OK, I have been debating with myself all day today about another incident at my mother’s ALF. She takes Tramadol on a prn basis, on request. It is a controlled substance so it is not in her room. It is not part of her daily medications, just when she needs it for pain. She takes it at night when she needs it, to help her sleep.
Well, she called me first thing this morning to tell me that she asked for a Tramadol last night after her regular meds.
The staff member came to her and said she couldn’t have one till after midnight because she “already had two; one at 9:30 am and one at 4:30 pm”. She had neither and she told them so. I have been on the phone all day long talking to and listening to the Director tell me she is “investigating”, however she has yet to answer why the pills were charted but never distributed to my mother. My mother never requested them in the first place. The story has changed; the Director seemed to imply that my mother”forgot” that she took the morning pill and she called the staff member on duty who fessed up that the 4:30 pill was never given, but no response about the morning pill in question. She also told me that the pill count was off by one. This happened one other time where the night cna insisted that mom had been given a Tramadol along with her regular meds, but she didn’t and she protested. Another cna who was assisting went and checked and brought her the Tramadol. The other cna did not apologize or acknowledge her mistake. She also told my mother on another occasion to “stop being so ornery “.
My mother also has had two incidents where her supervised showers (she is a fall risk) didn’t happen for over a week. She is scheduled for twice a week. She has been in this facility for less than 6 weeks.
My daughter and my niece are both telling me that it needs to be reported to the state.
Any advice? To whom do I report ? It is obvious to me that Tramadol is being pocketed , or at least attempted?
I was afraid more things would happen behind my back. Still, I send emails to facility manager, social worker with details about what happen and photos of my sister with filthy hair, dirty clothes, fecal mess on the floor. I got loads of excuses about what they say happened. I ask about a mat on the floor in front of the bed in the event of another fall. No they say-can't do that but i see mats on the floor in other people's rooms.
Thank goodness I got sis out of there after a 6 month grueling search for a better place that would take my sister. Nurse that didn't like me because I wouldn't agree to more medications-put a note in the chart saying i was argumentative and difficult family member. Same nurse said again outloud in a care meeting. The notes in the chart about about me being difficult- I am sure were read by prospective places and decided to take a pass.
I was afraid to complain while sister was living in the first place so I waited until we moved out. Complained to ombudsman and state department of health. No one would do anything except try to get a few dollars back on the $1,000 of missing clothes and shoes. They said they could have filed a complaint if she was still there but it was then covid time by the time I got sis out of there-nothing was happening at all. I know worse things would have happened in that place due to no family etc allowed. State says if I had exact days times and person who did something then they would look into it. Ombudsman told me it is okay for facility Doctor to order meds-that were specifically removed after hospital evaluation without talking to me-the POA.
I thought second place was gonna be better. Spent hours and hours trying to get someone to answer the phone. Sis could not use the phone by herself anymore. She lost more weight, needed help with eating. Got another case of scabies 6 months later and nurse is telling me my sister's skin was like that when she got here-No that is not true. In spite of having a better rating the staff were about the same as the last place. More clothes missing, more lost weight, missing glasses, It was covid time not much i could do to help her. I spent money on better fitting depends pants-they never used them on my sister. When i collected her things there were the 7-8 bags of underpants they never opened but about half of the clothes i sent with my sister and her name on everything was returned.
Are these pills 'obviously' being 'stolen' by staff?
Is your mother 100% cognizant 100% of the time so you know she's telling you the truth 100% of the time about everything? My mother was embellishing her stories 99% of the time, even before she was diagnosed with dementia. She had a negative attitude about the staff to begin with, which tainted her dealings with the ALF, so everything she said & did was slanted toward them being 'in the wrong.' That's a big problem for ALFs.
This is not to say that the ALF is in the right, just that elders DO make mistakes and so do ALFs. It's not always sinister happenings going on behind the scenes.
But if you feel that way, and that mom's showers were spitefully not given to her, or that the CNAs are pocketing her Tramadol, it's time to move her out of there and into a different ALF that you carefully interview beforehand. And make sure that only LPNs or RNs are handing out narcotics to residents, as was the case in my mom's ALF and Memory Care ALF both.
If this were me, I'd wait for the ALF's director to get back to me with a reasonable explanation for the confusion with the Tramadol first, before making any decisions. I'd also speak to him or her about your concerns of stealing, your mom not getting her showers, and your feeling that the ALF is not living up to your expectations in general. See what comes of it. If nothing is resolved to your satisfaction, move mom out of there and file a report with the state or the Ombudsman.
But even if you do move mom to another ALF, you can't always trust what she says implicitly w/o fact checking first. Elders have a lot of stories that aren't always 100% true stories, trust me on that. I can tell you tales about things these elders have cooked up over the years that would turn your hair gray! Kind of like the Operator game of old that starts out with one story but by the time it gets to the last person, it's twisted out of context to the point it's an entirely different story altogether! My mother instigated one of those one time that had the sheriff showing up at her door for an incident report, and had her slamming the door in the sheriff's face insisting she'd never said such a thing in the first place! Meanwhile, there were 5 other ladies' she'd gotten whipped up into a frenzy along with her. When I went in to see the Executive Director the next day to apologize, he laughed and said he'd seen it 1000x before, not to worry.
For us daughters & POAs, it can be difficult to know what to let go of and what to fight for on their behalf; what to listen to as gospel and what to shrug off as "I'm not sure that's the total truth I'm hearing". Again, that's not to say your mom is wrong or not telling the truth; just to say that she will have A LOT OF COMPLAINTS about any ALF she's living in. How many of them are you going to go to bat for on her behalf and how many of them are you going to shrug off? She 'should' have 2 showers a week; if she only has 1 shower a week once in a while, is that ok or are you going to fight that battle each & every time? Sometimes they're short handed and mom will fall thru the cracks. Our job as advocates for our moms can sometimes turn into a full time job if we're not careful. Just sayin'. Between making phone calls to the ALF, paying bills, sorting out medications, figuring out what supplies they need, listening to complaints, calling them, figuring out doctor's appointments, and and and. Having them in managed care is supposed to cut DOWN on our duties, not amp them UP.
Wishing you good luck getting all this straightened out to your satisfaction.
said she is conducting her own investigation. We are waiting for results.
Regardless, charting narcotics and not dispensing them is diversion and it is illegal. Hoping this is not the case, however, no credible alternative reason has been given as yet.
I start with the assumption that you are POA. Without that you have no rights or abilities here and should report the error to the person serving as POA. I also assume that your Mom is a reliable reporter (that is to say with no competency deficits at all).
Assisted Livings are not nearly as regulated as Nursing Homes and Memory Care. It is basically considered just what the name implies, Assisted Living.
If you are unhappy with the facility AFTER A PERIOD ALLOWING FOR ADJUSTMENT, if your Mom is a reliable reporter (no dementia) and you believe her, if you are POA, it may be time, after a good discussion with administration here, for you to explore options for other places Mom may be more secure and comfortable with.
Good luck and hope you'll update.
I include here your first discussion of Mom's ALF problems with medication administration. This link will supply more information about Mom's concerns regarding her medications. Do know that seniors have a VERY difficult time giving up control of their money and their meds! There will be an adjustment period.
https://www.agingcare.com/questions/have-you-any-advice-about-medications-and-assisted-living-474902.htm?orderby=recent
I am my mother’s POA but I have two siblings who are also concerned. And two relatives who work in health care; one in a care facility and one who is a nurse practitioner. Both said this should be reported and investigated. I am being a bit more cautious, allowing a bit more time. But I have not gotten any explanation as to why this is happening from the Director and I have been in contact with her several times over it. My mother told me what happened and the Director called me to report it, but of course their stories did not jibe. I did not accuse her of wrong doing, but I do require a valid explanation . It does look bad. And my mother’s Tramadol count is off. That, in and of itself is a violation. We will see what today brings. Thank you for your response.