Lenny’s surgery was a success!!!! NO NERVE DAMAGE PRAISE THE LORD!!!!!! Thanks for all the prayers. He is fine and resting.
Jean began the day with mom and it was fun and peaceful!! PTL!! She was awake when he arrived but didn’t seem to recognize him (she doesn’t seem to recognize us either since the incident). He put her hearing aids in and washed her face and hands and put her glasses on. He talked to her and used the magna doodle board to write names and words for her to read. He tried to get her to write or even hold the stylus but she couldn’t do it so he did a full manual prompt (hand over hand assistance). He said she appeared to be focused on the TV (it was turned on) at times—more so than on him. When it was time to leave, Jean kissed mom good-bye and then she kissed him back.
Dad and I did mom’s physical therapy/range of motion. Mom also went into the recreation room to listen to a man playing the guitar and singing oldies. People/staff were dancing. Mom mouthed some of the words to the songs he played (as per dad and some of the staff). She was even smiling at times. Dad said that mom was breathing way over the vent yesterday. She smiled at me when she saw me today too (very slightly but a definite smile).
Dad and I were given a copy of mom’s Care Plan. We reviewed it but it didn’t seem to be complete. We were told, by the person from Medical Records, that it is complete and that Care Plans are only updated quarterly otherwise they stay the same and unchanged. This is why most of October and November were missing. In the Plan, we did find a disturbing report. It was a behavior report that, we found out, was written by the Nursing Supervisor. She wrote the care plan regarding mom’s behavior. This Behavior Plan was written on the day that I arrived in the morning and found mom sitting in her bed with the blue pilot trach balloon in her hand. Because of this occurrence---it is written on her Care Plan that she is a threat to herself and others---potentially!!!!!!!! It also says that she “resisted care.” We don’t know HOW this pilot balloon was removed or broken—it already was off---no one saw mom break it off. Also we have had many instances of carelessness with some of her CNAs and nurses so it is possible to us that one of them ripped the pilot balloon off and then left it on the bed where mom found it. We just don’t know. The Assistant to the Director of the Respiratory Unit was given the piece by me---she panicked and asked where it came from and whose it was??? An alarm should have sounded but didn’t (or was ignored) and I said to this therapist, “Well, thank God Mom is OK and breathing alright. Is that why the alarm didn’t sound?” The language used in the Care Plan is VERY STRONG!!! Or it seems to be strong… I am going to include a copy of the report here. You make the judgment. Here is some of the information on the form that is checked off (mom’s first and last name is at the top of the form):
Monitor interactions with others
Monitor for signs of injury to self or others
Monitor for confrontational behavior
Praise for appropriate responses to others and safe interactions
Goals: Resident will demonstrate safe and appropriate social boundaries daily for 3 months
Goal: Resident will remain free from injury daily for 3 months
The form already has typed and hand-written information on it---the handwritten information looks like it was written on because it pertains to the person in question---misleading. Also there are items on the Plan page that are checked off---HOWEVER the check marks DO NOT mean that they apply to the person who’s name is at the top of the form necessarily---it only applies when there is a date next to an item---if no date, but checked off, it doesn’t apply to the person. The title on the Behavior Plan says--- “Potential risk for injury 2 degree cognitive impairments of self and others inability to comprehend personal boundaries and poor impulse control.”
Dad and I were told that the form is just a blanket form used for anyone with ANY type of behavior with the same format etc. with the SAME ITEMS CHECKED OFF--- evidently, the head nurse has her own system of tracking what applies to the patient on the form---if the item has a date next to it, then it means the item applies to the patient. If there is only a check mark next to an item, it doesn’t apply to the patient.
IF A FAMILY DOES NOT LOOK AT THIS FORM BY ASKING FOR IT---then what is written on the form applies.
As I was repeating myself for the 13th time, the facility social worker began to say to me, “I hear you” to which I replied, “Thanks for the psychologize that you are speaking to me in but I too have a background in psych and don’t need the counseling session or the confirmatory paraphrasing or the words of validation…but what I want is ACKNOWLEDGEMENT that what I am saying is true!! And that it is a careless, ludicrous system to use. This misrepresents the patient in question in a way that is dangerously misleading.”
When I told the Social Worker that they had the opportunity to prepare for mom’s meeting on Thursday, as a facility team today, and that we are just asking for the same opportunity but not being afforded that, she just listened. I told her that this form represents someone who cannot represent or stand up for him/herself...that it is a dangerous form with dangerous comments on it. If a psychiatrist saw it in mom's folder, would she be prescribed medication? Would she be restrained more than she is already?????!!!!! God help the system we have in this country....it is toxic.
At the meeting, at 5:22, the building administrator said that he didn’t want to give permission to be recorded during the meeting we were about to have. He wanted to have someone on the phone listening to our conversation last night with dad (a CEO of the facility). We asked again to see the Incident Report and he said no. but as Claudia spoke and mentioned an attorney, he said it is under debate with all such facilities as to whether or not let the families of the patients see such Incident Reports (investigations included). We then told we couldn’t see, then we were told we could see it. The Administrator then told us that we are an inappropriately aggressive family…all of us. That we are all sarcastic and have problems with many people at the facility. He said that he has received reports from multiple people about us all and particularly about Claudia and me regarding our inappropriate behavior. We brought up the Behavior Plan for mom and the inappropriate language and descriptions in it. Then we asked to have the report amended—we were told OK, no problem…but that the original report would remain in mom’s file and not be destroyed as dad asked. Dad and the building administrator fought over this or debated and dad finally said that if it stays in mom’s folder or file then it needs to have the word VOID stamped across it in red letters. The people in charge here either play dumb so much or act in such a passively aggressive manner that they push people into a defensive corner—which is what they want…and then they deny any part in the reactions they provoke. Some of people in our family have been pushed to places of sheer frustration…others remain focused and in control…I kept it together so far into the meeting but then realized it was spinning wildly out of control and had to leave. Claudia and Dad finished the meeting in a productive manner…I left and called some people to pray and then began to pray myself for dad and Claudia. When I came home, Lenny asked me to take him to the Deli after hearing about the events of the meeting and report and he said he was going to surprise me with something that would be good for both of us…he bought a dozen eggs and we went home together and stood in the back yard and, holding a half dozen each, (true confessions) we threw them at our fence…couldn’t exercise or play a sport in the weather to blow off the steam…but this felt great. To think this all started because we wanted to see 2 reports so that we could a part of mom’s Care Plan Team in an educated, informed way.
“bless those who curse you, pray for those who mistreat you.” Luke 6:28
(This is the challenge set before us…)
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