|
By
Marcinho Savant SHREVEPORT, La. --- Whether in hospice, hospitals, nursing homes and rehabilitative skilled nursing facilities, they are intimidating, frightening, and unnerving. Just because you cannot walk so well following a hip replacement, or spinal surgery, does not waive your right to autonomy over your own life, and the manner in which you are cared. There are some facilities, while certainly not all, which are ecstatic to have patients who are unable to speak for themselves, and demand what is right, because they are too old, or in other ways incapable. This, nearly, absolves them from doing the very best job they possibly can. Or so they’d like to think. I have worked in facilities wherein the administration is only truly concerned about meeting the bare minimum requirements per the letter of the code of the state mandates manual. Anything extra, they wholly resented. It annoyed them to have to go beyond the “book”, and really care about patient experience, or outcomes. I quit that facility in short order. If you, or loved ones are in care, you have a responsibility--- an obligation, to speak up for, and demand whatever it is you need, especially where nutrition, hygiene, comforts, or connectivity are concerned. State-based long-term care Ombudsmen are positioned to hear grievances which are unable to be resolved after being professionally, politely brought to the attention of administrators. Their numbers are prominently posted in public hallways in most every facility. It is required by law. Find it the DAY you are admitted to the facility. Use the number if you have a justifiable reason to. It is their sole job, to assure that patient rights are honored, and within reason, met. It WILL annoy many admins who prefer not to rock the boat. Those for whom the status quo is comfortable, and convenient. Remember, however, that while ALL medical facilities are a “business”, there is a fiduciary obligation to make certain that patient needs, beyond the minimums are addressed. It is too bad if your concerns or reports are inconvenient for them. If you feel that your reasonable requests are being shelved or ignored, blown-off or disrespected... You know the number to call. Conversely, I have worked in, or been a patient in, facilities which seem to ONLY care that the patient care experience is nothing but optimal! Ones that treat patients like guests, instead of “residents”. If you think about it, prisoners are technically “residents” of a prison--- whether called “inmates” or otherwise. The patient care paradigm truly must be revised generally, in order to assure that patients do feel like guests in their temporary, or permanent new homes. The top of the line facilities will embrace, and strive for, this paradigm shift with open arms. The low-budget, people warehouses will not. One can drive a Yugo, and some can afford a Bentley. No matter what you can afford, you’re entitled to a car that works, is comfortable, sufficient to your needs, and safe. In some of my recent personal medical care experiences, I have been told by administrators, and staff, that they have “bent over backward” for me. Really? First of all, that is an unprofessional, and unacceptable way to address a paying patient or guest. If asking for some vegetables every once in a while, or for a brighter light bulb in my dark “cave” of a room, or any other minor ask which was clearly perceived as an inconvenience, or a problem bent their spine so terribly, then perhaps an apology is in order, on my part. Clearly, there is a mindset in this region, which seems to say that patients should be grateful for what they DO get, and should accept it. This writer says that that should never happen to, nor should ever be expected of, people of sound mind, and in control of their faculties, even while in care. Clearly, and blessedly, our region, state, and parishes offer some of the very best healthcare available. Much like in any family, however, there are aunts and uncles that never do really quite live up to the family standards, or honor. Lesser relations really should not be given a pass. Most of the healthcare professionals I’ve encountered in work, and patient, situations have been devoted to honoring the nobility of their professions, and their personal moral compass. I have also encountered those that have been shameless, and dolefully harmful in failing to be the best they could be--- for their guests. A patient, or their family, may already be feeling powerless, and overwrought, in adjusting to new medical realities. Shouldn’t the caregivers make every possible effort to console, comfort, serve, and minister to those in their charge? Don’t you love rhetorical questions? Patients have rights, as do their family members. I don’t advise being rude, loud, and combative--- especially without justification. I do however, pray that any person with concerns about the genuine best-efforts, best-practices, and authentic care offered to themselves, or their loved ones, take advantage of appropriate, available, resources, by which to correct such situations graciously, swiftly, and professionally. If you are not proactive, and rigorously vigilant, in getting that to which you are entitled, there really is nobody upon which to lay that, is there? Participate in your care. It can save your life... Or someone you treasure. If you have a question about patient care, or advocacy, please contact the editorial office of The Sun in confidence, with your request, and I will do my best to address reader concerns on the topic in future editions.Your identity will not be published, unless you specifically grant us permission to mention your name, and city information. Contact us by calling (318) 631-6222. ### About the writer: Marcinho Savant, a disabled Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, entertainment executive, and nursing home survivor. Words: 1009 with Boilerplate 9-24-15
0 Comments
You’re Already Sick, but how do you Stay Well?Resident Accounts for the Little Things9/10/2015 By
Marcinho Savant SHREVEPORT, La. --- Haven’t you ever wanted a cold drink so badly, but found yourself without your wallet, a long way from home? There are very few pleasures within the walls of a nursing home/long-term care facility. Sure there are activities. Other residents. Lovely staffers. But sometimes you just want a Peanut Butter Cookie! In a number of hospitals, and skilled nursing facilities in which I’ve stayed, there were frequently vending machines available to residents and staff. For one dollar or less, I was able to purchase a soda, a snack, or even something healthy, like a granola bar. Some facilities provide transportation for “field trips” to a local super store, or casino. It doesn’t feel nice to not be able to take advantage of those provisions occasionally. It goes quite a way to making “homes” more bearable. I DO NOT recommend giving cash to residents, as sometimes things do go “missing”. Family members can easily, however, swing by the facility’s business office, and place money into their loved one’s “account”. The patient will sign for the cash, and are generally provided a receipt for the transactions. There are usually limits as to the amount a resident may take out per day, and when they leave the facility for good, all monies accumulated on their account will be refunded. I have used my account for many purposes, including the in-house hair salon, vending machines, in-house “stores”, food delivery, and other items. Many ladies paid for nail care as well. One of my friends at my care center was so glad to be able to go on the trip to the big box store, and buy a DVD to watch on the computer in her room. It is an escape on two levels... The trip, and the movie. All she had to do was stop at the window, and make a withdrawal. Civilized. One may not always be able to control being able to stay at home with family and loved ones. Sometimes we are placed in facilities for the purpose of getting the care that we need. Being in a place, twenty-four hours per day, seldom getting off property, can take its toll emotionally, and physically. The ability to determine, even the smallest of, decisions, lends a comfort to retaining some form of control over one’s life. Family members with dear ones who are of sound mind, should consider making weekly, or monthly, deposits to the resident’s account. It feels really good to be able to treat one’s self to a cola now and again. If there are no medical, or dietary restrictions on the resident, giving them a small, sufficient, amount of money helps them to feel empowered, and able to participate in the betterment of their time there with the simplest pleasures. If you have a question about patient care, or advocacy, please contact the editorial office of The Sun in confidence, with your request, and I will do my best to address reader concerns on the topic in future editions.Your identity will not be published, unless you specifically grant us permission to mention your name, and city information. Contact us by calling (318) 631-6222. ### About the writer: Marcinho Savant, a disabled Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, entertainment executive, and nursing home survivor. Words: 602 with Boilerplate 9-10-15 By
Marcinho Savant SHREVEPORT, La. --- Some residents of nursing homes, and long-term care facilities, are married or in meaningful relationships. In a 2007 study published in the New England Journal of Medicine (http://bit.ly/NEJMElderly) it is reported that 53% of people between the ages of sixty-five and 74 are sexually active. Despite this number decreasing to 26% for individuals aged between seventy-five and 85, sexual desire is present long into the lives of the aging. It is a safe supposition that the numbers break similarly in nursing homes, and long-term care facilities, which may, or may not, include geriatric patients. Even though we are all aging, it is scientifically borne out in the above-referenced study that our need for intimacy exists long into our later lives. So how then, as uncomfortable as it may be for some of us to discuss, or ponder, are our loved ones able to continue to maintain their life-affirming loving relationships, while in care? This is, clearly, a delicate subject, but nevertheless a fact of living. Intimate relationships of our loved ones, are a fact of life, and a factor of a beneficial quality of life for us all. When dealing with elderly parents, it is vital to recognize that the needs they had as younger people, may have presence in their current lives. It is irrational to believe it reasonable to interfere in the personal intimacies of consenting adults, who are of sound mind. It is their life, after all. As it turns out, married couples in Louisiana which are separated by admission to long-term care facilities, are, in fact, permitted to participate in conjugal visits with their spouse, provided that the resident of that facility is of sound mind, and able to consent to, or request, such visitation. "The nursing home is the resident's home. We want nursing home residents to have the freedom to make choices about the aspects of their life that are significant to them. Residents have a right to privacy that includes visits from spouses and others", said John Ford, a spokesperson for the Louisiana Department of Health and Hospitals in response to my questions. While the state does offer assurance of intimate visits for residents in care, each facility may have its own rules regarding same. Please discuss this with the director of resident services or at the care plan intake conference, before admission, so that appropriate arrangements can be made. Provided a resident meets those criteria, according to Diane Crouch, Ombudsman Coordinator at Caddo Council on Aging, “The facility is obliged to provide a private space in which such a visit would occur.” The Ombudsman’s office exists to assure, and advocate for, the rights of the resident, in all manner of concerns. I wasn’t certain what to expect when I called her office, but was greatly relieved to have been greeted with her professionalism, candor, and the dignified treatment of my question. There are some restrictions to the privilege of intimate visitation, however. For example, if it comes to light that the spouse, or partner, of that resident had been abusive, unkind, dangerous, violent or, in any other way, undesirable to the resident prior to their admission to care, that resident has the right to refuse any such visits from that spouse. The facility is, therefore, obligated at all times, to assure the safety of that resident. Inclusive of taking measures to prevent access by the unapproved spouse. All the aforementioned conditions apply, equally, to the intimate visitation of the unmarried, intimate, partner of the resident in care. There are few significant rewards in life as we get older. Maintaining important physical and emotional human connections has just as much value to every adult... in the youthful, middle, or elder times in living. Human touch, and emotional closeness are immeasurably vital to a complete life. As long as the partner is not harmful, or dangerous, to the resident in long-term care, don’t they deserve happiness as much as anybody else? If you have a question about patient care, or advocacy, please contact the editorial office of The Sun in confidence, with your request, and I will do my best to address reader concerns on the topic in future editions.Your identity will not be published, unless you specifically grant us permission to mention your name, and city information. Contact us by calling (318) 631-6222. ### About the writer: Marcinho Savant, a disabled Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, entertainment executive, and nursing home survivor. Words: 764 with Boilerplate 9-03-15 By
Marcinho Savant SHREVEPORT, La. --- Despite the enactment of the Affordable Care Act (A.C.A./“Obama Care”), there remains a substantial number of people who have chosen not to apply for health care. If you are in need of care, are underemployed, retired, disabled, et cetera, isn’t it wise to apply immediately, for the coverage that a large number of US citizens enjoy? In my case, I was ineligible for the ACA program, because, as a disabled person, I was already covered by Medicare, and Medicaid. With supplemental insurance bridge, and long-term care policies, at my expense, I was fortunate enough to have my recent medical bills covered for the parts my insurance did not. In the past seven months, so far, my medical bills (surgery, hospital stay, rehabilitation, therapies) exceeded $270,000.00. I humbly advise everyone to check their eligibility for any assistance available. If you are, or care for, someone elderly or disabled, it is worth it to contact your local Medicare, or Medicaid office--- particularly if you are in financial need. Help may exist for you that you don’t know was available. There is help for people caring for loved ones... Sometimes you just need a break. A moment away from the challenges of taking care of another person. If you care for someone elderly or disabled, there are programs to assist you as well, such as Respite Care, which has someone come into the patient’s home, and give the resident/family caregiver a break. Carers get opportunities to go shopping, to appointments, dinner, a movie... Anywhere that will offer them a break from the daily responsibilities of caregiving for a loved one. A good place to start is the Caddo Parish Council on Aging. They are a clearing house of helpful information, and referrals, to various agencies and organizations in existence to help those in need. The non-profit is located at 1700 Buckner St #240, Shreveport, LA 71101 Their number is (318) 676-7900. You may visit their website at http://www.caddocouncilonaging.org. You can reach the Shreveport offices of Medicare at 1240 S Pointe Parkway, Shreveport, LA 71105. Their toll-free number is (877) 319-3074. For local Medicare assistance, please visit their office at 3020 Knight St., Shreveport, LA 71105. Their free phone number is (888) 342-6207. There is no crime, nor any shame, in needing medical help. In this writer’s opinion, the worst crime is not seeking the help one needs. Isn’t it worth a phone call, or a visit to find out? ### About the writer: Marcinho Savant, a disabled Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, executive, entertainment expert, and nursing home survivor. Words: 457 with Boilerplate 8-27-15 By
Marcinho Savant SHREVEPORT, La. --- Doctor’s appointments, making groceries, maybe just an afternoon with friends, or family. I know that I, as a disabled person, am always hesitant to impose upon others, if I can make my own way. Fortunately, I’ve recently learned about two resources in the area for transportation which give me my independence, dignity, and autonomy. It is to anyone’s advantage to register for these services, if you’re eligible. Or to know about them, even if you don’t need them quite yet. Let’s say that you have a weekly appointment with a medical office... If you’re elderly, disabled, and without a vehicle--- or all three; there are options available to you. If you’re on Medicaid, there is a company, that dispatches dozens of medical transport companies throughout northwest Louisiana, including all of Shreveport-Bossier. You must call to schedule the ride two full days in advance, and typically, must be up, dressed, ready, and waiting, two hours before your appointment time. There is an intake process with this company, in order to determine what type of assistance or equipment is required by the patient/passenger. This company is only for medical transportation and only for current LA Medicaid-registered individuals. This round-trip transportation is free to the passenger. They will ONLY schedule rides with TWO DAYS NOTICE. Period. They MAY make exceptions for chemotherapy, or critical appointments. Southeast Transportation can be reached at: 1-855-325-7565. They would be able to let you know how to register, participate, and schedule rides. The city of Shreveport, via SporTran’s “LiftLine” program (http://bit.ly/LiftLine), offers transportation for the disabled as well, and an application process is also required. More flexible, this local service is not restricted to medical appointments only. The pharmacy, grocery store, mall... LiftLine will typically transport eligible riders to most destinations within the city limits of incorporated Shreveport. The current fare is $2.50, each way. One additional benefit is that the subscriber is entitled to have a companion accompany them on the rides as necessary. This added traveler must be mentioned at the time of scheduling the booking. If you have a printer, you can download the LiftLine application (http://bit.ly/RideApply) and mail it in to their offices. If you have questions, they can be reached by phone, at 318-673-7415. Though is is a great help to have these resources available, here’s what I’ve learned: Rides are not always on time, therefore, bring your next dose of medicine with you, in case your rides are delayed. If you are delayed, and stuck in a doctor’s office, bring a light jacket or sweater to combat the chilly air conditioning. Bring your phone charger with the AC outlet adapter. If you’re diabetic or hypoglycemic, bring a nutritious snack so that your levels maintain healthily. Bring a book, this column, some bottled water, hand sanitizer, an extra pull-up undergarment. Try to think ahead and anticipate your needs, in the event of a “glitch”. Always bring the name and number of the driver, or transport company with you in case there is a problem of any kind. As wonderful, and convenient, as transportation services are, they are unable to guarantee pick up, and drop-off times, as the rider before you may have had some issue(s) which delayed the driver. Having spoken with several drivers since I personally began using transport, I can tell that they really are dedicated to getting people to and from their appointments in as timely a fashion as possible. Things happen. To be prepared, packed, and comfortable in those times, will make your transportation experience much more bearable. ### About the writer: Marcinho Savant, a disabled Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, executive, entertainment expert, and nursing home survivor. Words: 657 with Boilerplate 8-20-15 By
Marcinho Savant SHREVEPORT, La. --- No one should be surprised that foods in hospitals, and nursing homes, do not rival the finest restaurants in the world. Their function is to deliver nutrition to their patients, three to four times per day. In my experience in the nursing home I just escaped, the food they served was dangerous for me. At least three times, they served me corn dogs, macaroni and cheese, and corn on the cob... To a diabetic! Hardly nutritious. They will tell you, themselves, that they are required by law to present trays to you at mealtimes, whether, or not, you plan to eat it. Nursing Assistants are required to chart the intake of food and liquids of every patient. Some do not--- at least not accurately. So how do you monitor, and keep aware of what, and how, your loved one is eating while in care? We all have busy lives, but our loved ones need us even more importantly, when it comes to nutrition. The meal I described above was hardly high in nutritional value, and only represented fattening, filling, foods. Some institutions are alleged to make sure to feed high-fat, high-carbohydrate meals, in order to keep patient weights high on state reports. Dropping patient weights in geriatric care, not due to a medical condition, are highly undesirable in facilities’ reporting to the state. Make it a point to visit the facility frequently to see for yourself what the meals are. Ask to speak to the dietitian, to ask questions, or notify them of your loved one’s preferences. The facility is responsible for cranking out meals for dozens, to hundreds, of other residents. It can’t hurt to ask. Maybe they’d make an effort to do some nice things for your family member, or friend. Ask your loved one about their meals. Do they like them? What is wrong with them? Ask to be shown the mealtime intake, and output, charts which should be being kept for each patient in their care. If your patient is not eating enough, who on the staff is responsible for feeding them. Typically, it is the nursing assistant’s function to assist “feeders”, or people who require assistance in eating. Some residents are fortunate enough to be able to have alternative meals brought to them from the outside. Many are not. If not medically restricted, maybe making some condiments available in their room can make the food more palatable for them to eat. If your loved one won’t eat for anyone but you, or someone they know, it is vital to create a schedule where loved ones can fulfill that role. If you are not satisfied with the level of dietary care, and service provision, take time to bring it to the attention of the facilities administrators, or department heads. It is fair to give them every opportunity to try to do something to make your loved one’s experience better. If you receive no satisfaction, after having spoken to the appropriate people in the facility, every patient-room hallway, and public areas, should have a poster displayed prominently on the wall. It will display the telephone number of the state Long-Term Care Ombudsman (patient advocate) which will then put you in touch with the specific Ombudsman assigned to that specific facility. That number is there to help the patients and residents. Ombudsmen are individuals who are trained to respond to the problems and needs of residents of nursing facilities and other long-term care facilities. Ombudsmen respond to any problem, complaint or concern a resident may have. Common problems are with the quality of care, food, finances, activities, visitation, and the ability to exercise their rights as a resident or citizen. Anyone who has questions or concerns about the care or treatment a resident is receiving should contact an ombudsman. Many administrators dread the involvement of the state advocate, and are inclined to pay attention once they know that you KNOW whom to call! Don’t, however, cry “wolf”, or abuse that resource. If things are bad, there is help available to you. If you already are having legitimate trouble with an institution or facility, have attempted to clear it up--- through proper channels--- with no results, the telephone number for the Louisiana nursing home/health care Ombudsman is (866) 632-0922. See the Ombudsman frequently asked questions page, online, at bitly.com/OmbudsmanLA ### About the writer: Marcinho Savant, a Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, executive, entertainment expert, and nursing home survivor. Words: 777 with Boilerplate 8-13-15 By
Marcinho Savant SHREVEPORT, La. --- Things slip through the cracks. Companies are staffed by humans, and as such, mistakes happen. If an employee at a burger joint burns the fries, there’s really no true harm done. Unfortunately, in a healthcare venue, mistakes can be fatal. Whether a patient in a hospital, or a resident in a care facility, both of which I’ve recently been--- here are some tips. We have a responsibility to be active in our own care to every extent possible. One nurse, at the facility I just left, was training a new nurse. She told the newbie, “...and this guy, he’ll keep you straight. He is aware of every pill, every thing, he puts in his mouth!” And she is correct. Any medicine cup they handed me, I looked inside and made certain that it was for me. I caught a, minor, mistake that could potentially have caused a problem. Accidents happen. Nurses are very hard-working healthcare professionals. I’m unable to passively relinquish all aspects of my care to another human being. I must, and did, remain actively involved in my care. Some people began to see me as a “... pain in the butt who stays on the light!” I am the patient. I have rights. If my insisting that I got the care to which I was entitled was a bother to my caregivers, or facility, that was not my problem. If assuring that I got everything I was paying for was a pain for them, oh, well. PATIENT INVOLVEMENT: 1. Press the call-light to get refills on water and ice as you need them. In work of mine in facility care, we did rounds every two hours. In the last place I was in, people only came to assist me when I pressed the call button, or to deliver meal trays. I was under orders to drink more water, but the aides brought my cup filled with ice... But no water. Leaving me forced to wait some time for the ice to melt in order to take sips. 2. If an aide or orderly is causing physical discomfort, pain, or makes you uncomfortable in any way, report it to the charge nurse, who will do something about having that worker reassigned. 3. Professionals have dozens of patients/residents to tend to. Wait a reasonable time between summoning attention. I have given between fifteen and 45 minutes for someone to respond to me. 4. Program the ward clerk/nurses’ station number into your phone’s speed-dial. For whatever reason, an aide might be detained. In urgent situations, I was grateful to be able to call the desk. I never abused it, but used it when necessary. Don’t cry “Wolf”. 5. Ask for dietary accommodation. Your body tells you what you lack. Pay attention. It is often shown through cravings. Ask the dietary department to try to accommodate your needs. Your loved one may not be able to self-monitor. Spend a day off, at their bedside, to see how they are cared for from sun up to sundown. ### About the writer: Marcinho Savant, a Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, executive, entertainment expert, and nursing home survivor. Words: 555 with Boilerplate 8-6-15 By
Marcinho Savant SHREVEPORT, La. --- Having just spent six months in an area nursing/rehabilitation center, I have fresh experience in managing self-care. My goal is to share everything I’ve learned with readers, so that they, too, can remain in charge of their health care, treatment, and comfort. Not just for themselves, but for their loved one’s as well. Not all care facilities are bad. The one I stayed in was marginal. Fair. It was not extraordinary. I found myself there due to a recommendation of somebody else. My urgent surgery required immediate physical therapy for recovery. It was a nightmare. The administration expressed, and demonstrated, their displeasure with my observations, but that’s all right. I’m the patient, and patients have rights. Each of us, at some time, may be faced with the challenge of managing the care of a loved one, or ourselves. Do you know what to do? What your rights are? Who to call for help? I will share this information with you. To begin: CHOOSING A CARE FACILITY
Remember that as a resident, you have the right to have your needs met. ### About the writer: Marcinho Savant, a Shreveport/Bossier resident, is a former health care worker in both private-duty, and institutional care environments. He is an author, executive, and performing arts expert. He has expressed a desire to write a recurring column on the subject of health and self-care for the residents of Shreveport/Bossier, if there is a need. There is much to learn about the topic. Words: 573 with Boilerplate 7-23-15 |
WriterMarcinho Savant, a Shreve Archives
September 2015
Categories
All
|
RSS Feed