My father passed away this week....

  1. Here's the situation: my dad's in a nursing home. In November (I think) he suffered a small CVA which affected his left side. The nursing home was careless about checking his skin integrity and repositioning him, so he subseqently developed a Stage 4 pressure sore on his left buttock. He's been bedridden ever since, and on a vac pump. Nice move...take an elderly man with dementia, confine him to bed 24/7, ALONE in his room, with only the boob tube and the occasional visitor for stimulation! :angryfire

    So, yesterday, I get a call from the NH saying that he's too heavy care for them, and they would like us to hire a private caregiver 4 hours a day to feed him, bathe him, etc. He eats very slowly, and it takes 45 min. just to feed him one meal. My brother called the agency they recommended, and they're asking $19.50 an hour for a health care aide. I did some math in my head, and said, "Hmmmm....that's pretty good money, very nice hours...hey, Bro, how'd you like to hire your sister to do the job??"

    I'm an RN, and I do homecare nursing, which, of course involves evenings and weekends. My schedule is very unpredictable, and sometimes days stretch past 5 pm, or start before 8 in the morning, and I'm paid per client, so my income is far from stable. To have a guaranteed, stable income, and still have enough time in the day for other things (looking after my sick husband, for instance, who's had a heart attack, stroke, and been dx. with Ca. of the bladder) would suit me just fine. To be PAID to look after a family member, and make sure he's getting the best possible care would be even better! Now, there's still the issue of who would look after my husband while I'm with my dad, but that's going to be an issue regardless of where I work, and it will be a lot easier to deal with if I have stable hours, instead of working 6 hours one day, and 10 hours the next, as often happens in my nursing job.

    So, what d'ya think? Am I nuts? Maybe I could still do some evenings and weekends, to keep my hand in and my skills current with the nursing....
    Last edit by Jay-Jay on May 7, '04
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  2. 36 Comments

  3. by   traumaRUs
    I say go for it! You know your dad will get good care and if it doesn't work out, at least you can buy some time. Take care...it sounds like you have your hands very full. Please take care of yourself!
  4. by   SmilingBluEyes
    I agree w/trauma nurse. I think you CAN do this, ifyou have the energy and drive (and it sounds as if you do). I think you want to do this also. I know you are under no illusions it will be easy, but you can do it.
  5. by   Cheerio
    Sounds wonderful Especially being able to spend more 1 on 1 time with your Dad, and know he's being cared for properly.
  6. by   Tweety
    Sounds like a good job to me.
  7. by   Nur_1996
    Sounds good, however; taking care of your own is very stressful at times.
  8. by   ktwlpn
    Quote from Jay-Jay
    Here's the situation: my dad's in a nursing home. In November (I think) he suffered a small CVA which affected his left side. The nursing home was careless about checking his skin integrity and repositioning him, so he subseqently developed a Stage 4 pressure sore on his left buttock. He's been bedridden ever since, and on a vac pump. Nice move...take an elderly man with dementia, confine him to bed 24/7, ALONE in his room, with only the boob tube and the occasional visitor for stimulation! :angryfire

    So, yesterday, I get a call from the NH saying that he's too heavy care for them, and they would like us to hire a private caregiver 4 hours a day to feed him, bathe him, etc. He eats very slowly, and it takes 45 min. just to feed him one meal. My brother called the agency they recommended, and they're asking $19.50 an hour for a health care aide. I did some math in my head, and said, "Hmmmm....that's pretty good money, very nice hours...hey, Bro, how'd you like to hire your sister to do the job??"

    I'm an RN, and I do homecare nursing, which, of course involves evenings and weekends. My schedule is very unpredictable, and sometimes days stretch past 5 pm, or start before 8 in the morning, and I'm paid per client, so my income is far from stable. To have a guaranteed, stable income, and still have enough time in the day for other things (looking after my sick husband, for instance, who's had a heart attack, stroke, and been dx. with Ca. of the bladder) would suit me just fine. To be PAID to look after a family member, and make sure he's getting the best possible care would be even better! Now, there's still the issue of who would look after my husband while I'm with my dad, but that's going to be an issue regardless of where I work, and it will be a lot easier to deal with if I have stable hours, instead of working 6 hours one day, and 10 hours the next, as often happens in my nursing job.

    So, what d'ya think? Am I nuts? Maybe I could still do some evenings and weekends, to keep my hand in and my skills current with the nursing....
    HO!!! Hold on a second.. :angryfire . It is my understanding that when an LTC admits a resident they are accepting the responsibility of supplying all care that this person may need...I have seen situations in which we have had to assign cna's 1:1 with certain residents....What would happen if your dad had NO family and NO money???? jay jay this makes me SICK!!!! :angryfire I would follow up with administration and then the ombudsman.They should be standing on their heads to make sure your dad is well cared for-especially after the pressure ulcer. Maybe you would be better off taking him home-if you have a good support system and other family members ready to step up and share the responsibility either financially or physically...He may qualify for the waiver program-check it out with the office of the aging(round the clock care in his own home)....That would be awesome for you all------I wish you could bring him to my unit-I have 4 empty beds and the very BEST aides.......Please update us....and take care of yourself......If you make yourself sick you'll be no good to either one of your men....
  9. by   LauraF, RN
    I can not believe that a long term care facility would say something like that! If they do not have the staffing to take care of your father they should not have accepted him as a patient. Those nursing homes get paid good money. I would look at the following:

    1. where will your health insurance come from?

    2. what are the legal ramifications, ie: liability

    3. what if there is a code? Are they going to expect you as an RN to do anything? What if it is your dad who codes? What are your responsibilities going to be?

    4. will you be considered in their staffing ratio?

    5. aren't LTC's by law required to provide care for patients? ie fine lines in medicare and medicaid.

    I think it would be a lot to deal with to bring him home. Having a sick Dad and spouse would take it out of you. How does the rest of the family feel about this situation? Should he be transferred to another facility that can better provide for him? I am soo sorry that you are having to make this decision. Weigh your options carefully. I'm sure you will make the right choice.
  10. by   colleen10
    I guess I'm confused about a few things.

    Isn't it the Nursing home's responsibility to see that he is completely cared for? Why should you or your family have to pay for extra care? Isn't that what the care facility is supposed to be taking care of? It's one thing to go ahead and schedule extra care on your own to be sure that your father is receiving a lot of one on one care and surpassing all of his basic needs but another if the nursing home is charging you extra for care that he should allready be receiving.

    Also, who exactly is paying for this extra care?

    Lastly, just because this "other agency" charges $19.95 an hour does not mean that is what the aide that actually does the work gets in pay. I would not doubt it if the aide doing the work only sees half of what is charged the family.
  11. by   jemb
    I also believe that the LTC is responsible for his care. The suggestion of contacting an ombudsman was a good one. The facility is getting paid for his presence there, isn't it? Grrrr....

    Also, generally an immediate family member is not eligible for private duty pay, so you might not even be eligible for pay if you took the responsibility. I realize that it may be different in your location, but that is definitely something to check out.

    Many ((((((hugs))))) and positive thoughts sent your way. You've had a lot to deal with lately.
  12. by   Jay-Jay
    Y'know, I really don't have the energy to fight this one. I'm committed to going back to work at my nursing job, and since we've got staff off on sick leave unexpectedly, I think they'd strangle me if I said, 'soorry, changed my mind!"

    I just passed the buck to my brother, and said, "It's going to help...even if they do move him to another floor, he won't get the same level of care he would from a private nurse. Just go ahead and do it."

    My parents have saved their whole lives, and put money away. Why not use it for their comfort in their old age? He'll be 90 in May...how much longer has he got? He's been going downhill steadily since being admitted (mental deterioration, lack of blood flow to the brain).
  13. by   ktwlpn
    Quote from Jay-Jay
    Y'know, I really don't have the energy to fight this one. I'm committed to going back to work at my nursing job, and since we've got staff off on sick leave unexpectedly, I think they'd strangle me if I said, 'soorry, changed my mind!"

    I just passed the buck to my brother, and said, "It's going to help...even if they do move him to another floor, he won't get the same level of care he would from a private nurse. Just go ahead and do it."

    My parents have saved their whole lives, and put money away. Why not use it for their comfort in their old age? He'll be 90 in May...how much longer has he got? He's been going downhill steadily since being admitted (mental deterioration, lack of blood flow to the brain).
    I understand that you are exhausted...But what happens to your dad if the money runs out before he does? I just think that this is fishy,honey......What happens to the rest of thoses residents? I don't like this at all.....but you have to do what is best for all of you...
  14. by   SmilingBluEyes
    by the way, I think you are WONDERFUL to consider doing this. Just wanted you to know....

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