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My father had a stroke 2 months ago, and luckily his left side of his brain was relatively untouched so he's still very much cognizant, and recently after staying at a rehabilitation facility for 5 weeks they decided to discharge him. I spoke to the social worker to get him transferred to place where he could get more short term care and be surrounded by people that could help him if something went wrong, I should've just sent him to live at the gym! In less than 48 hours, literally one day and an extra hour they are calling me telling me he fell. I'm so confused, apparently guard rails aren't allowed in nursing homes. OK, but the nurse was in the room when he fell, according to the women who called, and my father. They tried to stand him up and put him in a regular chair (he's partially paralyzed) but the chair slipped and he fell and hit his head.


On top of that he called before, telling me they didn't give him food when he got transferred over at 5 pm, I was like maybe dinner was over, but who gives dinner at 5 pm, and it wasn't over. Then they proceeded to tell me his breakfast got spilled, and they gave him a full blown turkey sandwich. My dad can only eat mush. It's been a mess I offered to send over the transfer papers because maybe they didn't get them. But they declined, my father told me to sue them for this, but I don't know if it was a mistake or actual negligence.

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Beehom, welcome!

My mom fell in Memory Care with two aides in the room. The discharge planner at the hospital where she had her surgery told me "MY mom fell with 3 RNs in the room, and one of them was ME!"

Call the dietician immediately and ask what orders s/he has for dad's meals? Is it "mechanical soft" or "puree"?

In my experience, putting a sign above his bed helps.

Then call the exec director, social worker and Director of Nursing and say you need to go over dad's care plan with them today, because medical errors are being made.

Make sure you have the number for the state Ombudsman who oversees this NH.
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The first few hours, days and weeks at a facility are going to be a learning curve for both sides - front line staff need to learn about the new resident's needs and temperament and family need to learn what's normal and what isn't. It's unfortunate that he was transferred over the dinner hour (and yes, most nursing homes do serve meals early). It's unfortunate that the kitchen hasn't yet got the memo that he is on a special diet - but it's possible that a kindhearted CNA grabbed him that sandwich without checking first. I get that this is all horribly distressing but you will get a lot farther a lot faster if you go in there "curious, not furious", and calmly ask how they are going to address these problems going forward.
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My mother lived in AL for 4 yrs and Memory Care Assisted Living for just under 3 yrs. During that time, she fell 95x. Why? Basically because she had mobility issues from strokes and neuropathy which nobody could fix. As her dementia increased, so did her falls. She was wheelchair bound in MC but insisted she could walk, resulting in many of her falls. A few times she took 3 falls in one day. Sometimes while a caregiver was in the room with her. A couple of times she slipped off the toilet while an aide was cleaning her up. Or slid off the bed during a wound care session. And I got The Phone Call each of the 95 times.

I never blamed anyone or anything but old age and mobility issues (and later on dementia) for moms falls. I never threatened to Sue bc there was no malicious intent involved and no damages, either. It's life as an elder in general. So is spilled food and drinks and food they dislike and gossip and yada yada.

Welcome to your new life. Pick your battles. Take it all with a grain of salt, especially dad telling you to Sue bc he may be demanding that on a weekly basis if he's a tough cookie. Life's not perfect in managed care, that's for sure, but it's far from perfect anywhere, especially at home where the children are the indentured servants and nothing is ever done properly. Mistakes happen bc we're all human. Try to keep that in mind as you move forward and focus on the overall quality of care he's getting instead of the more minor details.

My mother loved "her girls" who lined up at her door for a week when she was dying, to say goodbye and pay their respects to her AND to me. I gave most of them a memento of mom to remember her by. These are the memories I take away from her days in AL and the excellent care she received. I hope you wind up with those same memories.
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BurntCaregiver Nov 2023
OMG. Slid off the bed during a wound care session? This is incredible. Put the side rail up during wound care.

I can't even believe what I'm seeing here. I was a caregiver for 25 years and never had a client slip off a toilet or fall out of the bed when I was cleaning them up. There comes a time when the client gets weak and there dementia has progressed to where it's no longer safe for one person to clean them up on a toilet.
That's when two people have to assist or it's time for diapers.
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If you'd ever attended a stroke patient, you'd know that they can crumple and fall any minute. Your dad is partially paralyzed. This means that he's going to fall no matter what and no matter where. A nurse standing right beside him? Even with a gait belt around him, he could go down. Even with three attendants with him, he could fall. Happened with my dad with me and two professional caregivers who were walking him; he still went limp and was on the floor even with the gait belt and one supporting him on either side.

I don't know if your dad's incident was negligence, but there's nothing much to gain from suing. Don't let your father tell you what to do. Though you think he's cognizant, and maybe he is, his brain after a stroke is NOT going to be exactly the way it was before. Chances are you haven't learned everything yet about what's likely to happen to him. I wasn't informed that many months into stroke recovery, I should expect my LO to start having painful contracture of muscles. Even with plenty of PT and a patient eager to do it and recover, this happened. Then I was told about operations to fix the contracture, etc. etc. - just at the time that I thought we'd be past the worst consequences of the stroke. In other words, you have a lot to learn.

Approach the facility with an eagerness to learn so you can help your dad. Heed their advice. Don't start with the anger. That will get you nothing except the label of Troublesome Daughter. Take some cookies around to the aides. Show them you're part of The Team.

If you don't like the place after a reasonable period of time, you can move dad. But it may not be better anywhere else.
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BurntCaregiver Nov 2023
@Fawnby

They weren't walking him. See, nurses and CNA's learn how to handle it when a patient suddenly "crumples" down. If you have a proper grip on the person as you should and someone else who is properly trained is assisting, you can lower that person safely onto the floor. Or in this case where he was in his room, lowered to the bed.

I can't tell you how many times one of my clients suddenly "crumpled" and had to be safely put on the floor by me. One person. No assist. It can be done if you're trained properly.
Yes, I've had to call paramedics to get someone off the floor, or lawn, or sidewalk. That was fine because they didn't get hurt being put onto it.
There is no excuse for the type of injury the OP's father has sustained in the nursing home.
The only reason why such injuries happen is neglect and poorly-trained, incompetent staff.
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It is actual negligence and yes, you should talk to a personal injury lawfirm to discuss a potential lawsuit.

Everything you are saying here has raised the red flags for me. I was a caregiver for 25 years and have had to deal with nursing homes way too much. So I'm going to speak to you plainly and truthfully here.

All nursing homes lie. They also steal if you don't inspect and proof read every document they put in front of you to sign.

Ask yourself this. What kind of dumbf*** nurse who is actually in the room with the partially paralyzed stroke patient allows "them" to move such a person into a chair that can slide?

The answer is no nurse and the chair did not slide. Here's the more likely scenario. Your father is supposed to be an assist of two and transferred either with a lift device or a harness into the chair. The chair did not slide and cause his injury.

The nurse is covering her own a$$ and the facility's by saying she was in the room when the fall happened. If such were the case, surely a nurse would know better than to move a partially paralyzed stroke patient into a chair that can slide across the floor.

I'd believe what your father says. Maybe talk to a few people visiting other patients at the facility. I think you will find that he is not wrong.

Talk to a lawyer. Even if nothing comes of it, when a nursing home hears from a lawfirm and they're asking for records about a certain patient/resident that patient/resident will get treated like a king.

The staff will not be bringing the poor guy who's on a soft diet a turkey sandwich. They will be peeling him grapes like he's a Roman ceasar and chewing it for him.

The only thing nursing homes, rehabs, ALs fear are personal injury lawyers.
So make them fear. Have a consultation with one and then see what great and safe care your father gets when they know some legal tiger is sniffing around just waiting to pounce.
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AlvaDeer Nov 2023
"Damages" is the key word here. No big injury equals no lawsuit.

Under the law the compensation in suit is paid according to injury and level of negligence. There is, that we know of, no injury here.
Certainly anyone doubting how suits work should visit their own attorney or an attorney. But there is no suit here unless there is a personal injury. And in a stroke patient with a fall, there is almost nil chance in a fall suit. Suits cost attorneys a huge amount of money in investigation of past practices and history and expert witnesses attesting to "there but for negligence was someone who would never have fallen.l
As Handel on the law says with his marginal advice (and mine's worse than marginal) "This is where I tell you that you have no case" (hee hee).
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Is this a Skilled Nursing facility? If so, Rehab should have sent over discharge papers. They should have sent instructions on diet. And, I think transferring to a chair and the chair tips over, is a problem especially if Dad hit his head. Was he sent to ER because he should have been if he hit his head. I would talk to the DON or director. Dinner time is a weird time to transfer. He should have been given something. If Dad is paying privately, maybe see if an Assisted Living will take him. He will pay less and maybe get better care.
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beehom Nov 2023
Yes he was sent to the ER, because he was slo on floor thinner and he was bleeding. He's paying via insurance.
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Sounds like he didn't fall because of something he was doing but he fell because of the incompetence of the nurse trying to put him in a regular chair. I would be all over their a** about this (as calmly and diplomatically as possible to avoid retalitation) because it is not acceptable. They should have proper procedures to transfer a partially paralyzed man into a chair for pete's sakes.

About the food they should have read all the transfer papers and it sounds like they didn't. If you are nearby I would go over there and ask to talk to the head nurse at the facility to make sure dad is getting the type of food he can eat and to address you concerns about the fall incident.

If things continue like this you may have to find a new facility to move him into.
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beehom Nov 2023
This is exactly what I was thinking as well, my father has never attempted to stand up on his own and knows he can't like I said his cognitive side of his brain is very functional. I will follow up on this for sure and talk to legal help just for verification, thank you.
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While I agree with the others that falls do happen, it does seem that any chair transfers from now on should be to a chair with BRAKES. Surely there is at least one spare wheelchair in this facility.

The rules in these places are maddening. It's always stupid stuff like "you cannot just take one Tylenol; you either have to take the two the doctor prescribed or none at all." 

Or: You had to go all the way across town for a doctor visit (so that the doctor could bill) and now you are back one hour after medications were distributed, so you don't get to take your blood pressure medication. Too bad. And no, your daughter cannot bring you your own meds from home! That is against rules / unsafe!!!

Food is often placed on a table where the patient cannot even reach it.

Call lights flash all night and one exhausted minimum-wage night shift worker is dead to the world, slumped in a hallway chair.

Understaffing is making everything worse. My neighbor was in an SNF for pain management and one weekend the residents got NO meds. My neighbor is feisty like your dad and led a mini-rebellion over this (which did little good; they just gaslighted everyone and said meds had indeed been distributed).

I'm talking about SNFs in affluent neighborhoods.

I'm not helping you, just hearing you, for whatever that's worth.
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BurntCaregiver Nov 2023
@AndSoltGoes

It's a$$-covering, total incompetence, and neglect.
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Dad is clearly confused if he thinks such things worthy of a "suit". And you already know your Dad has deficits in balance and mobility.

Freak accidents happen, and often happen just as you say, on day ONE. When all sort of "newness" is involved. As I say over and over again about the elderly (I AM one at 81),
FALLS WILL HAPPEN. I am sorry, but even without a stroke that takes one side from us, due to our aging brains, our balance is awful. We DO fall.

We have many, many posts here about the imperfections of aging care facilities. You will have seen them. Staffing, pay, and the American way of doing business are all involved to make the already failing human condition in aging a true crucible.

I hate to say wait and see, but you are going to have to give yourself at least a few weeks for adjustment and to judge things. Keep a little notebook. Be ready to contact administration with your concerns and your list of things. Don't expect perfection as you will not find it in aging care facilities.

I am sorry. I recognize that this is very very distressing. I hope things get better. My heart goes out to you.
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sp196902 Nov 2023
There's a reason why mistakes by doctors and nurses are in the top 5 reasons for a persons death. They make a lot of mistakes.

And this wasn't a freak accident. They tried to move him into a chair and the chair slid and he fell. Just basic stupidity by the person trying to get him into the chair.
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Beehom, I want to emphasize to you as kindly but as clearly as I can that you need to learn "the lingo". It's not a "health plan", it's a "care plan". It's not "mush", it's either "mechanical soft" or "puree".

Learning to speak NH will result in much better care for your dad.
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