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 Resisting care in nursing home 
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Resisting care in nursing home
Yes, I must say it is a relief to me that most [not all] of the staff at Derek's SNF really seem to care about the residents and they know I want to be informed of everything about his condition they tell me everything. There are a few there who seem like unhappy campers and are not particularly good with the residents, IMHO. But most of them are not only caring but genuinely cheerful and seem to enjoy their work!

Yesterday afternoon I was just pulling his laundry out of the dryer at home and they called and said he was 'a little upset' and asked if I could come and calm him down. I always go in the morning and evening so I would have been there, anyway, after dinner, so I told them I'd be right down. Turns out he thought they were keeping him 'out of the lab' and he wanted to go back in the lab. He was in his wheelchair and was paddling into other people's rooms [he can't usually propel himself at all, so he must have been really motivated!] and getting angry about their 'redirecting' him [he doesn't redirect well when he's focused on a delusion]. Anyway, he was fine after I got there and I helped him with his dinner and sat with him until bedtime.

Today he slept much of the day--I guess all that 'lab work' tired him out! :lol:

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Apr 17, 2011 11:49 pm
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Resisting care in nursing home
Pat, it is wonderful that Derek is getting such good care. I remember when you were worried about having him in a SNF. The staff at my mother's SNF are the same. I don't know where they find such kind, patient people to do this demanding work, but I am grateful. It's just so sad that my mother doesn't realize it. She is so paranoid sometimes. Last week, the aides were trying to help her with her care and she told me later that they were mean and don't like her. But then, who knows what kind of delusions she was having about what they were doing?

Julianne


Mon Apr 18, 2011 9:04 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Resisting care in nursing home
Oh, I hear you! If I listened only to his reports I'd have quite a different picture. And he always refers to them as 'he', even though they are nearly all 'she'. And he calls one of them 'Fatso', which doesn't endear her to him, I'm sure. :shock: I suggested to him that it might hurt her feelings but I'm sure that doesn't register. :cry:

There are things they could do better. I have had to teach them how to do some things that I felt they should know. One evening a young nurse asked me to show her how to obtain a sterile urine specimen from his catheter tubing. She is a wonderful, caring nurse--a fairly new grad--and I was more than happy to oblige. But many of these 'deficiencies' I would not notice if I were not an RN.

And he obviously does not get the one-on-one care he had at home but that's not going to happen in any facility. Since I have the luxury of time to be there four or five hours a day, I can do some of his care and all the little extras.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Apr 18, 2011 9:31 am
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Resisting care in nursing home
Pat, Derek is lucky to have you watching over things and staying with him so much of the time.

Julianne


Mon Apr 18, 2011 9:59 am
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Resisting care in nursing home
I'm fortunate to be able to and there's nowhere else I'd rather be.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Apr 18, 2011 10:12 am
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Joined: Tue Dec 29, 2009 2:28 pm
Posts: 464
Location: Minnesota
Post Re: Resisting care in nursing home
Julianne,

I've noticed that incontinence strikes almost all of the residents in my mom's SNF. But I think a lot of it is that it takes time for the staff to get to them to help. Sometimes people in wheelchairs line up 3 and 4 deep, and this is an SNF with a great reputation and Medicare rating. With about 6 to 8 residents to 1 CNA, it's predictable that some might not be able to get to the toilet fast enough. I guess I've just assumed that everyone living there is in diapers.
Mom was used to me getting her to the bathroom as quickly as I could, but I'd have to be a track star to get there fast enough. I've had my hands in more mom-poop than any of my sisters. At home, it got to the point where I bought a hand shower attachment with a long hose just to get her bottom clean. Problem with that is that the toilet can only hold so much before plumbing problems show up.
It is something you get used to, whether you are the cleaner-upper or an aide is.
We are particular, though, about the diaper. The ones at the SNF irritate Mom's skin. So we use Depends. Preferably the pull-up kind. I'm finding that the adjustable ones only work when the wearer can stand up or lie down long enough for you to fasten them.
Mom now only resists care from staff that she doesn't know. Recently, when a new nurse was on the floor, Mom wouldn't talk to her at first. I suggested that she go get the nurse who was working the shift before hers and have that nurse (that Mom likes) introduce her. Worked like a charm! But then, Since Mom has so much trouble talking, the staff has no idea when she's angry.

Hang in there. And be glad someone else has to change the diapers. (When I was a kid, I thought all old people wore diapers. My grandpa did, my great aunt did, and a whole host of other relatives, too.)

_________________
Kate [i](Cared for Mom for years before anyone else noticed the symptoms, but the last year of her life was rough and we needed to place her in an SNF, where she passed in February 2012)[/i]


Mon Apr 18, 2011 2:14 pm
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Resisting care in nursing home
Actually, my mother is ambulatory and can get herself to the bathroom. She admitted to me recently that a couple of times she just "waited too long to get going." I assume that is what happened when she urinated on her bathroom floor. That was the first incontinent episode that the SNF told me about. She wears a pad for leaks but no diapers. Apparently on the occasion when the aides were sent to clean her backside, she had not cleaned herself well enough, but it wasn't incontinence.

Whatever assistance she may need, she resents and resists. My sister had a talk with her over the phone this past weekend and told her she needs to be more cooperative and accept that she needs help when the staff tries to help her. This seemed to sink in, at least for as long as she remembers it!

Julianne


Mon Apr 18, 2011 5:12 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Resisting care in nursing home
Julianne, I think they start to lose the control partly because they lose the sensation or the ability to define the sensation of having to go. Sometimes Derek will say he has to go [#2] and I will find that he already has.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Apr 18, 2011 5:21 pm
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Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Resisting care in nursing home
Could be, though it seems that my mother is aware of the urge but due to her slow ambulation, she is not be able to get to the bathroom as fast as she thinks she can. I guess this will all shake out when she becomes regularly incontinent and then the SNF staff will have to make the call about using diapers.

My main concern is not the exact kind of help she may need, but rather how to get her to accept help with anything. But this seems to be the trap I fall into all the time--expecting something logical to happen when we are likely beyond that point.

Only two days until the appointment with the new neurologist. I am looking forward to hearing his evaluation and advice.

Julianne


Mon Apr 18, 2011 5:38 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3432
Location: Vermont
Post Re: Resisting care in nursing home
Getting our LOs to accept the changes that happen to them with their declining health is kind of like beating our heads against the wall. At least that is what it was for us and several friends going through similar situations.
I remember my dad thinking all his aids were men even though only 1 out of 28 was male, and the name-calling when he first got there. It was very embarassing and difficult to deal with.
Yes, these are some of the things where we are expecting logic and manners to guide our LOs behavior and that is often unrealistic and becomes more unrealistic as they decline. :cry: Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Apr 18, 2011 8:55 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Resisting care in nursing home
Yes, Derek has always thought his caregivers were men, always refers to them as 'he', even though only one is a male. He also calls one of them 'Fatso', which I'm sure really endears him to her! :oops:

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Mon Apr 18, 2011 9:04 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3432
Location: Vermont
Post Re: Resisting care in nursing home
If it makes you feel any better, Fatso is only part of a 3-word name my dad routinely called one of his CGs that he didn't like. I was always extra nice to this lady because I didn't know what she might want to do when I wasn't around and he was calling her names and yelling explatives. :oops:

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Mon Apr 18, 2011 9:14 pm
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Joined: Tue Dec 29, 2009 2:28 pm
Posts: 464
Location: Minnesota
Post Re: Resisting care in nursing home
...which only goes to show the amazing type of person who is willing to go into caregiving as a profession. I really don't know if I could handle caregiving for anyone outside of my family. I'd be running away in tears the first day!

Kate

_________________
Kate [i](Cared for Mom for years before anyone else noticed the symptoms, but the last year of her life was rough and we needed to place her in an SNF, where she passed in February 2012)[/i]


Mon Apr 18, 2011 11:31 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3432
Location: Vermont
Post Re: Resisting care in nursing home
There are many reasons I chose another career! I couldn't do it for 5 min. :lol:

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Tue Apr 19, 2011 7:43 am
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Joined: Mon Jun 21, 2010 2:24 pm
Posts: 32
Post Re: Resisting care in nursing home
I am sure someone has already thought of this, but it was what worked for us when my husband became incontinent, even early on. He was embarrased, as they all are, to have to wear anything other than his underwear. So I first started putting the pullup inside the underwear and work until I got it on him, all in one piece. Having the underwear on the outside insured that he was still 'ok' and that nothing was wrong. That was in Jan 2011. Now he wears anything I put on him, without the underwear. This worked for us as a transitioning tool, to get over the hump, so to speak. I dont know if it would help anyone else facing this situation. But that is why we all are here, to help each other and to gain insight from others. Love to all, Misty.


Wed Apr 27, 2011 12:56 pm
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