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Is Weed the Solution to Our Nursing Home Quality Problem?

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By Steve Moran

Please allow me a little tongue-in-cheek latitude here . . .

A few weeks ago, we (my family) found ourselves needing to move my mom from an acute hospital to a lower level of care. She could have gone either to assisted living or skilled nursing. Our thinking was that skilled nursing was a better choice because she was eligible for up to 100 days of Medicare-funded rehabilitation therapy. You can read about my search for just the right nursing home HERE.  

I am getting to the weed part . . .

I Screwed Up The Choice

I confess here that I blew it big time. I went to the chosen nursing home and it was bustling with activity. The front desk and marketing folks were great. They told terrific stories. It SEEMED like the right choice.  

I had the first hint that I made a bad decision when the ambulance rolled up about 7:30 PM in the evening to move my mom in and all the staff cared about was getting the initial paperwork done. No one from the nursing home even bothered to go in to help the transport crew settle my mom down. The nurses at their station never even looked up.   

We tried to tell them mom was a fall risk and they didn’t care. They are, they said, a “no restraints” facility, so she was on her own. They said that the 2 CNAs and 1 LVN on the floor would “check on her frequently”, I guess to pick her up off the floor. I was already cringing at my decision but felt stuck.

In the background was a constant din of unanswered call lights. I peeked down the halls and could see at least 4 lit dome lights. The CNAs were scrambling as was the LVN passing meds. The RNs were oblivious. In fact we never saw an RN get up from behind the nurses station desk in the 10 days and many visits while my mom was there.

It never got any better!

A couple of days later I was visiting her and she needed help getting to the bathroom. We hit the call button and I started my stopwatch. It was 12 minutes before someone responded. That is more than enough time to cause a soiled bed or to ensure residents will try to get to the bathroom on their own.   

It never got any better!

At the one week mark we had a care conference that I expected to be attended by some folks who could make a difference. My wife and I both rescheduled work to be there. Nope, it was a hurried affair in mom’s room with the social services person and one therapists, both of whom seemed to want to be done with it as soon as possible. They conferred with one another and told us they could justify keeping her one or two more weeks. No dietician to discuss her special diet, no charge nurse, nothing. It was over in three minutes.

It never got any better!

They told us she was eating about 50% of the food she was being served but, based on what we saw on her trays, this was far from true.

When we asked mom how she was doing, she replied, on several occasions, “They sure don’t like to be bothered around here.”

She was supposed to be on oxygen but never once when we came in was her oxygen in place. In fact, the oxygen tubing was usually on the floor, often under the bed and, once, wrapped around the arm of a chair across the room. When I asked the nurse at the desk (she never came down to the room), she said my mother was doing that herself.

It never got any better!

After 10 days we made the decision to move her. She needed more personal care than a typical assisted living community could provide at a reasonable cost (something I am still trying to come to grips with). So we moved her into my favorite Board & Care in the whole world.

She has been there now for a couple of weeks and it is the perfect place for her.

The Last Day

The day we moved her is frozen in my mind. We showed up at 2:30 PM and found mom dressed on top in an inside out sweater and on the bottom in a hospital gown. She had clean clothes in her dresser, but no one cared enough to even get her dressed. Her sheets were pulled off and tossed on the floor. Mom was mostly lying on a plastic mattress. I talked to the charge nurse about it and it was clear she didn’t care even a little bit.   

Will Weed Solve the Problem?

I got this inspiration from a story at McKnight's that was sourced from a New York Daily News article about a medical marijuana operation in New York that sees nursing homes as a new market.

It is suggested over and over again that nursing homes would be better if government reimbursement was increased, which would allow for more staffing and better people and, in turn, result in better care. Maybe . . . but I would note that the building where my mom spent two pretty miserable weeks was likely receiving $600+ for every day mom was there . . . and was a 5-Star rated facility.

So I am thinking maybe the company in the Daily News article is on to the perfect solution to the nursing home problem . . . if we just keep the residents stoned, maybe they will not know how poor the care is.

I Am Ashamed

I confess that during the whole time my mom was in that Five Star skilled nursing facility and even today, whenever I think about her experience I am ashamed of how badly elders get treated in so many nursing homes. This experience confirmed every bad stereotype people have about nursing homes. It doesn’t have to be this way, even with the dollars the way they are.   

This was a local management failure and, ultimately, a corporate leadership failure. We can do better than this.

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