Planning to move my Mom to a different nursing home. Advice?
Tips from someone who's been there? My mother is 80, has Alzheimer's and has been in a nursing home for over a year. My mother is neglected. No shower for almost a year, etc. When I brought it up to staff in a very nice way and asked if we could find a solution together, they became defensive. I was yelled at, bullied, etc. They have started sending my mom to the hospital for typical dementia behaviors they are supposed to handle, and which they do handle when other residents do the same thing. Suddenly, she's a "danger to self and others." they send her to the ER where their doctor is on staff. They're trying to make a case against her to cover themselves. How sad.
Those old school nursing home ways are still very much alive. Be warned.
I am now looking for advice from anyone who has moved their loved one from a bad facility. Anything you can offer me as far as "insider tips" or "pitfalls to avoid" will be appreciated.
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The second NH required that I as DPOA sign off for them to evaluate mom at her current place to determine if they could provide her level of care needed. an RN and SW went to do this. They called me from moms bedside to tell me all ok. I went & completed a transfer request at new NH later that day. The new place had around 6 open beds as they just finished a renovation & they would hold moms bed for her. Now my mom was a pretty ideal resident as she had lewy body dementia with easy generic medication management, no diabetes or copd, still pretty cognitive, she was very social, did ADLs well and could walk with walker totally on her own. A low maintenance resident as demented but manageable.
You want to schedule the move do that it is right at the beginning of the month IMHO. They have to do their SOC to each NH to be compliant for medicaid. If mom gets paid on the 3rd, then move on the 5th - 7th. So you pay old NH to the penny the SOC for those days there & pay the new NH for the SOC for rest of the month.
If the old NH gets her check sent to them, you are going to have to deal with getting her funds back at whatever timeframe the old place wants to do this. You will out of your own funds have to pay moms SOC at new NH till you get control back on her monthly income. This can be a bit of a clusterF to deal with. Hopefully moms income goes into her bank account & you have been paying her soc from it each month.
If mom has a personal needs trust account at the old NH, you need to get these funds zeroed out & paid to you. I would suggest you do this as in advance as possible. If its just $50/$100 they will likely have the cash to pay it out. But if it's a larger amount, a check may need to be cut from corporate office. They can hold the PNA if there is any outstanding bill when mom moves.
You MUST make sure you get all her prescriptions & medications. Usually they are done in 30 - 90 day packs held in a big plastic bag at the nurses station or locked medication room. Medicare & Medicaid will not pay for a duplicate set of Rx's so you MUST get her meds. Otherwise you have to private pay for a second set. This could be quite expensive. Take zip locks & a sharpie marker just in case some meds are loose. Btw the nursing staff was totally ugly on doing this with my moms meds. The new NH told me about having to get their meds.
The new NH required mom to be there by 10:30 or so. I bet occupancy for medicaid reinbursement has a time which a count is based on. So ask about if there is a " need to be there by" time. Kinda like waiting till 9:15AM to get your kid out early from public school for holiday break cause district bills the state based on a 9:00 AM head count.
See if new place will let you set up moms room the night before. My moms second place did (tv, pictures on walls, curtains, bed linns all went in) and it made it really for a smoother transition.
Start holding back laundry too so you don't have clothes she needs in laundry on the day of the move if you need them. I jettisoned moms older & worn clothes during the move. Good luck in the move.
Whoever is dealing with your mom doesn't understand dementia. And so, I think you should probably ask the SW, kindly, to help you find a place that does.
What is the reason for no showers? Is she resistant? Do they say "we can't make her?" That to me is the answer of a place that isn't very skilled at dementia patients; you may find someplace nearby that IS. Does she need memory care, as opposed to NH services?
Another question; are your concerns addressed in your care meetings? Who is being defensive? the "everyday" staff or the SW and DON? If the later, I would find a different facility; if they can't work with you, you need to find your mom a new placement.
About getting urine odor out of fabric; I was told to get a product made for pet urine, available at Wal-Mart and some super markets. My supermarket had a good selection.
Pamstegma, thank you for telling me about the Baker Act. I will look into it more. I'll have to get her sent to an ER that has good geriatric psych, so I have some research to do.
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