What can I do?

[no_hypocrisy]

My former boss has a neurological condition. He lost his fine motor skills (e.g., buttoning his shirt, typing) but could manage.

He went into rehab for a while but was transferred to a nursing home. He isn't even 75. This was 2-3 weeks ago.

Our mutual friend went to visit him but could barely recognize him. The nursing home put him in a wheelchair and he was sleeping when he never was sleeping (about 2:00 p.m.) and couldn't be roused.

I think the nursing home put him on tranquilizers or something like that to make it easier to take care of him. But he wasn't disabled beyond what I described above. He had cognition, alertness. He was adverse to boredom. This doesn't sound like him.

Plus, our mutual friend quoted him, stating he would like some physical therapy. If he's denied that treatment, then I have really wonder what's going on.

Nobody advised him that he was being put in a home to die, sooner than later.

If he is on unnecessary medications, is there a patient advocate at nursing homes or what can his family do?

[elleng]

1. Depends on terms of his 'agreement' to enter the nursing home.

He and/or family should be consulted and INFORMED about his apparent status ASAP. As to advocate, depends on the locality.

Facilities of various types, rehab/nursing, etc, WILL use meds 'unnecessarily' to make their jobs easier, I was advised, when my mother declined.

[Princess Turandot]

2. You may not have this information, but is he in the nursing home as a Medicare patient?

Medicare pays for skilled nursing home services if they are considered 'restorative', following an inpatient hospital or an acute inpatient rehabilitation stay. The nursing home needs to have a treatment/care plan for him for Medicare purposes since the goal is to help them get back on their feet. (They should have a care plan, of course, under any circumstances).

Who is his next of kin? His spouse or adult child should ask to meet with someone at the facility to understand what the treatment plan is for him, along with your ex-boss, if he is able. They could ask to meet with the physician in charge of his care: patients in nursing homes don't usually get much hands-on physician services in the facility itself but there is a physician responsible their overall care there.

Also, when my mother was in a skilled nursing facility following a stroke, it was the social services department that we had the most day to day interaction with, sometimes at my instigation and sometimes at theirs. They were very helpful. So that's another possibility.

[JayhawkSD]

3. Your concern is kind and becomes you.

But there is great danger in playing doctor without a medical license. You do not know what his "neurological condition" is. You "think the nursing home put him on tranquilizers or something like that to make it easier to take care of him," but on what are you basing that conclusion? Not knowing what his condition is and not being a doctor, you cannot know if the condition is one which becomes worse due to natural progression or not.

You mention family. Presumably his medical providers are consulting with his family. They are not allowed by law to consult with you, nor to accept input from you as to his care.

You are a former employee, and it is one thing to care about him, but it is quite another to interfere in his medical care with neither authority or responsibility.

Again, I do not mean this as criticism. You mean well. But sometimes all we can do is offer kind thoughts and, if such is our way, prayers.

[No Vested Interest]

4. Most likely his neurological condition is progressing, and, in addition, he may be lacking

mental stimulation. He may also be having trouble adjusting to the new situation and may be depressed, or confused.

Medicare only pays for physical therapy for a certain period - say one month; then the patient is assessed to see if more improvement is to be expected; if not, therapy is discontinued.

A nursing home should have activities available to residents daily.

The presence of family and friends is all important to a nursing home resident, in order to support the resident, but also to exhibit to the nursing home that someone/family/ friends are interested in seeing that the resident is given proper and sufficient care. Usually the nursing home welcomes visitors. Perhaps sharing a meal with him would be a good way to spend time with him.

My spouse was in a nursing home because of a neurological condition for six years, until his death. It was difficult for him; he never wanted to be there, but the conditional was such that he would not have lived without the care and routine he had there. Family visited every day, mostly at mealtime.

[no_hypocrisy]

5. Agreed about my status and not enough information.

I called the county Division of Aging. It was suggested that my boss's family utilize the social workers at the Home. If that is not satisfactory, then to call the State's Office of the Ombudsman. (One number for questions, another for complaints).

I'm sharing this in case any of you have (or will have) a similar situation.