Last Monday, I went to the visiting nurse’s office. Oh boy, did that surprise them -- but I meant to do just that. I said how I didn’t know what was going on with my dad’s care, and needed to get more involved in what was happening. That surprised them, too, because I have been pretty involved so far, so now they knew something was up.

The outcome was that we would have a family meeting with the people involved in his care. There will be a nurse, physical and occupational therapist, caregiver, the nurse supervisor, the caregiver’s supervisor, social worker, dad, my husband, and me.

The point of this meeting will be to discuss my dad’s ongoing improvement, how his Plan of Care is being adjusted as he improves, and how the caregiver is supposed to interact with my father to facilitate his improvement.

One thing I am currently working on is making sure we don’t just sit around and have them talk at us and tell us what’s what -- and then not have time for my questions. Sorry guys, I have MY agenda.

I had a devil of a time just figuring out who is the point of contact for communication. Apparently it’s the nurse in charge of my dad. So it was to this person that I gave my typed-up agenda with my issues and questions. I have also left voice messages for the PT and OT person with the questions that pertain to them. And I have spoken to the nursing supervisor (who I think is good) and also the caregiver supervisor (whom I really don’t know yet.)

The social worker and I are currently playing phone tag, but I hope to talk to her soon. I will also be there at the house today for PT and again tomorrow for OT. I will show them things that my dad can do that they don’t know about (walking down stairs, out to street with rolling walker for instance) and discuss in detail the issues that I see, the issues that they see, and discuss where they are going with his care. In short, I am working hard to prepare them for the meeting.

By the time we have that meeting early next week, people should have done their homework. Then we will hopefully have a lively discussion – about what my father is and is not safe to do, and how we get him from here our agreed-upon goals. And anybody who doesn’t sign up for that program is going to be (politely, of course) fired.

Please comment and help me prepare for this! We’re not going to get this crowd together again, and I want to make the most of it. Suggestions are absolutely most welcome!

I reread all your comments at least 20 many times, and I’m still thinking about them.

BG I love your attitude, and I think you have it all absolutely right about nursing homes and caregiving in general. Sometimes when you see things from the outside, you wonder…

Bobcat, I don’t have the employer gene either, and hiring and firing seems so difficult. The CG does attend therapy sessions, and when I’m not there, she actually hands him his dumbbells or walks around the house with him. But as far as “real life” things, that’s where it breaks down.

I love the idea of the “Power Seat.” Should we be sitting at a table? Better than sitting casually around the living room? My dad could probably hear better, and be more likely to speak up.

Nursing/PT/OT is paid by Medicare, but we’d do self-pay therapy if we continue to see the kind of progress we’ve seen lately. Caregiver is LTC insurance plus self-pay. I’d be very interested, Bobcat, to hear how payment options could affect things.

I am trying hard to be sure the problem isn’t ME – jealousy, frustration, anger, just trying to vent my anger in a meeting? But by writing here, I think you’ll keep me honest.

On the unrealistic expectations, so far through this 8-month ordeal, my one-day-at-a-time, one-inch-at-a-time optimism has been right on. He has surprised everyone so far, and all I want to do is to reach for that next inch.

In January, dad was handling his own affairs, driving his own car, and as my cousin said, living the life of someone 10 years younger. Then he broke his hip, and had two surgeries and many months of serious medical complications. I’m sure many of you have similar stories. August, he was strong enough to have the enlarged prostate surgery that was originally scheduled 2 days after he fell. So he was able to get his catheter out after 7 months, CDIFF and UTIs are currently not evident, we’re tapering the last of his antidepressants, and the nurse who came out to do an evaluation agreed that he is much better than he was just 2 months ago when she saw him then.

But in terms of rehab, he’s “coming from behind.” The many complications had him lying in bed in a fetal position (bedsore the size of Montana) for months, and he was too weak and dizzy to do much therapy. Recovery was glacially slow, but recovery it was. And now, with the latest improvements noted above, he’s been making much faster progress. The OT person especially challenges him.

I’ll try really hard now to get the Plan of Care, especially since they all got my questions, and then came out to see him with those questions in mind.

Thanks all!

quote:

Darn, I do have to mention one more thing. Try to keep an open and objective attitude. Many of our LOs are not living as well as they could because of under-achieving attitudes, but others equally fall prey to problems of denial from family members. An open mind, yet one that is strong is your LO's ally. Denial can hurt, too. You haven't said much about your Dad's condition, diagnosis, etc., so I just am making a little footnote here about caution.

She is absolutely right Lan there are many I have dealt with that dont want to hear whats really going on with their LO's so please do have an open mind. All too often even I hear things I dont want to but it serves no one especially my patients and my LO.....but as you posted earlier on what he can and cant do I want you to emphasize on that area because YOU know him best not them.
Even my MIL who has had PT after a partial hip replacement tried to refuse but I dont allow that in my world I know what will happen if she doesnt comply, she gets worse and well the PT has no choice if a patient doesnt comply...they have to leave.
HAH! Not on my watch sweetheart. There are extenuating circumstances to my mil's case but at the end of the day to allow independence to be casually thrown away I wont allow I have a voice of reason and I use it with both MIL and the PT **shoot he aint goin no where not till he's done with what he came to do**


Look hun a person may be taking a slow road to heaven here on earth but that doesnt give anyone the right to take away that persons independence...if thats the case all us traveling nurses PT's OT's etc etc etc better find a nice cushy institutional job (cut your tongue out!) and we might as well put our LO's in a NH and let the ever so nauseatingly sweet staff ignore them right? Ok I aint never been nauseatin in my life I aint startin now! (and to those that might read this and are insulted cause they work in a NH DONT EVEN go there with me cause I been an done an Im workin privately now BECAUSE of what Iv seen) pppfffftttt! 1 hour settin in poop are ya kiddin me?! halls smellin like piddle SERIOUS! Ooooowwwwweeee Im havin a fit right now aint I.....
I mean statistics show leaving a LO in a NH decreases life expectancy by months if not years due to their lack of interaction, and care (lets not start with the sanitation issues)....trust me I dont make this cr*p up its out there for the masses to read just by doing a simple search.
Im still suggesting a change in cg's though.. I havent met this person but what you have already said just gets my hackles up

Hi lantern567, By now, you have (hopefully) had input from PT. Does this CG attend sessions with PT and OT? If not and she is in the house, she probably should. I get whoever is on duty when HHN, PT, or OT come, to sit in and get an update. Forgive me but who is paying for this? (you don't need to say, but there are different possibilities, Medicare, VA, self pay..) Based on the answer you might face some limitations that I don't foresee.

You have called the meeting. I doubt you will have as much trouble to control it as you think. Many agencies and agency personnel know they are hired because family can't or won't be bothered. They are prepared to proceed with very little input from relatives. I am one with a lot of input, it really drove them nuts that I insisted on meeting everyone they sent before Mom met them. It is not surprising for them to be surprised by your level of concern and input.

Until Momma Care began, I had never been an employer, and the only supervising I had done was as assistant grower in a large greenhouse operation. I trained people, and made reports on ability and progress, but I did not hire or fire. It is still awkward for me to be in this position.

You are going to do just fine. You called the meeting, get there early and choose the power seat for yourself (usually what they would call the head of the table). Your Dad on one side, Husband on the other. (Maybe put your Dad in the power seat ) It never hurts to type up YOUR agenda and put a copy in each place.

You know, you might have some fun with this. Don't get carried away. Focus on your Dad's recovery. This is going to work, just remember who pays.

Darn, I do have to mention one more thing. Try to keep an open and objective attitude. Many of our LOs are not living as well as they could because of under-achieving attitudes, but others equally fall prey to problems of denial from family members. An open mind, yet one that is strong is your LO's ally. Denial can hurt, too. You haven't said much about your Dad's condition, diagnosis, etc., so I just am making a little footnote here about caution.

You are goin to have a good meeting. I think you will find that everyone is actually on your Dad's side, just not on the same page about proceedure. That is what you are after.

This message has been edited. Last edited by: Bobcat,