Seagull management style is a derogatory corporate term that describes micromanagement at its most obtuse. The idea is that the manager perceives a problem, flies in, screams and poops all over everyone and everything and expects immediate results. This is exactly what we need to avoid when dealing with an aging loved one that may no longer have the capacity to advocate for themselves.
This is a touchy subject and there is definitely a fine line. I'm not saying that you should keep your mouth shut if you observe a problem. When it's someone you love and you perceive that they are being mistreated or have been put in danger in any way, of course your first reaction is to fly off the handle and try to fix it immediately, taking down anyone and everyone in your way. This feels like the natural reaction and in some cases it might be warranted, but in most cases, it's really not.
It's important to find a balance and not infuriate the care providers. I've seen it happen where a family member gets such a bad reputation that the senior is denied service. We as service providers in corporate America reserve the right to deny services just as you, as a consumer, reserve the right to choose your provider.
Keep in mind that the person who suffers the most when you piss off your service providers is your aging loved one. They need an advocate, not a seagull.
A few tips to help you stay in the good graces of the service providers:
When dealing with a doctor, be sure to be present or hire a care manager to be present at all appointments. Prepare questions in advance and take careful notes. Be sure that you understand all medication changes and or treatment options and educate yourself on your loved one's condition before visiting the doctor so you have a general understanding of what you're dealing with. Don't assume that you know more than a doctor or healthcare provider. If you have questions, definitely ask them and if you are dissatisfied with the answers, you can always get a second opinion. While doctors don't always love this, it's better to be prepared and catch any concerns on the front end than end up with a malpractice situation.
When dealing with a long term care home, either skilled nursing or assisted living, be sure to establish a relationship with the director of nursing from the beginning so that you have a point person if you feel that your loved one is being neglected or mistreated. If you find your loved one in a situation, establish if the response need is immediate. If it's a true life and death emergency, dial 911 and let the receptionist know that you feel your loved one is in immediate danger and have taken immediate action. If it is something that can wait, even 10 minutes, get your bearings and reach out to the nurse or manager on duty first, before jumping to conclusions and reacting to care staff, floor nurses or med techs. Also, reporting to the state or ombudsman should not be your knee-jerk reaction either, but you have that option later if it's needed. Give the director a chance to respond, and of course, if you are ignored, you can always go up the chain.
When dealing with a home care or hospice agency that is coming into your loved one's home, definitely establish if its a true life and death emergency before reacting as stated above. If it's something that can be solved by having a director get involved, please call the company first before reporting.
If any providers are asking you to change your trajectory regarding your loved one's care, be patient and open to suggestions. These professionals aren't asking you to do this because they are lazy and don't want to care for your loved one, there is usually a good medically backed reason. If your loved one needs a medication change, a move to memory care, or could benefit from rehab or even hospice services, know that these suggestions are usually coming from a place of experience and are not an attack on your ability to take care of your loved one. Approach these options with an open mind and thank them for their suggestion. If you feel that it's absolutely the wrong choice for you loved one, let them know that you are going to look into other options and reach out for outside resources to help.
Save your negative Google reviews for a last resort effort to get the manager's attention. While this may be your go-to way to complain about bad service, keep in mind that your actions not only effect the building and their reputation, but also the other residents who live there. They are human beings that may be on Medicaid and don't have other financial options for care. Before you hurl into a dissertation about your perceived abhorrent conditions, please try to get to the bottom of the problem with a director or even the managing company before becoming a keyboard warrior. If you must write, type out an email to the building director or the management company first. Understand that your opinion and your words on the internet have power and don't just effect some fat cat at the top, but all the other people involved.
Things to keep in mind when trusting others to care for your aging loved one:
Falls are not always preventable, even with one on one care. While the likelihood that a fall will happen with one on one care is less than any other care style, it's still not 100% guaranteed. I've seen seniors fall with their adult children standing two feet away from them. Just because your loved one falls, it doesn't immediately warrant a neglect claim. Accidents happen and if someone is very weak and unaware they are more likely to fall, even with someone standing right next to them. It's also important to understand that if you move your loved one into a secured memory care, assisted living, personal care or skilled care facility, the ratio of care givers to residents is never 1:1 so the chances of falls are even greater than one on one home care. If your loved one falls under the care of an elder care home, it should be reported to the state and to you as their trusted advocate. If, you feel that a fall has been mishandled regarding reporting, bring it up to the director, but know that if they reported it and handled it properly, you don't have cause for legal action and threatening to sue is never a good way to enter a conversation.
If your loved one seems unclean and wears the same dirty clothing over and over despite moving into assisted living or personal care, reach out to the care director before assuming that nobody is going in to take care of them. Often times, if the person is suffering from memory loss, they may refuse care, especially bathing. Because the building also has to honor their wishes and their residents' rights, sometimes it might take some sweet-talking to get someone into the shower and they might still be working on finding a good way to approach that. A resident with memory loss may also go into their dirty laundry to find something to wear. They often do this because it's familiar and might be more comfortable. This can and will happen in assisted living and doesn't automatically mean that your loved one is being neglected. Most buildings will have a care log that will document who went in and the conversation they had during the attempt. It will be documented if your loved one refused care as is their right. You can address this with the manager to see if there is any way you can work together to find the best way to keep your loved one clean and in clean clothing.
Medication errors are one of the biggest mis-haps in residential elder care. Missed medications happen, sometimes due to human error, computer error or the resident refuses, which is their right. The best way to avoid medication errors is to trust the building to order and distribute the medications and don't micromanage the situation. Most of the medication errors come when the family or the resident is trying to intervene with the process. If you're very worried about medication errors, ensure that the doctor signed med list is accurate and with any med changes, follow up to make sure everyone is on the same page. If there are missed medications for any reason, again, this is a state reportable offence and should be communicated.
Cameras are always an option but they must be disclosed. Most buildings have a clause in their contract regarding recording devices. Many families stay on top of the care of their loved one this way and if you have doubts, this might be a way to at least have photographic proof of your claims. Just keep in mind that if you choose to use this option, you must keep the camera in a location where it won't record any other residents in the community and again, you must let the director know so they can post a sign by the door of your loved one.
Keep in mind that your loved one may try to manipulate you to change the situation for themselves. I have seen this many times where the resident used guilt and manipulation to get their advocate to "get them out". This is somewhat of an extreme case, but I've seen it a few times. If they are calling you and telling you they are neglected and abused, don't just automatically assume that's the case. Get to the bottom of it before you fly off the handle to the working folks in the building. There are some cases where this might be true, but you want to be sure their claims are warranted before you take drastic action. Most places will want to have conversation to try to get to the bottom of the problem before hurling into lawsuits and drastic actions. At the end of the day, you have chosen a provider to care for your loved one because you can't do it on your own. Have a little trust in the process and understand that no place is perfect, even home with home care. Understand that you may need to be more open minded as your loved one ages and needs more care. Understand that the people that are paid to care for your loved one are doing the best they can and if you feel they aren't, have a conversation before getting emotionally triggered into drastic action.
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