@surfcity - very sorry for all you are going through.
I use the disposable no-rinse cloths to clean my mom. They work really well. Honestly, when a person is completely incontinent, you end up cleaning them very thoroughly several times a day anyway. She hates being wet and reluctantly lets me wash her hair once a week. There are also no-rinse shampoos that I use in-between, but I don’t think they are quite as good as a real shampoo so I’m trying to keep that going as long as she’ll let me.
Thanks for all your support. It is so helpful to know that others have gone thru similar. I am taking one day at a time.
Although their cognitive issues are new and strange to me, I have to believe that Memory Care or other places have experience in handling folks with these issues, so I am going to just trust that we will be able to keep them in their existing personal care apartment, or else they may have to move to the Memory Care side, which will be difficult, but doable.
@compmom, my mom is on a blood thinner as well so I get it; any fall is potentially a big deal. Thank goodness your mom will be ok but her bruising sounds awful. The morphine can be such a problem for elderly too - potential for falls, confusion, urinary retention, constipation. My dad had all these problems when on morphine for a short stint in the hospital several years ago. I don’t blame you for keeping a close eye on that use but all those calls in the middle of the night, ay yi yi. It was good they were abiding by your wishes and you kept her safe. I guess it’s our turn to do the worrying now - ah, the circle of life.
@esobay, the biggest concern I have is when I ask for info or did you let the doctor know about something, what is that big welt on her arm, when did she get showered, why is the moisture-barrier medicine that’s in her bathroom for her excoriated area not being used when she’s toileted (since it’s white and thick you can tell when it’s not being used), etc., they say they don’t know. Aaargh, don’t you chart these things and track their showers?
There is such a breakdown in communication on their end. It’s as if they don’t know how to properly access info and/or chart on their own computer system (which the DON admitted has been a problem). So the left hand doesn’t know what the right hand did and important info doesn’t seem to continue to get passed along in report from shift to shift.
It’s important that my mom stay clean down there because her skin breakdown started in the hospital. I was there four days in a row and whenever I toileted her, I put that medicine on. I take a day off and it’s back to the way it looked when she first came in, sigh. My mom has dementia but she’s always been easy going in rehab/hospital settings with her care, so they can’t use the excuse that she’s not cooperative. I did look at a website you recommended me to find for my state that tracks these things and there were many complaints - several where they found out it had been either weeks or a month for some patients to go w/o being showered. Thanks for reading my rant, lol. It was therapeutic to write that out. 
@rjm2018 - the failure to report issues or changes to you, as well as document it for internal communications is a big worry. Documenting is also necessary, but not sufficient to ensure the data “travels” as needed. Standardized care facility procedures may be violated here. (To give you an example, my father’s skilled nursing facility memory care unit head nurse once called me to report that my father had a 3 inch scratch on his upper leg that wasn’t there the day before. No pain, skin not broken, no bleeding. It was their procedure to document such occurrences and notify family. I think my father likely scratched an itch…)
New welts and failure to treat the skin breakdown is unacceptable. While prompting impacts some care facilities to get on track, in other circumstances, the casual attitude and disregard for procedure is institutionalized across disciplines to the point where there is little hope of change. I know what it is like to try to make that call. Not easy. These are indeed reportable offenses, as well as very common issues that should be routine for this population. Hang in there and all the best.
@rjm2018 you are welcome. I KNOW how helpful it is to post here, either just to vent, to find out I was not alone, and/or to collect advice. It is hard times.
Trust your gut on moving your mom. If there have been that many slip ups and another place is available, she might be better off moving.
@surfcity, same goes for you. It takes a bit to stabilize, but then maybe memorycare is a better option. Mom’s memory care let married people stay together so that was a huge benefit for the one couple that both needed to be there. No family discount though and memorycare is so much more expensive than AL. But by the time I had moved my mom, I had been paying for extra private care for so many things that the leap in cost wasn’t that big.
@MaineLonghorn, @tx5athome and @surfcity and everyone else struggling with aging parents, big hugs to all of you.
@esobay, I’m in the process of getting mom transferred to the place she was supposed to go to in the first place but the hosp. caseworker kept telling me they weren’t getting back with her. Both my parents have had to rehab there before. My mom was there almost two months a few years ago and many of the same people are still there, including the Dr., who I remember being a joy to collaborate with over my mom’s care.
How are those disposable washcloths different than baby wipes? If we already have baby wipes, is there any reason to buy those instead for a senior?
@somemom - I think they are thicker and definitely larger than baby wipes. Instructions call for using several to clean the entire body. Can’t remember if they would be easy to warm.
Interesting read for those of you whose parents end up in the ER regarding difference between Observation and Admittance and what it means for cost.
The other day when we were visiting elders, dad was very confused and couldn’t find his car nor keys. We told him that his oldest son had them and not to worry, we were there to give him medication and and him and mom to dinner nearby, eating something he loves. He brightened up over dinner and was smiling and laughing.
He was banned from driving his car months ago by the CCRC after repeated bad behavior on his part. We are relieved as they made the decision and no family member had to. It is much better having is drive. Fortunately my sibs and I all live on island and can pitch in.
@surfcity, what a story with both parents. Hats off to everyone on here. So much going on.@ rjm2018 glad for the move!
I have spent the last three days fixing medication errors that happened when our assisted living changed pharmacies. The AL sent old drugs on the list (error was theirs) and my mother was getting 4 meds that she should not have been getting. Plus, when I first found out about ONE, and said to the AL was it possible there were more, they said no. So I had to figure out myself by calling the pharmacy that there were FOUR. I had to clean up the list, and then write the MD to cancel these 4 (which had been cancelled before) and reorder 11.
Today we went to a plastic surgeon who made a slit in the hematoma despite blood thinner, and squeezed out the jelly-like blood. He said the skin might have died and an open wound created if we had not come. Every doc and nurse, including hospice of course, said to leave it alone and not do anything. Only my own googling let me know this was possible. It’s getting hard to trust (well it never was easy).
Tomorrow the surgeon wants a CT scan because today it was obvious, once the hematoma was emptied, that there is a fracture on her brow- a huge indentation. The fragments could be in her brain or sinus. We wouldn’t treat but after talking with the doc, the nursing director at AL (who ran hospice at one time) and my brother we are going to do the CT.
As a result, the hospice nurse is again telling me we may lose hospice coverage. If she stays on hospice, the hospice Medicare may not pay for the CT. We can revoke hospice for the CT then put her back on, but will lose the current aide. I am confused and talked again to the AL nursing director, the one who ran the hospice house, and she agrees this doesn’t sound right. If hospice is for dementia, we are allowed to address other issues.
So have to make a lot of calls tomorrow and make sure that CT is paid for by insurance of one sort or another!
Don’t mean to be so negative but it is exhausting to do the jobs of folks in the system honestly! Part of me wants to change hospice companies. This nurse is just so hard to work with.
I am in my pj’s on my mother’s love seat for the night. I went out and in those few minutes she had removed the pressure bandage on there to stop bleeding. I am here to make sure it stays on.
I find so much stuff out when I stay here, things I would rather not know. And I sure wish my mother had a couch!!!
Big hugs @compmom! I agree that if your mom has a fracture, that scan should be covered without having to drop hospice. I hope that is worked out easily.
Thanks/ She just brushed her teeth with hydrocortisone cream for hemorrhoids. I was out for a minute. I don’t know where she got it because I have removed all meds. I think it came from the hospital. Ugh!!!
My mom used to do that all the time :(. So hard to witness. Your mom is very lucky to have you!
Oh my goodness @compmom that is a lot to deal with! The medication errors are in excusable though. I am very patient and understand that sometimes things get lost in “whisper down the lane” and so forth, but a pharmacy switch should include double checks and belt-and-suspenders rechecking. (I know I’m preaching to the choir here)
It is exhausting to be the one working the system. I have spoken to many doctors who had questions about the drug allergies listed on my mom’s chart and discussed reactions and dosages etc and I am not a medical professional at all. I am glad I am able to do this - I wonder how folks without well-informed, available advocates make out.
I sense a new business opportunity. Dental hemorrhoid cream!
surfcity the cardiology nurse helped me with some med questions and said “What happens to people who don’t have anyone checking on these things?” I am starting to think about my own old age!! Right around the corner!!
Re: tests while on hospice- Last I knew, you could sign off hospice for a non-covered test and sign back on post-test. Likely an administrative step the nurse would wish to avoid, but doable if HCP (or the competent patient) decides it would be helpful. Fracture evaluation may be allowed, as pain management is often relevant.
My FIL has used brylcream. He says now that he’s using mouthwash (no toothpaste)
My dad refuses to brush his teeth. Mom brushes. At some point, you have to pick your battles.