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.

Objectives for Robert; Objectives for New Home

Robert has his second ISP meeting today at New Home. This is where everyone involved in his care (nurse, house manager, supervisor of house manager, speech therapist, regional center rep and me) decide on his “objectives” for the next three months. The last one was just after he moved in to New Home last February (which I realize was more than three months ago but, after the first meeting they wait for the client’s birthday month to have the next one.).

The objectives from the February meeting and the results so far:

1. Behavior modification regarding changing his dirty clothes and putting clothes in the hamper to be washed. Robert is doing much better with this although he still insists his jeans are clean when they are not. I make sure I set out a new pair of jeans when he’s at our house or when I visit him through the week. I’m not convinced New Home does this (even though they’ve been asked).

2. He is slightly over the ideal weight so they will watch his diet and create an exercise program with staff. Robert lost some weight just from eating different food than his last place (yes, that meant new jeans for him again). Exercise program? Hmm . . . I haven’t seen any evidence of this other than when I take him shopping for new jeans (you would think I would have every possible size by now)!

3. Learn his new address and phone number. Robert did learn his address! I was very excited to hear him recite his address during a recent visit. He was pretty tickled with himself too. I don’t think he knows his phone number but he knows mine which is more useful for him.

4. Help with cooking twice a week and plan and shop for meals twice a month. I will be shocked if they tell me today that Robert has gone grocery shopping with them. Sometimes Robert does help set out everyone’s napkins and bibs which is a nice task for him. (Cooking is too big of a reach for him but I’m happy with this small amount of involvement).

My objectives at the time were for New Home to get Robert’s medication schedule correct (they finally did) and for the Regional Center to get Robert into a Day Program (which has been a complete success!).

It will be interesting to see today what they tell me as far completing these objectives (since I’m a little dubious about their reports) and what new objectives they come up with for Robert.

My new objectives for New Home are for them not to run out of things like toilet paper and protective briefs!