Can unloving and uncaring environments create failure to thrive in the elderly?

Can unloving and uncaring environments create failure to thrive in the elderly? The Haven in Allyn Assisted Living / Long -Term Care Facility recently admitted this 97 year old man. He was on Hospice services for Failure to thrive. He was admitted November 5, 2010. When I went to do the initial assessment he could not open his eyes due to dried up mucous that was sealing them shut. He could not stay awake because he was so over medicated. According to the nurse that was giving me information this man was not waken up till lunch, but ate well. He was able to stay up for about 2 to 3 hours before being put back to bed because of pain. So this man ate one meal a day and was only out of bed from 1 to 3 hours a day. Basically,  he spent about 21 hours alone no people, no music, no food, and no love.

November 5 at 2:00pm we went to the facility to pick him up. He was very lethargic again lots of crust around his eyes. He had BM all up his back. We put him in a 1996 Cadilac and talked to him all the way to the Haven. He would answer us between naps. As soon as we got him back to the Haven we put him in the shower and shampooed his hair, he smiled the whole time. After the shower we feed him. We immediately started reevaluating the medication regime after the RN assessed him and discussed it with his MD. Now he start living the Haven life. He is gotten up about 7:30am showered and shaved dressed brought out to a warm dining room overlooking Mount Rainier and Case inlet. He is constantly greeted by cheerful caregivers. Lots of good food is set before him for breakfast, lunch, and dinner. All narcotics are on a prn bases. He began to talk, feed himself, assist with transfers and wanting to walk by day 10. He has also gained 2 pounds. Most of the pressure sores are healed and the crust in his eyes are all gone. He looks like a new man.

This is the 3rd time we have rescued a elderly person that was considered  'failure to thrive'. The first one lived 18 months after being given 72 hours to live, the second one 15 months, and now this man. There is a real problem in our system when it comes to caring for frail elderly people who are total care. Unfortunately most of them are over medicated and starved to death but we call it "failure to thrive". I beg to differ none of these 3 individuals were properly diagnosed. They all thrived and lived to laugh, smile, enjoy music, food, art, hugs, kisses, love and life at the Haven in Allyn.

My Witness 5-27-10

Today I witness why I'm in the Assisted Living / Long -Term care business. Do we believe we will never get old? Is that why we can ignore what we see when we visit a facility? Can we really ignore the terrible food and the smells? The less than respectful treatment. I went to visit a couple who lives in a facility in Silverdale. It is considered a " nice place". The couples room smells like urine. The gentlemen fell and was on the floor for three hours before anyone came in: and the only reason they came in then because it was time to get the women up and dressed for the day. The gentleman suffered some rug burns and a very swollen and sore right knee. He was not taking to the Doctor for evaluations. He is a diabetic and the edema around his knee concerns me. They invited me to have lunch with them, so I did. The food was absolutely terrible. It was unbelievably awful. I felt so sad when I left. I will be returning today to take this man to see his doctor. What is going on in our world? How do we sleep at night or look at ourselves in a mirror without vomiting? How do people work in places like this day after day as if this is acceptable? Do we think old people are invisible? Do we think they really deserve less than the best that could be given to them? How could we be so smart as a nation and so stupid to how old people are cared for? I'm so hurt right now and I'm not sure what to do. I can't ignore this couple's plight. I'm doing everything possible to move them into the Haven in Allyn. They visited the Haven and had lunch there three weeks ago. They cleaned their plates so fast that it was amazing, and some what interesting. I had no idea the type of food they are being served on a daily bases is so bad. They gentleman still remembers the brownies we served for desert. He said he had not had a brownie like that in years. He also remembered how beautiful it was there and how good it smelled and how clean it is. Everyone I do mean everyone comments on how nice it smells in the Haven. I could not imagine it being any other way. If we continue to live we will get old. You may require some type of assisted living care or long term care. Do you really want to smell like urine and eat awful food? Do you think you deserve that treatment because you are old? Do you think you will be unaware of your surroundings? You will be the way you are now just older. You will still enjoy the feeling of being clean after you take a shower. You will still enjoy the taste of good home cooked meals. You will still enjoy being treated with honor and respect. You will still want to be able to make your own decisions. These desires don't diminish or disappear as we age. If we don't stand up for our elderly community we will suffer the same fate. I'm not willing to do that. With the help of everyone who visits the Haven. I'm going to change the model of Assisted Living / Long Term Care. The Haven is a new model and my goal is that it becomes the standard for the industry. It is the kind of care everybody would want for themselves. It the kind of care I believe every human being deserves.

Advocate 5-28-10

Today I got a visit from the wife of a resident that previously stayed at the Haven in Allyn. She was inquiring on what she needed to do to bring her husband back. She has come t to me before about bring him back but she didn't follow though. Now I'm not sure what she is going to do. As we talk she still has the same issues with the other facility she had several months ago. Which includes awful food, high staff turnovers, getting only one shower a week, facility just generally not being a clean place. She tells me story after story of poor care and very bad food. I asked her to just taste the food and she said she would "never taste that food". Even though it is being served to her husband three meals a day 7 days a week. I told her that I could just choke her. Yes, I said this out loud. I also told her the impact that this type of care, food and environment had on his mind. That he was getting messages that he is not important or loved and how could she just allowed this. Yes, I asked this question out loud. She did answer, she just looked at me. She told me that she thinks people with dementia don't know the difference between good food or bad because they just eat for the calories. So, I asked why is she here at the Haven today and what can I do for her. She says she wants to bring her husband back because she is tired of driving so far to visit him. She said she is doing it for selfish reasons. As I began to discuss the kind of care and service we offer at the Haven and how much her husband would enjoy it and benefit and how he deserves this kind of care. I noticed I was advocating for him. I was pleading his case and speaking up for his rights. But, what I noticed is it was not making an impact on her at all because she did not really care about all of that. She is selfish and she wants to know "what's in it for me". I really was not communicating to her because my concerns were for his best interest. But, to be an advocate for him I should have been focus on her needs only. I learned a powerful lesson today about communication. In order to best advocate for the vulnerable seniors of the world I must understand what important to the decision maker, not necessarily whats in the best interest of the vulnerable senior. I love what I get to do for the residents and their family members at the Haven. We really do focus on what good for the residents first. We want to make them as happy as possible all the time. Needless to say this resident is moving back in a few days and for that I'm thankful. All the staff really loves him. And the day he left he was so hurt because he thought he had done something wrong. I'm glad God mad me with the heart of a caregiver.