Wednesday, October 1, 2014

Good for one is not good for the other - Death is no secret

1 October 2014

I often spend long hours in bed, sometimes whole days at a time. There are two reasons for this: 1) Once I am up in the wheelchair, when I grow weary and tired, it can take an hour sometimes more, to get a CENA to use the machine to get me out of the chair and back into bed.

The reason that this is because the venture capitalists who bought the company who operates these nursing homes are demanding that this facility save more money (in their expenditures) by hiring less CENAs. The push is to get three CENAs to do the work that four used to do. While the cost to me doesn't change the facility is paying less for CENA work, thus the unseen, unknown overlords receive more money, that which is now buying one quarter as much labor. Somehow these powers that be believe they are making more money off a previously inefficient operation, they win and nobody pays a difference.

And people wonder why the electorate didn't trust Mitt Romney, another venture capitalist, you know, the one who thought it was a good idea to put the family dog on the roof of the car for a long road trip. Must be chasing other people's money weakens the brain from making other good decisions.

EXCEPT, there is no mechanism for measuring the rise in dissatisfaction this causes in the CENAs or the residents. The CENAs recognize right away that they have no time between caring for residents. Their tasks are now curt, short and finished sometimes before everything is completed as they hear the call lights buzzing and are off in as quick as can be. Lots of mistakes are made due to this. Some residents believe the call lights are their personal signal to a maid or butler, or someone to keep them from getting lonely in this strange place, they hang on the button constantly. The CENAs have no idea what the problem may be without going to the room to find out. When there used to be four CENAs scheduled they would often cover the call lights for one another, no more. The administration has taken to measuring the length of time it takes to respond to the call lights, if the number gets too big a reprimand is in the future. Too many reprimands can result in fines. In some places this is known as motivation of employee behaviors.

  1. Once I am in the wheelchair my hips, legs and feet no longer move. But I still have a limited sensory system. The feelings may be hot, cold, electric, dull, sharp, narrow, wide, pulsing, or a combination of many at once. After a period of time with no movement certain aches begin to grow and take over my senses. About four hours into the chair and the various body parts affected are screaming for relief. A change of position usually does it. Sadly wheelchairs are not designed for wiggle room, and I don't wiggle any more.
When I do spend a long time in bed, one moment can grow to be quite like all of the previous ones. I try to keep myself distracted entertained. My neighbor uses his facility supplied television for this purpose. I do not particularly enjoy daytime programming; The Maurey Show, The Price is Right, the noon news – complete with a cooking segment, Judge Judy, Judge Ross, America's Courtroom all add up to a pretty sad commentary on the state of the Union these days.

I retreat to the earbuds and my iPod. The earbuds partially mute the seeping television as it comes through the door. The rest is blocked by my extensive collection of music. However after a few years, I have begun to down load and listen to podcasts. I have heard more interesting podcasts than I ever had before.

Earlier today I was listening to NPR's TED hour, there was an episode about privacy that drew my attention. The old notion of privacy is beginning to turn slightly, or quickly depending on the circumstances. Some ideas regarding privacy are pretty stilted. Here in this facility they won't reveal anything about anyone for fear of HIPPA laws. I used to help administer security and HIPPA compliance in the clinic I helped run, I know about HIPPA and the way this place operates is way too overboard in the failsafe mode to the point of being punitive. We are all residents here from different backgrounds, thrown in together for better or worse. Then we are told to get to know one another. First thing people do when they get to know each other is to exchange names and the reason that brought us all here. Then we gradually get to know each other. Except the lawyers who I have met here, they insist that no one know their names, what brings them here, or anything else about them. Then they complain about how lonely it is here.

When a woman I befriended here disappeared for a while no one would say a thing, citing HIPPA laws. A week later I just happened to see her in a new room. I was so glad to see her again, and told her so. She was a good friend, facing cancer and lots of chemotherapy. She had few visitors and fewer family. A few weeks later she disappeared again. Same as before my questions were answered with the dreaded, “We can't tell you, HIPPA laws” response. Everyone played silent for weeks afterward. Then I found her name listed in the obituaries of the local paper. When I confronted some of the administrators with this information, they all knew all about it, and were surprised that I had found out. Those fools were willing to continue playing games with the information as to my friend's whereabouts and what state she was in, even after she was deceased. Says a lot about how they value me, or any of the rest of the residents here.

These folks encouraged me to interact with her initially, saying that she could use some good intellectual stimulation. You know she did. But when she was out of sight the staff here suddenly played stupid, citing the HIPPA law for their apparent ignorance. You know that voluntary lack of intelligence leaves some residue behind each time it is invoked. The folks that occupy positions of power here often strike me as not knowing much beyond their limited original knowledge. I'm afraid they aren't capable of learning very well due to the rules they follow.

And yet the HIPPA law is not universally invoked, I am subjected to strange women coming into my room and performing the most personal tasks on my body, my private parts and absolutely no care is taken to hide or protect my privacy. I didn't think that laws could be arbitrarily invoked, guess I was wrong, or it depends on who has the money behind them to pay for the biggest lawyers.

Well, back to noticing the inequities of the situation.

This has been resident 322b2

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