So I have taken more cold showers this week than I ever have in my life. If you are not aware of these books you will. They are Fifty Shades of Grey, Fifty Shades Darker and Fifty Shades Freed. In a nut shell it is the love story between an innocent college graduate and a sadistic billionaire.
The story itself is compelling. The usual romance book fodder you find on the shelves that has some hunky half dressed guy on the front. The story is usually the same he has money, sweeps her off her feet, they get married, someone gets kidnapped,killed or blackmailed, someone saves the day, and they all live happy ever after.
Our hero has personal baggage that gets in the way of him having a normal life and the heroine Ana spends most of her time trying to get to the bottom of it all. Ana is also an airhead of the first degree she doesn't realize that Mr Grey actually stalked her wanting to make her his next submissive playmate. She also repeatedly does things to piss him off.
While the story is nice very endearing at times it also one of the most poorly written books. The same phrases are used over and over making the characters flat and boring.
The continual name dropping of brand names makes one believe that Apple and Audi paid them include their products.
Of course the one thing that ensures the book will sell and be controversial is all the sex. Straight sex, kinky sex with whips and chains, public sex, and any where you could imagine. These 2 have more sex in a 3 month period than I have in the last 20 years. They should be dehydrated and emaciated as they have no time for other things like eating and going to work. The sex scenes will send you running to the shower.
The books were an okay read, will never get a pulitzer, but they have made E.L James a rich woman.
Tuesday, July 24, 2012
Friday, July 20, 2012
Picking a nursing home
You have made it in the front door and are being used about the facility by the social worker or worse a marketing person and you need ask some key questions.
Is this a non- profit or for profit facility. More than likely it is for profit, non profits are few and far between. So find out which company own the place. You will need to find out in order to do your internet search on the stability of the company. Usually the cavorting around that happens in big companies doesn't trickle down to the local level. Remember these companies take government money and have to disclose everything.
You will want to know how long administrative staff have been there. The longer the better, stable staff is important. Ask random staff member how long they have been there.
Find out who passes the medications. One of the most prevalent mistakes or errors in any health care setting is medication errors. I have seen LPN's and Medication aides make some awful mistakes as well as RN's, the thing is if they have a professional license then if do make an egregious error then the board will make sanctions.
While you are walking around take note of smells and sounds. If you smell feces and urine down every hall then there is a problem. If people are tied to beds and chairs there is a problem. If people are screaming and yelling and running around naked there is a problem. You need to leave if this is what you find.
Is the facility mostly elderly individuals or rehab residents or do they have a population of mostly younger mental health patients. Keep in mind most state governments did away with mental health hospitals and now those clients are in the community and in nursing homes. If you are a placing a mentally ill person then it doesn't matter but if you are placing 90 year old grandma then leave. She will be defenseless when the schizophrenic drug addict goes postal and starts hurting people.
I have said this before but find a away to keep your loved one at home.
Don't even think about assisted living, they really are a huge waste of money. There is usually no licensed nurse about the place and in most states the person giving meds is a layperson.
Is this a non- profit or for profit facility. More than likely it is for profit, non profits are few and far between. So find out which company own the place. You will need to find out in order to do your internet search on the stability of the company. Usually the cavorting around that happens in big companies doesn't trickle down to the local level. Remember these companies take government money and have to disclose everything.
You will want to know how long administrative staff have been there. The longer the better, stable staff is important. Ask random staff member how long they have been there.
Find out who passes the medications. One of the most prevalent mistakes or errors in any health care setting is medication errors. I have seen LPN's and Medication aides make some awful mistakes as well as RN's, the thing is if they have a professional license then if do make an egregious error then the board will make sanctions.
While you are walking around take note of smells and sounds. If you smell feces and urine down every hall then there is a problem. If people are tied to beds and chairs there is a problem. If people are screaming and yelling and running around naked there is a problem. You need to leave if this is what you find.
Is the facility mostly elderly individuals or rehab residents or do they have a population of mostly younger mental health patients. Keep in mind most state governments did away with mental health hospitals and now those clients are in the community and in nursing homes. If you are a placing a mentally ill person then it doesn't matter but if you are placing 90 year old grandma then leave. She will be defenseless when the schizophrenic drug addict goes postal and starts hurting people.
I have said this before but find a away to keep your loved one at home.
Don't even think about assisted living, they really are a huge waste of money. There is usually no licensed nurse about the place and in most states the person giving meds is a layperson.
Saturday, July 7, 2012
Picking a nursing home
Wether for yourself or someone else choosing a nursing home is one of the toughest things a person does. Sometimes you get it right and sometimes not. It is easiest to do it right the first time. It is no big secret that one of more beloved career turns has been inspecting nursing homes. It is probably the most rewarding job I have ever had in terms of actually doing something worth while. So I have a few insights on choosing a nursing home.
Naturally the best thing to do is return home. If family or friends cannot help out with care issues home health may be available for a short period or employ outside help. I recommend investigating long term care insurance, trust set up for care issues, and being knowledgeable about alternatives before the time comes. Money issues will arise when it comes to Medicaid so plan ahead as they sometimes "look back " up to 6 years.
Nursing homes can have dual purpose with dual payor source. Medicare pays for 6 weeks nursing home care following 3 nights stay in hospital for what ever reason. Usually this is because the patient needs therapy in order to go back home. The other more typical is long term care for some one who cannot return home and care for themselves.
So the first thing is to do research on the homes and find which homes your doctor goes to, if any. You will also need to find out if they take Medicare, Medicaid and or Medicaid pending. Some facilities will not take Medicaid pending because there is no guarantee Medicaid will be approved leaving them stuck with a bill in the thousands.
Ask friends and family what they have heard about a building and the staff. Talk to your neighbors and listen to what they say about a facility.
Make an unplanned visit. Best if you go to see a friend or someone who is actually a patient there but if that doesn't happen pop in. More than likely they will ask you to make an appointment with a social worker or customer service representative, if they do this you might wonder what they are hiding.
While are waiting for your tour to start find the survey book. Any time the state comes and inspects the facility they write a report called 2567. These are the deficiencies found during the states visit.
The first column has the F tag it will appear as F 222 or F 323 followed by SS=A or SS=F. The F tag is the rule that the government has deemed necessary for all nursing homes to comply with you can find those online just search for appendix P and PP. The SS is scope and severity or how many people can or are affected by poor practice.The following is a copy of the grid.
Tags with SS of A, B, C are usually minor, D, E, are more serious higher than F you might want to start asking a lot of questions. If they have G to I consider going someplace else and J, K, L you need to leave and go someplace else. The yellow plots on the grid are tags in care areas. Care areas are the greatest concern. This means that the care staff are providing is substandard and possible harmful.
The first part of each tag will tell you what the requirement is. These range from providing private place to make phone calls to administering medications correctly. I consider "paper tags" those dealing with Frequency of assessments and doing care plans as drivel. Actual care tags are what you need to look at.
Go during a meal, lunch and supper are best. Go to the dining room and see what is happening. You need to see what the food looks like and smells like. Are the residents eating it or pushing the food away. Ask someone how the food is. Are office staff passing trays? Is the food left on trays or placed on the table like at home. Dining should be as home like as possible. Are staff offering alternatives? Is the food hot, cold food cold? Watch to see if staff are handling residents food with their hands. Are residents being fed? If so is the person doing the feeding sitting or standing over them, or feeding more than one person. Stop and think about how you would want to be fed and what you want to eat.
Will visit this more in Part 2. I do answer questions if there are any.
Naturally the best thing to do is return home. If family or friends cannot help out with care issues home health may be available for a short period or employ outside help. I recommend investigating long term care insurance, trust set up for care issues, and being knowledgeable about alternatives before the time comes. Money issues will arise when it comes to Medicaid so plan ahead as they sometimes "look back " up to 6 years.
Nursing homes can have dual purpose with dual payor source. Medicare pays for 6 weeks nursing home care following 3 nights stay in hospital for what ever reason. Usually this is because the patient needs therapy in order to go back home. The other more typical is long term care for some one who cannot return home and care for themselves.
So the first thing is to do research on the homes and find which homes your doctor goes to, if any. You will also need to find out if they take Medicare, Medicaid and or Medicaid pending. Some facilities will not take Medicaid pending because there is no guarantee Medicaid will be approved leaving them stuck with a bill in the thousands.
Ask friends and family what they have heard about a building and the staff. Talk to your neighbors and listen to what they say about a facility.
Make an unplanned visit. Best if you go to see a friend or someone who is actually a patient there but if that doesn't happen pop in. More than likely they will ask you to make an appointment with a social worker or customer service representative, if they do this you might wonder what they are hiding.
While are waiting for your tour to start find the survey book. Any time the state comes and inspects the facility they write a report called 2567. These are the deficiencies found during the states visit.
The first column has the F tag it will appear as F 222 or F 323 followed by SS=A or SS=F. The F tag is the rule that the government has deemed necessary for all nursing homes to comply with you can find those online just search for appendix P and PP. The SS is scope and severity or how many people can or are affected by poor practice.The following is a copy of the grid.
The first part of each tag will tell you what the requirement is. These range from providing private place to make phone calls to administering medications correctly. I consider "paper tags" those dealing with Frequency of assessments and doing care plans as drivel. Actual care tags are what you need to look at.
Go during a meal, lunch and supper are best. Go to the dining room and see what is happening. You need to see what the food looks like and smells like. Are the residents eating it or pushing the food away. Ask someone how the food is. Are office staff passing trays? Is the food left on trays or placed on the table like at home. Dining should be as home like as possible. Are staff offering alternatives? Is the food hot, cold food cold? Watch to see if staff are handling residents food with their hands. Are residents being fed? If so is the person doing the feeding sitting or standing over them, or feeding more than one person. Stop and think about how you would want to be fed and what you want to eat.
Will visit this more in Part 2. I do answer questions if there are any.
Friday, July 6, 2012
more ruminations
I try to be green. Spunky recycles all the newspapers Spunky even adds a little ammonia to the mix. (spunky is my elderly, overweight, deaf dog) I have all CFL bulbs in the house. It helps that they are less expensive to run. I plan all my outings so that I use the least amount of gas possible. I plan shopping trips and errand runs so that they are done in one trip. I have discovered Organic milk. Normal milk has hormones in it and it makes me have hot flashes.
Why do people stand right in front on the elevator door blocking your exit from the thing. Do they not know the sooner you can exit the sooner they can get on. Nearly had some goomba knock me down the other day trying to get on the elevator. For added measure I ran over toes with the suitcase I was dragging behind me.
If you sit around and talk bad about other people then you will talk bad about everybody and anybody.
If you don't feel good tell me once, but don't go on and on about all your illness and parts that hurt. I give empathy once but not a dozen times. Go to the doc and get yourself fixed.
Back to being green. We have a rash of dead birds here due to West Nile virus. I will spray and spray and spray because I can get it too and because the dead birds in the yard are a pain in the but, besides the dog keeps trying to eat them.
When you get to be my age if they shave off your pubic hair for surgery it doesn't grow back. Then you look like some dilapidated hooker.
Met a woman who has had more plastic surgery than I could count. She is older than I am. Her silicon fun bags would drive me crazy as she said she sleeps in a bra because she doesn't want them hanging to her knees. Her face has been stretched and it looks pretty good however they didn't do her neck or the skin on the cleavage. It is all old and gnarly. Kind of defeats the purpose.
I have great hairs. Others complain theirs is falling out, too thin, wrong texture, on and on. The only problem with my hairs is it is very grey as I have never colored it. A little "Sun IN" back in the day but no awful chemicals.
Watched "the Girl With the Dragon Tattoo" yesterday, awesome movie.
Your screaming idiot children who throw balls over my fence will no longer have a ball.
Doing all this is very cathartic. Have a nice day.
Why do people stand right in front on the elevator door blocking your exit from the thing. Do they not know the sooner you can exit the sooner they can get on. Nearly had some goomba knock me down the other day trying to get on the elevator. For added measure I ran over toes with the suitcase I was dragging behind me.
If you sit around and talk bad about other people then you will talk bad about everybody and anybody.
If you don't feel good tell me once, but don't go on and on about all your illness and parts that hurt. I give empathy once but not a dozen times. Go to the doc and get yourself fixed.
Back to being green. We have a rash of dead birds here due to West Nile virus. I will spray and spray and spray because I can get it too and because the dead birds in the yard are a pain in the but, besides the dog keeps trying to eat them.
When you get to be my age if they shave off your pubic hair for surgery it doesn't grow back. Then you look like some dilapidated hooker.
Met a woman who has had more plastic surgery than I could count. She is older than I am. Her silicon fun bags would drive me crazy as she said she sleeps in a bra because she doesn't want them hanging to her knees. Her face has been stretched and it looks pretty good however they didn't do her neck or the skin on the cleavage. It is all old and gnarly. Kind of defeats the purpose.
I have great hairs. Others complain theirs is falling out, too thin, wrong texture, on and on. The only problem with my hairs is it is very grey as I have never colored it. A little "Sun IN" back in the day but no awful chemicals.
Watched "the Girl With the Dragon Tattoo" yesterday, awesome movie.
Your screaming idiot children who throw balls over my fence will no longer have a ball.
Doing all this is very cathartic. Have a nice day.
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