Assisted Living and DNR (Do Not Resuscitate)

Posted by fatherscaregiver @fatherscaregiver, Jan 27, 2021

Hi! My dad moved into an assisted living facility about six months ago. At the time of admission they asked if he had a DNR. He asked to be a full code and worked. He is fully aware of his medical conditions and fully understands his choice between being a full code or a DNR. I respect his decision as it is his life and he is fully capable of making the decision. He does have medical problems, he has had a heart transplant and now has Parkinson’s. He moved into the assisted living for safety reasons. He had several falls leading up to the move. One of the nurses on staff called me today about a minor issue, no big deal. They call about everything! I do understand they need to keep the family informed. However after calling me about his hemorrhoids (they call about everything) she told me I should consider changing his advance directives to a DNR. I was a little taken back by this for a couple of reasons. I feel like this might be overstepping on her part? Is she somebody that should be saying this to me? Should this be coming from somebody in administration, social worker, nursing director? The other thing is my dad is of sound mind, involved in his health care and he wants be a full code. So, I go back to why is she asking me to change his directive to a DNR? I should add I don’t necessarily disagree, if I was my dad I would be a DNR, but that is not what he wants. Looking for what others might think, am I just being overly sensitive?

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@fatherscaregiver Anytime you have a question of anything being inappropriate or question of care speak to someone in administration. If that does not work speak to your father's case worker. My daughter-in-law's aunt is in a hospital (she had previously been in nursing home) because of a fall and having covid. They would not speak to my d-i-l's mom (who has power of attorney over health care and everything) about her care. I told her to get the social worker involved… she did and now they know what is going on with health care. Most cities and counties in the USA have social workers available through Health and Human Service departments. I think the name may be different from area to area.

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I have had issues with hospice too. My mom is not "dying" soon, but hospice likes to overdrug. Its been awful, very rude supervisor too, who claims to be a "pain expert" and gave my mom meds she was hallucinating on. They were supposed to go through me before giving but ignored it. Trying to figure out how to file complaints… NEVER will I go into hospice, told my kids. Its disgusting!

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@rarelybees2889

I have had issues with hospice too. My mom is not "dying" soon, but hospice likes to overdrug. Its been awful, very rude supervisor too, who claims to be a "pain expert" and gave my mom meds she was hallucinating on. They were supposed to go through me before giving but ignored it. Trying to figure out how to file complaints… NEVER will I go into hospice, told my kids. Its disgusting!

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Hello @rarelybees2889 I have a question based on your post here. Is your mom in an assisted living facility or actual hospice care? They are very different from each other. In my wife's case she had to actually have her doctor prescribe that she enter hospice care.

Strength, courage, and peace

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@rarelybees2889

I have had issues with hospice too. My mom is not "dying" soon, but hospice likes to overdrug. Its been awful, very rude supervisor too, who claims to be a "pain expert" and gave my mom meds she was hallucinating on. They were supposed to go through me before giving but ignored it. Trying to figure out how to file complaints… NEVER will I go into hospice, told my kids. Its disgusting!

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@rarelybees2889 Langold, you can either go up the chain… contact whomever is over the supervisor or contact your Mom's case worker. No matter if your mom is in a hospice facility, assisted living or nursing home.. they all have an administrator over supervisors that you can contact. You can find out who her social worker is through your local county.. sometimes city/town government… Human Resources or sometimes Health added in or other wording. If there is another place better you can move her to.. look into it.

Do you have Power of Attorney and power over health decisions? If not get them!

My mom went into a hospice facility about two weeks before she passed. Another woman across the hall was in there for respite care. The staff was very caring to all their residents. My cousin that lived in another state was in home hospice care for a couple of years or so. My cousin-in law said they were a wonderful help to him and her.

My problem was the nursing home giving my mom meds that she was not suppose to take. I got the statements from insurance telling me what they were giving her…. Sometimes I could tell they had given her something before the statement came. It was easier before covid when I could visit her. I would ask the nurse to show me my mom's med list… tell them to make a note that med makes her Mobitz (bradycardia) worse.

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@rarelybees2889

I have had issues with hospice too. My mom is not "dying" soon, but hospice likes to overdrug. Its been awful, very rude supervisor too, who claims to be a "pain expert" and gave my mom meds she was hallucinating on. They were supposed to go through me before giving but ignored it. Trying to figure out how to file complaints… NEVER will I go into hospice, told my kids. Its disgusting!

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We had similar experience with my mother-in-law. She was in a nursing home and her doctor had her go into the hospice program. The hospice program took over her care in the nursing home. After 5 days, she was so over drugged, she didn’t recognize her daughter or me, so we fired them and the nursing home took great care of her for almost 4 weeks before she passed. We would never want to go into a hospice program.

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@rarelybees2889

I have had issues with hospice too. My mom is not "dying" soon, but hospice likes to overdrug. Its been awful, very rude supervisor too, who claims to be a "pain expert" and gave my mom meds she was hallucinating on. They were supposed to go through me before giving but ignored it. Trying to figure out how to file complaints… NEVER will I go into hospice, told my kids. Its disgusting!

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Hello @rarelybees2889

As Scott, @IndianaScott, asked, did your mom's doctor prescribe hospice care for your mom?

In most areas, there are several different hospice care organizations. Have you looked into changing the hospice organization to another one? Given that you are uncomfortable with your mom's treatment and lack of communication with you from as you said, "very rude supervisor" I would be inclined to find another hospice organization to care for your mom.

Is this an option that you have considered?

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@rarelybees2889

I have had issues with hospice too. My mom is not "dying" soon, but hospice likes to overdrug. Its been awful, very rude supervisor too, who claims to be a "pain expert" and gave my mom meds she was hallucinating on. They were supposed to go through me before giving but ignored it. Trying to figure out how to file complaints… NEVER will I go into hospice, told my kids. Its disgusting!

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@rarelybees2889 I’m sorry you’re having problems with this particular hospice. There are so many hospice organizations in each town or city. Most are great, some not so great. Don’t give up on hospice, you’ve run into a few bad pennies. It was suggested that you speak to an administrator—are you able to do that?

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@fatherscaregiver

Moving him to another facility really isn't an option. The place he is at is a really good facility and everybody up till now have been great. I am hoping this was a one time lapse of judgement. I have sent an email to the director this morning asking to have a conversation about this. Will see how he responds, I always try to start off nicely. 🙂

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@fatherscaregiver– Good morning. Has there been a remedy for this as yet?

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@merpreb

@fatherscaregiver– Good morning. Has there been a remedy for this as yet?

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@merpreb I did speak with the social worker and nursing administrator early this week. They did explain the nurses know the residents the best, (in the facility) but also agreed that when calling about a hemorrhoid issue it would be an inappropriate time to bring up DNR status. They did say the nurses will go to them (social worker and administrator) if they feel there is a need and then a care conference will be scheduled to discuss it. They are going to address this with all nurses about when and how DNR status changes are addressed with the family to prevent this from happening again. I am hoping it was a lapse in judgement and will try to give the benefit of doubt but will also keep an eye on it best I can. I do understand that with the ongoing Covid pandemic procedures and normal meetings have not been occurring as they usually would. They were very apologetic and understood my concern.

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@fatherscaregiver

@merpreb I did speak with the social worker and nursing administrator early this week. They did explain the nurses know the residents the best, (in the facility) but also agreed that when calling about a hemorrhoid issue it would be an inappropriate time to bring up DNR status. They did say the nurses will go to them (social worker and administrator) if they feel there is a need and then a care conference will be scheduled to discuss it. They are going to address this with all nurses about when and how DNR status changes are addressed with the family to prevent this from happening again. I am hoping it was a lapse in judgement and will try to give the benefit of doubt but will also keep an eye on it best I can. I do understand that with the ongoing Covid pandemic procedures and normal meetings have not been occurring as they usually would. They were very apologetic and understood my concern.

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@fatherscaregiver Anytime you feel a care conference is needed you can insist on one. With the pandemic it can be via Zoom, FaceTime, Skype.. There is Google app I cannot remember the name of. …. But sometimes talking face-to-face even through video conference is a big help. All those can be used to talk with your father if visitation is not possible. I called my mom everyday, but only face-timed a couple of times a month.. only one lady had an Iphone. I had to complain because no one would answer any of the three numbers I dialed.. one was my mom's phone.. they kept it out of her reach most of the time. She could not work a cell phone, but through Verizon we set up a phone that is a cell phone, but works like a regular house phone.. like she was used to. My brother could not get them to answer either. If I used my husband's phone to call they would answer. I think something to do with caller ID.. I think they thought I called too much. Mom got to where she could not dial.. even speed dial because she had more mini strokes and a mild stroke.

I thought Zoom would be hard to do with a lawyer.. signing papers to sell land.. but his assistant called a few days before and helped me with the app. I'm 69 1/2 with brain fog half the time and probably would be called a Luddite by the younger generation. I prefer old-fashion face-to-face or a regular old phone. Technology overwhelms my mind sometimes.

ZeeGee

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@fourof5zs, Nice to meet you fellow Luddite. I believe that makes three of us. I surely understand brain fog. Maybe a lot of us have this now. I avoid technology as much as possible. My little grey cells are in need of updating! Best wishes, @joybringer1

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@fatherscaregiver

@merpreb I did speak with the social worker and nursing administrator early this week. They did explain the nurses know the residents the best, (in the facility) but also agreed that when calling about a hemorrhoid issue it would be an inappropriate time to bring up DNR status. They did say the nurses will go to them (social worker and administrator) if they feel there is a need and then a care conference will be scheduled to discuss it. They are going to address this with all nurses about when and how DNR status changes are addressed with the family to prevent this from happening again. I am hoping it was a lapse in judgement and will try to give the benefit of doubt but will also keep an eye on it best I can. I do understand that with the ongoing Covid pandemic procedures and normal meetings have not been occurring as they usually would. They were very apologetic and understood my concern.

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Hello, fatherscaregiver and all. What a great discussion pertinent to so many of us. I come into this from 2 very different life experiences and viewpoints.

First, I was my precious mother's caregiver for 12+ years during her long, difficult journey through Altzheimers. I was with her every day, as I moved into a condo in the same area……as a normal daughter, we decided it best for me to live near-by, 2 streets apart….within easy walking distance. Perfect set-up for us at the time. As she progressed through this illness, she lived w/me for a few months until I moved her into assisted living so she could live independently but overseen by caring professionals. I was a small business owner at the time and this was our best determination.

I took care of her laundry at first

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