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So a well-recommended, 5 star LTC facility opened up and we were able to get mom in. I'm utilizing this time more almost so I can wrap my mind around some things and still explore the possibility of hiring private caregivers to supplement PACE. She has to be out of her independent living facility, so the timing was good.


The staff was so warm and welcoming. Mom is a bit confused but overall seems well.


HERE is my issue,


I happened to look up one of the NPs that is part of my mom's care team on facebook. Her profile isn't private so I just scrolled down a bit and just in August she posted what I feel was a very disrespectful post about nursing home patients. It went like this:


"Dr., what happens after we die?


"We clean the bed and admit a new patient"


Her own comment at the top was "This is so wrong, but when you work in a nursing home"


I know her personal life is personal. I won't send this on to anyone...


But I am SICK. I need to get mom home sooner than later and this is probably a sign.


But why would an NP who is supposed to care for this population post such a thing?


Would this bother anyone else?


Thank you forum friends for letting me vent

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That was incredibly unprofessional!

Your research was excellent. Don’t apologize about finding information that someone published. Don’t apologize about feeling badly, either: there is no place for such an inappropriate remark, especially when made by a healthcare provider.

These centers are profit-making businesses. All the glossy ads they can publish won’t blind you now.
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She wasn’t saying this as how she feels she was making this comment as this is often how nursing homes present themselves as a business. She saw the pier and it resonated with her. She even stated this was not how she feels but some people/ places seem to.

she’s probably a great caregiver as she stated she does not feel this way. Making others aware. De-stressing. Please don’t take it personally. I as a teacher share smh 🤦‍♀️ memes I see to share with others as sometimes I can’t believe what others say.
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My comment about creepy was probably based on my distrust of social media. I’m not a Facebook user or any other social media. Aging Care is the only Internet forum on which I read or post. We discourage our employees from posting about our assisted living/nursing home and discussing residents/patients is forbidden outside of the clinical environment. If we became aware of an employee having such a discussion or a social media post they would be subject to immediate dismissal as stated in their signed work agreements.

The company we use for background checks does a criminal background check, credit, driver’s license and a personal check. We pay considerably more for our complete checks.
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I read a comment about how “creepy” it is to check social media pages. Seriously, a person can present one way.... and then “post” all kinds of unsavory and revealing content on social media. My husband would never want these potential employees to interact with his clients or staff. Recruiting quality staff is worth doing “real world” investigation. The 50.00 for a soft background check can show arrests, criminal charges, offender registries and bankruptcies, etc... However, a typical background check does not reveal crude language, treatment of women (trust me, you would be appalled) or inappropriate photos. Let’s be clear, there is a difference between a degree of “stalking” and being vigilant about the quality of people we expose clients, employees and others to. Seriously, having worked in social services, deranged people don’t always “present” as deranged... that is why victims... at times... allow them into their lives.

I am in no way inferring the NP that made the post on FB is deranged! However, my point is that as advocates for aging loved ones, we need to be realistic and seriously investigate caregivers we consider hiring or have nagging, gut feelings about.
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This is from December 2018, so nearly 2 years ago:

"I've posted various questions here and mentioned briefly about my background. However as a quick summary, my father took his own life at the age of 79 this past March. This has obviously left our family reeling and dealing with multiple emotions. I am a nurse and currently in school for my Nurse Practitioner. I "know" what I am supposed to do, and I have counseling scheduled to help me work through anger, grief, guilt, etc. So, I know I can't NOT address my own issues if for nothing else but to be the best mama and wife I can to my family so they don't suffer because of any unresolved issues I have.

That being said...My 80 year old mom has been abandoned and is depressed beyond words. Understandably so. 55 years with my father. The woman is broken. She may have had some early signs of dementia a year or two ago (now that I look back), that maybe my dad was hiding pretty well. Because now, especially in the evenings, she says some very "off" things. She is sleepy all the time. She shuffles around and looks 120 years old. She is living in a first floor apt. literally 2 minutes from my home. This was because of her knees and also because I just don't think it is healthy for my mom to live WITH me. I love her and respect her but she is stubborn and fiesty and has no problem just walking in our bedrooms unannounced. So...this is best.

Ok, so what do I need help with? The Mindset question...I CANNOT seem to be there emotionally for my mom. I am irritated by the way she has seemingly given up on functioning. The shuffling. The unkempt look about her. The falling asleep talking to me. The getting on my pre-teen daughter (Who TRUST me gets it from me ALL the time...she doesn't need two of us)in a very mean way at times...just her VERY negative way now. As you're reading this I bet I sound so mean. How can a nurse and a future NP feel this way? How can I be so heartless?

I ask myself the same questions. I want to know if anyone has felt this way and has any advice on how to turn my mindset around. I do a lot for my mom and she always says "You take such good care of me", but I don't FEEL warm towards her. I have to think that what my father did has broken something in me, and I too acknowledge my mom and her grief would require me dealing with what dad did and I need some professional help with that. (Soon to come next week first session). I just feel cold. I want someone to tell me that it will get better. Or even tell me to get my head out of my butt and just BE NICE. Mom said tonight all I ever do is tell her what she's doing wrong (stand up straight, pick up your feet, let's put on a prettier sweater, etc). I guess I just feel like I'm trying to perk her up.

Anyway, this was more of a ramble than anything. Just wanted some thoughts or advice. Or, even let me have it :-)

This website and forum have been very helpful to me. Thank you!"
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EB, I'm re-posting a question you asked more than a year ago, without comment.

"I've asked questions multiple times in and around this situation so my apologies for apparent overlap.
However....
My mom has expressed how miserable she is in her AL facility. She has been there almost a month. Now, unfortunately the FIRST week there the facility went on quarantine/lock down due to a stomach bug. Lovely. Then, I was VERY sick for 2 weeks and only saw her 2 times during those two weeks. Then, apparently she expressed she was going to "fly the coop" and was wandering down in the lobby with her purse and keys, so they put one of those devices on her ankle to ensure they could track her. I told them I thought this was a horrible idea as she was a scaredy cat, and would NEVER bolt, but they felt they had to do it. I gave in (like I said, I was so sick...didn't put up a fight). Needless to say this REALLY depressed her. They took the device off which I'm so glad about. But she continues to say how this is an "old persons' dormitory".

When I ask if anyone is unkind she says absolutely not and that everyone is VERY good to her. I even met a couple of her friends who seem about her age and one is in fact younger. The problem is, the ones in the wheelchairs and walkers seem to outnumber them so I guess to mom this sees unacceptable.
Part of this is that she is going on the anniversary of my father's death (suicide) and she will NEVER be happy again.

Her memory is very scattered still. So like on one hand she "looks" good, but on the other she's miserable and has some very real memory lapses all the time. This is part of the reason she's there. Either didn't take her meds or took them twice. Caught her robe on fire making bacon at 3 am. Recent hospital stay with BP of 241/108...possible mini strokes, etc. etc. She was in an apt by herself as I wasn't ready to move her in with us full time.
Well, as I said I feel horrible. To look at her she does look healthy and younger. I told her maybe she can come back and live with us in a few months and she said this "lightened her heart" and she keeps bringing this up.

Oops, I probably shouldn't have said it as now I know she'll not let it go. It was just my knee jerk reaction to hating how miserable she was.

When I asked her if she shared any of her misery with her new friends she said no....that this was between her, God...and me (her daughter). That she knows she is making me miserable but can't seem to help herself.

I don't know what I'm asking except maybe guidance. I worry as a Christian that I'm not "honoring" my mother. Technically...YES. She can move in here. Would be on second floor and she'd share a bathroom with my daughter. Was thinking I'd fix up a loft area with her Kcup machine, a mini fridge and her TV so she could have her own space so to speak.

She WILL drive me batty. She has said for YEARS that she only wants to be beside me. With me. Still says it. In the morning when she was staying here she is RIGHT next to me for morning coffee. I have no space. I told her if she did move in that we'd have to talk about boundaries (like not coming in me and my husband's room unannounced). She said she'd be a "good girl".

I'm so torn. I'm a nurse, in NP school and in the middle of raising my 13 year old kiddo. It will be so very hard. But I know this life isn't promised to be easy. We are all responsible for each other on this earth. I wonder what my dad would have done. I wrote a paper a couple of years ago on filial responsibility...I always struggle with what this "looks" like.

Thank you to whoever made it to the end of this rambling. Just looking for some thoughts."
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Thank all of you all again. I do know the NPs post was survival and I actually have a sense of humor (and do work in the health care field). I think I’m hyper sensitive.
However, I don’t think I am cut out for guilt/worry/limited communication in covid and am making plans to bring her back here and let the chips fall where they may.
i just can’t live with myself.
Thank you all again!
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I can understand your feelings. I agree that social media is not the place for a professional to share comments like the one you read. Then I read what Billygoat posted and that was outrageous! No one puts a patient in a body bag in front of their loved ones!!! As for the comment you read it was written without any mention of your loved one and I believe it was not to be taken personally. I also am sick and taking care of my husband with dementia. Give yourself credit for not all caregivers are both caring for another person but some, like us, are not well enough ourselves to be in this position. I have already told our doctor that I can’t do this much longer as my illness is progressing. He is going through cognitive testing within the month and I am pretty sure he will be classified as severe. Better not to compare your situation to others that are not both ill themselves and doing caretaking for another. We are more sensitive, IMHO.
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My husband and father, both physicians own an assisted living/nursing home. I work in the office part time. I find it, as someone commented earlier, that it’s creepy that the OP was checking an employees FB. If they were concerned about an employee do a legitimate background check. As far as the comment goes it was a direct question about what happens after death and the answer was honest and equally direct. We have a waiting list. People call daily to see if their loved one’s name has moved up on the list.
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"LIfe's a b---ch and then you die." It's kind of harsh that she wrote that, but it's certainly something the medical profession has to do to keep their own sanity. I don't think it indicates she's not a good, caring, trustworthy professional. No reason to take offense.
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By NP I take it you mean Nurse Practitioner. I'm sorry you took her wry, slightly humorous comment as a sign that she does not care about her patients. I'm sure she never expected anyone to take offense else she would not have posted it publicly. As an RN of some 30 yrs, having worked in both hospitals and nursing homes and seen many deaths, I can assure you that professionals do care about their patients and the patients' loved ones. But they recognize that death is a natural event. And it is frequently a subject in their conversation. Though they do their best to postpone it, and may experience sometimes great sadness at the loss, death is an everyday occurrence in hospitals and nursing homes. It seldom catches them off guard. A good nurse takes time to consider grieving family, but seldom has time for much more. There are living patients waiting to receive care.
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Unfortunately, her post is true. It's quite unsettling and very insensitive to post that but, it is absolutely true. I think (no, correct that, I know from personal experience) SOME nurses forget the deceased's loved ones are not used to their routine after someone passes on. For example, I watched the nurses stuff my beloved mom in a body bag and slap a toe tag on her toe several minutes after she died. I was literally a foot away from my mom when they did this and this was, and is, so unsettling. I cannot get those images out of my mind. The nurses meant no harm whatsoever but forgot that I never saw that before...and it was my precious mom they were doing it to! They were kind but, again, this is routine for them; certainly not me. Try to let it go. Not everyone is sensitive to others and as long as your loved one is being cared for properly that's all that matters, right?
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I think it’s insensitive and rude . I’d report it to management . I bet then Ms Big Mouth , won’t do it again .

Maybe she could save her comments for lunchroom conversation rather then posting on Social sites.
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Oh, my, I have been around EMS people most of my life. So has my daughter. As far as I am concerned you have to laugh or you end up with PTSD from all the horrible things you see. It does not mean you are uncaring, it just means you need to survive. I have seen a lot, and my daughter who was a fire captain has seen more. Cops, Firefighters, EMTs, Paramedics, see unmanageable horrors. Sometimes, you have to laugh or go insane.

I thought it was funny, and it is true.

ebmick, what do you think happens when a patient at any facility dies? Do you think they keep the room empty out of repect or mourning? They change the bed and admit a new patient.

This has absoutely nothing to do with the care your mother will get. Don't be in a hurry to bring her home. She is there for a reason. I am happy you are able to get beyond your grief to see the NP meant no harm. Now you can be your mom's daughter, not her nurse.
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The FB post accurately describes reality of nursing homes and hospitals. The nurse did nothing wrong, and posted about a standard SNF and hospital business driven cleaning procedure.

If you're unfamiliar with the inner workings of a hospital or SNF, then the post might seem harsh, but in reality, it's a VERY generic description of what transpires in a room, after a patient is discharged or dies.

All in all, it's a brief post about the reality about bed turn-overs.

Now you know, what happens to a bed, etc. after a SNF patient/resident dies or vacates, They immediately clear-out their belongings, clean the bed, room, etc., to admit a new person, as soon as the next day. Similar to the manner hospital beds are handled.

Sorry, in the U.S., it's a business, which the nurse described what happens at the end of a person's stay. The nurse did nothing wrong, and posted about a standard SNF operating procedure. What were you thinking happens?
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Imho, a medical professional should not be posting about a work ethic on a social media platform.

Harpcat: This is a discussion.
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weird that we can't reply to each other. But I just also want to add that I'm pretty impressed that they even hire a NP. Mostly it's LPNs running the shifts in a NH. As someone else said, pick your battles. It's your mom so you are uber protective, but put it in the scheme of what's really important. And DO NOT print this off and hand to a superior. It is not harming a patient and that would be very petty to do.
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It sounds like the CNA was frustrated with the system not that the she was advocating how it works.
Idor possible that you have misread her comment?
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I learned something during the 4 years my mother was in the nursing home before she passed. That was just because they have a name tag with “nurse” or “CNA” or whatever does not make them reach for higher standards. I had to run behind them all the time to get decent help and people told me it doesn’t much matter which one you choose, there will always be those few that don’t really want to be there. I can’t tell you how many times I had to go to the Administrator’s office! Even wrote the home office. After 2 years, I also looked on Facebook and saw things that were so unprofessional and downright raunchy and saw the worst ones were buds with the Director of Nursing there and Administrator! I told that administrator that I knew she was protecting them in their lies and behaviors and they all stopped making their pages public. Mama was a stretcher patient but I had her transported to outside doctors twice to get her the proper meds and treatment. There are good folks out there but most of them are there because they can’t abide by rules at hospitals or stricter places. The “pack up” too and cover for each other. Yes, I tried my best to get her moved but it would have been to a worse one and owned by same company. They did better when she was self-pay but not much. We did the spend down to Medicaid and I was POA. I paid them $6,000 per month for over a year out of her account. Don’t think I was one of those nit pickers that could not be pleased. I turned my head and tried to let things go and then hired a sitter for 4 hours per day 7 days a week and she confirmed things to me. She said nothing to them but they resented her being there watching them. Sometimes around lunch and sometimes she went in evenings. I would go too obviously so yeah, we caught them slacking off and talking trash too. As you can guess, I hope I can stay out of a nursing home myself. Mama had too much wrong with her to be home plus dementia so I did my level best. What you see there is not always the truth. I am a reasonable woman, not some alarmist or perfectionist either. Bless those patients hearts.
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You need to get rid of them NOW. I ran into another set of problems with a care give out of Fairfield Ca. This bunch of dishonest people & Managing Director are bait & switch, Scam artists, Dishonest, ETC. can't explain how bad they are. They took my deposit, never did any SERVICE, WORK or INCURRED ANY EXPENSE as My wife passed away in the Hospital. They refuse to send me my deposit back. DO NOT EVER SIGN WITH A CARE GIVING COMPANY THAT REQUIRES A DEPOSIT. If they say they want one KICK them out of your house. A reputable care giver never ask for a deposit. BEWAEE OF THE ONE IN SOLANO CTY, FAIRFIELD, CA. Check them out with the D.A.'s office, Att. Generals office @piu@doj.ca.gov. Get a back ground check on the people from White Pages or another comp. You will be surprised at what comes up on some of these people. NOT A GOOD BUNCH OF PEOPLE IN FAIRFIELD. If you need help or advice contact D.A.'s office & get an email address.
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well in reality, that is what happens and maybe she didn't mean anything "bad" by it, but just posting what actually happens.  When a patient passes away, whether in hospital or NH, they remove the body to the appropriate place and clean the room and get it ready for another patient.  Some of the staff may mourn the loss depending how close they were to the patient, but they must continue on with their work.  It doesn't mean they don't care or they are cold, its just the way life is.  I don't know if it would bother me, but only if they made crude remarks about the patients, then that would be un-called for.  hope this helps.
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CNAs are just so overworked, promised big money, and then paid less-- no wonder they get jaded and act bitter and childish. SO-- if it is so prevalent in the industry-- why not NPs-- ? SO MANY large companies -- assisted livings are based out of state-- and when you check their numbers--- such as only 60% full-- then think why the place only has so many CNAs and fewer head nurses. IT IS a business. AS IS hospice... so welcome to the world of older folks who are the most vulnerable.
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i am assuming she is a nurse practitioner so she is a professional and that was extremely poor taste for a professional. That being said that content would not make me feel uncomfortable with her care, previous professional complaints in her record and or law suits would.
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A nurse practitioner made a comment. She then said -Her own comment at the top was "This is so wrong, but when you work in a nursing home". I dont think its bad. It could have been its business as usual. Maybe she wanted to grieve perhaps? Or the comment is that all there is?? Maybe she liked that resident and felt hollow, that its money money money. But then again should they leave the room empty? For how long? A day, a week, a year? What should they do?

Maybe some other family is desperate for help. Can't work full time, and take care of a loved one full time, and a family too. Its extremely stressful. The bed is a godsend to them.

Maybe the np had off for the weekend and then came back.. The resident died and was replaced. Very jarring I bet. She might have taken care of them for years.

You can't really know what she was thinking. Its a fact of life unfortunately. It might not have been disrespectful at all. Maybe she missed the last person. Its her job. She doesn't really get tome to grieve like the family would. She has to keep working.
I don't think it was bad. Just venting. She has a right to. Its not an easy job.
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Nothing insensitive, unsettling, nor untruthful about the statement, which pertains to the business operations.
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This is dark humor no doubt, and a sad reflection on the fact that sadly as so many things in life, it comes down to the $$$. Empty beds don't generate funds. Also they probably have to have so many NP's (and do you mean nurse practitioner or Nurse ASSISTANT? (NA) Plus, actually....she noted that it was "so wrong." But she's acknowledging the reality. I wouldn't be as upset about this as many other things I have seen in re to former co-workers (things that were racist and worse and we work in a public agency serving all people). We were looking to hire privately for my mom. I did not realize that private hire companies were not REQUIRED to do background checks, but could. Before we had this person start I googled around...found out she had multiple driving offenses...and we had anticipated her driving mom to lunch, shop. And still the owner of the company did do a background check at my request and as much as she was a piece of slime, she was honest enough to claim the aide had taken the rap for trashing an apartment shared with her sister. You can imagine the level of damages if the landlord took them to court...When I asked the owner if she would be comfortable having this aide take care of her OWN mother, she responded YES. I told her her standards were far lower than my own and we were done doing business (in fact I'd not given her, fortunately, one dime thus far). As they say...it's hard to find good people to help. Good luck...and yes...personal lives are just that...but I believe it reflects on the person and you have every right to be comfortable.
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Most of my thoughts have been said I think but I would like to add two more thoughts, first it is possible this NP thought she was posting to a private group or something she belongs to rather than her public page or that she is unaware her page is public (with overhauls FB makes I know other who thought their pages were set to private found they suddenly weren’t as private). I realize your immediate concern was more about what she was thinking though rather than whether or not she was saying it publicly or privately and I hear you but maybe it’s a good thing she allows herself an outlet for her frustrations both with the system and the things she deals with regularly, it must be hard for the staff to come on shift and have every trace of a patient or even multiple patient’s gone when they start the next one and I imagine that has only gotten harder with COVID since they are often the only human emotional life line their patients have. I would rather she get those out In a healthier way, participating in bad jokes with her peers than at work with her patients. I think we all, no matter how much we love our jobs, have times of total frustration with something about them and blow off steam by complaining to friends and colleagues, even making off handed or heated comments but that doesn’t mean we don’t still love our careers and like our jobs. It might be better that this NP gets her emotions out this way rather than pent up and bursting out while with her patients, all be it probably not the wisest doing it on FB out in public.

Many if us do it here all the time, complain about cleaning up messes or being the brunt of a loved ones wrath and dementia, make inside jokes to add some levity but none of that means we don’t love and care for that loved one, in fact often we do in an effort to continue doing just that either by looking for helpful ideas and information or simply venting to others who have been in the same place. Would I pick FB to have the discussions we have here? No but I grew up without social media.

Give yourself a break ebmick1973, try not to find guilt in the personal pain of doing what you know is safest and best for Mom’s health as well as her families. Try to find optimism, positives in the bumps that present to you rather than confirmation that you are doing the wrong thing. My thoughts are with you at this difficult time.
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Since posting my original comment on September 3rd, I have finally had a chance to read almost all of the other comments and I must say you all have given such great thoughts and insight for "ebmick1973," and any of the rest of us who have dealt with a similar issue or who may deal with it in the future. Great words of the "reality" of it all. For those of us who have never been in the professional fields mentioned such as myself, it gave me the ability to put myself in their shoes to understand the "whys" behind what may seem as a lack of caring etc. You are all right and I felt I got a huge take away from each and everyone of you who shared their own experiences as someone either in those fields or just by witnessing it yourself with your own loved ones. Thank you!
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Why is this bad? It is the absolute truth. Why wouldn't they be allowed to say this when they were asked a question. Makes perfect sense to me. It is being realistic and honest.
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"Sunnydayze," - Excellent comments! Everything you said was spot on!
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