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Topic Nursing home dumping Go to previous topic Go to next topic Go to higher level

By cjsparrow On 2009.08.18 17:10
My dad has suffered from PD for about 15 years and is in an advanced stage. Mom could not take care of him any longer and we put him in a nursing home. He is young compared to most in the home. About a year after he was admitted he was "dumped" on an emergency room uder the accusation that there was an incident some months ago where he took the hand of another patient and put it on himself in an inappropriate place. The home said this just came to their attention and they wanted to reduce his sinemet because they felt he was on an abnormally high dose and this was causing some innapropriate behaviors. I said "give me 24 hours and let me consult his doctor and his neurologist and I'll get back to you. They kicked him out saying the family "refused to reduce his sinemet" and he could not stay there any longer because he was a "threat to the other residents". The psychiatric nurse at the ER exanined him and said there is nothing wrong with him, the Dr.'s refused to admit him to the hospital because he wasn't sick and wouldn't admit him to the psych unit because he did not qualify. The home refused to take him back. He was stranded in the ER for 24hrs with them ill equiped to handle his needs. After some back and forth between the psych unit and the home, the psych unit agreed to evaluate him. They found out nothing other than normal parkinson's related hallucinations, dimentia, etc. His nerologist said at this stage the level of sinemet would not change a thing. No other quality nursing homes will take him because he is labeled.
The other person involved in this alleged incident is not credible as she has dimentia. My opinion on this is the head nurse on a power trip. Every time he has a hallucination(he called the humane society to come out to get rid of the wild cats in the home) it caused her to do paperwork. I'm sure calling 911 to report he was being held prisoner and her having to woken up at 3am by the cops did not endear him to her. It's like they don't realize he has dimentia too. Like they have never read a book on pd.

I believe many homes do not understand Parkinson's. That PD patients eventually need care that homes have to struggle to provide and at the first chance to get rid of a hard to take care of patient they will for an easier to take care of patient.

Has anyone experienced anything like this? We are helpless and dreading seeing dad put in a home nobody else wants. Any help appreciated.

By annwood On 2009.08.18 20:15
So sorry that you are going through this. If you read my post of 2 yrs ago you will see that I experienced the same problem. I was shocked at the time because I had never heard of a nursing home kicking someone out - I thought that taking care of people was their job. In my case it was also a nurse that was responsible and she actually lied to my face at the discharge conference. I had my husband's neurologist admit him to the hospital under the guise of getting his medications straightened out (I actually had to call the Chairman of Neurology to get this done which really endeared me to the neurologist). It then became a real problem with placement because I would not agree to a feeding tube and no facility would take him because of his swallowing issues. I brought him home, got Hospice involved and hired a home health aide for 8 hrs/day - he passed away 3 months later. I really don't know how much longer I could have taken it because I was exhausted.

I agree that most nursing homes (and ER's) have no idea how to care for a PD pt. They have a 2 hr window either way to give meds so a pt can get meds 2 hrs early or 2 hrs late. This does not work with PD meds as I'm sure you know. No amount of explaining could convey this or perhaps they just didn't care. Common sense says give critical meds on time and let Mrs. Smith have her multi vitamin late or early.

That being said, I think there often comes a time when placement is the only option. Just know that it is not ideal and they will never get the same care as at home.

By susger8 On 2009.08.19 08:00
Great advice from annwood.

The only thing I have to add is that you might be able to find a "care home" for patients with dementia, if your father doesn't need skilled nursing care. I found one by accident (driving by it). This is a small facility (this one only has 15 residents) with a high staff-to-resident ratio, and is primarily for Alzheimer's patients but takes people with other types of dementia. The one I looked at is NOT a skilled nursing facility, and is meant for people whose other health problems are not too severe, but they will take care of patients for their entire lives if the amount of care needed is not too intense.

This one is private pay only, they don't take Medicaid. It's a very homelike atmosphere. Unfortunately, the point at which I would be looking for somewhere for my dad would be when he's completely bedridden, and I don't think he would qualify. I'm keeping it in mind for my father-in-law, who appears to have early Alzheimer's.


By WitsEnd On 2009.08.19 09:30
They wanted dad to go to a geriatric psychiatric unit to "adjust his meds". I refused. I told them they could have the visiting physician adjust the meds and that he needed closer supervision until that happened. We agreed he would have sleeping pills at night to reduce the wandering. He couldn't call anybody because they weren't allowed phones. If they wanted to talk to somebody or somebody wanted to talk to them, a portable phone was used that was distributed by the staff. If he pitched a fit and trashed his room, they let him. When it was over they cleaned it up.

They had video cameras that monitored so if unusual behavior was noted--you could see it. We changed his room so he could be closer to the center of activity which made it easier for him to be watched more closely.

Things sorted themselves out in a few weeks. Dad was also at one of the smaller "personal care homes". The home kept dad until the end--which would have worked out fine except I had a bad hospice that didn't do what they were supposed to do and I had to scramble to find nursing help at the end. If I had picked a different hospice that would not have been a problem.

By lynn On 2009.08.20 20:14
the nursing home I've identified specializes in alzheimers and dementia. I'm hoping they will be able to handle PD.

By susger8 On 2009.08.21 08:12
That sounds good, I think they should be able to handle PD.

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