Re: Re: Update on Bob

[Guest guest]

Dear Pat,

First, I want to send a big virtual hug to you! It sure seems like if it rains

it pours sometimes. I know everything sounds overwhelming right now, but the

fact that Bob is doing so well in therapy is pretty encouraging. Twelve days is

almost 2 weeks. If I were you, I would see if the facility that is caring for

Bob has a social worker and you can express your need for him to be able to

ambulate independently and that you need him to be practicing as much as

possible while he is there. Hopefully they will hear you and help you to be

able to bring Bob home walking.

My dad is the one in our family with LBD and my mom is his caregiver. She

recently contacted the Office on Aging in her county and they were a great help

to her. I'm not sure if each county or state has something like this but maybe

you can call and see if you can qualify for some assistance in some way.

Keep us posted on Bob's progress.

Kathy

The way they are so slow to try this, I

> > wonder if they will be able to get him to do it with just one person

> > assisting before they have to discharge him in 12 days? If he cannot

> > transfer with just my help alone then I don't know what I will do. I

> > want to bring Bob home, and we do not have money to pay for a nursing

> > home so what can I do? I may have to just bring him home and keep him

> > in a hosptial bed. I do not know and the worry is really getting to

> > me!

> >

[Guest guest]

There are no siderails here in Wisconsin, they are considered restraints

which are illegal. You bet I will be popping in to visit Bob in the

afternoon and other times as well! I have asked for a 'care conference'

this week.

Pat M.

> **

>

>

> Hi Pat,

> Is there any chance that you can make a 'surprise' visit to Bob in the

> afternoon, so you can see what is actually going on? Would it help to keep

> the railings upon the sides of the bed?

>

> Sorry to just be getting back to you. It's been a busy weekend.

>

> Hope you are well,

> Helene in NY

> (Mom 78, late stage LBD, at home in the Bronx)

>

>

>

> >

> > Hi All,

> > My husband Bob is in a nursing home now as he could never learn to

> > walk again after his repeat hip surgery in April The anesthesia

> > really took his mental state way down. He could not understand enough

> > to cooperate with PT to learn to walk with a walker again. Also his

> > legs are somewhat contracted at the knees and he cannot straighten

> > them even though the did six weeks of stretching and TENS unit

> > electrodes to stimulate his muscles. Anyway, the nurse called again

> > about 5 PM to tell me they found him on the floor next to his low bed

> > on the fall mat again this afternoon during rounds. This is the

> > second time in a week this has happened. They told me he is not hurt.

> > I said to check him over very well. I told the nurse they should

> > keep Bob up in the wheelchair close to the nurse's med cart all the

> > time and not put him down for a nap in the afternoons any more.

> > Apparently he is getting physically stronger, but is mentally out of

> > it. They tell me he is always trying to wiggle out of his wheelchair

> > also. By law they cannot restrain him here. Any suggestions for

> > keeping him safe from more falls?

> > Thanks,

> > Pat M.

> > 58, Wife of Bob, 76 dx PD 2003, LBD 2009, now in a nursing home.

> >

>

>

>

[Guest guest]

Wow, Pat, " rails are considered restraints instead of safety " . I will need

to file that in the back of my mind. I am glad that you are calling for a

" care conference " . If you have any family members that can attend, bring

them also. Good Luck and stand your ground. Vivian

> There are no siderails here in Wisconsin, they are considered restraints

> which are illegal. You bet I will be popping in to visit Bob in the

> afternoon and other times as well! I have asked for a 'care conference'

> this week.

> Pat M.

>

>

>

> > **

> >

> >

> > Hi Pat,

> > Is there any chance that you can make a 'surprise' visit to Bob in the

> > afternoon, so you can see what is actually going on? Would it help to

> keep

> > the railings upon the sides of the bed?

> >

> > Sorry to just be getting back to you. It's been a busy weekend.

> >

> > Hope you are well,

> > Helene in NY

> > (Mom 78, late stage LBD, at home in the Bronx)

> >

> >

> >

> > >

> > > Hi All,

> > > My husband Bob is in a nursing home now as he could never learn to

> > > walk again after his repeat hip surgery in April The anesthesia

> > > really took his mental state way down. He could not understand enough

> > > to cooperate with PT to learn to walk with a walker again. Also his

> > > legs are somewhat contracted at the knees and he cannot straighten

> > > them even though the did six weeks of stretching and TENS unit

> > > electrodes to stimulate his muscles. Anyway, the nurse called again

> > > about 5 PM to tell me they found him on the floor next to his low bed

> > > on the fall mat again this afternoon during rounds. This is the

> > > second time in a week this has happened. They told me he is not hurt.

> > > I said to check him over very well. I told the nurse they should

> > > keep Bob up in the wheelchair close to the nurse's med cart all the

> > > time and not put him down for a nap in the afternoons any more.

> > > Apparently he is getting physically stronger, but is mentally out of

> > > it. They tell me he is always trying to wiggle out of his wheelchair

> > > also. By law they cannot restrain him here. Any suggestions for

> > > keeping him safe from more falls?

> > > Thanks,

> > > Pat M.

> > > 58, Wife of Bob, 76 dx PD 2003, LBD 2009, now in a nursing home.

> > >

> >

> >

> >

>

>

>

[Guest guest]

Actually, at least in Minnesota, bedrails on both sides of the bed are

considered restraint. The nursing home my mom was at used half-rails that

helped a bit but she still ended up on the floor.

There are a couple of things that contributed to Mom's falls, that sound

like what Bob is experiencing.

The patient to aide ratio doesn't always allow a response as quickly as the

patient would like. This is especially a problem when it comes to

toileting. When Mom had to go, she had to go. And she couldn't see any

reason to wait for a half-hour (it seemed to her) before an aide got a

chance to help her. It looked like such a short distance that she thought

she could walk it. She couldn't and was often found on the floor mat.

Going from a full size or larger bed to the bed most nursing homes have

isn't easy. Mom was an active sleeper. She would eventually roll over so

far that her feet and legs were dangling over the side of the bed. It was

just a matter of gravity at that point and she eventually would just slip

down to the mat.

But that thinking she could handle a trip to the toilet was the biggie.

And that never stopped.

Also, I remember Mom trying to get to the bathroom when she was nauseous

and needed to relieve her stomach (whether she wanted to or not). The

natural response is to hurl yourself out of bed to get to the toilet.

Hurling herself out end up being hurling herself onto the floor.

There are a lot of adjustments that have to happen for both you and Bob in

working with a nursing home. At home, it was a 1 to 1 ratio between you

and Bob. When he needed something, you responded and he didn't need to

wait. At a nursing home, it is 1 aide to several residents ratio. If that

aide is helping someone else, Bob needs to wait. This is hard for both you

and Bob to get used to. And Bob probably thinks it's worth trying to do it

himself.

This is a thought for future needs. You can't do this all of the time, of

course. You have him in a nursing home for a reason. But when Mom was

sick, especially sick to her stomach, I would spend the night with her in

her easy chair. (I have a very understanding work situation and that was a

huge help.) The aides didn't always know if or when Mom got sick, so I

stayed there to be sure she was kept clean. I think it also calmed her to

know I was there just for that purpose.

The adjustment takes time and sometimes a lot of time. You learn that the

falls are seldom dramatic. If you hadn't been there to steady him, Bob

would have fallen more often at home, too. The NH is required to tell you

of each fall. Don't let it shake you. Just ask about if he was injured

and then, when you are with him, check him for bruises and cuts - just in

case something was missed. And remember that the aides are often run

ragged trying to keep up with the needs of the residents - especially at

mealtime and bedtime. Try to be patient. But if something is needed,

don't hesitate to mention the need. The aide might not get there right

away, but will as soon as possible. Also, sometimes so many things need to

be done at the same time. Being human, they might forget about one of

them. It's OK to remind them, but assure them that you are doing so

because you know they are so busy.

Also remember that the staff will respond to a fall or other incident as

soon as they know it has taken place or is taking place. Often, the entire

staff will come running. That's a good thing.

And, expect Bob's needs to change while in the NH. Keep communication open

with all of the staff, the physician and the administration. If they know

you are actively involved, they will get to know Bob better and will

respond to both him and you in a much better way.

Kate

> **

>

>

> Wow, Pat, " rails are considered restraints instead of safety " . I will need

> to file that in the back of my mind. I am glad that you are calling for a

> " care conference " . If you have any family members that can attend, bring

> them also. Good Luck and stand your ground. Vivian

>

>

> On Mon, Jun 4, 2012 at 9:50 AM, Mayhew

> wrote:

>

> > There are no siderails here in Wisconsin, they are considered restraints

> > which are illegal. You bet I will be popping in to visit Bob in the

> > afternoon and other times as well! I have asked for a 'care conference'

> > this week.

> > Pat M.

> >

> >

> >

> > > **

> > >

> > >

> > > Hi Pat,

> > > Is there any chance that you can make a 'surprise' visit to Bob in the

> > > afternoon, so you can see what is actually going on? Would it help to

> > keep

> > > the railings upon the sides of the bed?

> > >

> > > Sorry to just be getting back to you. It's been a busy weekend.

> > >

> > > Hope you are well,

> > > Helene in NY

> > > (Mom 78, late stage LBD, at home in the Bronx)

> > >

> > >

> > >

> > > >

> > > > Hi All,

> > > > My husband Bob is in a nursing home now as he could never learn to

> > > > walk again after his repeat hip surgery in April The anesthesia

> > > > really took his mental state way down. He could not understand enough

> > > > to cooperate with PT to learn to walk with a walker again. Also his

> > > > legs are somewhat contracted at the knees and he cannot straighten

> > > > them even though the did six weeks of stretching and TENS unit

> > > > electrodes to stimulate his muscles. Anyway, the nurse called again

> > > > about 5 PM to tell me they found him on the floor next to his low bed

> > > > on the fall mat again this afternoon during rounds. This is the

> > > > second time in a week this has happened. They told me he is not hurt.

> > > > I said to check him over very well. I told the nurse they should

> > > > keep Bob up in the wheelchair close to the nurse's med cart all the

> > > > time and not put him down for a nap in the afternoons any more.

> > > > Apparently he is getting physically stronger, but is mentally out of

> > > > it. They tell me he is always trying to wiggle out of his wheelchair

> > > > also. By law they cannot restrain him here. Any suggestions for

> > > > keeping him safe from more falls?

> > > > Thanks,

> > > > Pat M.

> > > > 58, Wife of Bob, 76 dx PD 2003, LBD 2009, now in a nursing home.

> > > >

> > >

> > >

> > >

> >

> >

> >