My dad keeps arguing with the staff at the nursing home about my mother's care. It's always something physical therapy or getting her on the toilet. The physical therapist told him if you didn't like it maybe he should look into going somewhere else. I know the director of nursing is fed up with him for constantly insisting she be on the toilet. She can't stand she can't communicate she's a handful to try to get on the toilet or into bed or to do anything. Can the nursing home tell us to take her somewhere else?
The compassionate and competent staff members are on the same side as their patients and their families. The people that are most likely to snap and be rude are ones that should not be working with infirm and dependent people. The fact is that these places do not have enough people to do the work, and the workers who bear the brunt of the work -- the CNAs -- are often working a second job because this work pays so little. It is truly heartbreaking that both the patients and aides are treated so poorly.
Is your dad being abusive to the staff or is he just distressed because he feels your mom's needs are not being met? As you know, it is really a loss to see a loved one in that setting and it takes awhile for everyone to adjust. If this is out of character for your dad, he might be burnt out and the stress of seeing your mom in that setting might be too much. If he is there everyday, it might help to encourage him to take a day off and let him see your mom will be all right if someone else takes a turn visiting.
I understand what your Dad is going through I went through the same thing with my husband a few years ago. It took me 2 months to get a seat riser for the toilet rather than a small rickety commode that had been placed over the toilet for the resident in the next room. Difference was the resident next door was about 5'5" and 100 pounds soaking wet my husband was 6'4" and 260 pounds. While the commode was stable for the next guy it shook like a leaf when my husband tried to use it. I won't get into the 100's of other problems. But there is a difference in advocating and being obnoxious or belligerent.
Tell your Dad the old adage is right...You catch more flies with honey than vinegar.
If he is violent or abusive, then the staff could take steps to have him banned from the facility, yes. But they are more likely to ask him to remove his wife, and that indeed is the primary concern of the original poster. In any case all the poor man is doing is questioning the care his wife is receiving, and the correct response to that is to explain and reassure - not to chuck him out on his ear for his temerity.
I suppose from wheelchair to room to bed to commode to bed to wheelchair and back again would take that time, yes, on reflection. I guess I hadn't really added up in that way before. I used to transfer my mother last thing before "bed-time", and in the whole performance of that, washing, teeth-cleaning, bed-making and the rest of it I lost track of time.
I also ignored the two-person rule. This was partly to do with reality - there weren't two of me, and if you think transferring somebody on your own is heavy going all I can say is try changing the bed on your own with the person still in it - but also because of at least two occasions when the frankly dangerous actions of professional aides, trained and qualified, made me insist they stop what they were doing immediately (I very rarely challenged our HCAs, or felt the need to). One of them would have had the hoist tip over - she was yanking on it to get it over a bed cable - and the other hadn't got the sling straight and my mother's torso was heading for a 45 degree angle to the right. I consulted the government's Health and Safety Executive's reports on the use of hoists in care settings to check what the main causes of serious accidents were so that I'd know what to be neurotic about. And although these reports are in Civil Service speak and therefore don't call anyone a moron, when you dig down accidents are caused by people not paying attention, not using the equipment properly and in one case having the spatial intelligence of a woodlouse. I suspect, too, that quite a lot of the inattention comes from pairs of aides chatting to each other instead of concentrating on what they're doing.
With practice you should get good at it, like a choreographed routine. What matters though is whether your mother is aware of continence issues or not. If she is at all concerned by it and is willing to persist with transferring, then the benefits to her sense of self, skin integrity, infection prevention and just simple hygiene make it worth the effort.
How do you feel the staff is performing ? How does the facility rate by Medicare? If you are uncomfortable then are there alternatives ?
What's taking them 45 minutes? I'm liking the sound of this NH less and less.
It sounds as if someone - you maybe, but a counsellor or support worker might be better unless you'd rather do it yourself - needs to sit down with him and have a gentle but candid talk about realistic expectations.
By the way. I do have experience of transferring using a hoist. And I have to say that if your mother is left swinging around with her butt hanging out then the two aides responsible should have the same done to them to see how they like it. Respecting the person's dignity is paramount, and it's a matter of technique and considerateness. A lot of blushes can be spared with just a little thought and some deft placing of towels.
And if dad continued to be pester the staff, then, I'd have to insist that he only come at certain times to visit when you or another family member could be there. You are Healthcare POA, correct? Are his questions polite and curious or loud and demanding. That would make a difference.
I know that when my Mom was going through post Cancer recovery, and staying with my eldest sister, Dad was still at the MIL apartment attached to my other sisters home, and he himself had such a dreaded disease process that required the assistance of this sister. My Mom then went through 6 weeks of Radiation therapy, and it was thought that it would be best if she continued to staybon through this with eldest sister to aid her in her rest and recovery. My Dad, while able to visit her there every day, missed her so much, it was heartbreaking, although he definitely understood, but he began a sort of downhill spiral, and we soon realized that he absolutely must stay there with her, even though it was a lot more work for eldest sister. We all (the other 5 of us) rallied around her and helped out and we got through it, plus we got an aide in, to help our Dad with his ADL's, getting up, dressing and breakfast every morning. I can't imagine being separated from my husband after so many years, but sometimes its not a choice.
I'm sure you've already spoken to him about this, but gentle reminders is all I can suggest at this time. I'm sorry this is so difficult for you both!
Do you think your mom was aware of the cutback in time your dad was with her?
My mom has a bad summer cold and was already asleep when I got to her facility last night - albeit in her clothes - I didn't want to wake her just to out her into a nightie but I stayed 2 hours in case she woke up and needed help until her overnight sitter arrived - although she woke calling my name I stayed at the doorway and let the sitter get her ready for bed - felt badly but didn't want to make her more upset by seeing me and then me leaving - although more frustrating that the baby monitor had fallen into a drawer in the wellness center and staff couldn't even here she was calling for help ....
Anyway, my Dad didn't quite understand what was going on and my Mom would tell Dad that she walked for 20 minutes that day.... of course my Dad believed Mom had walked, and he kept wanting me to get Mom to get out of bed so that they would walk. Same with whenever Mom wanted to use the bathroom... [sigh].
Thank goodness my Dad was a quiet reserved man, didn't give anyone any problems. But it took over a month before Dad realized that Mom won't be walking :( He still had hopes she would come home and everything would be like it was before that last fall. Once that hope was gone, Dad cut his visits down to a half hour each day. He really didn't want to remember his wife in that condition.
What people do not realize is that their loved one is not giving up and waiting to die ( although this may be the case) they are simply experiencing a progression of their condition and are content to simply be left alone. They have probably accepted their new really and are not able to change the inevitable so accepting this for the loved one is a great love and kindness if there is no hope of improving their physical or mental condition.
What if the therapist or whoever is in charge of her therapy or care were to go over her abilities and explain what she is no longer able to do. He may have in his mind that she might catch on if they spent more time with her or explained things better. And we know that dementia patients aren't really able to learn new things, so, if she is declining, he may have to be told specifically so he can adjust his expectations.
Even overlooking the childish petulance of that response to your father's concerns, whether or not the PT was being reasonable depends on what your father objected to.
My late aunt was very much of the 'oh don't complain you'll only make things worse' type. It used to drive me nuts. If there is a problem, say so. Say so politely, say so to the right person, and before you speak up have a clear idea of what you expect to be done about the problem. And if the NH can't cope with that kind of constructive approach and still gives you backchat, then maybe you should be looking for somewhere else.
Nursing homes and rehab facilities are tough places to be and generally are not comfortable for visitors to sit in hard chairs - I found having a sitter with my mom from 4-8 pm each day until I got home from work made a huge difference