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Due to C19 I have been unable to visit mom and can only see her in her new Memory Care Community through the window or glass doors. Tonight after dinner my husband and I drove by her community to see if we can see a glimpse of her before we went home. As we drove by my husband noticed through the common area window a person crouched over the side of a wheelchair, when I parked my car I noticed that it was my Mom. It was around 8pm so I know that it was near her bedtime and her night time meds were probably already given at that point. She is very active, so seeing her crouched over like that I know it had to be the medication. Suddenly she started moving and tried to lift her self out of the chair, but because she was so groggy from the medication she slowly slid her way down to the floor. I then noticed a female caregiver come by, but she didn't lift up my mom as my mom laid on the carpeted floor. Instead she went to help another resident to their room and another and another as my mom laid on the floor. I immediately drove to the front office to see if I can have the front desk connect me to the Nurses station, but at that time the front desk was closed. I called the # directly and was first sent to a voice message and then called back again and was connected to the Caregivers station. I let them know that I was outside and asked why is my mom laying on the floor and now crawling around on the floor. He sounded surprise and unaware that she was crawling but explained that mom usually starts falling asleep after they give her the bedtime meds. I asked him why she was allowed to crawl and lay on the ground when the she should be placed in her bed and he said that they were short staffed that evening and that they are moving as fast as they can. I have our first Care Plan meeting with the DON (Director of Nursing) and Director of Family (Social Worker) on Monday afternoon, should I bring this up?

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Why are her nighttime meds not given to her when she is IN bed?

Are you thinking of NOT bringing it up? Is there a reason that you think bringing it up might NOT be a good idea?
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musame Jun 2020
Great question in regards to why they don’t give her bedtime meds after she’s washed up and ready for bed, maybe because she refuses to go to her room since she’s so active and doesn’t want to sleep there? I will ask though.
I just don’t want to appear to be the over worried daughter, I guess.
Honestly, Mom is a handful, she has already been moved out of another Memory Community because they couldn’t keep her safe. She’s also been placed in Senior Behavior Health Units (2 separate places) for 6 weeks each and they still can’t find that balancing cocktail of medications without having her sedated and unable to walk.
The last Doctor at the SBH had her so drugged up that he said she’s probably never be able to walk again but will send her through Physical Therapy. 1 week into PT she was practically running around the SNF unit, 3 weeks she was walking on her own.
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If your mother was on the floor, she was probably quite safe to be left for a few minutes if they were short staffed and had a string of people to be moved. However it's a good idea to check that it was the exception not the rule, and also to question when they give the medication.

I know that people think that 'on the floor' looks all wrong. I have to lie down sometimes when I am out, because it helps my back pain. People really do get upset about it, while I am actually comfortable. 'Crawling' perhaps meant that your mother was trying to get up, rather than actually crawling along.
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musame Jun 2020
Thank you for your response.
Yes, it was very hard for me to see my mom slouched over in the chair and the Caregivers walking pass her and not sitting her upright or moving her to her room. The she just went to the ground herself. As soon as I called them they moved her right away to her room. Just heartbreaking.
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Thank you for providing the extra context!

I always found that as long as I brought stuff up with the attitude of "is there some way we can work together to make this better", most places are willing to explain and/or modify what has caused the problem.

I'm so sorry that they haven't found the right level of meds yet. (((((Hugs)))))))
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Perhaps it takes a lift or extra staff to safely assist her up from the floor, so without sufficient staff she is left til last - that's an explanation, not a suitable excuse, IMO this shouldn't be an acceptable norm.
When my mother was in the NH I noticed that meds were doled out on the same timed schedule to almost everyone. Evening meals included the presence of the rpn handing out and supervising medications, followed by toileting and putting everyone who needed assistance to bed, which of course means toileting and changing into night clothes - this is also on a schedule. One of the easiest solutions for your mom would be to ask that she be moved up on the schedule so that she is one of the first put to bed.
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musame Jun 2020
I’m not sure what is going on and I’ll ask about the schedule as well.
Mom is tiny she’s 109 lbs, she was 135 lbs about 2 months ago and then they placed her on a mechanical diet because she won’t wear her dentures any longer.
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Musame, the weight loss should have been flagged as very concerning, ask whether they have observed that she is coping better with her meals (logs should be kept of how much she eats). You should also ask about adding nutritional supplements to he diet to bring up her weight.

One other thought, her smaller body is going to metabolize medications differently, perhaps dosages need to be reviewed.
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Complain. When someone slips out of a chair like that it is a reportable fall. Not only should they have helped her, they should have called the POA (s that you?) to let them know. Tell them how appalled you are and how unacceptable that was. Is she being over-medicated? Go through every single medication and its side effects with the care team.
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