Since this selfie was snapped about three months ago, grandma’s health has deteriorated significantly. In an effort to meet federal standards of one-size-fits-all care, the nursing home moved Grandma from the TLC secure unit with a smaller patient-staff ratio back to the general population where all the aides had to learn all about her needs. (Even the terminology used in nursing home settings sounds more like prison and less like love!) This despite the fact that the sweet aides in the back had her on a good schedule. She was happy and smiling, and even though she couldn’t speak, she communicated with her eyes, her smile, and her facial expressions. She was eating well and her chronic bladder infections were being taken care of, as much as possible.
But the federal government bureaucratic regulations say that since she is no longer at risk of wandering because she can’t walk without assistance, she HAD to be moved away from that small, secure place in which she was familiar to the full capacity, loud, crowded general population on a “trial basis.”  The nursing director who assured me they would move her back if she didn’t adjust no longer works at the home (staff turnover is a constant revolving door).

After 91 days of being moved because the one size fits all regulations said she had to be moved…I can’t see the screen through my tears because my Grandma is failing. Her feet are swollen and have pressure sores. She no longer smiles. Instead she sleeps all day. She doesn’t interact with my mom. She stopped chewing and swallowing solid food. She has more bladder infections. We think she’s in pain but she can’t tell us where it hurts. The nursing home said her kidneys are failing but the doctor won’t return my mom’s phone calls. How bad is her kidney function? Are any of her medications causing the decline in kidney function? Or is this a sign of the inevitable end of days for her this side of heaven? 

As we await answers to these questions and more, I ask for my readers to #prayforBillie. I also ask health care policy makers to consider how their well-meaning regulations can directly contribute to a  steep decline in a patient’s health.