Whether your family member is in a nursing home or rehabilitation facility short or long term it is extremely important to be vigilant about their care. While many assume this is the responsibility of the facility providing care, do not become complacent and assume this is what actually occurs. Reality is often different. Many family members overlook or excuse the small things. A person not bathed frequently, a dirty room, increasing confusion or anxiety. There are so many things that can and do happen and if left unchecked continue to progress and become critical.
Consider the case of a father who had surgery and went for short term rehab. As a result of the surgery, this individual because anxious and extremely depressed. His daughter, knowing that dad had episodes of mental illness all of his life discussed this with the facility staff who mentioned it to the on call physician. The physician, having no background in mental health, prescribed ativan, a medication typically prescribed to calm anxiety. This worked for a brief matter of time until dad became increasingly depressed, a risk to self and according to the facility required 24-hour supervision which the family was forced to pay for privately if they wanted their father to continue to receive care.
More concerns were expressed by the daughter. The physician, again having no background in mental health, requested that a mental health social worker visit and make recommendations. The social worker proceeded to recommend an anti-psychotic medication that the physician prescribed. Unfortunately, dad had an immediate psychotic reaction from the medication and was transported to the local hospital emergency room for medication issues. In spite of the daughter requesting that the hospital emergency staff find a way to have her father evaluated from a psychological standpoint, they simply sent him back to the nursing home under 24 hour supervision.
This is a clear case of a daughter recognizing the needs of her father and the system failing to respond. The daughter, highly educated and intelligent, had no idea how to work within the system to achieve the desired result for her father. Fortunately I was contacted the evening of the hospital emergency room event and spent the next day having her father complete the requisite admission tests for acceptance into a psychiatric evaluation center.
It is important for families to understand that the health care system has limitations; that skilled nursing and rehabilitation facilities have limitations to the care they can provide. Even physicians, many who are general practitioners, are limited in their expertise. And that eventually the time comes to consult individuals versed in the situation with access to a wide range of resources. It is easy to assumewhat we know; yet more difficult to admit we lack the expertise to care for a family member. Many individuals experience panic in failing a family member because they do not know what to do. The best course of action is to admit help is needed and contact a professional who can help navigate the system.