all of them heart surgeons) say he could live a few years longer, and that it's "well worth giving it a shot." They speak as if they were discussing an 18-year-old with bad valves. By wanting to perform surgery on my dad, with his other medical issues and how weak he is, these doctors are willing to risk his life. All they're thinking of is: BAD VALVES ---> OPERATE. No alternatives. It's like the saying, "IF YOU'RE A HAMMER, EVERYTHING LOOKS LIKE A NAIL." That's how I see many medical specialists. They do their specialty and nothing else, and they don't bother even to LEARN how the person is doing in other areas. They just want to apply their specialty.
Quote:
Originally Posted by Oleg Bach
Very difficult to accept the idea that human beings are always commodities - My mother in law gets past around from one specialist to another. There really is not much left of her. She is aware and she dose get around but not without help. Here in Canada where we have universal health care there is a problem. When a person is doing their last lap in life they perform medical procedures that extend life by a month...or two..
It gets to a point where specialist pass around a patient like a piece of meat - each doctor taking a little bit of profit..and billing the tax payer. You have a woman with no kidneys to speak of- just had a heart by pass operation-hip replacement- knee replacement...drug costs of over 2000 dollars a month (payed for through the public purse)....a support worker that visits her home...also paid for...
Now they insist on opening up a vein in her leg to increase blood flow to her numb foot..she has open sores that will not heal..also- she has a walker - a push wheel chair - a high tech electric chair worth 30 thousand bucks...all paid for- and there is transport (pick up and drop off) again paid for...To take her shopping- dialysis a few times a week...So I am talking hundreds of thousands of dollars per year being spent on her--- The latest surgery regarding improving circulation is on hold...The new specialist refuses to do the procedure because the old lady is a heavy cigarette smoker...
Suddenly all this expensive treatment is going to come to an end because of political correctness- The fact that she smokes really bothers this doctor- His rationale is that the procedure will not be effective for as LONG...The woman is a walking zombie over 75 years old..smoked all her life - I don't believe that it makes much difference at this point if she smokes or not- This doctor is being a jerk...as if this surgery is so important- for one thing the incision probably will never heal anyway...
I guess what I am saying is that universal health care allows for experimentation in life extension..These curious doctors place a burden on family and stain the system because they have the luxury to toy with a dying person out of scientific curiosity...and greed.
Oh I forgot to mention she had her eyes repaired restoring her sight to perfect - she wore glasses all her life now she does not...You can wheel her off to the casino and she sees exactly how to waste her personal money while costing everyone a few million buck buy the time she leaves this world... okay that is my personal dislike of the old lady... back to the issue of tax dollars being paid to keep what is a corpse alive.
My own mother never got all these fancy treatments - in the alternative they did everything to speed her demise along...On once my mother was dead- I was approached by the doctors who were amazed at her will to live and they were curious on why she lasted so long...They asked me- "We want to perform an autopsy"---I looked at the clowns and said _"No ...you know what killed her find someone else to cut up"- They frowned and turned and walked away.
This fight with nature to extend life at all cost literally...that is funded by the public is one of the great defects in public health care and what in the end will make it unsustainable.
If I was put in the same position as my mother in law...I would take my chances and bypass being used as some money making device for some guy who needs a new Porche.
The latest news flash- our government wants to start restricting the earning power of doctors in Canada- There is great resistance by the medical profession.
It does get down to that- older people must keep their strength and brains power longer- we can not be eaten up--Grey power united...some are real strong and vital when they are old- these will be our protectors- those that have great genetics who are 70 with the power of 40 year olds...we had better form our army not to avoid the meat grinder====attitudes have to change and old people have to scream 'NEVER SURRENDER...
I think it was said already, but the resident to staff ratio can be obscene. It's not an issue necessarily of being understaffed (although some do work with skeleton crews) - when you look at the acceptable resident per caregiver ratio - and consider what the CNA or Nurse job entails - you could start to see it's a VERY stressful job, with high burn out. I've worked in a few different facilities, and the one thing in common was the amount of stress every employee was under - many even admitting to going home and crying after work (heck, my wife did that, and she's a nurse as well).
Why do people do it? I imagine because it's fulfilling unlike many other jobs, and that getting to know the residents and have a "work family" is extremely rewarding. It's generally not the pay - the amount of stress you deal with isn't worth the pay. For nurses - that's both during working hours and AFTER working hours - because if you screwed up that order, if you gave a wrong medication, if you didn't hear that doctor on the phone right - it's your license on the line. It's getting your picture and name printed in the next issue of the monthly magazine, under the "disciplinary action" (or worse) section, and - bye bye license.
Jumping to the title of the thread - I've personally had someone arrive in our facility only to die within 24 hours. When he arrived from the hospital, us nurses looked at one another with a "why are they releasing him?" expression, and braced for a long, very involved admission procedure.
He later died while I was listening to his heart sounds - I'll never forget them fading to silence as his daughters (in the room..) realize what was going on and reach out to hold his hand.
The fact is - people will die. Nursing homes get numerous admissions - statistically, some are going to die during intake. Also - skin does become thinner, and blood vessels weaker with age - certain medications can exacerbate that, and cause "bruises" to appear. Staff is more than likely not assaulting grandma - we appreciate you being concerned, but ACCUSATORY is a different issue.
On that subject - overbearing family are sometimes the biggest impediments to care. We sympathize that we can't give your loved one private one on one nursing care, but our mindset is necessarily geared towards the masses. It DOESN'T mean grandma should get ignored, but it means (assuming it's a good place) - let the nurses and staff develop their routine, let them experience grand dad sundowning and fighting with staff and refusing his meds - please, don't be the overbearing family that makes it a point to be there EVERY night at that time so you can mediate the situation.
That's unnecessary, dangerous, and hurts your loved one. You're not "protecting" us from anything - we've seen it hundreds of times - and we've taken the steps to work through it with others. Your meddling prevents that, and enables the situation to go unresolved.
So what should you do when you're looking at facilities? Research, research, research! Google for reviews, check the want ads for high turnover rates, ASK TO SEE THEIR STATE SURVEY! (And learn how to read it!!!!) Look at the residents there during tours, glance at their hair, nails, what they're wearing (stained? dirty?), sniff in the hallways to see if rounds are being done (if they're being changed timely), notice if the call lights make an audible buzz (those tend to get answered quicker...), talk to the staff (but realize the aides/nurses are incredibly busy..) - and when you find one you're comfortable with - LET THEM DO THEIR JOB!
Another thing - there are many incredibly handy medical apps on cell phones. One of the worst feelings is having your cell phone out doing an admission looking up drug information when a family member walks up and thinks they "caught" you playing around.
Even today I whipped it out and looked up a medication I nor the other nurses have ever heard about (and that wasn't listed in the drug manuals we had) - potentially adverting a med error.
And orders are needed for EVERYTHING. State will hit a facility HARD if they find an order made incorrectly, or something being done that doesn't have an order. The doctors in those facilities have a while to meet with an admission (I think it's a month in this state) - and usually come once a week (at least where I've worked/in this state). Going on between that is communication between the nurses/doctors regarding changes in condition, skin tears, pressure ulcers, etc etc. Once you get familiar with residents, you can identify when they're behaving differently, if it's an emergency (ie, they're going into respiratory failure, heart attack in progress, etc) there's a procedure to send them out, if it's nonthreatening (suspected UTI, etc) - there's usually faxes/phone calls to the physicians to address it. The Nurses are the eyes and ears of the doctors (I mean it, they'll ask us hundreds of questions we better have the answer for..), while the CNAs are the eyes and ears of the nurses. Good CNAs are gold...
The last point ill make - is the "the call light was on too long" topic. I believe 15 minutes is the "acceptable" time frame - you have to understand bowels generally work the same, and there are certain times (after meals) when EVERYONE has to go to the bathroom. Realize that the CNA worked their butt off putting 3 or 4 other people on the commode before they arrived at your granddads room, and they physically can't answer all the requests at the same time. If it's a continual problem, kindly (realizing what the situation is) bring it up with the nurse, maybe a solution could be worked out...but the most unhelpful attitude is one of confrontation, accusatory, and that is out of emotions and anger rather than logic. That usually solves nothing...
Very last point - that nurse "always at the nurses station or on the phone.." is most likely (almost a certain in long term care) incredibly busy, and usually on the phone with doctors addressing some other families serious issue. Or busy charting the progress of a particular symptom, so we have a record when it progresses. Nursing is one of those jobs where the uninformed will tell you "oh, you're not very busy" while underneath the smile you're holding back the stress, and thinking how you'll be there until 2am (when you're scheduled until 10pm).
Did any of you happen to realize it was national nurses week last month?
Myself, I haven't really noticed this, having worked in the same facility for 11 years now, people dying so soon after their arrival. There's residents who have been there the entire 11 years I've been there!
There are those who will always be on automatic pilot, they'll survive no matter what. Or it may be that strong fear of death! Or they've gotten addicted to pain medication and they look forward to those "highs" everyday, who knows! Frequent visits by family/friends can also be a factor. And the hope that some new cure will come along any day now!
There's one true survivor there, and you'd be mystified as to why this person hangs on, given his hopeless condition, being bed ridden for so many years, but there's always some new carrot that dangles in front of their eyes, that keeps them going, like: I want to live long enough to see my first grandchild.
Grandchild born, then? I want to live long enough to see my first great-grandchild!
Having a DNR (Do Not Resucitate) and no DNR can also make a difference.
I was thinking back to when I worked in nursing homes and you are right,most do seem to live in them for years.
I think people on here are getting "nursing home" mixed up with sub acute. Most who come straight from the hospital get sent to a subacute floor before heading to the nursing home part(Most go home)
The ones in subacute care seem to be the ones who die within days after leaving the hospital.
On the flip side,I have had MANY patients who came from the hospitals with bedsores they got while in the hospital and ended up dying in our facility 2 days later from the poor care received in the hospital.
I was thinking back to when I worked in nursing homes and you are right,most do seem to live in them for years.
I think people on here are getting "nursing home" mixed up with sub acute. Most who come straight from the hospital get sent to a subacute floor before heading to the nursing home part(Most go home)
The ones in subacute care seem to be the ones who die within days after leaving the hospital.
On the flip side,I have had MANY patients who came from the hospitals with bedsores they got while in the hospital and ended up dying in our facility 2 days later from the poor care received in the hospital.
Also, let's not forget the family members who arrive to these facilities with bedsores they acquired while at home under family supervision. So many family members simply do not do skin checks. If their loved one says, "No, I'm fine", it's highly unlikely that they are going to do a skin assessment of their loved one's bottom.
My father in law died within 48 hours of admission. It was not the home's fault at all. In fact, they did an excellent job and were very comforting to Mom and his son. Dad should have been admitted to hospice instead of being transported (stressful) to a surgery hospital. He never should have been put on a respirator and then having the decision made that his heart was not strong enough for surgery. He was given last rights, his wife took him off life support, and he rallied.
Then there was the additional stressful transfer to the nursing home where he died shortly thereafter. The whole thing would have been resolved with less stress on Dad and probably longer life if he had just been admitted to hospice. He had advanced Parkinsons and an enlarging aneurism that was causing pain.
I am a total believer in hospice and they would have done a much better job of addressing the end of life issues. He could have remained at home and been treated for pain while staying where he wanted to be.
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