New Coordination?

Today was my second time visiting Alison while Rolina, the CNA was there. When I came in, Ro was with Alison who was already in the Geri chair. Ro was massaging Alison’s neck . After together giving Alison a shower, we went into the day room. Alison was very tired and had a “flat affect”. Ro said she had been the same on Friday. I checked with nursing who reviewed meds – A is still getting Clonopin (?sp) 6am, 2pm and 10pm. Nursing feels it is because A has not slept much the last two nights. More about that below. So while Alison slept, Ro and I talked.

I asked Ro about how we would better coordinate care management for Alison going forward. So far we have been catch as catch can between me, Amy and Reenie. Ro says she writes daily care notes about Alison to her Supervisor. Ro said that as a normal course, Ro will raise issues. Her supervisor then will then get in touch with BridgePark to see if staff can correct an issue. WOW, how great!! We decided to try this process with two issues:

• Ro worries that the facility is taking advantage of her being hired for 4 days a week. Staff may skip taking care of A in the am because Ro will be there later. I asked Ro to track the following in her daily care notes: 1) Ask Alison if anyone had fed her breakfast 2) track whether Alison has already been changed and gotten up in the morning. We will see what Ro finds.

• Alison and her roommate have been fighting for the last two days because her roommate has been leaving the heat up. This is why Alison has not slept at night. Alison has started using bad words and nursing separated them this am. When I shared the issue for the second time with the facility staff, they said they had asked her roommate to turn the heat off it still continues. Alison says this is the only problem she has with the roommate (so it may not be time to ask for a roommate change). Instead Ro will work with her supervisor on ideas to request from the facility -- ask staff to go in there at night and turn off the heat after they're both asleep. Also leave the door open.

I had taken and washed Alison's dirty clothes as no one had touched her laundry since Alison’s return to the facility. Alison is missing some clothes but Ro thinks the staff has put them into the laundry system. Maybe we can have Ro work with the facility to coordinate getting laundry done and track clothing?

Yesterday, Ro had texted me toiletries and food supplies Alison needed so I took them to my visit today. I just restocked yogurt and lobster bisque. Alison asked for over the Odwalla carrot juice which Amy said she’d bring tomorrow.

I also was told today that Alison’s peg feeding is done every night from 6 PM to 8 AM. This is different info from my visit 5 days ago when they told me that were doing a peg feeding at 2pm. Is weekday different than weekend? Another open issue still to track down?

Going forward, I have to cut back to going once every 7 days. I have decided to go on Thursdays as much as I can. That way Ro does M/W/F/Sa and Amy does Sundays. Maybe we can get Mary Pat to do Tuesdays?

Reenie – some questions for you:
• Did you expect the group that Ro works for to take the lead in coordinating Alison’s care with the facility? This would be huge if we have someone local to coordinate with and oversee this!
• If yes, can I raise issues with them, for them to manage (eg the laundry, peg feeding schedule)?
• Can we ask them to share with us Ro daily care notes? When they raise an issue with the facility? It would be great to know what they are seeing and working on!