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After AML diagnosis in early July, my 89 year old mom moved from her home to an assisted living apartment. 4 weeks later she moved into a room in the full nursing care unit with hospice care. All were her decisions. I’m not comfortable with the care she’s getting. They seem overwhelmed and understaffed. Any advice?

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Here are my suggestions to you as a professional who worked in nursing homes for 25+ years:
* schedule a meeting through the facility social worker for a team care plan meeting. These should be scheduled quarterly, or at the very least annualy, by the facility but you have every right to request a meeting anytime you want. All disciplines should be present with a progress report ready for you. Have your questions written down ahead of time so you don't forget anything. Take good notes.
* make sure when addressing the staff with a complaint, that you do so in a calm, kind manner. Being nasty and aggressive will get you no where and will label you as a "difficult" family member. Showing your appreciation for staff goes a long way, too. (No cash tips or presents for individuals are allowed but donuts, cookies or pizza for the unit staff as a whole is acceptable)
* contact your area ombudsman who is responsible for your mom's facility. They are an outside entity that can assist with making sure your mom is getting the proper care she needs. They can also help you go through the proper channels to resolve those issues. It is important be mindful of not to go over a staff member's head as that is seen as tattleling and does not sit well with staff. An ombudsman is a trained volunteer but private Geriatic Care Managers can be extremely helpful in these situations as well. They cost money but are highly effective. To search for a care manager in your area go to alca.org and input your zip code. A Geriatric Care Manager can also assist in moving your mom to another setting if that is the path you choose to take.
* after all this and things still don't seem to have improved, schedule a meeting with the Director of Nursing and/or facility Administrator along with the Ombudsman or the Care Manager. Have your facts with specifics written down. If you are making a specific complaint make sure you have the staff members names or at least the date and time in question so they can reference the schedule to figure out who was working at the time you are talking about.
* your very last resort would be to anonymously call the Department of Health in your county to make a formal complaint. The phone number to call should be displayed prominently in the facility for all to see. The DOH will arrive at the facility unannounced to investigate the issue you brought to their attention. If the facility is found to be negligent and at fault, they will be given a specific time frame in which to complete a plan of correction. The Department of Health will return, again unannounced, to make sure the plan of correction is being followed and the issue has been resolved.

I hope this helps. I wish you luck and your mom well.
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Cover99 Sep 2021
Bribe with junk food, Nice.
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Have you talked to your mom about she feels about her care? Is she concerned? It is very likely that the facility is understaffed and they are overwhelmed....but that is probably the case everywhere these days. Be careful about what you want to do about this. It's unlikely for you to be able to take over her care yourself.
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Has your mom's condition gotten worse since July? Did she let her family know why she decided on the move? Perhaps someone encouraged her to move to full care?
Does she want more company?

Maybe start with a talk with Mom then speak with her care team to find out who determined her need for full nursing and hospice care.

Hospice doesn't require being in a SNF; if Mom's wanting extra attention, she could have it in the AL.
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Can you blame them? Many NHs heck maybe almost all, are very depressing to the point that the administrative part is almost separate from where the residents are. This is so administrative employees can come and go without having to go past where the residents are, otherwise, they would probably "lose it" too.
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Does the nursing home itself provide the hospice care, or it is provided by an outside agency coming in? If it's the latter get another hospice company to care for your mom in the nursing home.

It seems a lot of people who don't like the care their loved one is getting in hospice often don't understand exactly what hospice does and doesn't do. Be sure you're 100% up to speed as to your expectations as well as the reality of their caregiving abilities regarding staffing, so have a meeting with the administrators to clear the air.
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