by Diane Masson | Mar 15, 2015
My sedated mother-in-law
Apparently drugging and diapering seniors in the hospital is common knowledge in higher levels of senior living care, such as assisted living, memory care and skilled nursing?!!?
This is horrifying new knowledge for me. I am all about exposing dirty secrets in my new book, “Your Senior Housing Options.” So let me share what I have recently learned through my mother-in-law’s experience. My mother-in-law, Amy, has dementia and was cared for by my father-in-law for the last several years. Three days after he had a heart attack, she became psychotic. My husband and I had to hire a geriatric care nurse to help her because we live 1000 miles away. Learn more of the story HERE.
It took over two weeks to get Amy admitted to the hospital (it’s a long story). Initially, we were relieved that she was going to get the psychotropic drugs she needed. Since Amy was in crisis mode, we didn’t dwell on her being diapered because of diarrhea. She’d had colon cancer 25 years ago and has self-managed her own colon care with diarrhea medications for years.
Costs for Incontinence
As she was in the process of transferring to a secured memory care, I was promised that they would be diligent about avoiding Amy’s trigger foods (that cause the diarrhea). My assumption was that she would surely regain continence again. This was vitally important, because incontinence can cost an additional $300 to $1,000 per month depending upon the assisted living community.
My Mother-in-law Was Over Sedated
We flew to Seattle to see Amy and to help find a reasonably priced memory care community for her. She was so sedated that she could not keep her eyes open and kept saying, “I am so tired,” over 25 times. She apologized that she needed to lie down and take a nap. She was in a wheelchair and needed a one person transfer to get in bed. What?!!? One month ago, she was walking around. My husband and I were shell-shocked to see her so drugged and lethargic. We talked to the memory care community and they said they would contact the doctor immediately to reduce the medications.
The next day, we arrived to see Amy again. After being told that she was engaged and walking around, we found her asleep in a wheelchair in the middle of a singing class. It was heart wrenching to witness. Again, she spoke of her sleepiness.
Advocacy is Key for a Senior with Dementia
The administrator came over and had the nerve to tell me, “My team feels we should follow the doctor’s recommendation of not changing Amy’s drugs for one or two months.” What?!!? I asked the nurse, “Do you see Amy’s lip trembling?” She said, “Yes.” I inquired if she saw both of Amy’s arms shaking too. She agreed. Then I said, “Do you see how sleepy she is and how her eyes can’t stay open?” “Yes,” she said. I simply said, “That is not Amy.” “Oh,” she said, “Then she is on too much medication.” “Exactly,” I said and was relieved that someone finally understood.
It took till the next evening for the community to contact her doctor and reduce one of her medications by half.
At this point Amy has been drugged and diapered for five weeks (between the hospital and the memory care community).
Conclusion:
That was five weeks too much of over drugging and diapering a senior with dementia. Can she ever come back and resume continence again? Will she be able to walk freely like she used to in her own home? My own mother was given psychotropic medications in skilled nursing care. Four months later, her walking had decreased dramatically; a few months later she became wheelchair bound for life. Was it the drugs or aging decline? I will never know, but I want to protect my mother-in-law from being over sedated and permanently wheelchair bound. I hope she has a fighting chance to walk again.
Drugs as Restraints?
I have talked with several administrators of assisted living and skilled nursing communities. They say it is common for seniors to arrive from the hospital drugged and diapered. The hospital can’t use restraints, so they use drugs as restraints. My mother-in-law was prescribed haloperidol twice a day and trazodone four times a day as needed. Why did the hospital dope her up so much? It is an advocacy nightmare to get it reversed.
What have you encountered? Has you ever witnessed the sedation and diapering nightmare of a senior?
Diane Twohy Masson’s new guide book for seniors, “Your Senior Housing Options,” is available on Amazon.com with a 5-star rating. It reveals a proactive approach to navigating the complex maze of senior housing options. It will help you understand the costs and consequences of planning ahead or waiting too long.
More related articles by Diane can be found at Tips2Seniors.com or like Tips 2 Seniors on Facebook.
Diane Twohy Masson has worked in senior housing since 1999. She is an award-winning certified aging services professional and the author of Senior Housing Marketing: How to Increase Your Occupancy and Stay Full for senior living professionals.
Among the thousands of seniors she and her teams have assisted in finding the right senior living community, the most difficult case has been helping her own parent. Masson spent two years exploring senior housing options with her mother before finding the ideal Continuing Care Retirement Community for her. After eight years in this independent living setting, she helped her mother transition into an assisted living community. Seven years later, even as a senior housing expert, Masson struggled with the decision to move her mother into a skilled nursing community.
by Diane Masson | Mar 2, 2015
Diane and Chris Flying 1000 Miles to Look for Affordable Memory Care for my Mother-in-law
My mother-in-law is currently in a secured memory care community. The price is very high – $6750 for 30 days of respite care. If we don’t move her within two weeks, the community fee for a permanent stay will be $10,000 and her monthly fee will be $9,000 a month. Are you kidding me? Who can afford this?
She was living in her own home six weeks ago, but a crisis you can read about HERE has left her adult children scrambling to find a permanent solution for my mother-in-law.
My husband, Chris, and I work in the senior housing profession, so who is better than us to evaluate the choices. We flew 1000 miles yesterday to be the experts on the ground in Seattle. We are going to visit three memory care communities today and one or two tomorrow. The best way to evaluate and compare retirement communities is in a short span of time. The crème always rises to the top.
We can’t base our decision on what the community looks like, the size of the rooms or the wonderful sales person. We are going to dig deeper and ask the following questions of each memory care community:
- What is the staff turnover? We want to see longevity of staff – particularly in the administrator, nurse, caregivers and possibly the chef.
- Do the staff and residents look happy? We will talk to some of each.
- What will be my mother-in-laws quality of life? What programming is offered? How often does live entertainment come in the building? How will they minimize her anxiety?
- How many hours does the nurse work per day? Twenty-four hours will always be the best answer, but you get what you pay for.
- What is the procedure if my mother-in-law falls? When my mom was in an assisted living community with dementia, every fall led to a terrifying emergency room (ER) visit that was stressful for her. If a nurse is on shift around the clock, it may save my mother-in-law from this stress. If the fall happens at 2:00 am and only a caregiver is on staff, the call to 911 will almost always lead to the terrifying ER visit.
- Do doctors come and visit my mother-in-law here or does she have to be driven to her doctor? Who will do that? Will someone accompany her? What are the costs?
- We will discuss my mother-in-law’s dietary needs and meet the chef. When my mother-in-law was in the hospital, she became incontinent. We hope it is not permanent and assume the diarrhea was from feeding her too many raw vegetables and fruit. She has not eaten those in years because of too much radiation after colon cancer. So it is important that we advocate for her in this regard. Just incontinence can cost an additional $1,000 a month.
- What is the initial community fee? What is the current monthly cost for room, board and care? What is the maximum cost it could potentially be? What are the additional costs? What have we not asked that could cost extra? What happens when someone is broke and can’t pay these hefty fees? We need to find out if the memory care community charges for my mother-in-law’s care by points, levels of care, or is all-inclusive. Pricing can be very grey and it is easy to be confused. Even us experts will have to see beyond the sales “smoke and mirror” answers.
- What is the history of their year over year monthly increases? We can’t just look at affordable costs today, but what if my mother-in-law lives for years?
- Is the room furnished? Do we just bring personal affects? Do we need to go buy a twin bed, TV or special chair?
- How do they handle hearing aids and glasses? My mother-in-law has two hearing aids that she has not used in six weeks.
- What is their procedure in contacting the family to give updates or let us know of a change in our loved one’s health?
- Is there anything that we should have asked but did not?
We will look at the entire memory care community space, her possible room and the outside walking area. I will keep you posted on our family evaluation and pricing for these communities. Hopefully, sharing my experiences and tips can help you too.
Diane Masson’s new guide book for seniors, “Your Senior Housing Options,” will be available next week on Amazon.com. If you sign up for my weekly newsletter on the right side of this blog, you will be notified when this valuable resource can be purchased. Check out my new website: Tips2Seniors.com or please follow me on Facebook.
Diane Twohy Masson is the author of “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” available at Amazon.com with a 5-star rating. The book is required reading at George Mason University as a part of its marketing curriculum. Within this book, the author developed a sales & marketing method with 12 keys to help senior living providers increase their occupancy. Masson developed this expertise as a marketing consultant, sought-after blogger for senior housing and a regional marketing director of continuing care retirement communities in several markets. She has also been a corporate director of sales and a mystery shopper for independent living, assisted living, memory care and skilled care nursing communities in multiple states. Currently, Masson is setting move-in records as the regional marketing director of two debt-free Continuing Care Retirement Communities in Southern California – Freedom Village in Lake Forest and The Village in Hemet, California. Interestingly, this career started when she was looking for a place for her own mom and helped her loved one transition through three levels of care.
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