<p>Re: the yellow tape, easy enough to say that some work is scheduled for that spot, with explanation later as needed. We have not seen the property, and septic tanks are often in the rear of the house. </p>
<p>Very cool, CF.</p>
<p>I am assure you CTmom that though my email to my sister on Sat was over-firm and I apologized, there has never been an angry word spoken or exchanged between us. I coudn’t sleep and got up at 5, she wrote a friendly email last night. I replied affectionately. I can assure you that during her visit, as during the past three over 5 years, everything will be warm and affectionate.</p>
<p>Good idea to follow up with the workman’s comp - thanks for the idea.</p>
<p>
this will always be unknown. I was told by both septic co directors, until the men dig deeper and deeper, essentially finish the job. How much it costs will be known when they reach normal soil. So, my understanding, is there CAN be an estimate, it is likely, I was told to be in the neighborhood of $15, but in a worst-case scenario, can reach over 30,000. So I am getting it fixed at our expense, amount to be paid at closing. </p>
<p>The handyman will yellow-tape the region tomorrow. Through a kind of slip up he was there during the inspection and talked to the guy, thus he has a very clear idea of where to mark.</p>
<p>Dropping the girls at school and heading straight to NH at 7:30. Got to get nicely dressed and children ready.'</p>
<p>A big day! Even involves moving a piano from my mother’s house to mine.</p>
<p>All the best today. Here’s to a smooth transition. </p>
<p>Fingers crossed for a smooth transition. </p>
<p>Have to go back tomorrorw at 8:30 am to the Al To meet a moving truck again (and pay again) because the assessment team assessed some of the furniture, once I had everythig moved in, as 'unsafe," eg., two ladder back chairs. Would have been useful to have had prior to move-in a list of unacceptable furniture Will report tomorrow after the moving company day on what was an astonishing day, with great deal of behavior on my mother’s part toward trained and caring professinals (by my mother, for whom the day must have been extremely stressful and trying), who ASSURED me that she was acceptable as an AL candidate. At 7 pm, the director helped me carry suitcases to the car, and held my face in her hands and said "“don’t worry;; we will take care of your mother.”</p>
<p>Dharma, hope you are ok! What kind of behavior on your moother’s part?</p>
<p>I am sure they’ve seen it all. It comes with the territory.</p>
<p>Dharma, they’re not going to kick her out because of her “behavior” on move-in day. Don’t worry. Trust me, she’s not the first difficult resident they’ve dealt with, far from it. They are well trained to handle her.</p>
<p>oldmom and LasMa, yes, I quickly–I mean, while driving home–reminded myself that they are geriatric specialists and have seen it all before.</p>
<p>The specific behavior–first, after doing nothing but sitting in a wheelchair for 3 wks at the NH my mother insisted I give her her walker and I did. Stupid, bad, mistake–I should have known much better and told her to remain seated.</p>
<p>No sooner than she stood up, she fell on the floor–more kind of slipped against the bed and the walker, not a big fall.
In the hall I found the in house phone and called both the director of nursing and the director of admissions to come down. They spent a long, gentle time trying to encourage my mother to use a strong chair and the bed leg to ease herself into a kneeling and position to get her back into the chair. Apparently, unlike in skilled nursing, they are not allowed to “help” you-you have to be able to do it for yourself (I am thinking, okay, back to the NH, we are going to undue all this costly and time consuming work.) The professionals called 911 and the EMTs came and got her back to her chair. But while she was on the floor, for some reason my mother picked out the young, petite kind nursing supervisor to single out for abuse and was shouting at me Get his woman out of here! Get her out! I never want to see her again! Etc. I spoke so calmly and said things like, Mom, this is a big day for you and you fell and of course you’re upset and scared. But these women are here to HELP you. In just a few minutes you will be back in your chair. Put your head against the bed and relax. She said to me SHUT UP!!!</p>
<p>After the EMT guys got her back in her chair, I suggested to the Director that A be taken to “the great room” and wait till dinner while I finished the room. She said ok and complied so from that point I did not see my mother again. The Director, who was still around at 7, helped me carry empty boxes and suitcases to the curb. </p>
<p>I forget the EARLIER big, big thing that happened. When I arrived back with the movers after lunch, the Director told me there was a problem. She nurse discovered a healing wound on one of my mother’s two purple legs. Wound care is not taken care of in AL. The director talked to both the SW and the MD about the wound. The SW didn’t know about it (hadn’t she read the discharge papers?) and the MD said she didn’t know the rule and apologized. So, I thought, back to the nursing home. BUT the director said, we signed all the papers this morning (two long hours) and paid two months rent and they are KEEPING her but as an exception and from the county visiting nurse assoc having a nurse come three times a wk to dress the wound. The MD told the director it is healing and will be fine (but who knows whom to believe anymore).</p>
<p>So you can see, on admissions today, two events occurred that disqualify my mother for AL,The director and head of nursing, not at all equivocally, but hopefully and reassuringly, made an exception for her and told me they would keep her.</p>
<p>I guess my mother was eating very slowly as usual. It was late, and the Director and I were in her room. I outlined what would be TAKEN away today. She recommended some excellent big changes, which I thought, I am too exhausted to go these things. But I am fine now, and with the moving men, we will do the changes she recommended this morning.
I will have to rush into her house this early am to get a sturdy captains chair - the director showed me a sensible way to eliminate/rearrange so she can take the small table (the kind two two leaves which you can take down and make very small which we will do, but it will give her a place to write. Simply to put the tv in a safer place (above a bureau) the men will have to rearrange three big dressers/hutches, but that is just nothing to them. I will just have to find a way to keep my mother out of the room, even if I wordlessly push her to the great room and leave her there. What do you think? I feel I must tell her that if she continues to make trouble, the CAN and will send her back to the NH, and would she like that? As we parted she Director said to me, oh by the way. I just got a cal from Med management. Your mother is being resistant and giving them a hard time. BUT she was very reassuring to me about the future, truly… /still, I recognize if stuff like this continues and does not stop, papers we signed yesterday said the Plaza can ask you to leave.</p>
<p>What a tiring day. Nice job supporting your mother and working with staff. You kept a lot of balls in the air. Smart to get some set up time with your mother elsewhere. </p>
<p>She is in professional hands and yet, at some point, due to her health status, she may need more care. Given that, it may not make sense to use going to NH as a disincentive for disruptive behavior. Staff is likely to expect some transitions to be more complicated, but “perfect” cooperation may not matter, if down the road, it is determined that she is appropriate for NH care. You don’t want to disparage a level of care that may be necessary. </p>
<p>Is she expected to operate her own wheelchair to meals and activities? Can she? I am trying to understand what the high level of care translates to in this particular AL. Some AL residents find a power wheelchair useful; depends on layout, regulations and her capacity to operate it appropriately. </p>
<p>It will be interesting to see how her needs and expectations match up with staff availability. She is likely used to a different staff:resident ratio at the rehab. All of that just has to unfold over time. You have your plan for today and have accomplished a lot. Glad the movers can help you with the room and that the staff were so supportive yesterday. Today is a new day. Hope you can get some rest and family time soon. </p>
<p>I’m confused that the staff is not allowed to help residents who fall. Isn’t that a common occurrence at AL?</p>
<p>I’m sure the staff is used to difficult residents as to behavior, but It sounds like your mom is borderline for staying at the AL, in terms of her health. Here’s hoping she settles in and gets a little stronger.</p>
<p>I’m not sure we know what challenges Mom faced yesterday and, going forward, how representative her reactions were. Dharma said she wanted NH to have her ready around 815. the implication is that, when Dharma “arrived back with the movers after lunch,” her Mom had been left at the AL-??</p>
<p>What did the frail woman do all day? I’d guess she was mighty frustrated and plenty tired.</p>
<p>Re picking up a resident who’s fallen – I believe the following is law here in CA (at least, two different places told me this). AL/IL is not permitted to render medical aid, except first aid for a minor issue. When a resident falls, or any other situation in which they might be injured, the AL staff does an assessment. If it reasonably appears the resident is not injured – and bearing in mind that not all injuries are immediately visible – they may help the resident up. But if there’s an injury, or there might be, they are required to call 911 and leave the resident in place. They stay with the resident until the EMTs arrive, offering comfort, holding their hand, covering with a blanket, etc. In my experience, they err on the side of caution. We had instances with Dad where the EMTs did nothing more than help him up, after they checked him out.</p>
<p>Thanks, LasMa. That makes sense, sort of. When I was trained in first aid, we were told one of the first things to do (while putting on gloves) was to tell the potentially injured person not to move. We would then assess the situation, while keeping their spine from moving. </p>
<p>But what doesn’t make sense is to urge them to get up by themselves. Either you suspect an injury, in which case the person should be immobilized and not urged to get up, or you don’t, in which case you might as well help them get up.</p>
<p>That’s interesting LasMa. Especially considering that at the AL/IL facility they have RNs and LPs on hand who are much more medically qualified to assess the patient than the EMTs. </p>
<p>I’m not sure that RNs are more qualified to assess potentially injured patients than EMTs. RNs have more training than EMTs, but EMTs are trained <em>specifically</em> to assess people who have suffered accidents and might be injured.</p>
<p>bookreader, Mom’s AL does not have any medical staff. It may be the rule is that non-medical staff may not render medical aid, which in our case means no staff may render aid. </p>
<p>Fang, it was jarring to me when it was first explained, but it does make sense. Plus there would be a huge liability problem if an aide helped a resident up, and it turned out there was a hairline hip fracture or something. But yes, I 100% agree that the one thing that makes no sense at all is urging the resident to get up on their own. As unsteady and shaken up as a resident is after falling, that’s just asking for trouble IMO.</p>
<p>But in this case, Dharma was there when it happened, and was (apparently) the informant, said she “more kind of slipped against the bed.” We don’t know how she described it to the staffers, what they asked, nor what Mom had to say. It’s the sort of thing we can ask about, when we have relatives in AL. </p>
<p>Slipping against the bed will trigger that same response as a keel-over fall. I think the idea is that any time a resident is on the floor, it could be trouble.</p>
<p>The response should either be, “Don’t move, you might be injured, here is a pillow and blanket to keep you comfortable until the EMTs get here,” or “Oh no, you took a little tumble but you’re fine, let me help you get up.”</p>
<p>“You might be injured and need to wait for an EMT, GET UP! GET UP!” makes no sense.</p>
<p>Exactly, Fang. </p>
<p>Dharma, you might want to clarify their policy on falls.</p>