Holding a Care Facility Accountable

It’s a fine line between advocacy and being known as That Woman or Pain in the Rear (or worse). It’s not that I care what I’m known as (frankly, I’d rather these care facilities be on their best behavior because they think I might just cause some trouble for them). What I don’t want is Robert to suffer the consequences of my being pushy so I pick and choose my battles.

Robert’s ISP meeting was held last Thursday. That’s “Individualized Service Plan” for those who don’t yet speak Care Home Code (don’t worry if you don’t – I’m still getting used to these acronyms).

The night before the ISP, I hunkered over the first ISP and reviewed my notes from the months after Robert’s move-in. Reading of the struggles when Robert first moved into New Home was depressing but I wanted to focus on what objectives were set out for Robert at that time and how he seemed to be accomplishing them. I also made a list of issues to discuss with New Home so they can do a better job and be held accountable (the Regional Center and his Recreational Therapist were involved in this meeting so there were witnesses!). I’d love to bring up all the problems I want solved but decided to focus on what can be fixed now.

The House Manager was not invited to the meeting which I found odd. Nurse Ratchet was not at the meeting which I found to be a relief. The person who is probably the least hands on with the clients (we’ll call her Ms. Z.) was at the meeting and her lack of knowledge about what actually goes on at the home became evident very quickly.

Her priority is not the “consumer” but the paperwork she has to complete and send in to her boss.

Robert’s morning routine. Robert dawdles. He’s on the OCD side. He takes 2.5 hours to get ready in the morning (grooming, dressing, eating, grooming again). He’s missed the bus a few times but the House Manager worked with me to create a system that works for Robert and he hasn’t been late since.

Ms. Z. insisted this was still a problem and suggested a visual chart for Robert so he could see all of his morning activities and when he’s supposed to do them. Did she just take some sort of continuing education class that presented this as the Greatest Idea Ever? A chart Robert has to spend time looking at and deciphering is only going to delay him further. I explained that House Manager came up with a good solution and that is working. The problem is fixed!

She wasn’t satisfied. She wanted to write down a plan (other than the one I told her about, apparently). Someone suggested Robert shave when he showers at night. This will disrupt his Jeopardy and Wheel of Fortune watching, I said, but then it was suggested we get him DVDs of those shows so he won’t miss them.

Ms. Z. sat with her pencil ready to write down this complicated, expensive and unnecessary plan. I reiterated this is no longer a problem to solve but if they really want to try something else, then that would be fine. I only agreed because (1) the television doesn’t work right now so Robert can’t watch his shows anyway and (2) the other plan will actually still be in effect and this new process will not interfere with it.

Ms. Z. discussed other “objectives” and told me how Robert was performing on them. Percentages were assigned to each of these tasks as if he were being graded on them. It seemed to me he was accomplishing what I would expect him to accomplish and if they want to grade him on his progress, then go ahead. I’m not looking for straight A’s here.

I discussed a few problems I’ve noticed lately when I realized I didn't think Ms. Z. was being honest with me. Does she get a bonus for that, I wonder?

Television. The television doesn’t work and hasn’t for about a week. When I first mentioned this to Ms. Z., she feigned shock as if this was the first she had heard of it. Two seconds later she was explaining her company no longer pays for cable because their budget was slashed by 10%. We discussed how they could get television again (a converter box or me paying for a cable box for Robert). Ms. Z. is supposed to look into getting the converter box (although, as of today, she hadn’t done so).

Today, I politely explained that not having television was interfering with Robert’s ability to practice his religious beliefs (since he watches church on television). That should get them to spring into action. Yes, I can be a PITA (another acronym but I’ll let you figure this one out).

Air Conditioning. I reported the a/c doesn’t appear to be working in Robert’s room. It was very hot in his room during one of my recent visits. Ms. Z. declared the thermostat is always set to 72 – 74 degrees and I burst out with “There’s no way!” (I actually didn’t mean to be so contrary but the statement was just laughable!). One of the aides had already told me the thermostat is set to 78 degrees and is under lock and key. The actual temperature in Robert’s room was in the 80s so I suggested they have maintenance look at the unit. Ms. Z. at least agreed to do so but as of today reports that “it’s fine.” I told her “no, it’s not” because the unit was on but no air was coming out of the vent in Robert’s room. I asked her to have it looked at again. We’ll see.

We discussed how New Home had run out of protective briefs for Robert and asked what procedures were put into place so that wouldn’t happen again. The supply company was blamed and everyone was assured it was a one-time issue. I decided against mentioning the time New Home ran out of toilet paper because I realized House Manager would take the fall for that and I need her on my side right now. I pick and choose my battles while doing my best to hold New Home accountable.

Here’s a tip for New Home (and all the other Care Facilities out there): how about remembering there’s a person behind all that paperwork.