Icky

[classicman]

Best of luck to you and your friend. I have helped a few people look for an extended care facility for their kids. The problem is the same but different. Special needs for coma or minimally conscious patients require special nurses and equipment. Basically, there are none. The term you used "warehouse for the dying" is far too appropriate.

[wolf]

I know a GREAT vent facility, if any of your contacts need one ...

[glatt]

So how do you find an assisted living place that's good? We're looking for a place for my father in law, and called basically a referral service who told us about area places in our price range. So we toured half a dozen, and got impressions from that. But the tours didn't take us to every floor of every place. Some of the tour guides were greeting all the patients by first name as we went around, in other places, they clearly didn't know any of the patients and the places just seemed depressing.

But is there some agency or other entity that can give an unbiased assessment of these places? I wish I had some connections around here in health care who could give me some insider tips.

[Spexxvet]

Originally Posted by glatt

So how do you find an assisted living place that's good?

http://www.medicare.gov/NHCompare/st...ub&PubID=02174

a pdf from here:

http://www.medicare.gov/nhcompare/in...rch.asp?bhcp=1

[wolf]

The tour is a big part of the decision making process. If the agency won't tour, don't take them.

And when you do tour, you're looking for some specific things ... does the place smell like pee, do the residents look well cared for, and, if you're looking for a specialty service, make sure they take you to that area while treatment is going on, Physical rehab, for example.

And you might want to show up around lunchtime ... you'll see what they're serving the residents in the dining hall, and may even be able to get a taste test.

Best secondary sources of information: the ambulance squad that serves that nursing home for emergency calls. Also, if you have any friends who are primary care physicians, they might know about the agencies, and may do coverage hours there.

[glatt]

that's helpful. It also made me thing to look up the state social services website and they had some info too.

[SamIam]

Originally Posted by glatt

So how do you find an assisted living place that's good? We're looking for a place for my father in law, and called basically a referral service who told us about area places in our price range. So we toured half a dozen, and got impressions from that. But the tours didn't take us to every floor of every place. Some of the tour guides were greeting all the patients by first name as we went around, in other places, they clearly didn't know any of the patients and the places just seemed depressing.

But is there some agency or other entity that can give an unbiased assessment of these places? I wish I had some connections around here in health care who could give me some insider tips.

Back in the day, I was forced to put my Dad in assisted living. Don't depend on the official guided tour. Show up at unexpected times and see what the staff is up to when they think no one is looking. Wander around and see if patients are just parked off in hallways somewhere with no one really keeping an eye on them. Invite yourself to lunch or dinner. Is the food edible? Is it hot if it's supposed to be and cold when it should be?

Any outfit that objects to drop in visits may well have something to hide. If possible, strike up conversations with the families who have a loved one residing there. Strike up conversations with the patients who live there. Have valuable belongings ever mysteriously vanished? Does a licensed professional dispense the medications? How difficult is it for a confused patient to wander out the door and be gone for a few hours to a few days?

It is SO hard to find reasonable care. My Dad did in fact wander off from an assisted living facility and vanished for over 24 hours. I was beside myself. He eventually turned up at a local pinball arcade, watching people play the machines.

After that I moved him to a very nice place that was very difficult to wander away from and was run by an order of Catholic nuns. Even there, someone on the staff stole my Dad's watch.

I am really hoping that I get an especially pernicious form of lung cancer that metastasizes everywhere and kills me in a few months or even weeks. The one upside of smoking.

[classicman]

Lotta great points from Wolf and Sam.
I'll add - Get a few names of patients and talk to their families.

Trust virtually NOTHING from the people who are basically paid to show you how wonderful the place is and all. Many of the liaisons are paid a commission or bonus.

I learned the hard way when selecting an acute care rehabilitation facility, but was very lucky to have the help of some people who had similar experiences to mine.

[monster]

Maybe the wound needs Hello Kitty Duck Tape?

[Dagney]

Wolf, would your friend be able to utilize Home Health services? I know the home situation is rocky, but just want to throw the option out there. I can give you some tips on finding quality agencies in that realm if needed.

[Dagney]

Originally Posted by classicman

Lotta great points from Wolf and Sam.
I'll add - Get a few names of patients and talk to their families.

While this is a good idea, I think with HIPAA requirements and disclosure rules, that you will most likely not be able to get these directly from the home or agency you're looking to do business with. However, word of mouth is a great tool - I'd ask friends and family members if they have any experience with the facilities you're looking into.

Dag

[classicman]

HIPAA covers medical info. Doesn't have anything to do with asking a patient or their visiting family for names or info on the facility. Perhaps I should have been more clear.

[wolf]

Somehow the discharge planner got crazynurse to agree to go to one of the places on my "rancid shithole" list. But apparently they sold her on it because it was a rancid shithole with an on-site dialysis unit.

And let me tell you, it is a rancid shithole.

The first floor is mainly administrative, but the first thing you notice is a strong uriney stench.

And there's carpeting.

One of my ambulance guys told me, "never go to a nursing home that has carpeting."

I do not know why this is true, but it is.

Nobody from her family did a site visit. Her sister saw it for the first time when crazynurse was admitted there ... and is already working to find someplace that isn't that bad. AND she's going to do site visits this time.

Unfortunately most of the not bad places either want better insurance or significant amounts of cash money.

In the meantime, crazynurse is so despondent she's wondering if having had the surgery was worth it, and occasionally talks about just giving up and discontinuing dialysis. Most people last less than a week. I smacked her and told her she's overreacting. She's only been there two days and so far they haven't done anything awful TO her, it's just a genuinely awful place.

They've got patients lined up in geri-chairs in the hallway with several different kinds of movement disorders.

There are some good, efficient staff there, but the ratio of good to lazy-ass is about 1:3.

Tried to get her into the place where my mom was, but they don't take patients with a wound vac.

Oh, and I stood up for my whole visit. She kept telling me to sit down ... I said no, I'm fine ... until finally I told her the truth.

I don't sit on upholstered furniture where there are people with incontinence.

Or scabies.

I particularly don't like scabies.

[Griff]

Jesus....

We're running into a lot of nasties in SEIT this summer. I've been lucky but my coworker was describing staking out a spot on a hardwood floor away from all furniture...

[Trilby]

wow - I just read this thread and am feeling kinda sick. Yikes. I've told people this before but this story really brings it home - YOU MUST BE YOUR OWN ADVOCATE (Or, better still, have wolf be your advocate) because the health care system is foooooooked.