Thursday, April 19, 2012

Tuesday's visit, and my concerns about elderly care

Tuesday afternoon, I went with my daughter to visit my dad at the assisted living home. When we arrived at about 1:00, he was sitting in the dining room area at a table alone, with a slice of Boston creme cake sitting on a plate in front of him. He was just sitting there, staring at the slice of cake. This was something I had not ever seen him do before. As much as my dad loves food, and especially sweets (and I say that in a very affectionate way because he is not overweight), it struck me that he was not immediately digging in. And I wondered: Why had none of the workers there noticed and tried to help him?

We said our hellos and gave hugs, sitting down at the table with him. I then asked if he wanted some cake and picked up his fork and put it in his hand for him, pushing the plate closer to him. At that moment it was like a light bulb went on, and he began to eat, just like any normal person would. One of the workers there then offered my daughter a slice of the cake, which was nice, and she was all too happy to accept. Personally, I passed on the offer, since I had had a Coke with my lunch. Then I noticed that my dad didn't have anything to drink with his cake. This did not make me too happy, since I knew he had been sitting there for awhile with the cake, and as I looked around, none of the workers were making the slightest move in the direction of bringing him a cup of water. I was not angry, just a little perturbed, because it wasn't the first time it had happened.

I said, "He needs some water," to anyone who might hear it and got up and went to get a cup of water from the water cooler using one of the cafeteria type cups they normally have available there, but found none.

One of the workers noticed I was looking around and said, "Do you need something?"
"Yes, he needs some water, but there are no cups," I said as pleasantly as I could.

She was happy to oblige, maybe realizing at that point that they had forgotten to give him something to drink, and went to look for one. To my surprise, they had trouble finding one. Finally, they found a cup and brought it over and gave it to me so that I could fill it with water, but couldn't find a second one for my daughter, so they came up with a Styrofoam cup for her to use. I was surprised that they didn't have more cups available. Sufficient funds surely cannot be an issue. It is quite expensive for a resident to live there. 

I guess the thing that concerns me is that there seems to be a general lack of attentiveness to the residents there. The lack of a drink is just one of many things I've noticed during my many visits there. Other times it's been a resident in a wheelchair crying out for help repeatedly but being ignored (I think I mentioned that incident in a previous blog post), or any number of other things. Many of the residents, including my dad for much of the time now, cannot communicate their needs properly. They have to have someone looking out for them. To "assist" them in having their daily, even hourly, needs met.

Another example that has concerned me greatly is that when the alarm in a resident's room or one of the bathrooms goes off, it is ignored. Not once have I seen an employee pay attention to an alarm when it goes off, or if they do, it is only after several minutes.

The very first time I heard one of those alarms going off was when I was waiting to use the public restroom in the hallway near the main entrance. There was an office near there, and I could hear the beeping sound with a computerized voice repeating every few seconds, "Emergency, emergency. Bathroom One." There was no-one in that office at the time, so I went and found a worker and alerted her to it, thinking that an elderly person might need help. Her reaction really surprised me. She stared at me with a blank look and said matter-of-factly, something like, "Yes, we're aware of it. We can hear it on our walkie talkies. We'll take care of it." She didn't even thank me. Then she went right back to what she was doing and continued to ignore it.

I walked away scratching my head, and finally came to the conclusion that maybe they knew something I didn't. Maybe residents accidentally pulled the string all the time. But I couldn't help but wonder what would happen if there was ever a real emergency.

Then on Tuesday's visit, while we were in the activity room with my dad, there was an alarm going off again, and this time the computerized voice was giving the name of the resident and the room number. It went off several times, with pauses in-between. Then it went silent, so I assumed it was taken care of. But a couple of minutes later, it went off again. A family member of another resident there and I exchanged glances and were concerned that whoever was needing help wasn't getting helped. I was just about to get up and go tell someone when I finally heard one of the workers yell at the top of her lungs to another worker: "(Name of worker), can you go check on Mrs. (name of resident)! Her alarm is going off."

The family member and I looked at each other again and she looked thoughtful for a minute and then told me that the other day, one of the residents had pulled the fire alarm and they evacuated everyone. Then she said, "But they didn't evacuate the residents in this area." (Meaning the Alzheimer's/Dementia Unit.)

I wasn't sure I heard her correctly. "What? They didn't evacuate the residents here?"
"No," she said. "They wanted to wait to make sure it was a real fire first before evacuating these residents."

My first thought was that they considered these residents less important. But then I thought that maybe they were concerned because these residents tend to want to wander off or get confused and combative.

Yet, it still bothered me. They could very easily take them all out into the courtyard area that was fenced in with a high fence. At least that would be better than being inside the building if there was a real fire with smoke. They would need the extra time to get them all out.

I can't help but wonder if the elderly, especially those with Alzheimer's or Dementia, are being treated with the attention and respect they deserve. I am sure that in most cases, it is not intended. We all can get immune to things after awhile if we aren't careful... alarms going off all the time, the constant needs of needy people, etc. But we need to be careful. They are people, with real needs, and they need to be taken care of and paid attention to.

I also wonder: Do people tend to care less about the elderly in general?

If so, I hope to change that by bringing it to the attention of as many people as possible. And it also just reinforces my desire to make enough money to one day open up my own assisted living home and make sure the residents there are well-taken care of, and never, ever, ignored.

Back to the visit with my dad, he is now having to use a wheelchair exclusively, and has been for some time. Funny, that particular wheelchair doesn't have the big wheels on the sides, only a set of four smaller ones, so he can't wheel himself around, and no foot rests, either. Apparently, it was the only wheelchair available at the time and my step mom has a better one ordered.

The recent change in his medication seems to have solved the issue with him wanting to use the restroom anywhere and everywhere and he seems much calmer; however, he is also much more sluggish and slow now, and doesn't make much eye contact at all. Getting him in and out of the wheelchair is quite the task, too, as he will say he's ready to get up, but then doesn't seem to understand how to bend his legs to do so, and won't try to get up until after several prompts. I guess it's either a choice between high agitation and inappropriate behavior, and a calmer demeanor and sluggishness.

My daughter wanted to wheel him around herself, but I had to insist on having her "help" me instead. We took him for a ride outside and visited there for awhile, and my daughter once again gave him flowers, which he smiled at and said, "Thank you." After a few minutes, he managed to say that he needed to go to the bathroom, so we took him after getting a worker to help, and after that took him for a ride around the facility. When I passed by the exit door, I can't tell you how tempting it was to just wheel him right out of there and to my van, but instead, I reluctantly turned and went into the activity room/resting area, figuring he might be ready for a nap.

First, I took him to a wing back chair and asked if he wanted to sit in it, to which he responded, "Yes. That would be good." (I am amazed by how well he can respond at times.) However, instead of getting out of the wheelchair, he just kept putting his feet up in the wing back chair. Finally, I moved him from there and took him over to an easy chair and after getting him in it, discovered that it had a broken foot rest, so a worker helped me get him back out of that one and into one with a working foot rest, which was no easy task.

I got him nice and settled in the easy chair with his feet up, and that's when my step mom came in for a visit. It was so good to see her, as we had not seen her for a couple of weeks. She checked his feet, which--I discovered--had been swollen, causing his toes to rub up against his sandals. She had brought antiseptic spray and sprayed his toes, which he winced at and complained, in his own way, that it bothered him. I can see why, too, as he had broken skin there, so she blew on them to cool the sting, then applied band-aids and put his socks and sandals back on.

When it was time for my daughter and I to leave, I leaned down to make eye contact with my dad to tell him we had to go, and he protested and said, "Noooo." I laughed and hugged him and said, "I know, I know. We'll be back, though."

He didn't hug us in response, but that was okay, I figured it was the medication and that he was probably hugging us back on the inside.

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