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Today is Christmas Eve. And much like Mary and Joseph, my mother and I have been looking for a bed for my step-father, Norm. But, there are very few beds available in good homes. No room in the inn, so to speak.
Kaiser filed discharge papers for him yesterday with no bed available. Today they finally found one for him in a below average home, which we have yet to see. They said they were looking all week, but I've talked to several today and Kaiser had never called them. One administrator, emphatically, wanted me to know that. And she had just made arrangements for her last bed minutes before I called.
It will be the 3rd home he's been in since this saga began back in June of 2008. It is a saga of mismanagement, confusion, misinformation, malpractice and finally elder abuse.
What's even worse is that since I've begun telling my story to family and friends and whom ever would listen I've gotten nothing but empathy and sympathy from other children of elderly parents. Sounds like a 12 step group.
The fact is that care for the elderly and poor is atrocious in this country. I've had a whirlwind education in the ratings systems for convalescent homes. Reading the ratings system and reports on each home is down right scary.
It all started back in June of 2008. Norm fell after work and broke his hip. He'd been working a night watchman job at 75 years old because he and my mother couldn't manage with just their social security checks. Before he hurt himself he had done most of the shopping, and driven my mom to all of her Dr's appointments. She's 81. They live in a small one bedroom apartment in Santa Monica, under rent control. They could never afford to move, the way rents have skyrocketed. And Norm, used to sleep on the couch, because he had restless leg syndrome and it would keep my mom awake.
One day he fell at Albertson's. But he got back up and kept going. He was in horrible pain, but could still walk and he needed to keep working, or at least that's the attitude that drove him. But a week later when leaving work, he stumbled and fell again on his way to the car, and he could not get up.
They brought home, but my mom's brother told her to call 911. She did and the took him to Santa Monica Hospital ER where they did the initial diagnosis. Kaiser immediately wanted him transferred to their West LA facility.
Once there the Dr said he needed a half hip replacement.
He made it sound so easy, and everybody was at ease.
(NOTE: around that time I heard about a hip replacement that had been recalled by the FDA or some agency because it had a tendency to dislocate a lot...but this was a half hip and...they wouldn't used a bad implant...or would they)
After a few days in the hospital and Norm in extreme pain they told him he had to go to a recovery home to heal and get some physical therapy. Again, all this sounded so easy
and healthy. But, there was a problem. The hip kept dislocating. The home kept sending him back to Kaiser in great pain. They kept resetting it. The Dr was getting very angry with Norm, saying he was doing it to himself.
I wonder.
He lost his bed at the recovery home and had to be sent to another place that was 20 driving miles across town from us.
It made it almost impossible for my mother to take the bus to see him and force me to become her driver. She took the bus once and got rides from neighbors a few times, but he was so far away we couldn't keep and eye on him. AND I was still under the impression that they were taking good care of him.
He started loosing weight. He wasn't eating. The new home was noisy and loud with a loud speaker going off all the time so one could barely keep your thoughts together.
He kept calling my mom in great pain. I called and asked why he was in such pain and they put him on more meds.
But it turned out that his hip had dislocated again and nobody caught it. There he was in acute pain because of a real condition. He should have been transferred back to Kaiser immediately.
Finally, during a regularly scheduled appointment he was sent back and they found the dislocation. We were all mortified. Why hadn't the home discovered it? There are supposed to be skilled physical therapists and nurses there to catch these things.
The Kaiser Dr, put him in a body cast up to his chest.
Turns out he had threatened Norm with this after the last dislocation. They were accusing Norm of doing this to himself. I highly doubt it.
Once in the cast he could no long be rehabilitated so he was put in a different category of custodial care. Norm lost more weight. They cut the cast down so he could sit up. They promised him a Cardiac Chair because of his heart failure, but never delivered. And he began loosing more weight. I remember one day I could see a huge gap between the cast and norm. Almost big enough to put my hand in.
He'd lost 20 pounds or more.
And nobody thought to recast him. We asked and they said, oh he might gain weight again. He didn't.
When they took the cast off he had deep wounds in his foot and knee, caused by pressure and friction.
Not too long later he got a staff infection from the home.
Nobody noticed. They brought him back to kaiser for a check up and when the blood tests came back they brought him back from the home and put him in Kaiser West LA and called us.
He now also had foot drop. But even though the Kaiser Dr told us about it the Dr at the rest home denied that he had any such thing.
Several weeks later, perhaps 6, we met with Norm at Kaiser West LA to be there with him when he got his cast taken off.
I began to take pictures of the wounds that were still bleeding.
Norm was still in a diaper and a catheter. And although he was joking around and laughing he had a cough and very wet cough.
He told my mom that night on the phone that the man in the bed next to him had died of pneumonia. The next day she asked the Dr to check his chest. The Dr. said, he'd just checked Norm and he was OK, but Norm said, he came back and took a chest xray. We called the home later. My mom asked the nurse how Norm was, she said, "oh the same." My mom said, "so he has a cold?" The nurse said, "oh you know, yes he has pneumonia, but we're treating him."
We got there that night to have Norm sign and Advance Health Directive so that my Mom would be maid aware of what was going on. We had an Ombudsman there with us. Norm was un-responsive.
We stayed there for 4 hours trying to talk to Norm. He would wake and start and open his eyes and fall back. Two assistants came in and woke him when we requested that he be fed his dinner. He now only weighed 150 pound. He was 190 when all this started and 220 not too long before that.
He only ate 4 bits of mashed potatoes, a little milk and a bite of fudge. Then he was out again.
Finally, around 8pm the charge Nurse came in to give him his meds. We asked her if this was normal. We'd never seen him so out of it. She indicated that it was and we couldn't believe it, because my mom would call him all the time. Then the charge nurse, slapped him hard on the very knee where he was wounded in order to rouse him and give him his meds. When we asked her what she was giving him she said it was his sedative he was supposed to get every 4 hours. He was also supposed to get a breathing treatment every 4 hours and he wasn't. He didn't want the meds, she put it in his mouth, he didn't want the juice and she made him drink it. We were shocked.
We asked for his vitals, I couldn't believe this was how you treated someone with pneumonia. His pulse Oxy was 94,
she said that was great, I know better, his bp was 110 over 40 his pulse was 89. His breathing was labored, when he did cough it was very wet. I felt he should be on oxygen and in a hospital getting treatment. So my mom called the Dr. on call. He said he could admit him for observation for a few hours.
When we got there the Nurse told us that what we had witnessed was Elder Abuse. That was the last straw for me.
I never wanted him back in that home again. We are filing a complaint.
But, when we started to look at what was out there we discovered the rating system for convalescent homes. Where Norm had been was only 2 Stars out of 5. The description online of the inspection was horrifying.
HOW CAN FACILITIES LIKE THIS GET LICENSED?
THIS SYSTEM IS BROKEN AND WE NEED TO CHANGE IT NOW!
BECAUSE WE'RE NEXT. I'm going to do everything in my power to change the way the elderly are treated in this country.
It's obscene that we warehouse our parents like this!
It brings to mind the final scenes of "Soylent Green,"
only not as humane.
I don't have time now, but next I'm discuss Good Cop/Bad Cop discharge coordinators and Kaiser.
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