I’m writing about an experience that happened to my family earlier this week involving the Cape Heritage Rehabilitation and Health Care Center (owned and operated by Athena Health Care Systems), and o ur interaction with the Director of Admissions specifically. My mother was coming to the end of her care at Mass General Hospital in Boston, so the MGH case work teams advised us to start looking into long term care facilities that she could be transferred to continue her care with skilled nurses and professionals. She has several active brain tumors which have caused significant changes to her thought processes, personality and overall ability to live independently, which is unfortunate enough.
We were of course apprehensive and challenged by this important next step in her care, but undertook it nonetheless as we really needed to make a good set of decisions in a short time frame without any other choice. So on Tuesday (12/22), my father, sister and I were told that there was a bed available in the secure unit at Cape Heritage Rehabilitation in Sandwich, MA. The case worker asked if we wanted to take the bed therefore initiating the transfer of my mother from MGH to Sandwich the following day (Wednesday). As we were new to this entire process and hadn’t heard anything about or even seen the facility, we asked if it was possible for them to hold the bed for us for 1 day, allowing us the opportunity to be able to go to Sandwich and get a tour of the facility, meet with staff, etc to see if the medical setting would meet our family’s needs, and if we would feel comfortable having our Mom there in residence. Cape Heritage said yes, they would hold the bed for Wednesday and scheduled a tour for us that morning.
On Wednesday morning (12/23) my father, sister and I went to Heritage for the tour. We were introduced to the Director of Patient Admissions, who took us into her office and asked background questions about our Mom, her condition, etc. We explained everything to her as best we could, and in turn asked her questions we had about the facility. She then gave us a tour of the facility. All of this was very pleasant, and the Director couldn’t have been nicer or more willing to answer any questions we had, work with us in any way. My family and I determined at the end of the visit that we liked the facility as well as the staff. We felt that this very personal introduction was a good representation of the entire facility.
The visit lasted about 45 minutes, and concluded with us saying that we’d be in touch very soon. The Director then said that as of now the bed was still open if we wanted it, and if that changed she would let us know. So after that visit, we concluded we liked this specific atmosphere and locale and the possibility of our Mom being there, but since again we were new to this entire process and facilities like this, we thought it would be a good thing to do our due diligence. Since it was early in the day see if we could possibly tour any of the other nearby facilities to see how they compared to Heritage in Sandwich.
We were able to visit 2 other facilities on or near the Cape that day, and after those visits we concluded what we had already determined that morning: we liked Heritage in Sandwich as the best alternative, and would love it if our mother could be transferred there. So on our way home in the afternoon, we decided to revisit Heritage one more time to make sure everything we remembered was correct, we still liked it as much as we thought, and if the Director was there to ask her any follow up questions we may have come up with during the day. We went back to Heritage, and met once more with the Director there. We asked her a few more questions as she offered additional time for discussion. We went back to her office and chatted for a few minutes, she answered all of our questions and we were pretty reassured that this was still a great place and we liked it, etc. We got ready to head home, and we directly indicated to the Director in person that we really liked their facility, programs and staff and would likely be choosing it, but just to be safe wanted to sleep on the decision and proceed with our final decision in the morning.
We then asked again the status of the open bed. The Director said that the bed was still available, and no one had shown any interest in it besides us. This was great news, but we (again) asked her to let us know (i.e. give my Dad a call on the phone, she had his name and direct cell number) if that changed between now and tomorrow. She said she would. Keep in mind at this point it was now late afternoon/early evening and we planned to make our final decision on choosing Heritage first thing the next morning (Thursday 12/24).
We then spoke with the case work team at MGH so that a scheduled discharge for Thursday morning could be put into motion for transfer to Cape Heritage. The MGH team had also spoken directly with the Director to assure a smooth process would ensue. We all agreed to speak at 9am regarding the now schedule 11am discharge for my Mom.
The next morning (Thursday 12/24), my father, sister and I were all still very confident in our decision to choose Heritage to have my Mom transferred to. So around 8:50am EST we called the case worker at MGH to let her know of our decision. At that point she lets us know that she had just gotten off the phone with the Director at Heritage, and had been informed unexpectedly that the bed was no longer available, they had given it to someone else. You could imagine our surprise and disappointment to find this out, because not only had barely any time passed between when we had last talked directly with the Director the day before and the bed was still available with no interest from anyone else besides our family. We were not informed when interest had been expressed by someone other than us by her, even though we asked her not once, but at least twice to please let us know if anything having to do with the open bed’s status had changed.
All it would have taken was one phone call (which she said she would do), and my Dad would have picked up, and we could have made our decision right then and there. We had every intention of deciding to go with Heritage, but as this is an extremely difficult decision that was new to our family, we wanted to make sure that we were giving it the weight it deserved without being too frivolous or quick to come to a conclusion (within reason of course).
We saw Cape Heritage on Wednesday and really liked it by the end of that day, and by Thursday morning we had our final decision. Any later than that is of course pushing it I would say, but again, not even a full 24 hours had passed and we needed to come to a decision so we were doing the best we could under the circumstances we found ourselves in. We wanted to do what was best for our Mom (or what we thought was best) and put her in the nicest, most open and seemingly loving facility we could. And if we had been contacted by the Director before Thursday morning (which only really leaves Wednesday night/very early Thursday morning), we would have made the decision then as opposed to when we did at 8:50am Thursday morning. But we never got a call from the Director at Cape Heritage saying that someone else was interested in the bed as she promised that she would do. And we put all of our trust in that, which obviously we really shouldn’t have. That’s our mistake.
But in our opinion, the larger shortcoming was the Director assuring us that she was on our side, had our family’s best interest in mind and actually cared about the process we were going through. Instead, one may conclude that the situation was not handled with sincerity, honesty and professionally which has been a very disappointing realization for us. How she chose to handle this was, in our opinion, extremely insensitive and not in keeping with the appropriateness of our family’s interest for a loved one. Once we heard the news from the case worker at MGH on Thursday morning (not from her) that this had happened, my father tried to call her and left her a voicemail asking that she please call him back. She has yet to do so.
We also never received any kind of explanation or apology as to why this was handled in the manner that she did. And if this is the conduct of a care focused business, then I hope that this can be investigated and that proper recourse will be taken to make sure that such outcomes are not experienced or continue happening to other families.
Because the Director took what was already the extremely painful and difficult experience of having to transfer a loved one into a long term care facility like this and made it that much more upsetting and unpleasant. And the worst part is that we didn’t even see it coming. We assumed that honest, friendly, accommodating and reliable interaction would be a priority and it turned out none of those things seemed to prevail for our family.
We have requested that the Mass General Patient Referral Case Network has been so annotated with regard to this set of circumstances and will be reflected for future considerations on secure placements at Cape Heritage.
So not only do I hope this experience doesn’t befall anyone else (in terms of having to put a parent or loved one into one of these facilities), but if this does happen and you are considering the Cape Heritage facility in Sandwich, MA, I hope you do not have to encounter similar impediments occurring without notification or follow up the way my family was. And if that is any reflection on the way intimately personal family decisions are conducted in this business, then I can’t imagine how that trickles into the rest of the facility.
Certainly no one wants to imagine that in an established skilled nursing atmosphere that there is anything that might be evidence of callous or untrustworthy outcomes, at least that’s how I see it. So maybe it’s a good thing my mother didn’t end up there, we’ll never know for sure, but we have to take it as some sort of sign, maybe we avoided even greater tragedy that could have occurred in the future.
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