Karen McPhail, RN, MSN
Behavioral changes and a recent experience!

I was working with the husband of one of clients in choosing a memory care facility for their loved one. Although a difficult decision, the time had come and we were together making the best choice for the client and family long term. She would benefit from a more structured, secured, environment with social opportunities and memory care programming. In addition, the family would be able to enjoy time with their loved one more rather than focusing on direct care and tasks. The process took time, was emotionally difficult for the family, but after viewing numerous facilities and having guidance and support, they decided on two that would be an excellent fit for their family member. A home nursing assessment was arranged as usual with the facility. At the time of the assessment the individual was not herself. The family even remarked that she was more resistant to care lately. The assessment coordinator came and met with the family and immediately rejected her as a client, saying that she had behavioral issues and would not be able to be managed at their facility. As their Care Advisor I was surprised by this as this was not the woman that I had described to them or evaluated myself recently. She had been pleasant, easily redirected, able to walk with a walker, and more...she was an ideal memory care candidate! I asked if she appeared ill in any way at the time of the evaluation? They assured me that they had done this for years and that they were very knowledgeable from a nursing standpoint. A full evaluation had been done on their end. I was not as confident and decided to visit and assess my client further. Upon arrival I was immediately able to see that she was confused, delusional, and not well medically. She was showing signs of dehydration, was agitated, combative, and unable to eat or drink. Being diabetic this was a huge concern for me as it could obviously be blood sugar related. Being unable to assess her blood sugar quickly in the home due to her cognitive situation I immediately called 911. I was also very concerned as I noticed signs of possible sepsis during my assessment. She was quickly assessed further and admitted to the hospital with a urinary tract Infection, sepsis, dehydration and other issues. I am glad that I was able to advocate for this client and allow for a successful outcome.
It saddens me that even professionals working in the field are sometimes so quick to dismiss potential residents without going the extra mile and really taking the time to assess properly. We have many nursing facilities popping up all over the country, but sadly many more seniors requiring care. Things are out of balance in a challenging way. Seek guidance and support through a geriatric care manager or care advisor if possible to avoid issues and help in moving the process in a positive direction.
And, if your loved one has a cognitive change ensure that they are assessed promptly and advocated for as there are so many possibilities aside from a downturn due to dementia.
If you would like guidance in finding a trusted facility for yourself or a loved one, feel free to message me through the contacts page! I am happy to provide you with a customized list of trusted care providers!