My aunt lives to go to church every week and has someone that picks her up. When she gets there, they get her out and she immediately is put in a wheelchair where they push her around the whole time. The nursing home told me that she is getting weaker and they do not think that she should be going out. After a few days of thinking it over, I decided that her quality of life is more important then her quantity of life. A fall can happen anytime - even at the nursing home and I feel that the people that pick her up are able to help her. She also does not go if she is not feeling well that week. When I told the nursing home how I felt, they immediately told me that they are now using a lift to transfer so they will not allow her to go out. Are they allowed to do that? As her POA, I am trying to do everything in her best interest but I feel that they are overriding her/ my wishes. Can someone please let me know if they are able to do this? If not, what can I do?
A not so nice thought; Maybe they want to keep her there as a patient, receiving the income from her. If she falls, she would go to the hospital, then to a rehab facility for a long while. If she's not there, they don't make money. You don't want to think that way but I can't figure out why they are laying down the law. Contact an elder law attorney to get this set straight.
A fellow-member of my local caregiving group took her late-stage dementia husband to church frequently. She hired special transportation to take him in his geri-chair and to return him to the facility. He had a special jacket/lap robe for wheelchair users. The facility did not object because all of his needs were being met and the risks were being mitigated. And she could be the Caregiver From Hell when she needed to be. :P She also arranged for communion to be brought to him in the NH between his church visits.
Having kind volunteers to pick Aunt up may no longer meet her increasing weakness.
Once my mother was a two-person transfer with a sit-to-stand device, she seldom left the facility. Once a month they transported residents to Walmart. She did not get out of her wheelchair for that ride. My sister met her there and wheeled her around shopping. She rode back in the special van. The challenge was, what if she had to go to the bathroom? Well, that could not have happened. She'd simply have to wait to be changed when she got back. Other residents were in the same situation, and the trips were kept short. The only other trip she made was to her sister's 100th birthday celebration. We hired a van so she didn't have to get out of her wheelchair, and limited her visit to about an hour (which was enough for her energy level anyway).
If Aunt really wants to go to church, ask the facility what would make that possible. Could you hire a medi-van and take her in a wheelchair? What would make this safe, in their view? Could you sign a waiver, taking full responsibility for the period she was gone?
I agree that quality of life is way more important than quantity at this point. But if Aunt falls or is dropped or bumps into something, the quality of her remaining life could be miserable. Getting her from the wheelchair to the car and back again is an increased risk period.
My mom's nursing home had several church services per week, of different denominations. Residents could attend easily, without getting dressed for outdoors and without leaving their wheelchairs if they used them. Aides came and got them and brought them to the chapel. There were also a couple of Bible study sessions, and rosary sessions, and hymn sings each week. My mother was not religious at all, but she sometimes went to the religious music events.
I wonder if participating in what is available at the nursing home might be a good practice now for Aunt. It would be another way to connect with the residents she sees often. And maybe those kind people who pick her up for church could instead occasionally visit her where she is, perhaps even going to a church event with her there. Ask her pastor if there is a visiting committee who could come and see her occasionally so she doesn't completely lose touch with her church buddies.
I give you gold stars for advocating for your dear Aunt! She is lucky to have you. What is best for Aunt may change over time. Stay flexible, while continuing to work in her best interests.
Many church goers tend to be elderly to and it may be that the nursing home feels those who transport her are not now up to the job. Would they allow you to transport her? There seem to be a lot of unknowns here. it might just be a case of "Mother knows best"when you challenged it.
I don't know your aunt's condition, but I would object to them using the lift all the time! Muscles and ability decline rapidly when use is stopped: "use it or lose it".
Working with many patients with major mobility risks (clear for me after helping my brother for so many years), I know that with patience, gentle direction and supports they can hold onto, position legs and use leg strength to lift - it is possible to help most people up - sounds as if someone in the nursing home is using the lift use as a way to follow some medical equipment idea - that may not be what your aunt needs. I took care of a woman who would tell all her aides, when she was 106, "Don't help me, damn it! If I let you help me this time, soon I won't be able to get myself up anymore"." She was walking - with more difficulty yes but she was not bed-ridden until the last 6 months of her life, she died at 106.
I find the nursing home relate to my wish to focus on keeping my brother active at his level, so he walks to the bathroom with his rollator, despite some falls when he recently got sick. He gets up and dresses and is picked up 4 days a week for a day program. He walks with his rollator outside on flat streets, including to church, and I support the services in avoiding any gaps in these routines unless clear reasons, for I know that when he stops, he will sit and not get up. They already let him gain 50 lbs in there.
I would suggest maybe a Physical Therapy consult. You should ask the church helpers also, do they find your aunt able enough and alert enough so the routine is safe?
When I have difficulties with one person at the nursing home, I call and express my concerns with others there, including the Director. And of course, check with your aunt's wishes, that's another card in your deck. Use the cards you have to find some people there who agree that the goal is not to have 100% non risk by letting a patient lose what remaining abilities they have to help themselves - but to be as kind and resourceful as you can, and get the staff's help to help her maintain the quality of life she has developed and loved in every way possible. I've found that there are people there who understand - and at every level, there are always some who use rules to take over - but I think you are right, keep talking, with many, asking again: what is the goal here?
And yes, if they are using a lift - they can "suggest" you not take her out of the NH and would most likely make you sign a waiver in case she falls.
I did much the same when my nephew tried to take my dad out of state. I let him know that for the time he was away from home, total responsibility was on the nephew.
There are legal aspects of allowing a resident to leave the building when it has become not feasible. Even if a waiver is signed, the family can still try to sue, if something happens, saying that the Assisted Living or Nursing Home knew about this but still allowed the resident to leave the complex.
It is not unusual for the resident to return back to the complex and become a hand full for the Staff, not cooperating, wanting to leave again, etc. That takes time away from other residents who need hand-on care. Since the relative isn't there to see this happening they think their Mom, Dad, or other love one had a good outing.
I don't have a dog in the fight.
Grace + Peace,
Bob
she is unable to travel due to her health. I am sure you would be able to get help from them, or someone that they could connect you with. my mom once she came home had hospice till she recently passed and they had a Decan come in and chat with mom and give her communion once a week. it cant hurt to try....good luck.....
#1 Pastor coming to the facility
#2 Live streaming sermons on computer assuming she can get to one and be able to see it
#3 Bible study
#4 Bible scripture reading by volunteers who are looking for this type of work
It may be that the nursing home staff is concerned about those from church being able to transfer her safely or that she is no longer able to safely support her weight.
If your aunt needs to put more than 25% of her weight on those assisting her during the transfer and they have to do more than 25% of the repositioning of your aunt's body during the transfer, then, I'm sorry, it is in your aunt's best interest and "QUALITY OF LIFE" that she NOT be taken to church in a car. She needs to be taken in a wheelchair equipped van so that she does not have to get out of the wheelchair at all while attending church. Most facilities do not operate their vans on the weekends nor do they use them to take people to church services.
In regards to you labeling the use of a mechanical lift device as a "quantity of life" item instead of a "quality of life" item, the use of mechanical lifts is one way to maintain a person's current "quality of life" because it decreases the possibility of that person falling and breaking a bone or injuring themselves in other ways. More than 50% of the elderly who break a bone experience a rapid decline in overall health and/or DIE within 6 months of breaking a bone.
Please, please reconsider your decision!! Sit down with the nursing staff and talk with the nursing supervisor about how much help your aunt really needs. You may find that NOT taking her to church will be the BEST choice to maintain her "Quality of Life."
Another technique I use when getting the patient to go from sitting to standing I call 'count of three'. Number one and two the patient rocks his body while seated. On number three, patient rocks but then stands with assist. Before starting, I tell the patient we're going to stand on number three.
As a caregiver, I love to see family involved in hands on care for their loved one. It takes a special sort of person to do this. Mary RN