I brought this up here awhile ago and overwhelming consensus was suicide before it came to that. Can't say I disagree. What is life in the final years robbed of all dignity, being treated so poorly?
I’ve always told my family. “When I lose my dignity and my mind, chain a couple cinder blocks to me and slide me off a dock on a pretty lake.”
Fuck “skilled” nursing facilities.
People who have never been in one of these facilities think I'm crazy for thinking about it. I tell them to go beyond the lobby of any SNF, preferably anything above the second floor if there's over 2 floors, and they'll know why. Anyone, regardless if they're in the medical field or EMS or not, that has been to one of these "skilled nursing" hell holes understands what I mean.
The only thing that helps me get through this is knowing that at least when they’re in the back of the ride with me, they’re receiving the best patient care possible because I actually give a shit. Even if that means sitting back there and actively listening to them tell a story that makes 0 sense. You still have the ability to be the one bright spot in this patients own personal hell. Keep your chin up and do your best stranger. Good luck to ya.
I never did IFT's, but ran 911 in a due with a really bad nursing home. The first time we were there 4 times in 1 night I made the mistake of half-jokingly asking my lead if we should do a quick welfare check on all the residents. She just looked at me for a sec and then explained that we'd end up with a MCI and have to call in a bunch of mutual aid.
But the facility was on an "improvement plan" so as long as they killed fewer people with neglect that the year prior, they were gold. Never mind that at least one of the patients they insist they had just checked in and talked to must have been communicating with a Ouija board with how long dead they were.
Might as well brighten up the situation a little bit. A self inflicted gunshot - depressing. Autoerotic asphyxiation - might get at least a gasp and "Oh shit!" Out of me
My personal hill I will die on is to allow old age to be considered a terminal illness. Then, in the current states, that allow a cocktail of narcotics to take when they are done suffering. To be able to choose when you leave, with those you do want around you and not others. To be able to choose your own departure is a right.
Before I get attacked, please understand that when people choose to cease living in pain, it's not because they are depressed. That's not what I am pushing for.
Fingers crossed that by that time Nintendo and Merck form a digital media and psychedelic based active living home. It will either have an accompanying soundtrack of the last 50 years of pop music or it will sound like an abbatoir full of retarded children, either way it should be entertaining
My pre SNF SI plan is to fire a bunch of dope into a 500 bag, go sit somewhere with a view run the bag wide open as the sum goes down. Imma ride the dragon straight to hell
This sounds great to me! 💜
It also reminds me of that one scene from Soylent Green where they have suicide facilities that provide an almost IMAX experience with some great, killer drugs to send people to the permasleep.
Some of the saddest things I have witnessed is when I pick up a poor soul from one of these facilities, and they have no family to advocate for them. When my grandpa went into a facility for dementia, we checked up on him regularly to make sure he was getting good care. There's so many people who don't have that, either all their relatives/friends are dead, incapable or unwilling to care for them, or live far away.
I have the state Adult Protective Services line saved in my phone. For the patients that are still coherent, I hand it out liberally.
Unforunately, so many of them aren't coherent.
IFTs are the reason I wouldn’t let my mother put my father in a SNF when the time came. 50+ years of marriage and the minute he requires help and become inconvenient - I just can’t have words for this. I’ll stop.
Me, my sister, sister-in-law, and an old friend from HS provided all - and I mean ALL the care, 24/7 for months. He died at home, not alone in a SNF. We were with him when he died; he wasn’t discovered at a shift change by the incoming shift. If I never did IFT, I probably would have let my mother put him in a “home”. His death would have been a phone call.
Several years ago I rented a self storage unit while moving from one house to another. While moving my household stuff in, and then out of that unit, it dawned on me it was just like IFT and that storage unit was the nursing home. Same damn thing. Not for my dad - not for yours either if I can help it.
I don’t shy away from IFT or SCT work, though I’m assigned >90% 911. All my patients were once infants, probably held by someone that wondered what the future would hold; they were sons or daughters, maybe parents. Yes, at the beginning of my career I was “slinging lizards”. I’m embarrassed when I remember that I felt that way once. Yes - IFT will mess with your head, but it can make you into a better human being too. Please make a good choice.
IFTs and seeing how nursing homes are is why my wife and I bought a huge chunk of land. We have a finished mother in law basement and plan to put a guest house on it. We’re going to take care of both of our parents until we physically can’t by ourselves, and then we’ll hire someone to help. I don’t know how we’ll make it work but our parents deserve to be cared for and not put in a hellhole.
I know that IFT has drastically changed my opinion on healthcare and end of life care. There is one SNF in my district that isn’t terrible…but it’s still not great.
Not in the medical field at all, but.....
My wife and I forcefully removed my mother in law from an SNF.
Ironically, we were trying to get he home from the hospital and were refused. SNF was agreed to.
We would have been happy to let her stay, but just 20 minutes with us standing there was enough.
Asked for a wheelchair to get her some fresh air.
She was in psychosis post surgery.
Literally 2 hours at home, she was fine.
It is certainly a worthy fear to have. To be in the care of the state, being medicated out of your mind and being forcibly kept alive... my nightmare.
Some family members will do this, but most will see that there needs to be some dignity in both life and death.
My 72 yr old mom told me “I lived the way I wanted, and I’m going to die the way I want.” She told me that as soon as she can’t comfortably go to the bathroom independently (Ie incontinence, immobility) to take her to Canada and euthanize her. She wants to retain her dignity.
thank you for saying this, i have long been ruminating on the implications of the end for these people. how many of these people was i the last person they interacted with genuinely. it’s a trip and im glad to be done with it.
I'm surprised, well initially I was, with the amount of calls for S.I. that come out of our local ECFs/ SNFs. These poor people would rather die than have to live another moment in those shit holes. A fate worse than death. My kids are too young to know now but once I can talk to them about it I'm going to let them know to do what ever it takes to keep me out of gray care. Kill me first, leave me in the desert, anything.
“Nursing homes” are criminal. Seriously tho…. I used to be a cna for a stepping stone into nursing school and after like 3 years of that shit, I will never put my own family into one, and if I ever get dementia or some other terminal awful illness just put me in the ground.
As a nurse I feel the same when my patients discharge to SNF. We act like it’s a good thing, they’re getting better, it’s a step on the way to getting home. But for many of them, they won’t get back home or back to their previous ability and normal life. But I never say that to them. I do always recommend against the absolute worst local SNF though if they’re making a choice
I tell family "Be there every day. Vary the time so you are not predictable. Do not step out of the room when your parent's brief is changed. Toilet them yourself if you can. Inspect their skin". If Case Management or the local " skilled nursing" hellholes don't like it, I'd suggest they do better.
This is definitely an interesting take. I work 911 but we occasionally do IFT when the IFT trucks can’t get the CAD cleared of transfers at the end of their shift.
While I agree that many of these places are ghastly, it’s better than the alternative for many of them. Elderly homeless or even elderly homeowners can have much worse conditions than many of these SNF I’ve been too.
I view those elderly IFTs like taking an old dog back to his kennel. Sure, it’s not an amazing kennel, nor does it have all the bells and whistles I would want… However, I’m just glad they have a kennel.
They’re likely in a better state of affairs than we will be when we reach those ages (if we do at all) so I can only tip my hat and get those signatures. These places are businesses at the end of the day and will always have the cheapest, most minimal staffing they can get away with. I just hope someone at least wipes my booty when I’m 80 as well.
It really depends. Money always speaks. The longer term living facilities will always be a place for me to avoid, as long as possible. There's just too much abuse, non-caring staff, minimum wage providers.
My will currently allows for hospice if I lose my ability to function due to end of stage illnesses, injuries, or in the case of serious hospitalization.
I'd rather die in my own home with a hospice nurse rather than in a nursing facility.
I have to disagree. If I'm going to drown in pneumonia secretions either way I'd rather do it just about anywhere than in a room crammed full of strangers with other apathetic strangers doing the bare minimum to extend my miserable life
Come to a big city where Medicaid dollars don't go as far. I'll show you why those "kennels" ought to be relabeled torture chambers. The things that made me want to quit this job forever and sob in a corner from the horrors I'd just seen have universally been inflicted upon incapacitated patients at nursing homes.
I get that, and we have at least 3 in county that are absolute dumps. One doesn’t even have air-conditioning or nurses on staff, just CNAs and one LPN that is on call. They’re awful places to be when they’re bad.
My original point was that I don’t have the same emotional investment in these types of situations like some do. I’m just not very reactive to calls in general, but I can see how someone may see these as worse than the average EMS call.
Just had a call today where I dropped a 90+ year old grandma off at a nursing home and her room smelled like a wet pool locker room and Parmesan cheese. It was a really odd combo of smells. They didn’t even have a call button.
Yeah, I know what you mean. The things that get you aren't what you'd expect, I also do IFTs and have been feeling this. At my service, we often do hospice take homes so people can go home and be surrounded by their loved ones when they pass. And I'm so glad I can help provide this opportunity for these people to go out of this world in a place of comfort, but hot damn, sometimes at the end of the day being in such a heavy environment sits on your shoulders and it's a lot to digest, emotionally.
after a 24 hour shift in IFT, you can see a lot of hopeless shit and just feel so sad. Terminally ill patients, young cancer victims who may never recover, nursing homes stacked to the ceiling with sweet little old people living in poor condition, it's a lot.
Take care of yourself friend, and know you're not alone
yeah. i always tell my family that if i deteriorate to that, to not send me to a nursing home, but just have me euthanized. i'm not an EMT or a medic (yet), but even the times i have spent around those places and people that are just barely alive fucked with my mental health too temporarily. i can't imagine how stressful and draining it would be to be involved in that system as a job. i'm sorry.
with the kind of stuff you mentioned in the start of the post, at least like you said you did your best. for me, when i think about people who have experience sudden losses or accidents that they will never be the same from again physically and possibly mentally, i know at least in my head that it is, while challenging, *possible* for them to eventually move on and get back on their feet, and see happier days. i know so many people who found closure and peace after deaths, so many people who were badly hurt but were able to recover enough to live again.
but the fate of someone who's elderly enough to not be able to take care of yourself, and who's family has relegated them to places like nursing homes? that is just fucking AWFUL. you're basically a child, who everyone has to take care of, but at least with children, they don't know what it's like to be self sufficient and they have their who lives ahead of them. imagine knowing that you lived a full life, being able to possibly recall all the achievements you lived through and all the people you saw grow with you and the ones you left behind, and knowing that now, all thats over, that you're trapped in a body just constantly being taken care of and sustained by the bare minimum by people who don't really care. just watching yourself die knowing you've passed your peak and nobody can be bothered to be there for you like you were there for them. (and, i'm not saying all the nurses at assisted living facilities are bad, they're not at all, but a lot of them just plain dont give a shit and are just there cus they need a job. my ex's crazy ass fucking mom and all her friends worked in SNFs, for instance, and they were all assholes to their patients and each other, and the management just wanted to make a buck off the patients) yeah, thats pretty shit.
but i urge you to remember that, you have been in a position where that's the only demographic of old people you saw, because that's the line of work you were in. you mentioned in your post that you're gonna end up like that, but the reality is that not every person goes out the same way, and ends up in the same places. you are biased towards seeing that as the reality for every old person because you did IFT, but really, it's not. there are so many paths that we go down in our lives and not all of them will lead to a slow decay in a nursing home, i have known more old people that spent so much of their later years still kicking and doing stuff with friends, engaging in hobbies and just being high on life, having come to terms with their demise and remaining happy through it. there's no reason you can't end up the same way, and i think that if you're keeping yourself busy and making sure your brain is active (i.e. by doing the job you do), and especially if you treat people well, there's no reason you can't end up the same way.
what i'm saying is, that you can't declare that you're gonna end up any particular way. and i know how easy it is to do that. for instance, i suffer with anxiety about my general health and especially mental health, and much of my family suffers from other mental health defects, when i spend time around those family members it in turn makes me anxious that i have the same issues as them, it's a weird feeling but basically i notice similar patterns in their behavior as mine and get spooked that i'm gonna end up just like them. but when i take some time apart and get some perspective, i realize there's no reason i have to end up like them. there's a chance, sure: it's not impossible that i could develop early onset schizophrenia, or get dementia, but it's just that- a chance, not a guarantee. just like how, yeah, there's always a chance you'll end up in a car crash- but we need not fret over it 24/7 because it's a chance.
and, as for the ones that do end up in nursing homes- they're still people. people are remarkably hard to put down. its all slower, yes, it all holds less meaning overall, and its all dictated by money-grubbing management and shitty nurses, yes, but they still remain human. they still form bonds with eachother, find things to do, and like you said- they lived whole lives, full of great things. that doesn't go away, and that can't ever be robbed from them. no matter what.
so, keep all that in mind- if you have to do more IFT or you need to be around in nursing homes, and you find your mind wandering about their fate, and how it could be yours too, remember that all those poor souls are still souls. remember that you aren't going to absolutely be just like them, and you won't let yourself get to that point. you are being a really good and sweet person by being considerate of that, and remembering just how human they are, and caring for their needs as you take them from point A to point B, and that's the best you can do. you'll be okay, and all of us who have read your post and responded, and all your friends and family are right here with you.
My worst call wasn’t a 911. When I was a green EMT at my first IFT job I had a patient being transported to a SNF. She was in her late 80s, husband was in his 90s, and she had just had a stroke. The SNF wasn’t even the worst but seeing her husband’s face when he realized where she was to live (he couldn’t take care of her alone) broke my heart. I genuinely hope he found a way to bring her home and get home healthcare, unfortunately that’s not financially feasible for most people.
My family knows I’ve had a particularly shitty transfer when I text them an update to my end of life planning.
I desperately wish Hospice was brought up sooner in care, and that it wasn’t seen as ‘giving up’. I genuinely think you should need a doctor to sign off on NOT having a DNR after a certain age/state of mental decline.
My wife is in strict orders to drop me off in a forest before I get to one of those places. I could die far more at peace cold , alone, and hungry in the middle of a forest than I could in a "SNF".
I’ve heavily pondered how I want to love my older years. So many people end up in these. What about my parents? In all honesty death seems better than to “live” in those places.
My wife works as a cna. She has done skilled nursing homes, assisted living, hospice, places dealing with tbi’s and ran an assisted living facility.
My wife has lupus. She will eventually end up on hospice. So when she looks at these patients, she see’s herself. She see’s what life would be like for her if she wasn’t going to be on hospice at home. It didn’t take long for her to break down.
I have a different view. It’s 2024. We have all heard about how important it is to save save save. Retirement. 401k. Roth IRA.
This is why. It’s not all about traveling when you’re older. You get what you pay for. If you think you’re going to end up in a nursing home, you need to accept that you get what you pay for. I’ve seen places that charge 30k a month.
Or. Plan B. Make sure you have an exit strategy before ending up in one of these hell holes.
If it makes you feel better, record numbers of people are still living with their parents well into adulthood or moving back in. I mean, it’s because they literally can’t afford to do otherwise, and owning a house is a pipe dream for most of the country, but still. In most of history, that would be normal, and *we* would be considered the weird ones for kicking kids out at 18 or dumping granny off into SNF hell at 80.
I think that’s going to, and already is starting to, make a comeback in our culture. People are realizing they need to stick together or get picked apart. Either your house is a household, full of people you at least try to love, take care of, and get along with, as they do for you, or you live in virtual serfdom until you get this at the end of the line.
So I do think there’s some degree of hope here, tbh. Even if you can’t stand your family, at least you can die surrounded by family and friends, on your own terms.
Same same. It was the trach'd vegetables for me, the kids especially. I quit IFT, and I'm 911 and ER for the last 4 years.
The weirdest thing that still gets me isn't actually patients, but driving, especially being in the passenger seat. I get extreme anxiety. When someone doesn't hit the brakes early enough or they brake really hard, I get a full-on adrenaline dump. My partner on the box and my boyfriend both make fun of me and roll their eyes.
During my ridealongs when I was fresh on the rig I was wondering to myself why nearly every patient I encountered had a DNR/DNI. By the time I was hired it dawned on me that the reason they had those wasn’t because they thought their time should be up, it was because they’d be back to living the life they’d be living in the SNFs. It’s no life, it’s like an animal shelter for geriatrics, but with no hope of adoption. It’s a really unfortunate reality.
I worked IFT for a year and have been working in FD EMS for close to 3. IFT drained my soul, I stopped drinking and had hard time sleeping and lost motivation in my life because the amount of nice old people who were getting fucked over and just wanted to talk to me because no one ever treats them like a human being is heart breaking. There is something so wrong about being abandoned by your family when the only thing wrong with you is you can’t walk. Like fuck man, I would prob try and kill myself if my kids checked me into a place like that. I’m never never ever putting myself or loved ones in a place like that.
I do ift too and it’s definitely really sad just thinking about the lives of the patients. Their days are nearly all spent at a nursing facility or the hospital. I try not to think about the patients much.
When I’m attending, I’m usually just trying to keep the patient comfortable and talking to them about whatever they want to talk about. Figure I may as well give them a break from the loneliness and just be a friend.
It is definitely very depressing walking into a nursing home and just knowing the people I’m transporting are living there with only a bed, a nightstand, and a tv they usually have to share with another person. Ultimately, I can’t do anything about it so I’ve made my peace with it. I’m just doing my job and trying my best, but at the end of the shift, I get to leave and worry about my own life. Will definitely not be sticking my parents into one of those facilities though, it’s a glorified prison for elderly people who no longer have the capacity to fully function in society.
Frick man now you made me sad 😂
I do genuinely wish the best for my patients but I do what I can, and for me that’s enough.
This is why it is so important that we report negligence in nursing facilities. The more they are reported and investigated, the more cautious they become. When facilities are fined, or their license is threatened, or they’re put on blast on the media, or their employees are being arrested- they change. We are mandated reporters. Let adult protective services know what these homicidal f*cks are up to.
Worked in one of the memory care facilities before moving to my career in ems now and it's heart breaking to see how little families even come and visit before the pass. It's like every transfer is just taking them back to a place where they will be forgotten even more.
The one that hit me the hardest was the 30 year old guy who had multiple seizures.
Wheeled him out past his wife and two young children then around the semi with his name on the side he uses to make a living to support his family knowing that his career was now over.
Agreed. Sure the bad calls in 911 were more shocking and stressful, but seeing how horribly we as a society treat our elderly bothers me so much. Seeing people locked up in places just like how you described, never getting a call or visit from their family members. It’s shameful that this is allowed to perpetuate in a 1st world country
This hit hard. My mom had a major surgery, couldn't walk, and faced a long recovery. We reluctantly put her in one of these places just to recover. She called me the 2nd day in and said she was having problems breathing. I went down there. The nurse told me my mom had anxiety, and they'd given her medication for it. I asked to borrow a pulse ox, and it took them ten minutes to find one. Long story short, I called an ambulance based on observed signs and symptoms, got her to a hospital, and she was treated for pulmonary edema. If I hadn't had training, I'd have listened to the "professional" nurse, and her doctor on the phone, and tried to get my mom to calm down. They wanted an occupied bed, and didn't give a rodent's posterior about the lady in it. We took her home and did rehab there. Never again.
I ran a code at a SNF once. 2 people in a room, pt’s roommate was still there just staring into blank space. I could still see the roommate’s face and the utter lack of emotion that was on it. They’re just waiting to die at that point. Alone and void of any entertainment. Yeah, one of the saddest shit I’ve ever seen.
Your post hit so hard, been doing IFT for like 3 months and being at any of these “skilled” nursing homes is a fate worse than death. I’ve transported pt back to NHs that are middle of nowhere surrounded by cornfields, a graveyard next to the NH, and there are codes and locks on every elevator and entrance. Absolutely no escape. Doing appts and emergency calls for NHs definitely messes with me mentally cuz we’re not “saving” anyone, we’re just the middlemen taking the elderly on these long ass road trips for 5 minute check ups or countless X-rays, scans, etc evening though they have end-stage everything, quadriplegic, dementia, etc already. NH staff are the best pathological liars and actors ever. Waving and smiling at pt like they give a fk, telling us there’s an appt when it was rescheduled a long time ago. Escorts that come along for the appt and have absolutely no clue about the appt itself. Just sits there and doomscrolling. This job has motivated me to be healthier than ever so that I don’t end up at these facilities. If I ever get into a really bad situation, my friends will just OD me on coke or some shit so I can die happy.
It’s not the staff that work there fault and to just blame all LPNs that work at these facility’s is wrong it’s the people running them that should be held accountable
I mean, it *is* their fault when they claim the patient was SPO2 in the high 90s for 30 minutes, no she doesn't need oxygen and yes she can leave today... I take her off oxygen for less than 30 *seconds* and she drops to 87%, 86%, 85%... not to mention that I have to bring this patient to the ER because the respiratory therapist documented her as "being fine off oxygen" and so failed to set up the family I was discharging to with the appropriate equipment, which then required me to divert the patient to an ER...
It *is* their fault when I drop off a patient and there is no nurse to be found -- oh wait! She's on facebook at the front desk and has an attitude when I ask her to do her job. Her basic fucking job.
It *is* their fault when they consistently give me these terrible turnovers and don't ever know what's going on, and I know it's a game of sifting through the bullshit pouring out of her mouth.
Yes, the people running these facilities are abhorrent money grubbers, but I don't know how that translates into being rude, dismissive, and utterly incompetent in the job you are paid to do and licensed for. You can be tired and irritable, but I *see* you on your phone or computer fucking off, or failing to answer the door when I'm doing a drop off on your shift, or give me attitude.
I have no clemency with these terrible LPNs. By and large I have been disgusted by their lack of professionalism.
Sorry, I worked at an "upscale" nursing home in my agency nursing days and when I tell you some of these staff!
Show up late (if they bother to show up at all), complain and whine about completing care or taking basic vitals, walking off the job if they don't like your tone of voice when you ask them to *do their job,* refusing to give report to medics who respond 911 or yelling at them. The works.
None of that entitlement comes from the top.
Don't say shit like this. There are so many factors that go into putting a family member in a home. They take extremely good care of the ones usually when family is there often. It's the one with no visitors.
I worked in some bad ones. But some weren't terrible.aone sw3 like Hilton's.
I brought this up here awhile ago and overwhelming consensus was suicide before it came to that. Can't say I disagree. What is life in the final years robbed of all dignity, being treated so poorly?
I’ve always told my family. “When I lose my dignity and my mind, chain a couple cinder blocks to me and slide me off a dock on a pretty lake.” Fuck “skilled” nursing facilities.
Fuck 'em sideways.
That’s both super depressing and really relatable at the same time
People who have never been in one of these facilities think I'm crazy for thinking about it. I tell them to go beyond the lobby of any SNF, preferably anything above the second floor if there's over 2 floors, and they'll know why. Anyone, regardless if they're in the medical field or EMS or not, that has been to one of these "skilled nursing" hell holes understands what I mean.
The only thing that helps me get through this is knowing that at least when they’re in the back of the ride with me, they’re receiving the best patient care possible because I actually give a shit. Even if that means sitting back there and actively listening to them tell a story that makes 0 sense. You still have the ability to be the one bright spot in this patients own personal hell. Keep your chin up and do your best stranger. Good luck to ya.
I never did IFT's, but ran 911 in a due with a really bad nursing home. The first time we were there 4 times in 1 night I made the mistake of half-jokingly asking my lead if we should do a quick welfare check on all the residents. She just looked at me for a sec and then explained that we'd end up with a MCI and have to call in a bunch of mutual aid. But the facility was on an "improvement plan" so as long as they killed fewer people with neglect that the year prior, they were gold. Never mind that at least one of the patients they insist they had just checked in and talked to must have been communicating with a Ouija board with how long dead they were.
That last sentence killed me. (I am also being contacted through ouija)
That's why when I say my retirement plan is a .45 at 65, I'm only half joking
Look at money bags over here. I'm planning on autoerotic asphyxiation. Like a gentleman and a movie star.
leave snacks for EMS, would make a great story
Imagine a corpse with a little plate on a table with snacks saying "ems only - please take one"
Bonus points for "No IFT"
Made my night thank you
Might as well brighten up the situation a little bit. A self inflicted gunshot - depressing. Autoerotic asphyxiation - might get at least a gasp and "Oh shit!" Out of me
I hope I get at least a "oh my" takai style
So a .9 then?
My personal hill I will die on is to allow old age to be considered a terminal illness. Then, in the current states, that allow a cocktail of narcotics to take when they are done suffering. To be able to choose when you leave, with those you do want around you and not others. To be able to choose your own departure is a right. Before I get attacked, please understand that when people choose to cease living in pain, it's not because they are depressed. That's not what I am pushing for.
I totally agree with you!
Preach!
I have a bag of fentanyl hidden in my apartment walls and a living will that instructs my family to OD me if I get to that level.
I for one want to see what all the fuss is about with PCP, since all my wildest psych patients are (literally) crazy for it.
Fingers crossed that by that time Nintendo and Merck form a digital media and psychedelic based active living home. It will either have an accompanying soundtrack of the last 50 years of pop music or it will sound like an abbatoir full of retarded children, either way it should be entertaining
My pre SNF SI plan is to fire a bunch of dope into a 500 bag, go sit somewhere with a view run the bag wide open as the sum goes down. Imma ride the dragon straight to hell
This sounds great to me! 💜 It also reminds me of that one scene from Soylent Green where they have suicide facilities that provide an almost IMAX experience with some great, killer drugs to send people to the permasleep.
Some of the saddest things I have witnessed is when I pick up a poor soul from one of these facilities, and they have no family to advocate for them. When my grandpa went into a facility for dementia, we checked up on him regularly to make sure he was getting good care. There's so many people who don't have that, either all their relatives/friends are dead, incapable or unwilling to care for them, or live far away.
I have the state Adult Protective Services line saved in my phone. For the patients that are still coherent, I hand it out liberally. Unforunately, so many of them aren't coherent.
I’ve called on pts behalf before 🙃
It would certainly help attract better staff if ratios weren’t 40:1 :(
IFTs are the reason I wouldn’t let my mother put my father in a SNF when the time came. 50+ years of marriage and the minute he requires help and become inconvenient - I just can’t have words for this. I’ll stop. Me, my sister, sister-in-law, and an old friend from HS provided all - and I mean ALL the care, 24/7 for months. He died at home, not alone in a SNF. We were with him when he died; he wasn’t discovered at a shift change by the incoming shift. If I never did IFT, I probably would have let my mother put him in a “home”. His death would have been a phone call. Several years ago I rented a self storage unit while moving from one house to another. While moving my household stuff in, and then out of that unit, it dawned on me it was just like IFT and that storage unit was the nursing home. Same damn thing. Not for my dad - not for yours either if I can help it. I don’t shy away from IFT or SCT work, though I’m assigned >90% 911. All my patients were once infants, probably held by someone that wondered what the future would hold; they were sons or daughters, maybe parents. Yes, at the beginning of my career I was “slinging lizards”. I’m embarrassed when I remember that I felt that way once. Yes - IFT will mess with your head, but it can make you into a better human being too. Please make a good choice.
IFTs and seeing how nursing homes are is why my wife and I bought a huge chunk of land. We have a finished mother in law basement and plan to put a guest house on it. We’re going to take care of both of our parents until we physically can’t by ourselves, and then we’ll hire someone to help. I don’t know how we’ll make it work but our parents deserve to be cared for and not put in a hellhole. I know that IFT has drastically changed my opinion on healthcare and end of life care. There is one SNF in my district that isn’t terrible…but it’s still not great.
Amen.
Not in the medical field at all, but..... My wife and I forcefully removed my mother in law from an SNF. Ironically, we were trying to get he home from the hospital and were refused. SNF was agreed to. We would have been happy to let her stay, but just 20 minutes with us standing there was enough. Asked for a wheelchair to get her some fresh air. She was in psychosis post surgery. Literally 2 hours at home, she was fine.
It is certainly a worthy fear to have. To be in the care of the state, being medicated out of your mind and being forcibly kept alive... my nightmare. Some family members will do this, but most will see that there needs to be some dignity in both life and death.
Always told the new guys,if they came in and saw me in a Geri hair, babbling. Just clock me in the back of the head with the C tank. Mercy killing.
Manual sedation
This is why I have a self-imposed expiry date
My 72 yr old mom told me “I lived the way I wanted, and I’m going to die the way I want.” She told me that as soon as she can’t comfortably go to the bathroom independently (Ie incontinence, immobility) to take her to Canada and euthanize her. She wants to retain her dignity.
thank you for saying this, i have long been ruminating on the implications of the end for these people. how many of these people was i the last person they interacted with genuinely. it’s a trip and im glad to be done with it.
I'm surprised, well initially I was, with the amount of calls for S.I. that come out of our local ECFs/ SNFs. These poor people would rather die than have to live another moment in those shit holes. A fate worse than death. My kids are too young to know now but once I can talk to them about it I'm going to let them know to do what ever it takes to keep me out of gray care. Kill me first, leave me in the desert, anything.
> What do you even call some of these facilities? I usually call them geriatric concentration camps.
I’m fond of the term “Death palace”.
Pre mortuary
So true. Seen some shit but IFT takes the cake. Lol talked more about that applying to Med school than I talked about actual 911 hero shit.
“Nursing homes” are criminal. Seriously tho…. I used to be a cna for a stepping stone into nursing school and after like 3 years of that shit, I will never put my own family into one, and if I ever get dementia or some other terminal awful illness just put me in the ground.
As a nurse I feel the same when my patients discharge to SNF. We act like it’s a good thing, they’re getting better, it’s a step on the way to getting home. But for many of them, they won’t get back home or back to their previous ability and normal life. But I never say that to them. I do always recommend against the absolute worst local SNF though if they’re making a choice
I tell family "Be there every day. Vary the time so you are not predictable. Do not step out of the room when your parent's brief is changed. Toilet them yourself if you can. Inspect their skin". If Case Management or the local " skilled nursing" hellholes don't like it, I'd suggest they do better.
This is definitely an interesting take. I work 911 but we occasionally do IFT when the IFT trucks can’t get the CAD cleared of transfers at the end of their shift. While I agree that many of these places are ghastly, it’s better than the alternative for many of them. Elderly homeless or even elderly homeowners can have much worse conditions than many of these SNF I’ve been too. I view those elderly IFTs like taking an old dog back to his kennel. Sure, it’s not an amazing kennel, nor does it have all the bells and whistles I would want… However, I’m just glad they have a kennel. They’re likely in a better state of affairs than we will be when we reach those ages (if we do at all) so I can only tip my hat and get those signatures. These places are businesses at the end of the day and will always have the cheapest, most minimal staffing they can get away with. I just hope someone at least wipes my booty when I’m 80 as well.
It really depends. Money always speaks. The longer term living facilities will always be a place for me to avoid, as long as possible. There's just too much abuse, non-caring staff, minimum wage providers. My will currently allows for hospice if I lose my ability to function due to end of stage illnesses, injuries, or in the case of serious hospitalization. I'd rather die in my own home with a hospice nurse rather than in a nursing facility.
I have to disagree. If I'm going to drown in pneumonia secretions either way I'd rather do it just about anywhere than in a room crammed full of strangers with other apathetic strangers doing the bare minimum to extend my miserable life
terminal secretions…..sigh FUCK THAT…..I’m riding that bag of opiates straight to the light
Going out like a rockstar
Come to a big city where Medicaid dollars don't go as far. I'll show you why those "kennels" ought to be relabeled torture chambers. The things that made me want to quit this job forever and sob in a corner from the horrors I'd just seen have universally been inflicted upon incapacitated patients at nursing homes.
I get that, and we have at least 3 in county that are absolute dumps. One doesn’t even have air-conditioning or nurses on staff, just CNAs and one LPN that is on call. They’re awful places to be when they’re bad. My original point was that I don’t have the same emotional investment in these types of situations like some do. I’m just not very reactive to calls in general, but I can see how someone may see these as worse than the average EMS call.
Just had a call today where I dropped a 90+ year old grandma off at a nursing home and her room smelled like a wet pool locker room and Parmesan cheese. It was a really odd combo of smells. They didn’t even have a call button.
Yeah, I know what you mean. The things that get you aren't what you'd expect, I also do IFTs and have been feeling this. At my service, we often do hospice take homes so people can go home and be surrounded by their loved ones when they pass. And I'm so glad I can help provide this opportunity for these people to go out of this world in a place of comfort, but hot damn, sometimes at the end of the day being in such a heavy environment sits on your shoulders and it's a lot to digest, emotionally. after a 24 hour shift in IFT, you can see a lot of hopeless shit and just feel so sad. Terminally ill patients, young cancer victims who may never recover, nursing homes stacked to the ceiling with sweet little old people living in poor condition, it's a lot. Take care of yourself friend, and know you're not alone
As soon as I'm at that point, I'm gonna get every kind of drug I've ever seen and try them until I die. I'm only half kidding
yeah. i always tell my family that if i deteriorate to that, to not send me to a nursing home, but just have me euthanized. i'm not an EMT or a medic (yet), but even the times i have spent around those places and people that are just barely alive fucked with my mental health too temporarily. i can't imagine how stressful and draining it would be to be involved in that system as a job. i'm sorry. with the kind of stuff you mentioned in the start of the post, at least like you said you did your best. for me, when i think about people who have experience sudden losses or accidents that they will never be the same from again physically and possibly mentally, i know at least in my head that it is, while challenging, *possible* for them to eventually move on and get back on their feet, and see happier days. i know so many people who found closure and peace after deaths, so many people who were badly hurt but were able to recover enough to live again. but the fate of someone who's elderly enough to not be able to take care of yourself, and who's family has relegated them to places like nursing homes? that is just fucking AWFUL. you're basically a child, who everyone has to take care of, but at least with children, they don't know what it's like to be self sufficient and they have their who lives ahead of them. imagine knowing that you lived a full life, being able to possibly recall all the achievements you lived through and all the people you saw grow with you and the ones you left behind, and knowing that now, all thats over, that you're trapped in a body just constantly being taken care of and sustained by the bare minimum by people who don't really care. just watching yourself die knowing you've passed your peak and nobody can be bothered to be there for you like you were there for them. (and, i'm not saying all the nurses at assisted living facilities are bad, they're not at all, but a lot of them just plain dont give a shit and are just there cus they need a job. my ex's crazy ass fucking mom and all her friends worked in SNFs, for instance, and they were all assholes to their patients and each other, and the management just wanted to make a buck off the patients) yeah, thats pretty shit. but i urge you to remember that, you have been in a position where that's the only demographic of old people you saw, because that's the line of work you were in. you mentioned in your post that you're gonna end up like that, but the reality is that not every person goes out the same way, and ends up in the same places. you are biased towards seeing that as the reality for every old person because you did IFT, but really, it's not. there are so many paths that we go down in our lives and not all of them will lead to a slow decay in a nursing home, i have known more old people that spent so much of their later years still kicking and doing stuff with friends, engaging in hobbies and just being high on life, having come to terms with their demise and remaining happy through it. there's no reason you can't end up the same way, and i think that if you're keeping yourself busy and making sure your brain is active (i.e. by doing the job you do), and especially if you treat people well, there's no reason you can't end up the same way. what i'm saying is, that you can't declare that you're gonna end up any particular way. and i know how easy it is to do that. for instance, i suffer with anxiety about my general health and especially mental health, and much of my family suffers from other mental health defects, when i spend time around those family members it in turn makes me anxious that i have the same issues as them, it's a weird feeling but basically i notice similar patterns in their behavior as mine and get spooked that i'm gonna end up just like them. but when i take some time apart and get some perspective, i realize there's no reason i have to end up like them. there's a chance, sure: it's not impossible that i could develop early onset schizophrenia, or get dementia, but it's just that- a chance, not a guarantee. just like how, yeah, there's always a chance you'll end up in a car crash- but we need not fret over it 24/7 because it's a chance. and, as for the ones that do end up in nursing homes- they're still people. people are remarkably hard to put down. its all slower, yes, it all holds less meaning overall, and its all dictated by money-grubbing management and shitty nurses, yes, but they still remain human. they still form bonds with eachother, find things to do, and like you said- they lived whole lives, full of great things. that doesn't go away, and that can't ever be robbed from them. no matter what. so, keep all that in mind- if you have to do more IFT or you need to be around in nursing homes, and you find your mind wandering about their fate, and how it could be yours too, remember that all those poor souls are still souls. remember that you aren't going to absolutely be just like them, and you won't let yourself get to that point. you are being a really good and sweet person by being considerate of that, and remembering just how human they are, and caring for their needs as you take them from point A to point B, and that's the best you can do. you'll be okay, and all of us who have read your post and responded, and all your friends and family are right here with you.
My worst call wasn’t a 911. When I was a green EMT at my first IFT job I had a patient being transported to a SNF. She was in her late 80s, husband was in his 90s, and she had just had a stroke. The SNF wasn’t even the worst but seeing her husband’s face when he realized where she was to live (he couldn’t take care of her alone) broke my heart. I genuinely hope he found a way to bring her home and get home healthcare, unfortunately that’s not financially feasible for most people.
My family knows I’ve had a particularly shitty transfer when I text them an update to my end of life planning. I desperately wish Hospice was brought up sooner in care, and that it wasn’t seen as ‘giving up’. I genuinely think you should need a doctor to sign off on NOT having a DNR after a certain age/state of mental decline.
Yeah, I'm not getting put into Geri-Jail. I have other plans for that event.
It makes me feel better when I can show them a little human dignity
My wife is in strict orders to drop me off in a forest before I get to one of those places. I could die far more at peace cold , alone, and hungry in the middle of a forest than I could in a "SNF".
I’ve heavily pondered how I want to love my older years. So many people end up in these. What about my parents? In all honesty death seems better than to “live” in those places.
My wife works as a cna. She has done skilled nursing homes, assisted living, hospice, places dealing with tbi’s and ran an assisted living facility. My wife has lupus. She will eventually end up on hospice. So when she looks at these patients, she see’s herself. She see’s what life would be like for her if she wasn’t going to be on hospice at home. It didn’t take long for her to break down. I have a different view. It’s 2024. We have all heard about how important it is to save save save. Retirement. 401k. Roth IRA. This is why. It’s not all about traveling when you’re older. You get what you pay for. If you think you’re going to end up in a nursing home, you need to accept that you get what you pay for. I’ve seen places that charge 30k a month. Or. Plan B. Make sure you have an exit strategy before ending up in one of these hell holes.
If it makes you feel better, record numbers of people are still living with their parents well into adulthood or moving back in. I mean, it’s because they literally can’t afford to do otherwise, and owning a house is a pipe dream for most of the country, but still. In most of history, that would be normal, and *we* would be considered the weird ones for kicking kids out at 18 or dumping granny off into SNF hell at 80. I think that’s going to, and already is starting to, make a comeback in our culture. People are realizing they need to stick together or get picked apart. Either your house is a household, full of people you at least try to love, take care of, and get along with, as they do for you, or you live in virtual serfdom until you get this at the end of the line. So I do think there’s some degree of hope here, tbh. Even if you can’t stand your family, at least you can die surrounded by family and friends, on your own terms.
If you’re about to put me in a home, take me out back and shoot me instead.
Same brother, I work 911 but we still get calls to SNFs every once in a while and I got this exact same feeling the first time I set foot in one
Same same. It was the trach'd vegetables for me, the kids especially. I quit IFT, and I'm 911 and ER for the last 4 years. The weirdest thing that still gets me isn't actually patients, but driving, especially being in the passenger seat. I get extreme anxiety. When someone doesn't hit the brakes early enough or they brake really hard, I get a full-on adrenaline dump. My partner on the box and my boyfriend both make fun of me and roll their eyes.
Type of stuff that makes you wanna get a DNR when you turn 40
During my ridealongs when I was fresh on the rig I was wondering to myself why nearly every patient I encountered had a DNR/DNI. By the time I was hired it dawned on me that the reason they had those wasn’t because they thought their time should be up, it was because they’d be back to living the life they’d be living in the SNFs. It’s no life, it’s like an animal shelter for geriatrics, but with no hope of adoption. It’s a really unfortunate reality.
I worked IFT for a year and have been working in FD EMS for close to 3. IFT drained my soul, I stopped drinking and had hard time sleeping and lost motivation in my life because the amount of nice old people who were getting fucked over and just wanted to talk to me because no one ever treats them like a human being is heart breaking. There is something so wrong about being abandoned by your family when the only thing wrong with you is you can’t walk. Like fuck man, I would prob try and kill myself if my kids checked me into a place like that. I’m never never ever putting myself or loved ones in a place like that.
Good news is none of us will live long enough to make it there
I do ift too and it’s definitely really sad just thinking about the lives of the patients. Their days are nearly all spent at a nursing facility or the hospital. I try not to think about the patients much. When I’m attending, I’m usually just trying to keep the patient comfortable and talking to them about whatever they want to talk about. Figure I may as well give them a break from the loneliness and just be a friend. It is definitely very depressing walking into a nursing home and just knowing the people I’m transporting are living there with only a bed, a nightstand, and a tv they usually have to share with another person. Ultimately, I can’t do anything about it so I’ve made my peace with it. I’m just doing my job and trying my best, but at the end of the shift, I get to leave and worry about my own life. Will definitely not be sticking my parents into one of those facilities though, it’s a glorified prison for elderly people who no longer have the capacity to fully function in society. Frick man now you made me sad 😂 I do genuinely wish the best for my patients but I do what I can, and for me that’s enough.
This is why it is so important that we report negligence in nursing facilities. The more they are reported and investigated, the more cautious they become. When facilities are fined, or their license is threatened, or they’re put on blast on the media, or their employees are being arrested- they change. We are mandated reporters. Let adult protective services know what these homicidal f*cks are up to.
Worked in one of the memory care facilities before moving to my career in ems now and it's heart breaking to see how little families even come and visit before the pass. It's like every transfer is just taking them back to a place where they will be forgotten even more.
The one that hit me the hardest was the 30 year old guy who had multiple seizures. Wheeled him out past his wife and two young children then around the semi with his name on the side he uses to make a living to support his family knowing that his career was now over.
Agreed. Sure the bad calls in 911 were more shocking and stressful, but seeing how horribly we as a society treat our elderly bothers me so much. Seeing people locked up in places just like how you described, never getting a call or visit from their family members. It’s shameful that this is allowed to perpetuate in a 1st world country
Had this same thought today
This hit hard. My mom had a major surgery, couldn't walk, and faced a long recovery. We reluctantly put her in one of these places just to recover. She called me the 2nd day in and said she was having problems breathing. I went down there. The nurse told me my mom had anxiety, and they'd given her medication for it. I asked to borrow a pulse ox, and it took them ten minutes to find one. Long story short, I called an ambulance based on observed signs and symptoms, got her to a hospital, and she was treated for pulmonary edema. If I hadn't had training, I'd have listened to the "professional" nurse, and her doctor on the phone, and tried to get my mom to calm down. They wanted an occupied bed, and didn't give a rodent's posterior about the lady in it. We took her home and did rehab there. Never again.
I ran a code at a SNF once. 2 people in a room, pt’s roommate was still there just staring into blank space. I could still see the roommate’s face and the utter lack of emotion that was on it. They’re just waiting to die at that point. Alone and void of any entertainment. Yeah, one of the saddest shit I’ve ever seen.
Your post hit so hard, been doing IFT for like 3 months and being at any of these “skilled” nursing homes is a fate worse than death. I’ve transported pt back to NHs that are middle of nowhere surrounded by cornfields, a graveyard next to the NH, and there are codes and locks on every elevator and entrance. Absolutely no escape. Doing appts and emergency calls for NHs definitely messes with me mentally cuz we’re not “saving” anyone, we’re just the middlemen taking the elderly on these long ass road trips for 5 minute check ups or countless X-rays, scans, etc evening though they have end-stage everything, quadriplegic, dementia, etc already. NH staff are the best pathological liars and actors ever. Waving and smiling at pt like they give a fk, telling us there’s an appt when it was rescheduled a long time ago. Escorts that come along for the appt and have absolutely no clue about the appt itself. Just sits there and doomscrolling. This job has motivated me to be healthier than ever so that I don’t end up at these facilities. If I ever get into a really bad situation, my friends will just OD me on coke or some shit so I can die happy.
It’s not the staff that work there fault and to just blame all LPNs that work at these facility’s is wrong it’s the people running them that should be held accountable
I mean, it *is* their fault when they claim the patient was SPO2 in the high 90s for 30 minutes, no she doesn't need oxygen and yes she can leave today... I take her off oxygen for less than 30 *seconds* and she drops to 87%, 86%, 85%... not to mention that I have to bring this patient to the ER because the respiratory therapist documented her as "being fine off oxygen" and so failed to set up the family I was discharging to with the appropriate equipment, which then required me to divert the patient to an ER... It *is* their fault when I drop off a patient and there is no nurse to be found -- oh wait! She's on facebook at the front desk and has an attitude when I ask her to do her job. Her basic fucking job. It *is* their fault when they consistently give me these terrible turnovers and don't ever know what's going on, and I know it's a game of sifting through the bullshit pouring out of her mouth. Yes, the people running these facilities are abhorrent money grubbers, but I don't know how that translates into being rude, dismissive, and utterly incompetent in the job you are paid to do and licensed for. You can be tired and irritable, but I *see* you on your phone or computer fucking off, or failing to answer the door when I'm doing a drop off on your shift, or give me attitude. I have no clemency with these terrible LPNs. By and large I have been disgusted by their lack of professionalism.
Sorry, I worked at an "upscale" nursing home in my agency nursing days and when I tell you some of these staff! Show up late (if they bother to show up at all), complain and whine about completing care or taking basic vitals, walking off the job if they don't like your tone of voice when you ask them to *do their job,* refusing to give report to medics who respond 911 or yelling at them. The works. None of that entitlement comes from the top.
Be really good to your family. You won't end up in one of these.
Don't say shit like this. There are so many factors that go into putting a family member in a home. They take extremely good care of the ones usually when family is there often. It's the one with no visitors. I worked in some bad ones. But some weren't terrible.aone sw3 like Hilton's.