Not For Sissies!

As most of you know I spent eight years (2003-2011) working as a nursing home administrator. For those not yet blessed with exposure to nursing homes each home is required to have a Licensed Nursing Facility Administrator on staff to direct EVERYTHING associated with the day-to-day operations. To do this job you had to understand and in some cases do everyone's job that is working there. Public relations is very important in maintaining census. It was the toughest job I ever had and I thoroughly enjoyed it!

Well that chapter is somewhat behind me and, while I miss the residents, I do not miss the aggravation of dealing with government funding. The Medicare and Medicaid regulations make the Internal Revenue Code looks like a Dick & Jane book. And I know them both so I speak from experience. I spent a couple of hours yesterday with a friend facing the prospect of placing someone in a facility and after that talk it hit home how convoluted the whole system is! Funding is being cut and requirements to meet "medical necessity" have been ratcheted up to the point that someone that is still lucid has trouble qualifying for government assistance for their care. And with the monthly cost of nursing home care averaging around $4,000 per month fewer and fewer people will be able to carry the whole nut themselves. This puts added stress on the families because, in many cases, the only choice they have is to move the person into their home and try to provide the required care there. The whole system sucks so if you can qualify for long-term care insurance buy as much as you can afford!

All of the above is really just background information for the subject of this blog entry : my mother. As I said I am not totally out of the nursing home business as my mother has been in residence at a local nursing home for the past 5 years. I am what is called the responsible party so I am the go to guy when there is a problem or they need something signed. With my background in the business this is not a problem and being my mom's advocate is not a big deal for me. However it is for the nursing home.

Let me explain. Mom spent most of her adult life working in healthcare. While she was a late bloomer professionally she ended her career working as an RN in the mental health field. From all accounts she was a great nurse. The blessing is that she has lost very little of her cognitive abilities. If she had to qualify for nursing home care today it would not happen. She has retained much of the knowledge from her career and is not bashful about pointing out the shortcomings of her young caregivers.  It was amusing the other day when I got a call from the Director of Nurses reporting a medication error on my mom. It was a defensive move on the Director's part because she assumed my mom had called me. She had not. So the funny thing is that my mom is the one who caught the medication error, told the nurse she made the error, and then reported it to the Director, who begrudgingly admitted it to me. Fortunately their were no serious repercussions from it but I dare say she is one in 1000 that MIGHT catch it.

Mom just turned 79 on August 4th. She has many health problems and really needs someone managing her care. She reads at least two books a week (thank God for her Kindle) and is the unofficial greeter at the home. She knows everyone and all their business that they will share. Truly a blessing right?

Not so fast. The problem is that while she is truly blessed not to be afflicted with dementia unfortunately most of the other residents are. There is a cognitive test that must be failed nowadays and most of them do. So she still has interest in current events, politics, and the outside world and most of the folks around her are not as blessed as she is. Meeting her cognitive needs is not a high priority for the home so she gets bored a lot. They rarely take the residents out of the facility so she sits there day after day. My weekly visits are anticipated but rarely do any of her friends visit her there. So she talks on the phone nightly with a sister-in-law, we talk for a few moments on the phone, my sisters visit infrequently, and she reads books. And is bored. And sometimes practices nursing by "helping" her caretakers. And reporting wrongdoings by staff members like yelling at residents, not answering call lights, etc. She looks after some of the more helpless ones. As you might imagine she is REAL popular with some of the slackers on the staff!

Hence, the title of this blog entry. She has been a tough old bird as long as I have known her and continues to handle a difficult situation with purpose. I dare say I would whine infinitely more than she does were I in her circumstance.I get frequent calls about her and some of them are not too nice. She deals with most of their complaints herself. However she knows I have her back if she needs me. And so do the nursing home folks. And my reputation precedes me!

I don't know how much longer will have her but I plan to use all of the runway while I do! Getting to go out to dinner is a special treat for her, unexpected flowers, a hug and an "I love you" mean so much. I saw so many old folks admitted to the nursing homes I ran that never had visitors. If you still have your parents, love and appreciate them! You will never regret it!