What to do when a rehab is not providing the proper care?

RR, how often do you go see your mom? When my mom was in SNF, I went at least twice a week and for the first year, more often. I went at different times and got to know just about the entire staff, especially the aides who were assigned to her. My mom could be a pain in the you-know-what and I often commiserated with the aides about that. I still giggle at some of the stories they told me about her behaviors. When my hubby was hospitalized with a near-fatal heart infection, they were all worried about me.

This is how I got things done for my mom. I’ve mentioned here that they would call me about everything from putting a bandaid on Mom to a new Alzheimer’s medication she was to be given.

When you go for this meeting tomorrow, be polite, firm and informed. Do not accuse. Ask “why” or “why not” and listen to their answers. Bring a notebook to document what they say. And let us know how it goes.

All of moms charts say diabetes and no salt. Also restrict fluids. The dr at hospital was great. Now if the rehab will follow dr instructions and protocols. I am not over reacting. I am reacting to substandard care. Meeting scheduled for 11:00 this Monday. I have also contacted county who say I am exactly correct. If not corrected file a report. Oh and today we discovered that her laundry had not been done on 4 days. Mom had no pjs left. Cna washed then for us today. Really!

I have to kind of side with the rehab. When I found Mom was not getting a med, it was because the doctor at the hospital dropped the ball. The rehab is only as good as the hospital who sends over the correct paperwork. Actually, I was told I would have a care meeting in the first week. Ended up being 10 days. Start with the dircector of nursing. If you get nowhere ask for attending's number. If you get nowhere, ask Moms doctor to call and speak to the attending. You have your good nurses and you have your bad nurses. I let ,my daughter go in with her srubbbs on. They tend to jump then.

Very sensible approach OvertheEdge

I had a similar reaction to seeing the food diabetic Mom was being given in rehab. When I cared for her at home, I got her A1C down to a seven - which her doctor told me was amazing & she was clearly being fed and managed appropriately. I felt great - especially after Mom's complaining about my cooking and my menu planning that I tirelessly worked on.... Anyway, when I saw what they were feeding her in rehab... I was pretty shocked. I mentioned the diabetes and her other problems & nursing said they would get on it. I didn't see significant changes to what they were giving her, but they WERE checking her blood sugar (including in my presence several times) and all sugars were indeed in range. Surprising as that was, I guess what they gave her wasn't wrong after all and I'd done a lot of needless worry. Other lab work has improved in general since she's been there. My point is that different isn't always wrong. However, if you're saying sugars aren't being checked & diet seems random I'd say to approach this from the standpoint of getting her sugars checked regularly & then ask them what your mom's numbers are. If she runs high, ask the reason for that and the dietary concerns you have will likely get addressed as part of an overall plan which will be comprehensive in nature.

I’m sorry you are dealing with this.
I think you have to decide what’s most important.

I spent an hour one time with a dietician in a rehab who told me what my mom should be eating and then when I tried to order it for my mom, I was told they didn’t have it. Wouldn't be getting it etc. I asked why did you send the dietician in to discuss food with my mother if you don’t follow the guidelines?? In the end I figured they must have had a box to check.

This rehab was supposedly the best in a major city. I’ll admit the PT guys were great but everything else was a joke. My mom had CHF and ended up back in ICU after several events at this rehab I won’t even go into.
I was able to get her in the rehab at the hospital which was much better.

Most hospitals have horrible (for you ) food offerings. It doesn’t make any sense.
My husband got hooked on artificial sweeteners following a hospital diet for weight loss. The latest medical journals report that that stuff is horrible for all of us but it’s offered like a health food on this diet. He lost weight but then had to deal with those cravings.

No accountability.
It’s a hot button of mine but at 94 if your mom likes it....why not is what most people think.

I hate to say it but it’s pretty much the same all over.
And we wonder why our children are obese and diabetic.

I would let her stay for the therapy. It will really help her get going again.
Sorry for the rant.
If you are there adjust her tray as much as possible. With diabetes you are one meal away to better numbers. And you sometimes have to stand on your head to get the most basic thing corrected in a file. 

My mom wasn’t diabetic but I caught the head nurse about to check her bs one day. I told the nurse, it won’t hurt my mom to be checked but what about the person you are supposed to be checking?! Another time she was bringing her an enema that wasn’t intended for my mom.
This was my first experience with a rehab and I was horrified and afraid to leave her.

Therapy is hard work so your mom needs plenty of protein to offset that sugar. Maybe you can bring her a protein drink or whatever she’s allowed normally.

I kept plenty of Lysol wipes handy and kept everything wiped down. I was thankful that I wasn’t having to do the laundry or the floors or the bed linens. I was grateful she had great therapy. She liked the food but knew it was bad for her. I lived very close to the rehab and could check at odd hours and often. So, no, don’t take her home but impress on her to watch what they bring her and do the best she can with therapy so she can get strong and go home soon.
I know people don’t always have a choice. With your mom’s advanced age and all her issues she must be very tough. Hang in there.
Edit:
I went to ALL the meetings and met with everyone DeeAnna mentioned. This place was just inept. I learned a lot. Mostly stay healthy. 

It would have helped if the nurses would have worn their readers. They were constantly trying to figure out who was supposed to get what. I was probably there too much and could be the “what to not do” character in a training manual but I do believe in the therapy and that is why she is there. 

Dear geewiz, that doctor sure dropped the ball in regards to your friend's diabetic Mom as did the Nursing Staff! I am glad that I never had to work in a place like that, I would have quit.

COMMUNICATION is KEY in making sure that your loved one is being taken care of properly. Has your friend's mother had any Care Conferences yet? If not, your friend needs to contact the Nursing Manager and find out when the next one is and/or schedule a special meeting with all departments, with her Mom in attendance, to discuss her Mom's care and any concerns your friends or her Mom have.

NO, you do NOT need to "Get Tough"---You need to COMMUNICATE{:-)

You need to talk with the DIETARY STAFF and the NURSING STAFF at the facility and tell them your concerns about your Mother's care; (but only after you have calmed down and can talk with them respectfully and are willing to LISTEN to them about your Mom's care.)

Your Mom's diet at the facility depends on what TYPE OF DIET was ORDERED BY the DOCTOR and how many calories the Doctor stated that your Mom can have.

Based on a PRE-DETERMINED MENU, the Dietician/Dietary Manager and Dietary Department CAN serve sugared drinks and cake with icing and give your Mom salt or items that are salty. Usually when such items are given, the person gets "half of a regular portion" or specially made versions that has less sugar or has sugar substitute OR less salt or has salt substitute.

You need to talk with the NURSING MANAGER of the Hall or Unit that your Mom is staying on and discuss calmly and respectfully your concerns about checking your Mom's blood sugar. Again, how often someone's blood sugar is checked is determined by the DOCTOR ORDERS.

No one is "ignoring" you, they are following the DOCTOR'S ORDERS and if you disagree with what has been ordered, then you need to communicate your concerns to the appropriate person or persons.

Make an appointment to have a "CARE CONFERENCE" with all of the department managers (Dietary, Nursing, Social Service, Therapy, Activities) and with your Mother attending also--it is her RIGHT to attend these conferences. There should be a Care Conference every 30 days or so while your Mom is on Medicare (100 days total) and then every 3 months after that. Write down your concerns prior to the Care Conference or meeting with the Dietician/Dietary Manager and the Nursing Manager.

I think once you understand how Rehab and the nursing home staff operated, you will be able to be a more effective advocate for your Mother. When a loved one has as many health problems as your Mother has, it is easy to get over-concerned and react in a way that isn't always conducive to good working relationships with the facility staff. Please remember that they have Rules and Regulations and Doctor's Orders that they have to follow while caring for your Mother. Be willing to communicate with the facility staff and I think that you will find that they are looking after your Mother's best interest. God Bless.

Staffing is always a challenge. When my friend's diabetic mom was in rehab, the patient (totally cognizant) asked for her medications and blood sugar testing. They totally ignored her. So when her daughter (my friend) arrived, she told her what was going on. My friend visited the nursing deak and ultimately had to go to the director. here is what they told her: The doctor's orders are for sugar testing and oral meds for two weeks and it's into the 3rd week now! : - / My friend asked if they thought the diabetes would go away! The doctor's order were stupid. The nursing staff, just as stupid for not questioning. And only heaven knows what to do with all of the patient's inquiries. You REALLY have to be on top of things in any facility!

Go to the Administrator of the facility and share your concerns with them. You can also speak with the floor nurse and ask her why Mom does not have a special diet listed on her chart or in her orders. Also ask why her blood sugar is not being tested. They have to keep a record of it. Speak with her doctor to make sure orders were given for a special diet. Sounds like somebody dropped the ball somewhere and you’ll need to research and find out who. Don’t let them ignore you. You have rights. Keep making noise until they give you answers.