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GOOD SAMARITAN SOCIETY - MANZANO DEL SOL VILLAGE


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2005 Apr 15, 7:21am   2,036 views  3 comments

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1   Mortemis   2009 Feb 18, 4:39am  

Manzano del Sol is a three-tiered residence: independent living apartments where a resident can obtain additional help in negotiating life's challenges, a skilled nursing unit and a special dementia unit. We placed a relative, who was moved from out-of-state to New Mexico because of advancing dementia, into an apartment paying an initial fee of $27,000 plus monthly rent. We were very happy with the situation. Upon breaking a hip, the relative was hospitalized and then released to the Manzano del Sol Nursing Unit for recovery and physical therapy. After several months, a team comprised of social worker, physical therapist, and nurse recommended that the patient be transferred to the dementia unit because her major deficit was memory. For six months, I retained the apartment and repeatedly asked the staff if the placement into the dementia unit was appropriate. They always said "yes". A few weeks after finally giving up the apartment, they said that my relative was "too high functioning" to live in the dementia unit and that she would have to be moved to the nursing unit with my approval. I said "no" because her only real deficit was memory and they replied that she would be evaluated monthly and they could move her at any time. Is this ethical? I found another residence that specializes in persons with dementia. The Manzano del Sol Nursing Unit is a very busy place and strives to do a good job. There is constant activity with many visitors who come and go at all hours. However, I learned that it is critical that the patient has an active and persistent advocate to ensure good care.

2   elliemae   2009 Feb 18, 11:15pm  

You asked "is this ethical?" Honestly, I don't have enough info to say yes or no. But a dementia unit is traditionally a unit that is locked so that patients who wander won't be in danger of leaving the building and hurting themselves. If your relative needed help with her ADL's (activities of daily living such as bathing, meal prep & eating, dressing, etc), she would be probably be appropriate for the nursing facility. However, many times dementia patients in the beginning phases can be better served in a more homelike environment that can ensure their safety without being as institutional as a nursing unit. Remember that facilities are in the business of making money - they received several (9?) months of payment for the apartment, Medicare rehab monies plus co-payments, and room & board in the dementia unit. They would have continued to receive $ for her nursing home placement - so of course their recommendation would be for her to remain in their facility as long as possible. Did they give you the option of moving her to other facilities that were less restrictive?
(I'm a social worker with 20 years of experience in working with the elderly).

3   Mortemis   2009 Feb 19, 12:54am  

Thank you, elliemae, for your response. You have much more experience and education than I do in these matters. I am just a family member trying to do the best for my family, learn the system and negotiate it without incredible stress.

My frustration was in their suggestion that she move back into her apartment of 2 years which had just been reluctantly vacated. Because that was no longer an option, they said she would have to return to the Nursing Unit, a place for people obviously sicker than she was and not the most uplifting environment for her. The dementia unit, in my opinion, was the perfect place for her needs. I found it incredibly stressful that we were "on notice" month-to-month.

Thanks for your response.
Artemis

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