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Posts tagged ‘Haydel Consulting Services’

Five Things 5 Days at Memorial gets Right

Seven of the eight episodes of 5 Days at Memorial have aired and thus far it stays true to Sheri Fink’s book of the same name. So far, the Apple TV series has gotten five things that may be relevant to us absolutely correct.  I recommend that you all watch the series or read the book and then talk about it in your next Emergency Preparedness table meeting.

  1. A strong leader from your organization must be chosen before a life threatening emergency occurs because regardless of what you have done, a strong leader will assume authority.  It would be in everyone’s best interest if you approved of the person. At Memorial, Anna Pou, an EMT assumed control for both Memorial and Life Care which was an LTAC leasing space from Memorial hospital. Do you really want a doctor you don’t  know or who has no affiliation with your agency running your show?  
  2. If you are fortunate to have ample warning of a natural disaster, encourage your patients to move.  Move them out of your service area if that’s what it takes.  Lose money if necessary.  For the sake of comparison, I had an LTAC client that leased space on the top floor of a building across the street from Memorial.  Prior to the storm, they moved patients to Baton Rouge. It was expensive and most inconvenient but everyone was safe.
  3. Communication sucks before, during and after a disaster.  There is no other way to state that in a ladylike or professional manner. As soon as there is an inkling of a possibility of a disaster on its way, the employees need to call the patients and families and find out where they might be should they evacuate.  Although this information is part of the admission process, things change.  For weeks after Katrina, we were getting emails from people looking for relatives and loved ones.
  4. Plans fail.  Katrina was likely a category two storm when it hit New Orleans down from Category 4 or 5 while it churned in the Gulf.  Everyone was fine the next day.  It was around mid morning when the first trickles of water from a breached levee started to flood the street.  A city prepared for a storm ended up suffering from some of the worst flooding in history.  The generators in place to maintain power were under water. Focus on keeping your patients foremost in your plan and don’t try to anticipate how a disaster will evolve.
  5. Even though plans fail, it is important to have one.  If you work for an agency or hospice provider, be available if there’s any way possible.  Know what the plan is and if you are knocked off course by an unforeseeable event, at least you will know where you should be and can work to get back on track.  

Many of you are wondering why I am stating the obvious.  It’s because many people don’t learn.  Last year, Hurricane Ida hit and one nursing home owner, Bob Dean, thought it would be a good idea to warehouse almost 800 people in a warehouse.  It flooded and the patients were moved to a dryer area.  Most patients were side by side on wet mattresses that were touching with no room for nurses to get through.  Eight people died as a direct result and more died in the following weeks.  It is impossible to care for 800 elderly patients in a dark warehouse with no electricity or running water. Bob Dean felt he was treated unfairly when his licenses were revoked.  When that was largely rejected by the public he went on to say that he suffered from temporary Dementia.  He thinks his licenses should be restored.  Maybe if he hadn’t been visiting friends in the cool dry climate of Connecticut and been out to the unsanitary (to be kind) warehouse, he would have a different opinion.

When we live through a once in a lifetime event, we tend to believe that it is just that – once in a lifetime.  These unimaginable events are exactly that – beyond the scope of our imaginations.  All we need to keep in mind is that bad things happen and our patients come first.

Save The Date

Your comments are needed on the 2023 proposed regulations

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Misdirection

The real reason your claim was denied.

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A Long Summer

There are a lot of jokes about 2020 not being such a good year. For me, it is the year that I lost my mother at the tender age of 89 just weeks before her 90th birthday. To be honest, my math skills led me to believe she was 90 and on her way to her 91st birthday. Oh well.

Throughout this long summer while hanging out with Mama, I realized that we were living through history. Like the 1918 Spanish Flu, the Covid pandemic is an event that will continue to influence history for decades. I knew I should be writing about it but honestly, is there anything left to write? Maybe.

I lived through one aspect of Covid that isn’t getting as much attention as the number of cases and the mortality rate. My mother was ill since February and it had nothing to do with Covid. How she was treated and if she was treated had everything to do with Covid. In the end, I wonder if Covid will totally transform our healthcare industry.

My mother, always social, had very few visitors in the months prior to her death. I did not encourage visitors and when people asked if they could visit, I usually refused. I had two parents and my Dad, with Dementia, simply can’t remember to wear a mask correctly. It was uncomfortable for him and also, Mama. Covid would have been a death sentence for either of them. Even after it became clear that my mother was terminal, I would not have wished a Covid death on her. And who would have cared for her and my Dad if my son or I became sick?

Hiring help was similarly difficult. We got very lucky when an aide who is otherwise unemployed became available. She is sitting out the semester in college due to the pandemic and we are learning from the news that she may have made the very best decision. Agency help would have meant an aide that possibly went to different homes and it would be unfair to limit someone’s ability to work. Covid has changed the economic status of many Americans.

At times, I received a lot of encouragement to send Mama to the hospital. Each time her condition exacerbated, I called the local ERs and learned that nobody was allowed to stay with her in the Emergency room and if admitted, only one person who tested negative for Covid could stay with her. This person was not interchangeable. That meant my Dad who would forget rules about leaving the room would not be able to visit and either me or my son would not be able to see her.

Chances are we would have dropped her off at the ER like so much dry cleaning that got lost and we would have never seen her again. I could not do that and I had her written power of attorney for healthcare so it did not happen.

But there were friends and relatives who made life easier. I have a cousin who is a physician who visited. His approach to Mom’s care was like mine – as long as something was not painful or invasive, Mama got it. No extensive treatment or ‘heroics’ (as she called them) were attempted. If Mama were around or if she is reading this blog post, she would tell me to add to it that there is nothing heroic about shoving a tube down the throat of a senior octogenarian simply to prolong a heartbeat. And Mama is always right.

A cousin who is a nurse along with her daughter provided the very best palliative care – chocolate peanut butter cookies from the Snoop Dogg and Martha Stewart collaboration cookbook aptly named From Crook to Cook.

Another local cousin dropped off meals. It was gourmet meals on wheels. Like kids playing a joke on neighbors, the doorbell would ring and nobody would be at the door but when I would look down, there was dinner. There are no words to express how grateful we were for the care packages.

Cards were also delightful especially to mother. The beauty of cards is that they can be set aside when appropriate and read repeatedly when someone is awake.

I tell you all of this because unless a treatment is found for Covid very soon, everyone will have a friend or relative with Covid or another illness that prevents visits. You can still let them know that you care. Snoop, Martha and Cousin Tillie would want you to find a way to bring chocolate comfort.

Still, I would have hired help earlier had it not been for Covid. I would have maybe, just maybe, taken Mom to the hospital when she first had a GI bleed just to see if the problem was easily correctable. I would have had hospice come in earlier. As it was, I had access to a hospice client who gives excellent care and they were on call for me whether they knew it or not. Thanks Audubon.

Humana saved a ton of money on my mother without changing the outcome of her illness. I realize this a luxury because not everyone can take a break from life to provide total care to an elderly patient but I wonder how many people are not accessing healthcare because of the pandemic. Are outcomes in general significantly changed?

But that’s just my story of how Mama saw a return on investment on my nursing school tuition.

Covid has affected every aspect of our lives from how we work and shop to how we educate our children, socialize and even experience illnesses. Politics has played an inappropriate role in determining our response to Covid.

I hope you’re keeping some sort of record. 102 years after the Spanish Flu, it is the personal accounts of the patients and the healthcare workers, and even the San Francisco Anti-Mask league of 1919 that tell the story of the Spanish flu. Some numbers are just too high to comprehend.

If you are keeping some sort of record, please consider sharing all or part of it with us. You can email me here.

COVID-19 for Visiting Nurses

How should home health and hospice visiting employees address Covid19 and protect staff and patients?

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