Challenges

Rolina, the CNA Reenie hired to visit Alison 4 times a week, has been feeding Alison the special foods we leave as well as showering her and massaging her. It makes us feel better for Alison plus gives us important info on Alison’s situation, per below:

First, Alison has had two grand mal seizures. One was for three minutes 4 days ago when Rolina was there, and one was for one minute today when I was visiting. After the first occurrence, the facility had their in house doctor see Alison. I talk to the doctor today when I first arrived and he said that Alison’s seizure meds were at the proper level in her blood stream. They have made an appointment to send her to a neurologist. Her neurological appointment is now set for May 27 but they are going to try and move it up.

Just as I was about to leave at the end of my visit today, Alison suddenly complained of a headache. She then recollected that she had a headache when she had her seizure 4 days ago. As I left the facility, I reported this to nursing staff, as input to the neurologic doctor visit. After talking with the nurse, Alison was calling out so I popped back in. She asked me to remove the pillow from under her legs (there was none), said her foot hurt, and then started mumbling… it was a second grand mal seizure. It started about 4 minutes after she first said she had a headache? I got the nurse who observed it. We talked to Alison as she regained consciousness one minute later and kept her calm. The facility is going to try and move up the neurological appointment. When I updated Marissa of Caring Companion about the grand mal seizure, she was going contact Jimmy to see if Jimmy wants Alison to be taken to an ER for observation now or just wait until the neurological appointment. Jimmy was going to call the facility.

Second, we need to figure out how to work together to get issues raised and resolved that affect Alison’s care. Who takes the lead in coalescing issues? Who takes the lead in working them out with the facility? Rolina, Amy and I can just report what we see….

Over the last week or two, we have been identifying concerns about Alison’s care at the facility. I have raised some in my blogs. Rolina has also been texting me concerns from her visits which I have shared with Reenie. Amy too has texted and blogged some concerns. The issues are 1) Alison not being regularly changed or taken care of in the am, 2) staff unwilling or unable to assist CNA in moving Alison to the shower 3) roommate issues re overheating the room and threatening Alison, and 4) questions of whether Alison gets regular feeding by anyone other than the CNA or visitors.

Given continued lack of feedback that the facility had done anything on the issues, I went into my visit today ready to “shoot bear” (in a collaborative sort of way...). I talked to Yolanda (heads the unit) and Karen (Alison’s social worker) to raise the four issues. Yolanda and Karen did NOT know any of these issues and met with the floor nurse who said she also did NOT know. Yolanda then asked that Rolina contact Yolanda if Rolina had any issues during her visits. I then contacted Marissa of Caring Companions to update Marissa on the issues and instruct Rolina to contact Yolanda. Marissa did NOT know about any of the issues either! Rolina prepares daily reports but they are turned in every two weeks. Rolina had not raised them directly with Marissa.

Actions:
• Marissa is going to talk with Rolina so issues are identified real time. Marissa will raise them with family.
• Amy and I will continue to blog on issues from our visits.
• As I just was leaving, Monica the floor nurse told me they were talking about changing Alison's roommate situation. I ask what that meant. What they normally do when someone is acting aggressively toward a roommate is to move the aggressive person out of the room. Let’s see.

Note: Reenie left today and returns April 30. She asks to not text or call her unless an emergency given the high intl telecom costs. She will see blogs and email. Jimmy Webb is family point of contact in the meantime, jamespwebb@earthlink.net, cell (818) 414-1646.