My 63 year old FTL, mobile, Dad, was placed in a Geri-chair by the NH social worker the other day. Just found out about it.

It is my understanding that my Dad was being high maintainence and was on his way to the lobby couch holding the hand of another female resident. Apparently, the social worker had had enough, and placed him in the Geri-chair. He was able to scoot himself around while still in the chair.

We live in Ohio, and from what I have researched on the web tonight, the use of physical restraints is not allowed unless there is a physicians note, or immenient danger to the person.

There is no physicians note and from what it sounds like, the only danger my Dad was in was getting on the nerves of the social worker.

Thoughts? Experiences? Advice?

I definately will be talking to the social worker about this.

Thanks!

My understanding is that a gerichair is considered a restraint and that there are significant legal limits and requirements on their use so discussing it with the social worker and the NH administrator is important. It may be that they felt that your dad was behaving inappropriately with this other patient, the women he was holding hands with may not be able to decide on her own company and the staff might have interpreted the hand holding as sexual in nature. I hope that you can get a clear explanation, and a treatment plan to avoid further use of restraints.

If I were you ,,,I would go to the facility ASAP and talk to the Social worker,,and I would also do it with the facility director and a nurse present.

You are right,,they have no legal right to do any type of restraining,,simply cause someone wants to sit on their ass and not pay attention,,or just cause they themselves are having a bad day,,and take it out on one of the residents.

Should your discussion with the social worker,,director and nurse not sit well with you,,,then I would contact the Ombudsman,,and also file a written letter of complaint to the State and also the facility owner,,wether it is privately or corporate owned,,or state owned.

I think that many people that deal with different dementia's simply aren't trained enough to understand what is serious and what to let slide,,,either way,,the so called professional gets burned out and angry and doesn't always act responsibily,,,,nor in the best interest of our LO that we have entrusted to their care.

Absolutely raise hell about how it was handled. Remember,,it will take everyone of us caregiver and caregiver/advocates,,to get things set in motion for better care,,cause that could be our future one day. Peace

Restraints should be used by doctors orders for an individuals own safety. If restraints are used for any other reason, this is a misapplication of restraint and is abuse.

Wow.

A meeting was scheduled for Monday with the nursing home team. I called the social worker to confirm the time, and she (who helped schedule the meeting) said that the meeting was cancelled. When asked "Why?", she said that I would need to talk with the administrator.

Basically, to sum up on of the more unbelievable conversations I've had in a while, the administrator told me that they didn't have time to meet because it is tax time and we would have to wait until June for my Dad's next care conference. She assured me that my Dad would never be put in a Geri-chair again. I explained to her that I'm pretty darn sure that at some point a Geri-chair will be necessary and I would like to have prtocol in place for the staff... again, she told me it would never happen. She assured me again that they absolutely had no time between now and June to meet.

What the ?!?!?!

I let her know my feelings and she told me to put it in writing.

So, I called the Ombudsman and explained the situation (unapproved physical restraint, denial of a care conference, etc). The intake worker said that the ombudsman assigned to that NH just happens to be the director of the ombudsman program- and she added how nice that would be.

Ughh!!!!!!!!! I work in medicaid/case management field... and it absolutely floored me that this happended! Denying a case conference?? I don't think I'm being unreasonable to request a protocol! I WANT to WORK WITH them- not against them! Are they trying to hide the unapproved use of restraints?? I'm dumbfounded!

Needless to say, we are looking for another placement!

Just needed to vent- thanks.

Jenifer,
so sorry this is happening; as a small business owner myself,
I just wanted to say that YES, it IS tax time, and I myself
am "going thru" some stuff regarding that, BUT!! Thats what
accountants are for, and the NH administrator's job (at least
to me) is running the NH, NOT DOING THE TAXES!!! If all of
the staff is unavailable to due it being "tax time" then
their accounting department isn't very organized. This
sounds like an excuse to me too. You probably don't know
my story but I placed my Dad in a NH in Jan. The place
was old and there were a few minor issues, so I had
him moved. Big mistake! The newer, nicer NH had just
about everything I could ask for, EXCEPT a good administrator.
This lady over-involved herself in EVERY single area of the
NH. She even went up on my Dad's wing and was "walking him"
with his walker. Long story short is Dad was a fall risk,
so they had him doped to the eyeballs to keep him still.
After THAT, the administrator calls me one day and says
"we CAN'T handle your father, we're sending him out to
the hospital." And, on top of it, this NH advertises
that they have a Alz./dementia wing. NOT!!!!!!! Dad's
back at the original place; yes, there are things I'm
not thrilled with, but Dad's always clean, fed and
seems generally OK. The hard part about moving our LO's
is it can be hard on them. I applaud your being so on
top of things and for not allowing the NH to get away
with things. I hope it all works out WELL for your LO
and your family. Take care.

jenifer

Did you speak with that social worker one on one about this issue?

If not..find her..and have a relaxed conversation and be a good listener..maybe she needs to share with you.. and then.. let her know your feelings..and comfort level..about what happened..as starting..with that person..then working your way up..is best for your.. understanding..

you said there is no..doctor's order for restaint in a geri chair from what it sounds like...Ask one of the staff to show you the chart..and explain..what orders are written there.

.also.. consider...asking to see ..the nursing homes...policy manuals...and sit down..and read them.

what would you like..done when your dad is walking down the hall holding the hand of another femele resident? what would be the solution to this issue? is what I would put in writing..for sure..

I can only speak for myself..but I would have ignored it maybe even smiled to myself thinking..what a gentleman..as maybe he was being kind and helping her along..as men tend to do..but...I was not there..I did not see..for myself..what actually..did happened

Social workers..are very professional.... special compassionate..people..I know many..and if they work with the elderly they are extra special....they..know about boundaries..and structure..and they have read ..all...of the policies..and follow them..to the letter..

I would have... hoped ..this social worker..did the least possible..forum of..separaion...of these two people by..walking up and taking the female's hand and smiling at your father and say..its time for group..and if that did not solve the issue..

then the nurse needed to be notified and decide..the proper..protocol..and use the skills..she uses all day long..working with..patients..

Jenifer..other than this issue..has this nursing home been a good place?..is your father happy there?

you said you just found out about it...you did not physically see what happened? who did?..and what did that person do at that time? did they take your father out of that chair?

the fact you were not there..make sure..all of your little ducks are in a row..sort of speak..before you...blame..

my reasons for saying this..is..there are always 2 sides..to most issues..and it is so important..everyone..works for a solution..as to what could have been done differently..and make it a learning experience for that staff if..this staff.. used poor judgement skills..at that moment in time..so it will not happen to others..

I only know about hospital policies..so I do not know ..if this nursing home..put in his chart ..the issue of what happened..

but this I know for sure..the he said ..she said..the person..who..found your father..in that geri chair..needs to..be there with you..at your meeting..

I wish you the best..and it is good..you want to work with them..for a win win situation..for your father..as change is hard on our Loved ones..you are his guardian angel..Love Rosie

I would not accept the idea that no one will talk to you for 2 months. I would get my dad out of there, regardless of anyother issue.

Know what? Being a complete outsider, not knowing what was happening when the SW took the step of using the restraint (gerichair) I'd like to feel she meant no harm. She maybe erred against policy, certainly. I hate to think she'd "willfully" go against policy for "no" reason. I wonder - was she the only staff in the immediate area responsible for too many people at once. Too many needing "right this minute" attention to keep them out of trouble/danger.

That aside, if it were my family member, and I was told about it I'd possibly be quite livid myself.

I'm curious who told you, and why..... I just find it interesting that someone told you without further explaining circumstances to try to legitimize (to the extent that they could) taking that step.

As a nurse I've known the fear of being unable to keep adequate watch when charged with several patients, all mobile and headed for trouble. Many times I felt the fear that if something happened I'd be the unfortunate recipient of a nasty guilt trip, angry family, a lawsuit, an administrator taking me down for letting something happen, to even losing a job.

What I feel is the WORST, in this whole situation is that the facility people are putting you off. There simply is NOTHING that can justify avoiding a face to face meeting with you. Their excuses (taxes? Ha!) are horrendously inadequate.

Jenifer,,,I have to wonder who in the hell made it ethical to put the director as "Omsbudsman"? I mean really,,I would lodge a formal complaint with the state on that. How can the "director" of a facility possibley be nuetral and impartial? Not to mention the fact that she is way out of line making you wait til May for "discussion" on this matter!!! Absolutely outrageous!

Please look to moving your LO,,but not without first filing a "formal complaint of complience" with the state. This woman needs to have her ass kicked around a corner to open up the CEO's of the company's eye's.

Remember dear friends that are reading this,,,if we dont' care for our LO's now,,,this is what will possibley be happening in our future,,so make haste,,stand up and be heard. Peace

Uh-oh! Would you clarify if the director of the nursing home is the Ombudsman for her own facility? Or did you mean the director of the Ombudsmen happens to be the ombudsman assigned to that nursing home?

Cuz it's true, it would be terribly unethical for the facility's director to also be the Ombudsman

Originally posted by Jenifer:

"...The intake worker said that the ombudsman assigned to that NH just happens to be the director of the ombudsman program. ..."

The administrator of the nursing home is not the director of the Ombudsman program. :-)

I in no way place blame on the staff that put my Dad in a Geri-chair. I know she probably tried everything before doing that... he can be a handfull to re-direct.

I know the staff at the NH care about my Dad. I know the NH administrator cares about him... it's obvious.

I don't think it was a crazy idea to want to sit down with the team to discuss a protocol for the use of restraint. The staff person used restraint without a physicians order, without the family consent.

We found out about it because the staff who did it, told my Mom and asked if it was "ok". My Mom said she didn't completely agree with it, and didn't there need to be a physicians order?, the staff got upset.

So, I think maybe they are worried?

I wanted just to talk, and come to a solution- but to be denied a case conference? That pushed me over the edge!

All in all, my Dad is well cared for, but the two things that stick out in my head are unapproved physical restraints and denial of a care conference?!?! Those are big issues to me.

Thanks everyone.

It sounds to me as though they are hoping that by the time June rolls around this will all be forgotten.

I would suggest writing the Administrator and explaining what you have told us. That you have come to expect excellent care from the staff at the SNF and were disappointed in the way in which the episode was handled. Further explain that canceling the meeting... and at the last minute for what was OBVIOUSLY an excuse... only fueled the fire. Delaying the meeting for TWO months when it's a matter of EXTREME importance to you and your mom is cowardly. And that the incident itself pales in comparison to the way the situation was handled AFTER the fact. Explain that their reactions led you to report them to the Ombudsman and have had you second guessing whether this facility is really the "right" place for your dad.

Then after all that... I would suggest to her that she find an earlier date for a conference.

But that's just me... and the suggestion is FREE!!!