What is the expected response time to a call button and are SNH required to keep a log of calls?

It’s a shocking thing to witness at first…if not outright traumatizing. During my father’s stay at a SNF/Rehab center it was not uncommon to see every single patient’s call button lit up & a chorus of blood curdling screams begging for help echoing through the halls. I had to wait at least a full hour each time I visited to get someone to help me transfer my father to wheelchair so that I could take him outside his room to visit. This was at a facility with very high ratings, and after I frequently bought freshly baked goods & coffees as a good will gesture to the staff.

The bottom line is this - There is & will continue to be far more people in need of care then there is or will be people to provide that care. No one ( Seriously ) takes on the job of caregiving or nursing with the desire to do or cause harm. I truly believe that these staffs are made up of good people struggling under horrendous circumstances.

I also understand that the Silent Generation & Boomers grew up experiencing service with smile… customers always right kinda world. It was time when a grocery store clerk earned enough to support a family & could buy a home on that single income. Times have indeed changed. Those working today in any service industry face economic hopelessness in a way that our current elder generations simply do not appreciate.

Of course it’s very important to report any issues you witness to the administration of the SNF. My father was once left to stew in his own feces for almost an entire day because he was ignored. Totally unacceptable.

But try to do so with a sense of empathy for those caring for your loved one & the circumstances in which they are forced to function.

Truly, I wish you the best during your journey. And if you actually want to change how we care for our elderly & disabled, write a letter of complaint to your congress person or senators. Only squeaky wheels get oiled.

Lily,

Overall my mother’s stay at rehab was very good.

It is unfortunate that serious issues occur from time to time. Nursing homes are short staffed and there will always be some workers who aren’t up to par. There are good and bad workers in all professions.

I experienced a frightening incident when my mom was in rehab in a skilled nursing facility. Mom was always very conscientious about her meds. She was quite capable of handling her own medication at my home. So, I didn’t doubt her when she told me what happened.

I went to see mom in rehab and she looked a bit upset. I asked her what was wrong and she told me that her nurse had given her a double dose of her Parkinson’s medicine because she didn’t want to return to her room later to give her the last dosage.

Mom politely told her, “That’s twice what I normally take. Will it hurt me if I take twice the amount?”

Mom believed her nurse when she said that it wouldn’t hurt her but she was uneasy about taking a double amount of her meds. She thought it was odd that the nurse said that she wanted to save a trip back to her room to give her the next dosage.

This nurse had no way of knowing if the double dose of meds would harm my mother. I certainly wasn’t happy with her decision to double dose my mother.

Naturally, I was upset but I didn’t want to alarm my mother. I calmly told mom that I would handle it. Mom was anxious about retaliation from the LPN if she found out that she told me what happened. Again, I told mom not to be concerned about it because I would handle the situation.

I called the pharmacy that we use and asked our pharmacist if mom was in danger being double dosed. She said, “If this happened only once, probably not but if this happens again it will be a problem. I think you should report this issue to the DON at the facility because if this nurse is doing this to your mom then she is most likely doing this to other patients as well and it is dangerous to double dose patients.”

So, the next day I did report the incident to the DON. I also told the DON that mom was concerned about retaliation.

I am happy to say that mom’s incident was handled very well by the DON. The LPN was questioned. She admitted what she had done. She was written up for the incident. She was ordered not to ever return to my mother’s room. So, my mother and I were satisfied with how it was handled.

Please don’t allow one or two mishaps to convince you to not to place your mom in a facility. Look at the entire picture. I think if you take the time to weigh the pros and cons you will see the advantages of placing her.

If and when something disturbing does arise after placement, remain calm, speak to the DON in a respectful manner and trust that they will handle it. If it isn’t handled properly then go to the Ombudsman in your area.

Don’t allow all of the ‘What if’s?’ in your head stop you from doing whatever is necessary for you and your mom.

Wishing all my best to you and your mother.

Lots of folks here are encouraging me to place my mom in a SNF to save my sanity (which I appreciate). But remembering mom's past two rehab stays holds me back.

Mom was in a highly recommended rehab. She would often have "morning meds" brought between 11:00am and 1:00pm. She would wait 2 hours for an Ensure (she wasn't eating), if she got it at all.

But the absolute worst was the time a nurse spilled her IV antibiotic dose. It was a mistake, she didn't cap the tube when she was called away before hooking it up, and the IV bag slowly emptied onto the floor. Mom wasn't upset, but simply asked if she would get a replacement dose (she was told yes, but didn't get it).

In the meantime I guess the nurse was reprimanded. The next morning, after mom had been given prune juice, 2 stool softeners and a laxative the night before, that nurse angrily refused to allow mom to go the bathroom. (I know it's the CNA's job, but the nurse was with her when mom was begging to go). Mom wasn't safe to go unassisted, but tried to anyway, and of course had a humiliating accident.

My daughter showed up for a visit a short time later and mom was in a chair halfway between the BR and the bed crying, because she couldn't make it back to the bed, with the mess still not cleaned up.

I, of course, wanted to file a complaint immediately, but mom was terrified of even worse retaliation. Even to this day she won't let me send the letter because she's afraid she could end up back there. You can be sure when mom passes a complaint will be made, including to the state.

And, yes, at other times mom was in the BR with her O2 sat around 80, unable to get off the toilet, and pulled the emergency switch. No one came. She was not even supposed to be in the BR alone in the first place. This was the rehab specifically recommended by her pulmonologist. I guess they have good pulmonary rehab, but not good general care.

This is why I'm so adamant I don't want to "place" mom.

I agree 100% that 45 minutes is a long time to wait. No question. And no one wants that for their loved one. But I had my eyes really opened a few weeks ago to what it really looks like from the inside.

Let's say you have 2 CNAs assigned to 8 rooms (and that's being generous - with understaffing right now it is usually more) and that 8 rooms can be anywhere from 8-16 residents. And let's say that my FIL needs to be changed. That's a 2 person job. And it's going to take a minimum of 15 minutes no matter how you slice it - but a better estimate is closer to 20-25 and on a really bad day - it could be upwards of 30-45 (diaper, clothing, cleaning, bedding, etc). And they may come in and out of his room a couple of times in that window for supplies. So to someone outside of his room - it may look like they are ignoring everyone else.

What they are doing is responding to the calls in the order they received them - and dealing with whatever the situation is - however long it takes - which in some cases it could be longer than they want or expect and it may take all hands on deck.

Now I'm absolutely not saying that it doesn't happen that there are situations where people are ignored or mistreated or even abused in nursing homes.

But what I am saying is that when you have every call button in your care group going off - and you have to go in the order that the call came in - and you run into a situation that takes a while- you have to finish it. And unfortunately other residents have to wait as a result.

I've seen them walk right by my FIL's room when his call button was going off too - on their way to another resident's room. But I've also seen them RUN to help people. I've seen them IMMEDIATELY react when my FIL needed help.

There are pros and cons to residential living. There are no two ways about it. And you should be diligent in you concerns. But you also need to really know and understand the realities of staffing and how much time things actually take in a nursing home to accomplish. Changing an adult diaper takes way longer than changing a child's diaper. Getting someone on a hoyer lift and into a wheelchair or changing bedsheets with a resident in a bed even when trained for it, can take a long time. And you can basically double all of that when the resident is immobile or robust in size (like my FIL). And there are situations when you can leave a resident and come back, and situations where you can't.

There are some who think that all nursing homes are inherently bad and will tell you that anything they do is bad. But you have to look at it with your reality glasses on and pay attention to whether the situation is truly problematic and neglectful - or just unfortunately a product of taking care of that many people who need 100% care from another person.

I feel your pain but the reality is that the staffing in all medical facilities right now is bad. Now you get "bad" people who don't care in any industry but you tend to get a lot more when you pay $15/hr and don't have a career ladder for advancement. Even those who are caring and concerned are often stressed and over worked. Here's an observed scenario to point out what can easily happen.
NJ currently requires a min of 1 CNA per 8 residents during the night. So we have CNA A, CNA B and CNA C scheduled for the evening to care for 24 residents. All good. At 3:30 CNA A calls in to advise that her childcare has not shown up and she hasn't been able to find anyone else so she can't make her 4 pm shift. Nursing staff starts calling agencies to see if anyone can cover (pretty hard at that late notice but they try); meanwhile CNA B and CNA C now have an extra 8 residents to split up for care. No agency replacement CNA has been secured and the RN on duty is on the other side of the building documenting charts, scheduling any night meds, calling doctors, and fielding calls from families. At 11 pm CNA B goes on her lunch break. The minute she leaves a resident call light goes on. CNA C goes to investigate and finds that a resident needs to be toileted but also finds that the resident is documented as a 2 person assist so she can't help at this time (a single person trying to perform a documented 2 person assist is a disaster in the making; the CNA can get hurt, possibly contributing even further to staff shortage if she/he is badly injured, the resident can get hurt, and if anyone gets hurt, it has to be reported to the state and the facility will get a demerit and a state visit!) so she advises resident she will be back in a minute with her co worker to help. She leaves the room and goes to answer another call light. CNA B returns from her break, checks the first call light that went on and also realizes that it is a 2 person assist. 2 more call lights go on so she goes to check on them. CNA C is now available to help the first resident but CNA B is busy with a call light. Only when they are both available will they get a chance to get back to the first resident -- which might leave a 4th light still on. I timed this scenario - it was over 45 min and the CNA C ended up taking a very late break because they were trying to respond to all the call lights before she went on break. Does this happen to nursing staff in hospitals or ICUs? It sure does and in many cases it does burn them out (critical shortage of nurses these days also) but they get a better pay rate so that they may be able to take time off to resuscitate themselves or since they often have a better education, to find a new career.

You do need to have a discussion with Admin but I cite this scenario so that you will be aware of the opposite side of the mirror so to speak. Also be aware that in some states, unless you are responding to a critical situation (fall, loss of consciousness, etc) just because you work in the facility, you are not always allowed to touch or assist a resident. Was the NA you saw really a nursing assistant? My friend is a kitchen staff worker and although she can go into resident rooms to get their menu selections she is not allowed to touch a resident as she is not a medical staff member. It can get both confusing and frustrating!
I wish you good luck in this journey and hope this a resolution for this issue soon.

Nina1965: Perhaps you should address your concern to the administration of this facility. In all professions, there are going to be individuals who excel at their profession and some who are rather lackluster.

My husband was in an assisted living facility early this year. He had surgery and required nursing care for two months. It always took them two hours minimum to respond to his call button. One night he called for help and they responded, changing his bottom sheet but tossing the wet top sheet over him and leaving him that way for 17 hours. I hope we never have to rely on any facility again. It was a harrowing experience.

I am sorry that your mom is going through this. Nursing homes are short staffed but that is a long time to wait for assistance. Speak to the DON at the facility.

Wishing you and your mother well.

Kudos to the the DON for quick and professional handling and for the reprimand to the offending staff member, who hopefully will go into another field or at the least not try this maneuver on another resident.

This is an issue we cannot judge.
Your report goes to administation.
Call today to arrange an appointment.
No, logs of calls are not kept; you can imagine, given staffing that there is no conceivable way to do such things.