Town Square

Lytton Gardens reprimanded over care of patients

Original post made on Nov 16, 2012

The California Department of Health and Human Services is requiring Lytton Gardens Skilled Nursing Facility in downtown Palo Alto to retrain and monitor its staff after an investigation found staff took as long as one hour to respond when a resident asked for help getting to the bathroom. ==B Related materials:==
• [Web Link State investigates, fines local skilled-nursing facilities]
• [Web Link Top complaints about skilled-nursing facilities]

Read the full story here Web Link posted Friday, November 16, 2012, 9:17 AM


Like this comment
Posted by Marvin Lee
a resident of Community Center
on Nov 16, 2012 at 11:34 am

Shame on them and on Palo Alto for not insisting on quality care. We have used the facility in the past and never had any problems like this.

Like this comment
Posted by moi
a resident of Another Palo Alto neighborhood
on Nov 16, 2012 at 11:40 am

No one has commented yet? Hard to believe. Get some of my fellow donkey fans to come over here.

This is a horrifying story. I could tell you others about a different facility, but I'll keep the dirt to myself.

BTW, is Lytton Gardens for profit? If I missed that in the article, sorry.

3 people like this
Posted by Anon.
a resident of Crescent Park
on Nov 16, 2012 at 11:56 am

Hello ... hello ... wake up ! ;-)

Every one of these places is like this. They hire the cheapest most desperate labor and then overwork them to the point I wonder how any of these places run. If they people make the slightest mistake they are reprimanded or fired, sometimes personally held responsible. Most of us in jobs get breaks and do not have to really work hard every minute of every day ... not so with the caregivers in places like Lytton Gardens and elsewhere. They do a great job, even though it is an impossible one and deserve a hand, or some understanding even when they sometimes fail. It is often the management trying to eke profit or good stats for themselves and their bonuses. The penultimate economic justice issue in a way is these kind of lower skilled service sector jobs. And now, as a country we want to make it even harder for them with this euphemistic "austerity" nonsense.

It is good that someone is overseeing these places, but institutionally it is impossible to really make these places much better. They do about the best they can, and you are lucky if you do not have major problems.

That's my opinion based on a relative being in a nursing home setting for over 5 years now, and being on their Family Council during that time and hearing people's complaints.

Common complaints are the cheapest food ingredients ... they actually service hot dogs calling them healthy? The other one, maybe the most common one is the laundry is always messed up. They make a bit point of labeling everything when the patient arrives, and then it goes crazy from there. And slow reaction is another common complaint too. I have heard of many occasions of > 1 hour response time. One lady's demented mother took to using the trash can of her room because no one would come to help her.

They are earnest and do the best they can, and I do not mean to be critical, but trying to do masses of laundry with quick turnaround for generally older people with problems going to the bathroom or health issues is a major task, and impossible task without sufficient time and resources.

I guess the bottom line is - do not think anything is improving institutionally because one nursing home is fined and makes the papers.

3 people like this
Posted by horselady
a resident of Community Center
on Nov 16, 2012 at 12:00 pm

So much for the statement that Palo Altans would never let something like this happen!

1 person likes this
Posted by Gisele
a resident of College Terrace
on Nov 16, 2012 at 12:32 pm

I do not think that any of these places are trustworthy, which ius why you simply cannot just dump your elders in them!

1 person likes this
Posted by frank
a resident of Community Center
on Nov 16, 2012 at 12:38 pm

Should shut it down. My mom was there b4, i pulled her out and tranferred her to another facility. Nurses were no where around, my mom waited forty five minutes after ringing call button. I found all the nurses in break room gossiping and ignoring their patients. I want that place shutdown now!!

1 person likes this
Posted by the_punnisher
a resident of Mountain View
on Nov 16, 2012 at 12:42 pm

the_punnisher is a registered user.

" But Ivy Adjivon, senior director of health services, said Lytton Gardens has a nursing assistant-to-patient ratio that is better than the state requirement. The state requires each staff member to supply 3.2 hours of care per patient per day. Lytton Gardens provides 3.8 hours of staff care per patient per day, she said. "

Lies, damned Lies and Statistics!


After my second stroke, I was supposed to stay at a similar care facility in MV for 2-3 weeks to get PT & OT. I lasted FOUR DAYS and only that amount because the PEOPLE WAREHOUSE WOULD NOT CALL IN A DOCTOR OVER THE WEEKEND!!!

I had seen a similar situation appear at my " people warehouse ". The PT room looked like an afterthought, patients got the minimum shower 2 times a week and nurse calls when they got answered were at the half hour forty five minutes wait times.

Back to my parent's house and the REACH program and back to my house once I " graduated " again. My father experienced the same conditions when he was hospitalized.

You have a problem called " warehousing " the elderly and handicapped. Better fix it.

Like this comment
Posted by Nora Charles
a resident of Stanford
on Nov 16, 2012 at 4:32 pm

Shameful. And you know it's happening in such places all over the country.
The U.S. really needs to start spending money to improve the lives of our citizens at home.

1 person likes this
Posted by Ducatigirl
a resident of Old Palo Alto
on Nov 16, 2012 at 5:34 pm

Sounds like these places need to be inspected on a surprise basis, frequently. Keep the employees in constant fear of an inspection so they never let the quality slip or get lazy. As it is, they know that inspections are rare, so they slack off a lot.

I had a similar experience four years ago when I had a knee replacement at Stanford Hospital. Then, they blamed it on the nursing shortage. Does Lytton Gardens use the same excuse? Seeing as all the nursing schools are so full that they turn away applicants, I find it hard to buy the nursing shortage excuse.

I hope the state fines the hell out of this place and closes it down.

Like this comment
Posted by neighbor
a resident of Another Palo Alto neighborhood
on Nov 16, 2012 at 7:59 pm

These facilities are so important and necessary at times so they MUST be better monitored! I agree with the idea to have more frequent inspections without advance notice. I have known caring persons who worked at such facilities but it isn't universal. Theft can be another problem (note: we have no experience with the facility in this story)

Like this comment
Posted by Anon.
a resident of Crescent Park
on Nov 16, 2012 at 8:44 pm

> Ducatigirl
> I hope the state fines the hell out of this place and closes it down.

That is short-sighted, immature and unintelligent! Shutting this facility down just makes it worse for the other already stressed facilities. Where else are people in this situation going to live that their Palo Alto relatives can visit them? And visiting and being hands on is the key.

The solution is better management, and more staff. You can train people all you want but the folks working there put up with more, more stress and pardon the expression, more crap, in a day than any resident of Palo Alto would in a year. Their every move is monitored, and accounted for, and they are paid very low wages.

My Grandmother lived in Lytton Gardens for a long time and ended up dying there. I have gotten quite an education on these places.

Don't fine the facilities, put the managers on a bonus system that cuts starts low and gives them bonuses for not having violations. What ever happened to this country that we reward incompetence so highly as a general rule?

Give some of those rewards or incentives to the workers.

Like this comment
Posted by Chris Zaharias
a resident of Crescent Park
on Nov 17, 2012 at 12:37 am

Anon nailed it. The reality is that Lytton is *relatively* good.

1 person likes this
Posted by Relative
a resident of South of Midtown
on Nov 17, 2012 at 12:40 am

This all surprises me not at all, given my family's experiences.

When my father was in a nursing home (in the East Bay), any time my mother would bring him anything nice or new, it would be "lost" by the next time she visited him. She soon learned that if she brought him ratty old sweaters instead of nice new ones, somehow those would never get "lost".

My autistic sister has been in a succession of state-funded care homes for a few decades now (in the East Bay and North Bay), and several times when visiting my mother she would show signs of physical abuse. She told my mother that "staff hit me" or "staff pushed me down" or some such. When my mother would raise holy @#$%, these staff would be fired, and fortunately she has been in a better placement for the past several years.

The lesson here is that if you have a relative or friend in such a care situation, be sure to visit often and keep tabs on what is going on! Some staff may be caring but overworked, but some are dishonest (maybe the reason they are employed by organizations with little choice in whom they hire due to pay scales and turnover), some are lazy, some have no tolerance for frustrating and demanding patients, and many staff are poorly trained to deal with, say, belligerent clients.

Certainly, better monitoring should be instituted, both by the institution itself (staff assigned to frequent monitoring duties, incentive pay for good service, and perhaps even some cameras installed), and by the state or Feds or an industry accrediting organization.
And certainly, training could be improved.

And it's not just minimum-pay organizations. My last overnight stay in Stanford Hospital was a horror, filled with non-responsive staff (one nurse got into shouting matches with me when I complained of waiting for hours), and also getting meds from the pharmacy delivered several hours late, with many errors uncorrected after three attempts on my part. I think about how bad it could have been had I not been awake and lucid (too bad for them and lucky for me, I was), and had the support of my husband as well.

Like this comment
Posted by Mayfield Child
a resident of Green Acres
on Nov 17, 2012 at 8:40 am

OH, the horrors of having to take a hospital stay!! When I was only four years old, I had to concede to having my tonsils out, but it was to be a grand time!! I was to be able to eat a lot of ice cream and jello!!! (My very favorite foods in the whole world!!!!)
Times have changed, over the years I watched as my grandmother was robbed of her false teeth for starters ("misplaced" by staff~never found~) My nephew's clothing was "lost"..I brought him a Paly shirt with Palo Alto in big letters down the sleeves which rendered a huge smile from him~he was a Paly Athlete...(only never to be worn a second time).. Besides the petty theft that went on in these places, I am dreading getting older with the thought that I may end up in a hospital or care facility, at the mercy of strangers who have problems they think are of need of more attention than I.....scary.....very scary thought.
I went to visit my father in law and went to give him a hug when my hand landed on a bump on his back. He told me the nurse made fun of him instead of drawing attention to the doctor over it...that was when I made a visit unannounced and found him slumped over in a wheel chair outside of his room, his neck bent so far down he was in pain and wanted to be put back into his bed but not enough staff around to attend to his need...
My neighbor was taken out of a home care facility when he slipped on the slick hardwood flooring in his room and had to go to Kaiser hospital..while there, the County came and moved all his belongings, put his home up for sale, all without his knowledge as he became under the Public Guardian's office because he had no relatives to look out for him...I went to visit him in the hospital and found him tied up to the bed, he "wanted to go home"....he died shortly after that, I believe from depression, of being taken out of his comfort zone. The County had no one to help him cook and clean and it was decided that he should go to a home care facility and they could sell his house, that way saving money from sending in or paying for someone to live with him. That was the horror story, again, from older people not being taken care of...with or without a light above their room door...LET THE LIGHT SHINE ALL THE TIME~ SHAME SHAME on the way elderly people are vulnerable even more when their health deteriorates and they are having to BEG for assistance...

Like this comment
Posted by Anon.
a resident of Crescent Park
on Nov 17, 2012 at 10:44 am

Mayfield Child, did you advocate regularly for your grandfather? Were you on the Family Council or similar body for the nursing home? DId you accept being your grandfather's proxy as he got older? Did you grandfather name a person to be his power of attorney in health and financial matters? Did he do any estate planning? Did you or another relative find out for him what would need to be done to care for him as he declined? If not, then how is it that you expect the state with a limited budget and way too many people to manage to do a better job than you?

And I bet you are busy writing about how bad the government is and how taxes are too high too, right? And how the free-market, or the gold-standard will solve all these problems??

I have gone to every Family Council meeting since my relative has been in the nursing home ... not Lytton Gardens by the way. It is rare for anyone to attend these meeting but myself and one other guy. Maybe someone with a very critical issue, but then they are gone. We have had maybe 4 people show up once or twice in the last year ... out of 26 or so bi-weekly meetings. There is a group, CANHR, California Advocates for Nursing Home Reform (CANHR), a statewide nonprofit 501(c)(3) advocacy organization, has been dedicated to improving the choices, care and quality of life for California’s long term care consumers. Did you find them? Did you use or contribute to them?

The staff of the nursing home says that maybe 10% of residents even get visitors.

One of the good things about Lytton Gardens is that they are local to downtown so their visitation rates are probably higher than normal. I know if my relative where there I would be able to visit and check much more often.

We really as a country have to get over this idea that we can carp and bitch and moan in an online chat room and think we are solving our problems while leaving them up to a government that we also just love to criticize, but without any facts or better ideas as to how to do things.

Scratch the surface of something of these claims in an objective manner and all kinds of things can be learned. One thing is that the experience of having to care for older people for the already stressed families out there today can break a family down and destroy it. People who would be functioning at a high level in business or employment are often taken out of circulation to care for relatives, or without health care insurance themselves if they cannot afford it.

Just having someone sign in and "kitchen sink" these issues without qualification or a point is not very helpful and does not really convey to the casual reader who might want to know more what the realities are.

If people care about this issue I would recommend getting in touch with CANHR, California Advocates for Nursing Home Reform, ask for some literature, donate your time or money. The system is over-stressed and so for most residents this means the squeaky wheel gets the grease - that is just the way it is. No one has bad-will in these places. You take a look at their jobs and you can see no one would want to put up with this kind of job for the low wages, job burnout and very hard work.

Like this comment
Posted by neighbor
a resident of Another Palo Alto neighborhood
on Nov 17, 2012 at 10:55 am

It strikes me there is a real need for emphasis on eldercare facilities from politicians -- it is not a politically "sexy" topic at all, but if any of you are connected to any politicians, please note this should be a priority. Many of us regular, non-politicially-connected folks have felt helpless at times when dealing with eldercare situations in the hospital, assistant living,and it is a complicated "problem." Still, there are some steps that can be taken, shine a light on all the problems and issues, including staff turnover due to low pay, low prestige; find a way to build attractive facilities where people will be proud to live and work. I know some are far better than others - I have been in them enough to know.

Like this comment
Posted by Anon.
a resident of Crescent Park
on Nov 17, 2012 at 11:58 am

>> It strikes me there is a real need for emphasis on eldercare facilities from politicians

I agree, there is.

There is a need to refresh people's understanding of why the social programs we have in place are there and what they actually do.

The US and other intelligent, (in the past), governments and think tank equivalents started to realize the deficit not having these programs caused in the country. The long term and negative feedback loops that occur when we leave people, families and even towns to fend for themselves in a social environment dominated by the rich and powerful or pure business interests.

The world tends towards the Hobbsian.

By having services and institutions that take care of people many aspects of society and civilization are buttressed and advanced, and yet somehow for the short term profit and power of the few, a few who have been dominated by even a smaller few's mistakes and crimes, our whole society has paid the price and even gone into debt to a system that does not work optimally and which as obstructed even the understanding of what we used to be about and working towards in this country.

The current elder care system is another way to play into the isolate and deconstruct our society instead of fortifying it in a healthy way. We put aging, death and dying into a package that most are programmed very negatively to avoid and deride and steer clear of, when this is in some way going to touch all of us.

You don't have any inkling of this aspect of the world when you are younger, and most do not until they see their parents distantly having to deal with it with their parents. By the time it hits any one person they often end up like Mayfield above, bitter, confused and fragmented in term of what they can do or how they can be effective - and that is often easily taken and aimed at the government by the same abusive powers that profit by deconstructing society in the first place.

Like this comment
Posted by Ducatigirl
a resident of Old Palo Alto
on Nov 17, 2012 at 3:16 pm

Ducatigirl is a registered user.

It takes a very special person, it is true, to work well in a senior care home. But the kind of nurses and other employees hired in these institutions are not usually the right kind of people to be doing this job.

My grandfather died in one of these places. It was humiliating for him to be straitjacketed into a wheelchair (because he could not stomach another lunch with orange jello) and then be force-fed food he hated. This infront of his children and grandchildren! What did they do to him when we were NOT there?

I also had a cousin who became mentally retarded as a result of meningitis at age three.
When we visited her, she was dirty and had food up her nose . She was blind and deaf, could not feed herself, and they treated her as if she were sub-human. It cost my uncle a fortune, and he had four other children to support, too. Again, how did they treat her when we were NOT there? It was bad when we were there.

These places do not get inspected frequently enough, and family members do not visit enough, otherwise ther would not be such egregious violations.

My grandmother could not drive, nor could my uncle's wife. A lot of people, esp women did not drive in those days. Today, people have no real excuse for not visiting their elderly in Lytton Gardens if they live in PA. But obviously, not enough do, otherwise how did the staff have the opportunity to commit all these violations?

Are there not new facilities being built to accomodate the aging boomers who will now stress that system as they have stressed the other systems they have moved through in their lifetimes? Surely the powers that be have been aware of this for years, and there has been opportunity and plenty of warning that eldercare would be a high growth industry soon, due to the sheer number of boomers.

As someone else said earlier, you cannot just dump your elderly in these places and hope they will be okay.

Like this comment
Posted by Ahmay
a resident of Another Palo Alto neighborhood
on Nov 17, 2012 at 4:57 pm

Shamed for those kids who just dumped their love ones in the nursing home with out doing their thorough investigation and just quick to blame nursing home staff. If you are so good why don't you take care of your love ones in need instead of putting them in the nursing home. You guys should realized that working in this kind of institution is not a easy job. Since,Lytton Garden is located in downtown Palo Alto residents and family member they have a right to curse out staff and be little them sometimes because they leave in a rich neighborhood. Think people...If you are so good why don't you build your own nursing home or take care of your love ones..

Like this comment
Posted by Anon.
a resident of Crescent Park
on Nov 17, 2012 at 6:07 pm

> Shamed for those kids who just dumped their love ones in the nursing home with out doing their thorough investigation and just quick to blame nursing home staff.

Have you ever been through this? How do you know that is what is happening? You should not say anything based on your preconceived ideas and morality or familial loyalty or out of ignorance willfull or otherwise. There are layers on layers of this stuff that are hard to separate out. Don't judge people until you walk in their shoes, and even them you never know, they may have different feet that you do.

It is really pointless to concern oneself with blame, let along blame based on hypocrisy.

The majority of Americans voted for or allowed us to drift into this situation of indebtedness and forced austerity presumably because they do not want to pay for other people they consider a bother or beneath them, this is the kind of thing that happens when people do not think deeply about what the effects of their actions and opinions are and act in what they think is their short term self-interest.

1 person likes this
Posted by neighbor
a resident of another community
on Nov 17, 2012 at 6:59 pm

ANON -- this nursing home problem has very little to do with politics, and it has been going on forever.

During the Reagan administration, my father was in 3 different nursing homes as we tried to find excellent care. It doesn't exist. My father had end-stage Alzheimer's and could no longer be cared for at home. We had done our best for 11 years at home.

He died in what was supposed to be a modern, humane, clean and upscale facility. He was neglected horribly. These places are scandalous money-grubbers, are woefully understaffed...and many of the staff are untrained, some have criminal records.

This has been going on forever. It is not a simple political issue -- it is so much larger than that.

1 person likes this
Posted by Former worker @ Abilities United
a resident of Another Palo Alto neighborhood
on Nov 18, 2012 at 12:11 am

Thanks Anon for telling the truth from the workers point of view. I used to work for the Adult Day Program over at Abilities United.
If you think Lytton Gardens is bad you should see the dog and pony show over at Abilities United (Adult Day Program). I remember the talking points meetings we had before the funders drop-ins . All the director cared about was her salary, the clients care was the highest priority on paper not in practice.

2 people like this
Posted by susan
a resident of Barron Park
on Nov 18, 2012 at 8:05 am

I am a RN and worked over 35 years in long term care. Finally got burned out because the corporations that own these facilities will not allow sufficient help to take care of the patients. More RN's, LVN's and aides are desperately needed to take care of ever sicker patients but it will never happen. The facilities get slapped with light fines when deficiencies are found and nothing changes. The solution .....don't get old!!!

1 person likes this
Posted by Anna
a resident of Midtown
on Nov 18, 2012 at 9:58 pm

My mother had to be in Lytton Gardens after some surgery, and she couldn't WAIT to get out. I wasn't very impressed with the situation there. A friend, who had a stroke and was partially paralized, fell out of his bed in the night and lay on the floor for hours, because no one checked on him. I hope I never have to go there.

Like this comment
Posted by Roger
a resident of Adobe-Meadow
on Nov 20, 2012 at 8:53 pm

I have occasion to work in a professional capacity with the staff at Lytton Gardens. Staff on the 3rd floor, the memory unit is good. There are activities for the residents and some actually thrive there. Second floor is HORRIBLE. Staff from the charge nurse on down have an attitude, they resent having to engage with outside professionals who come in to work with their residents. Rudy and Myra are exceptionally rude when I try to get information about a particular resident.

2 people like this
Posted by Lyn
a resident of College Terrace
on Nov 28, 2012 at 1:08 pm

I have never written in here before, but feel like I must chime in now.

My father passed away at Lytton Gardens 2 years after being a resident for 4 months. Despite this being the most terrible time in my life (only child to care for 3 children, 3rd a newborn, my mom also going through terminal cancer, and my single/childless aunt suffering from a fall/dementia), I was grateful for Lytton Gardens. My dad planned to die at home, but considering the circumstances, this was the best we could do. I researched and visited innumerable facilities, and felt lucky to get a bed for my father there.

No, the food wasn't good. No, the facility wasn't new. No, there is no dignity in dying a miserable, painful death. But, yes, I believe he got the best care he could. His CNA genuinely cared for him as did his nurses. (Wow, did they have tough jobs!) Even the patient coordinators checked in on him regularly. Perhaps this was because my mom or I were ALWAYS there. I was his full time advocate. I made sure he rarely went more than an hour or 2 without someone being with him. I packed the big kids off to school, and took the baby to Lytton to feed him breakfast. Then I'd leave for an hour to take the baby to the park or mommy/me class or my mom to her doctor appointments. Then I'd come back for a few hours over lunch. Then I'd leave to pick up my big kids from school, and make sure my mom would be arriving for the late afternoon through dinner. After I fed my kids, I'd go back over to spend a couple evening hours and tuck him in for the night.

Bottom line, I made sure he had the best care he could, because I was there. It was a horribly stressful, exhausting, and emotional time in my life, but I couldn't bear to just leave him there. I don't know whether he got better care than the other patients there--I did see some call lights on and would notify the nurses when I did--but I know his needs were met. And I was happy enough with his care, despite his terrible health.

I feel bad that all these complaints about care facilities IN GENERAL are reflecting poorly on Lytton Gardens. It is one of the best places around. In fact, for rehab and PT, it is THE place that Stanford nurses/doctors go. There were 3 Stanford nurses on our floor during the time my dad stayed. They all said they waited for a bed opening at Lytton to schedule their knee or hip surgeries.