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Mom has dementia but knows her pills at breakfast, lunch, supper and bedtime. She claims the caregiver gave her the wrong pills but she took them. She says she knew there should have been 3 but there were 6 and they didn't look like hers. Unfortunately she really realized it after she swallowed them. She went to the nurses office to report it and was told they would have to wait and see what happens. I wrote the director an email and the head nurse and they have not acknowledged receipt or responded.
In addition that same night a caregiver unlocked my moms door while she was sleeping and allowed another resident in who proceeded to use her toilet. Mom had to walk her down to the nurses office. Again she told the nurses office and they apologized. I included this incident in my email. They have severe staff turnover lately and new employees on weekends.
Does anyone have any other suggestions of what else do to?
This place has a good reputation and I know many care givers and the management but they seem to have a lot of issues with inconsistencies. They fix one thing then it's another and some of the staff seem unhappy especially on weekends. It seems all ALFs and nursing homes are like this and some are worse.
Thanks,

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Medication errors are never acceptable. I tried to search nurses' protocol post medication error, and mostly came up with hospital reporting systems. I see that your mom went to the nurses station and not you. I've been slowly learning that staff is more likely to believe me rather than my mom who doesn't have dementia. Obviously you weren't able to be there at the time and had to write an email. My first take on this is that they don't want to respond to you in writing. Whatever they say can be used against them. I may be wrong, but it makes sense.
Today I would either go there if I could, or get on the phone with the director of nursing to explain what happened and what they plan on doing to make sure this never happens again. Ask if an incident report was put on file and if not, why?

If the director of nursing gets you nowhere regarding the med error, try the director of the facility. Don't forget to include the problems you've observed on weekends. When all else fails, or even if it doesn't, a letter to the Board Of Directors should get some attention.

I am only describing what I would do if I was in your shoes. Good luck and I hope it's resolved soon.
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There are battles we choose to fight and battles we choose not to fight. A medication error and letting some strange person in to use the bathroom would fall under the category of battles you choose to fight, in my opinion. I can almost picture it, a staff member was probably walking with another resident who told her that he/she had to use the bathroom. It was probably urgent so the staff member, not wanting to deal with the mess, opened up the first room she came to and it was your moms. It's creepy and just plain wrong.

I would follow up with the administrator and supervising nurse by phone or in person. Tell them your concerns ("concerns" vs "complaints"). All they will really do is probably reassure you that it won't happen again. They probably won't take any responsibility but hopefully they will put a bug in someone's ear that you're concerned about these things and maybe....maybe....someone will take it seriously and go to any length to prevent something like these things from happening again.

When my dad was in the NH I discovered that the caregiving didn't stop, it just got different. As you know, we still have to be hands-on, build relationships with the staff, and advocate on behalf of our parent all the time. That's when I realized that I had to let a lot of things go, pick my battles. But as I said before you have 2 battles here that need addressing. Good luck to you.
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Certainly it's true that even the best-run institution can have its wobbly patches. Hm. Difficult.

Also not acceptable. Your mother seems to be coping admirably but she really shouldn't have to - that's kind of the point of her being there, isn't it.

What about asking for a face to face meeting with whomever you see as being the lynchpin manager and thrashing this out? As a minimum you'd want to come away with proposals for preventing recurrences, plus a clear set of instructions (fire drill notice style) for your mother about what to do when anything worries her - call her key worker, pull her alarm cord or whatever.

I'd be extremely irritated that they hadn't replied to emails; but on the other hand if they're already firefighting it's probably a matter of lack of time rather than atrocious manners or something serious to hide. Anybody else worried, that you know of? Get on the phone and request (read: demand) a meeting, I should.
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Thank you all for your helpful answers!! I sincerely appreciate them
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They are also supposed to have posted insturctions on how to contact a long-term care ombudsman/office of long term care, if your face to face discussions with responsible people on site don't go anywhere. Bear in mind some health professionals/facilities have policies against using e-mail; where I am I can only use e-mail for patient communication if it's encrypted in our system, and I have some collegauges who just won't do it at all. That has gotten worse lately too; people have become more fearful and tightned up all possibiity of a HIPAA breach since the consequences include huge fines, mammoth disclosure requirements, and even possible criminal penalties for any "breaches" which have also been more strictly defined. They should be a lot more comfortable face to face and unless this is just turning into a genuinely bad versus an imperfect facility, they should be willing talk to you about the issues and ways to prevent recurrences.
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