Care Conference Summary - Fri., May 28th

Care Conference Review
In attendance: Lyn, Matt(Dietary Consultant), Dan (Director of Nursing), Pam(Recreational Therapy), Patti(Sociologist), Jon (Day Charge Nurse). Pat was sick so stayed home but participated through a speaker phone.

Overall – I was pleased in that their overall philosophy was that they (Riverview Staff) were there to work in concert with family to try and better the quality of Mom’s life.

Mom’s crying and wailing has been disruptive to other residents and to staff. They have tried numerous interventions – i.e., attention, comfort, engagement, firmness… and on Thursday morning they felt they needed to try a medication change ‘to try and reset her scales,’ as the other interventions were not working. . (I did not realize it but at meals she was doing some wailing so the whole dining room experience was a bit altered. (understatement, I believe.) Dan, the Director of Nursing did finally go into her room yesterday morning and eyeball to eyeball told her that her crying was upsetting the other residents and the staff so he was going to have to close her door until she could get under control. She did stop crying at that point, but was still very anxious/agitated. So in working with Dr. Dentler they removed the Xanax and started Haldol. The script is for 1 milligram 2 times a day…but they started with .5 milligrams once a day in the morning. It seems to be working for now.

Mental Health Evaluation – They are going ahead with a mental health evaluation from Spokane Mental Health. We did receive the one from the Tri-Cities but there were no recommendations.
They also said at some point in the meeting that they didn’t expect to figure things out today or tomorrow, but they would figure it out. … They did say that at some point we (family & staff) might decide that another placement in a different part of Riverview or a difference facility might be in her best interest. Pat and I acknowledged that possibility, but communicated that right now we feel that we have seen progress and want to pursue interventions other than moving her.

They asked Pat and myself to give them more of a history and so between the two of us we gave them a synopsis of their life and particular the events of the last 7-8 years. It becomes pretty evident to everyone that Mom has experienced a number of losses during the past 8 years.. Loss of farm, loss of ability to cook, loss of physical mobility (when she broke her hip), loss of core of friends, loss of Jim, Loss of 2nd home- Charbonneau, and change of facilities – Callaway to Riverview. We told the story of Dad’s relatively wonderful passing – showed them a pic of Mom and Dad in bed that last day.
Dietary Issues. They have noted that Mom weighs 117 and would like her to maintain or gain a few pounds. They have noted that she on average eats 50% of meals so they have encouraged and added high density foods, i.e., the Boost Shakes, other shakes, encouraging family to ask for any snacks at any time. During this meeting they decided that stocking a snack basket in her room would be good. (It was in her room within the hour. It will be automatically restocked on Monday of each week but we should feel free to ask for more if we need it – or for something that is not in the basket.

Pam – Recreational Therapy. She said in trying to help with the crying they have tried adding music to the room, and have engaged her in their exercise group. They asked about other things Mom might be interested in… We said she used to do Word Searches. They will enlarge some simple word searches and RT staff will sit down and do them with her. (We should do the same when we are there.) Any other ideas???

Future Care Conference Meetings. They usually have Care Conferences when there is an issue – not necessarily on a regular basis. We most likely will have another in a month or so or sooner if there are continuing issues. We are expected to have a family meeting with Dr. Dentler who is at Riverview on Wednesdays. I will call his office and arrange that – hopefully making it for time far enough in the future that Barb, and maybe Davenport or Coulee Ericksons could also attend and meet Dr. Dentler.