ASK FRIA – Why doesn't anyone want me?
Q. My dad has dementia and is getting worse. He has been in several homes over the past three years; it seems that whenever his behavior becomes "difficult," i.e., he gets angry or hostile with staff or other residents, the nursing home asks me to take him someplace else because they claim they don't have the ability to care for someone like him. I fear that soon no place will take him. I was wondering what I can do to make sure my dad's nursing home won't make him leave?
A. As it turns out, your dad may not have to leave his home. Alzheimer's and dementia residents experience unique challenges when living in a nursing home. But, your father has rights. New York only permits a transfer or discharge if the resident is a danger to him/her self or others or if a resident's condition changes drastically from the time of admission and the nursing home does not have the ability to cope with that change. Assuming that none of these circumstances apply, as long as your father is on Medicaid and has been in the home 30 days or more, the home must provide him the opportunity to appeal the discharge to the DOH, and to raise his rights in a hearing. The hearing is usually held in the nursing home, with a judge listening to the arguments presented by both sides. You do not need an attorney to present your evidence at this hearing, although it is preferable if you can afford one. Read, also, the article on page 2 about a family that successfully challenged a threatened discharge of their loved one. Call FRIA's Helpline if you have any questions or need help.
ASK FRIA - Alzheimers
Q. My father has Alzheimers and we recently made the decision to place him in a nursing home. His memory loss frequently causes him to become frustrated, to help him I created some small signs that I placed beside his bed to remind him of his favorite television station and wear his favorite sweater can be found. When I went to visit him a few days later all the signs were gone. I asked my fathers aid where his signs were and she said that it is against the Department of Health (DOH) regulations to post any signs regarding a resident. Is this true?
A. In the past nursing home staff was prone to writing signs concerning a resident's condition or medication requirements on his door or over his bed. The DOH determined this practice violates a resident's right to medical privacy, as anyone who walked in to the room or by the door became privy to the resident's health status and needs. In practice, signs should never be used in lieu of proper medical documentation and staff communication. However many nursing homes have allowed signs referring to non medical issues, recognizing that information posted to assist the resident can be beneficial for their continued independence and well being. It sounds like your nursing home needs to develop a Best Practice to address an issue that may very well be affecting other Alzheimer residents. Nursing homes develop best practice to address the problem areas that concern families and suggest a new attitude toward caring for nursing home residents.
ASK FRIA – Medication
Q. Recently, I have become concerned with the medications my mother is receiving in her nursing home. The nurse appears to be giving her more medication than usual. Although my mother is frail she is generally very alert and when I visit we enjoy chatting. Lately, she is very lethargic and doesn't seem to have the stamina to carry on our usual conversations. How can I find out what medications she is on and how or if they are causing a change in her ability?
A. You are right to be concerned. Dementia and loss of mental capacity are not inherent in aging as many of us are led to believe. There are several factors that cause a loss of capacity such as depression, thyroid problems, sudden injury or illness and drug interactions. You and your mother should contact her primary care physician at the nursing home and set up an appointment to go over all of her medications. Take this opportunity to have the doctor explain the purpose of each medication and possible side effects and interactions. If there is a medication hindering her capacity, insist on exploring alternatives. Keep in mind that if you are your mother's health care agent you have a right to view all her medical documentation and can act in lieu of her for medical decision making purposes. Even if you are not her health care agent you have the right to voice your concerns and uphold your mother's rights. According to DOH regulations, nursing home residents must be maintained at their highest possible level of independence, therefore the nursing home should be just as concerned as you are in solving this problem.
