Horrors After the Lights Go Out in High Priced Nursing Homes and Assisted Living Facilities

it is common knowledge about the horrors that go on in the lower quality nursing homes but do you think you don't have to worry about your mom because she is in one of the best....think again.

For awhile I worked in several high priced assisted living facilities in the San Diego area. I was hired by the clients parents serving as a private care giver giving additional care within the facility. I saw things that made me sick. In one situation, I was there to entertain a man who had severe dementia and had broken his hip. I was there to keep him company. Because of facility rules, I was not allowed to do much else.

One night I came to visit him right after he had been served dinner in his room. When I opened the door to his room, he was choking on his food. I rang the emergency bell and they came in and saved him. The point is usually they gave him his food in his room. No one helped him eat or watched him. When I began wheeling him into the cafeteria where they all ate, I noticed that sometimes his hands shook and most of his food ended up in his lap. I also noticed that on the weekends, when family visited most often, there was more staff to help feed the various patients. Many of them did a horrible job of feeding themselves. They were slow and more food ended up on the floor. When the time was up, they were wheeled back to their room even though they had not really eaten much. After 4 months, I observed it was standard practice on the weekends to be staffed adequately and on the weekdays to be understaffed. The ones that got the most attention and the best care were the patients whose family members visited often. These family members came often unannounced to check up on the service their loved one was getting.

In another case, I was a private care giver for a couple who moved to an expensive facility. The wife had broken her hip, was bed ridden, unable to talk, unable to feed herself or give herself liquids. She was helpless. Often the staff would set a glass of water on her tray at her bedside. The problem was there but no staff to assist her in drinking that water left on her tray. . I was hired by the son to make sure she got liquids, was fed, to take her out into the garden to get some sunshine, check her for bed sores and general care. The skilled nursing floor of this facility did try to give good service but often staff was sick or did not show up. Sometimes the staff just quit right on the job. On those nights, that left a staff of only two CNAs to help 20 or 30 patients on that floor. I have seen it go two hours before the staff had time to put my client to bed. I was not allowed to do so because of their insurance policies. I often did anyway against the rules. My client would be bent over, unable to support her weight, from weakness.

Often at night as I was leaving that floor, I would find a patient on the floor needing help. I would go back to the nurse in charge and let them know the room and the patient in trouble.

In the general cafeteria area too there were often problems. Often they were understaffed for the people needing to be fed. The food was over cooked and tasted awful at times. In the time period right before dinner, the staff was absorbed in bringing in the patients from their rooms into the dining area. While they went back and forth retrieving patients, there was often not proper supervision. Three times a day I helped the woman to eat. I fed her personally.One evening when I was waiting there, about 14 patients had already been brought into the cafeteria area but there was no staff present.. One man in a wheel chair with dementia went over to the coffee pots and grabbed one trying to get a cup of coffee. I saw it happen and rushed over to take it away. I wheeled him back to his table and alerted the nurses. If I had not been there, he could have suffered severe burns.

There is another problem too with being understaffed. Often, I saw the nurses and CNA staff sick with colds and flu. They could not call in sick because there was no one to replace them. I then saw in the coming days, patients get sick and die from the illness given to them by the sick staff. I was a private care giver in that facility for almost a year for that woman and her husband. I was there 10 hours a day for six days out of the week. The staff did not want me there but the son was insistent on my being there. The daughter who hated her mother did not want me there. The son and the client won.

The husband was on the upper assisted living floor and his wife down on the 3rd floor called skilled nursing. This is the floor generally where they never leave. These patients are the most helpless, the sickest, and the most neglected. I watched over time as the woman's husband got on the nerves of the facility because he brought attention to the lack of service, bad food, and other problems connected to his wife's care. He became a thorn in their side. After most of one year, after many run ins with the management over the care of his wife, the facility required him to go for an evaluation of his mental capacity. He was fine except for being very outspoken on the care given to them.

When it came time to bring him home from the evaluation, the nursing home management refused to let him come back to his apartment. They shipped him down to the psych ward down in the skilled nursing floor. There was nothing wrong with him mentally other than being cantankerous and outspoken. He didn't like being told how to live. He felt he should have more choice over their lives. He did not understand the power he didn't have and the power management had over their life. I fought with the family on the issue but they were too busy out of state to do anything. They were tired of the calls from management complaining that the father was always causing problems. So he was kept in the psych ward against his will. To begin with, they kept him isolated for three weeks. He was not allowed to see family or friends. He was allowed to visit his wife once a day. They gave him medications to make him compliant. The daughter who hated her mother let me go. She decided that the quality of her mother's life was not worth keeping me employed to make sure she got fed and received liquids. Within two weeks, she died of dehydration. Her husband, also my patient, lost all will to live. When his wife died, a short time later that was the end. With the stress and grief, he caught pneumonia and died shortly thereafter. I watched this whole thing go down from the families lack of intervention to what the nursing home did. I got so sick from seeing this happen that I did not work for awhile. I had grown to love them but had no power to save them.

In this same facility, I saw the grief of couples being separated after being married for 50 years. Their family had decided they should sell their home and move into a facility. When one of them gets worse sooner or later, they have no choice but to move down to the next floor where more care can be given. The healthier spouse must then stay on the upper floor according to the state and nursing home rules. In many cases, they could have stayed together at home with in home care services. I saw one woman who refused to eat when separated from her husband of 60 years. She died a short time later.

In many cases, insurance would have paid for their care at home but. it was the family who made the decision against home care. I will state here that sometimes there is no choice insurance wise or because of family circumstances. That is the reality. Often, it is not always the best option to have them cared for at home. But often it is covered by insurance and is the best option for the happiness of the couple involved. Often the decision is taken out of the couples hands by family or whoever was given the power of attorney. I have seen both sides.

I will state here also that I have seen wonderful families who did all that was possible for their parents. I have worked with some wonderful kids and family members. To them, I give such respect for their dedication and their devotion. I have also seen my share of greed and incompetence in the families care and in the facility itself. These facilities were not the lower priced ones. There were in well to do areas and over $5,000 a month. They had beautiful brochures and a great PR staff that gave wonderful tours to the families. Only those of us who work there know what actually goes on.

If you want to know how the care is, do your own research. Visit the place and ask a number of the residents how they feel about living there. Ask them how the food it and how the service is. Keep under the radar of the staff. Visit the place unannounced with the excuse of visiting a friend there. Time the visit during the weekdays, during meals and bedtime routines. Ask family members of the patients living there already how they feel about the facility. Go undercover and do the real work to determine if the care is as good as the brochure states.

Price does not always mean quality so remember that. It is your responsibility to make the staff and facility stand up to what the brochure says are their standard of quality in care and services.