FIL is 80, almost 81. Incapacitated (at rehab, not our choice told needed for safety) w/vascular dementia and Alzheimer's. This was after a failed home care plan because he couldn't or wouldn't follow it on his own and multiple serious hospital stays this last one was for pneumonia due to aphasia, and we were REALLY lectured hard on how dangerous that would be the rest of his life now that he advanced to that point. He was deemed a wander risk while in the hospital, and he required video surveillance. Once in rehab wandering issues continued several more weeks, hence the Memory care requirement, safe sealed space. He still to this day thinks he is 100% and is angry he's not home, because he is just fine. That is fed by a brother that refuses to follow Med advice for therapeutic lying, which is an ongoing issue too. When we were doing the advised therapeutic lying he had hope and was content in care, but the brother blew that and it did a lot of damage now he is just really angry mostly at us that he is not home. Home alone is an obsession now as a result :( They do take good care of him physically, we know it! His level of care is now obviously good for him, diet and regular meds have made a huge difference all around & we are very grateful for the physical care being quality because it has made a difference for sure. He is doing so well he's rebounded and is super feisty but his PT coming in has expired and warned she expects a physical slide because he doesn't practice on his own and he cannot recognize the need to or what has happened to him. We get no care info from the memory care center other than verbal "he is good" on rare occasion, so the only updates we have gotten was from the incoming insurance contracted PT :( We have probably two dozen requests to be included in the care plan to ensure DR advice is even in the plan (including the therapeutic lies for his mental health) We have been told "this Sunday" a couple times but we never end up called/included. When we researched and chose this center we were promised we would be kept up to date and included, now on his 3rd month and nada. Yesterday hubby sent an email and cc'd corporate so fingers crossed that helps. We don't want to make such a stink we alienate anyone but he has been harmed already, and it's our job to be sure his best interest are met. Any advice how to proceed and make sure the DR/counselor advice is understood, included and hopefully followed? Can they change off of DR advice without the POA? Yes POA is durable all inclusive. How often is reasonable to ask for an update if his progress is shifting around? Honestly I think the problem is, while they do a good job care wise, they have staffing issues and therefore time management issues and well they maybe think they know better than the evaluators? Not sure about the last but kind of the vibe and we feel we need to listen to the pro's who advised for his needs too.
Who is POA? Is it your husband?
Maybe if you do not get a response to the email that was sent yesterday a "gently" worded letter from the attorney that drew up the initial paperwork establishing POA might help.
Who is the "brother" that is stirring the pot? Is it a sibling of your husband's or is it FIL's brother? I would see if visitation could be restricted to supervised only. If that does not work then not allowing visitation if it is stressing FIL to the point where he become unmanageable.
The brother stirring the Pot and upsetting dad is his disgruntled little brother who thinks all Dr's are quacks and he's the conspiracy theory type. He is used to getting his way with bully tactics and being a tattle tale when he doesn't so we probably should have seen this coming, but we were hoping for the best. Limiting visits and calls if he will not stay in medical advice compliance was one of the things we want to bring up in the care plan. What he's done is honestly very cruel, even his wife has been really upset with him about it all.
His other son is a pain in the neck. Your FIL is lucky you and DH are so sensible.
PS When you visit with the admin start with the compliments on care, Dad's condition, and your feeling the care is overall excellent. THEN discuss expectations versus reality.
I am afraid a lot of this is about communicating. Not that things will not fall through the cracks. You are correct that staffing issues are AWFUL right now and in my city that includes closed bank branches, closed cheese shops and closed hair salons because there is no staff to manage them.
At some point you will need to conclude that nothing will be perfect; that overall you DO/DO NOT trust the care level given, and etc.
Again. Things will go wrong. If I told you the plumbing/heating/leak issues we deal with every day as landlord, you would know--things do go wrong. At any age in life, under any circumstances in life.
Now then. Your FIL's PT, very conscientiously, is keen that he continue his exercises even after she finishes with him and has alerted you that he will need staff support to motivate and encourage him with this.
We are a reablement service, and it is not unknown for us to organize a dressing routine so that the client is required to stand, sit, stand, sit half a dozen times while putting his pants on. Subtle, eh? We also apply a principle called "Positive Risk Taking" - not as alarming as it sounds, we would always have to be extremely sure that the risk is under control - to build confidence and gradually stretch a person's abilities.
But people joining us from a traditional care background experience considerable culture shock over this approach. It is a different discipline. Does your FIL's rehab really offer its staff the training for what he needs? Because without it I can imagine the managers having nightmares about PT follow-up.