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Sunday, January 11, 2009

Local Assisted Living Nightmares

Have you or a loved one been asked to leave an Assisted Living facility because of a perceived “increased” medical complexity that does NOT exceed the level of care the facility is licensed to provide by The State of Maryland?

When you signed your contract, was it ever made clear to you that, regardless of what you thought of the care being given at the facility or if you had any concerns to express, the facility had the right to terminate your residency with as little as five days notice?

If this has happened to you, were you told to vacate immediately? Or even worse, were you sent to the hospital and not allowed to return? Was the explanation given that it was because you had expressed your concerns and the management decided their facility had lost “the essential trust and comfort level that a resident and his/her family have in the delivery system of care serving the resident”?

Do you feel that your loved one was punished because you exercised your right to be their advocate and to speak for those who can’t speak for themselves?

If you have had a similar experience, please post your comments.

37 comments:

Anonymous said...

Joe, this is interesting.

Tilghman Oil fined by MDE
SALISBURY -- Maryland Department of the Environment recently fined Tilghman Oil Co. $65,000 for past non-compliance.


Representatives of MDE said Tuesday the Tilghman facility on Columbia Road had a history of noncompliance which was the cause of the retroactive fine.

Violations date as far back as December 2007 with the citation of underground oil storage tanks. MDE spokesperson Dawn Stoltzfus said the underground tanks have since been replaced with required above--ground tanks, bringing the business into compliance.

Tilghman Oil is currently owned and operated by Philip Tilghman, a former member of the Wicomico County Council.

Anonymous said...

Lakeside was exectly this. It was a nightmare. I would have sued thier ass off, just wasn't worth the energy. Very nice facility, butthe management is the worst, they SIMPLY DONT CARE, they are rude and down right nasty AFTER to write the $20,000 deposit. I never say the word hate, but I will go to my grave HATING them. I dare them to post on here, or I will provide names, times, and documents.

Anonymous said...

What does this have to do with assisted living?

Anonymous said...

They are all the same , as far as I'm concerned. They hire a couple of CNA people (want to be nurses)
and off they go. Their only certified to empty bed pans and they do a poor job of that.Assisted
living is making your life a
living hell. Then you die.

Anonymous said...

Healthsouth is the same way. A lot has to do with there nurses attitudes there. My mother was there for a few years and it was a mistake putting her through that. It was usually the night staff that treated her very cruel. She felt they were lazy in some aspects, and rude in the other. Starts at the top. Managers to nurses to staff. It always rolls down hill.

Anonymous said...

Assisted Living Centers and nursing homes take better care of patients who have families that are around and actively involved in their lives. If you visit regularly and at different times during the day your family member will be well cared for. If you dump them and only show up a few times a year, they will be treated no better than the potted plant in the reception area. I've worked in small home care facilities, and large cororate owned ones, and this fact never changes. As a family member, Be friendly toward the staff...all the staff, and their treatment and attention will be off the chart.

Far From Home

joe albero said...

Far From Home,

As a businessman, your comment just floors me to no end. So pay an average of $5,000.00 a month and IF everyone lives by your rules, their loved one will be taken care of like none other. To talk about a human being like a potted plant clearly tells me you need to get the hell out of the business.

Unfortunately for many Americans right now, it's extremely trying to stay afloat, let alone put out an additional $5,000.00 a month to expect the absolute best care another human being and facility could humanly deliver!

What a shame!

Anonymous said...

Im going to share these private thoughts with you, I hope Im not disrespecting this privacy. This was a letter sent to someone I know who works at a nursing home from the mother of someone who lived there once.

Dear D, were back from our two trips to Tenn,N.C., S.C., Ohio, Indiana, and Ky. All is well, but I think of you quite often and hope everything is going well with you. I still havent picked up the nerve to go see Mrs K or maybe the home that was Sandys for so long. I still have bad days but Im learning to cope. Thanks for all you did. I will always be grateful for the Love you gave my Sandy.Just you being there meant a lot to me. May God Bless You.

I will always Love you,
Mrs W.

(Theres some good people working in some of them to, and in this case one of the best).

Anonymous said...

Ahhhhhhh Joe

I've never been involved with the day to day hands on care of residents. I've worked in dietary and more recently as an activities coordinator. I'm one of those employees that are invisible to the CNA's, LPNS, and RNs. I plan residents activities and encourage all residents to participate. I check on the residents that never participate, and find out if there is anything that they'd like to do or see incorporated in their day.

A typical day of activities may include a non-dom service or a mass, bingo or card games, musicians and concerts by small groups ( we have an arrangement with a few private music teachers) Matinee movies, and teas or socials. We have an exercise period every morning. Last night we had a New Years Party with music from the 20's-50's. including a sparkling cider toast at 10:00.

As far as the care "rules", they are far from mine, and I agree with you that they are wrong. The caregivers are wrong in their attitude and where they focus their attentions. A typical day will see a cna with 4-8 patients that they must feed, bathe, dress and care for. If they know that a mans wife comes everyday at 9:00am, he's the 1st one done. If they also have one that gets no visitors, he'll be the last one done. For the most part they aren't neglected, but the degree of care is almost never the same. The caregivers logic is the same as a squeeky wheel. Would I like to see this changed? Yes I would, have I tried, yes I have. I have filed a handful of negligence and abuse complaints in the past, and twice at risk to my employment and in violation of the law contacted families to inform them what was going on with their loved ones because I believed the care was lacking.

I like all of the residents and enjoy talking with them, and working with them. They are the reason I do this job for 8.25 an hour. I seek out residents that don't have many visitors and try to engage them in activities, or even conversations. Many of the residents are lonely and would love to have someone come visit them.

If you and your readers know someone in a care facilty, stop in and say hi, take a look around and talk to the resident. If you see something you don't like mention it to the floor supervisor. If it doesn't change contact your local officials. In my state it is the county health department. If you don't know someone, but would like to adopt a resident, contact a facility and ask to speak with the activities coordinator, they would be happy to pair you up with a resident that needs a friend. There's no financial responsibility, just companionship.

The facility I work at has 63 residents, and of those over 30 of them receive a visitor less than once a week. I have 11 that haven't had a visitor in over a year. Either they have no family left, or they have been left there because it was easier for the family, and it becomes out of sight out of mind.

It is a shame how the elderly are treated in this country. Most of the residents don't have the power to change the circumstanes in their facilities, but their friends, family, and a well trained staff do.

Far From Home

Anonymous said...

I was working for a contractor that did renovations at Salisbury Nursing home here in Salisbury. We renovated a wing that had at least 20 rooms. The specific numbers escape my memory because while I worked on that job the stench was so terrible in this hall I could all but stand it. Each room reeked so bad of urine we were allowed extra brakes from being exposed. It was then and there that I decided that if my own were to ever need this sort of care that it would NEVER be at this place.

If you are placed in a cituation of ever seeking assisted living for a loved one all I can recomend is that you go into the home and check out the living quarters for your self. I mean it wasnt just a one time accident that caused this stench. I only resolved that at least they were fixing up the place with new renovations but its been some years past now and Id bet a quarter to a dollar that the rooms smell as bad. Dont they have some kind of regulatory inspect done ? I cant express how horrible it was , but it changed my mind about letting another tend my loved ones.

Anonymous said...

"Far from home," your the same sh++ I saw at Lakeside (Mallard Lakes)Assisted Living, if the family stayed on your ass, you would do a little better, otherwise, can you spell WORTHLESS! Thats the entire reason some families need to seek assisted living, DAILY help for meals, showers, bath duites etc. They have to beg, or be a bit++ just to get the bi-weekly shower that was paid for, much less use a call button during the middle of the night, or when the employees are eating, don't get me started.......... I swear if I had the time, and heart left, I could close thier doors with what I saw.

Chimera said...

Far From Home....
There is NO excuse for substandard care-PERIOD! My Mother died young but my Father is almost 60 and you can bet your booties if he is incapacitated that between all his children we will work out something before we ever put him in "assisted living".

Anonymous said...

My mother passed away in my living room. She was well cared for, loved, happy and content. All she asked is that we don't put her in a bedroom alone, so we didn't. We set her up in the living room where she could be with the family at all times. It was the very least I could do for the woman that gave a large portion of her life for us. She was under hospice care, which couldn't have been any better. We took care of all her needs, they took care of her health.

Be careful how you treat your elderly relatives, your children are watching and learning.

Anonymous said...

6:45 and Bluto.....I agree with yu 100%, and 6:45 I have never worked on the Eastern Shore in a nursing home. As an Activities Director, I am not allowed to help with any of the daily tasks associated with patient care. I can and do file almost daily reports on patients that show up for activities that are not dressed, fed or bathed. I have also directed my 2 part-timers and volunteers to do so as well.

I do my part the best I can to make sure that the 63 residents that I plan activities for are taken care of. Most had not left the nursing home until I started there and planned field trips for them. I've made arrangements with the school down the street from us to allow the residents to attend plays and musical productions. Any activity that makes them feel a part of something.

In a perfect world our elderly would live like kings and queens. Unfortunately the assisted living industry is like any other, there are good and bad people and places everywhere.

99% of families looking for assisted facilites have never been in one, or have a clue what goes on. They take the tour, and make a decision based on what the administrator (Sales Person) told them. Many have very little time to investigate because of health situations. Then they become locked into a long term or permanent situation.

Most families that visit don't stay long enough to see what goes on in a facility. When they visit they go to the residents room and close the door to visit. They don't walk around. They don't sit and visit in the dining room or the various areas we have set up for that.

One thing everyone should ask about is not the staff to patient ratio, because that includes janitors, cooks, dishwashers, housekeepers, launders and admin on all shifts and its a great number....any where between 2-3.5 patients per staff member is great. But remember only CNA's, LPNs, and RNS can actualy handle a resident. The facility I work at has 5 CNAS, 2 LPNS and an RN on each shift. Thats 8 people caring for 63 every 8 hours. No where near the 3-1 ratio they advertise. A typial CNA must assist in the care of 8 people where I work. I'm fairly certain that I couldn't bathe, dress, and get 8 people fed, I can barely manage my husband and 2 daughters in the am. No one can.

You have to thoroughly investigate a facility. Don't just take the guided tour. Show up at odd hours and have a peek. Stop and talk to the residents without a staff member around. Find the nearest coffee shop, and stop by and eavesdrop on the conversations of the staff. Check with the state for abuse complaints, and ask about the SKILLED staff to patient ratio. The facility should smell clean, and be clean and the food should not smell like a school cafeteria. Check the actvities posted for the day and the week, will they be busy????? Do the residents look happy or are they just waiting til its their time.

There is no excuse for substandard care, and believe me I'm not making any. I can tell you from experience yelling at the staff doesn't help. Document and report. If your loved one isn't dressed or bathed, find an administrator, make a formal complaint. Unexplained bruise, make a complaint, if they won't take a complaint or can't explain it satisfactorly, call the police.

I do the best that I can in my facility to make sure the residents get the care they deserve, and most of the staff dislike me for it but thats ok, because the residents in the year I have been there seem to be happier, they are more involved, and the staff knows i will make a report if they are not dressed and ready for another day.

I advise anyone that asks me to try to find another way to care for their loved ones; inhome nursing, as bluto said the families doing it. Kids check your benefits at work, many companies allow you to buy long term care insurance for your parents as a payroll deduction. Invest in it for your self, check into supplemental health insurance, and medicare and find out exactly what your family is eligible for. Adult day care centers exist, that can fill the gaps while you work. There are other options if you just look for them.

With this new year sit down with your elderly loved ones and plan now what you will do if the need arises. Many seniors that have been hospitalized are told they have to go to a rehab center. Often this isn't true. Many qualify for in home visitations, but don't find that out until its too late. If you know ahead of time what you are entitled too, you won't have to make what could be a poor decision during a stressful time.

You can continue to criticize me and thats fine, but as an activity director I can only do so much. I make it my job to ensure that your loved ones are not wasting away in front of the TV. I do this job not for the money, but because of the people. My last paycheck after taxes wouldn't buy a Wii. But I get a sense of fulfillment from working there that money can't buy.

Anonymous said...

One of the biggest problems getting quality employees in this area is the fact that they must pass a criminal and drug screening, it doesn't have to be a felony and assault or violent actions are rejected, most can't pass the first cut. The work force in this area has a lot to be desired.

That is in no way an excuse for abuse of the elderly however at this time of year people feel guilty about dropping their parents, we live in a throw away society.

Those older people also get very depressed during the holiday especially when they aren't included in family gatherings, they miss their loved ones or spouces that have died.

If you think being a CNA is easy why don't you get a job in a facility and do some real homework. There are few that can handle that kind of care over the long term watching people decline in life then die, over and over. Those that provide great care long term are special people and they don't come along everyday.

The level of care sometimes becomes an issue because assisted living properties don't provide long term health care such as life support and that is a state regulation.

I'm most sure whoever wrote that letter probably does have a legit complaint.

I'm just saying that some health care is regulated by the state and has a lot to do with the residents needs. Calling someone a bedpan cleaner is totally disrespectful to many that are dedicated to high level care.

Anonymous said...

After surgery, my grandfather stayed at Healthsouth for 6 weeks. My experiences there were VERY positive. The staff was very considerate and helpful the enture time, no matter the situation. I was at the rehab center at least twice a day, everyday for those weeks. I couldn't have asked for them to be any better towards him or be any more attentive. Everyone was wonderful!!

After his 6 weeks, they transferred him to Anchorage Nursing Home next to the hospital. Now this was a DISASTER!! They would forget to bring him his dinner, and when they did, it was so horrible, I started making dinner at my home for him and bringing it to him every night. He would call for nurses and they would never come. The rehab staff was very good with him, but the nurses were horrible. They just didn't care. It broke my heart while he was there and killed me each day I went. I signed him out for a day pass and came back at 7:00 that night with him to find a female patient sleeping in his bed. I went to the nurses station and they said they would send someone down. It took 10 minutes for them to get there, and when they did, they woke the woman up and walked her out. The woman had 'relieved' herself in his bed and they didn't even change his sheets. I stripped his bed and threw the sheets in the floor and screamed in the hallway for someone to come change his bed. After that night, I got his doctors permission to sign him out and brought him home with me. I may not be a nurse, but he was a lot better off with my than those so-called 'nurses'. I filed a complaint with the state and NEVER EVEN GOT A RESPONSE. After this experience, I will NEVER put a family member in a nursing home.

Anonymous said...

Believe it or not a nursing home is more expensive than assisted living

Anonymous said...

No shit sherlock. That's because they receive more care in a nursing home. Assisted living is for those who need minimal assistance. Nursing homes are for those who are very to totally dependent on others for daily activities.

Anonymous said...

A friend of mine passed away recently and was staying at
assisted living home. They stole
all her belongings . They left her body in the basement by mistake ,
instead of calling PRMC or the
coroner. Her body couldn't be
located until the following day.
This place , I found out , is 50% owned by the hospital(PRMC).

Anonymous said...

To the person or persons who posted at 10:06 and 6:45 I would like to talk with you. We have had a simlar problem maybe even worse. If you are willing to talk please contact Joe by email with your information. If these are two different people I would like to share information with both of you. I would understand if you dont't want to get invovled, but we can't let this continue!

Anonymous said...

As a retired pre-hospital provider, that has had the honor (sarcasm inserted) to visit many nursing facilities in the mid-atlantic area. I have told my kids since. That if I ever need to be put into a nursing home. Give me a gun, one bullet, and leave my room for 5 minutes.

I will never step foot in a nursing home again. They are the site of most disgusting, vial, and inhumane treatment of humans. I have ever seen in my life. I would rather eat a bullet then to be sent to one of them.

Anonymous said...

Refer to patient resident rights, guidelines of the state

Anonymous said...

The owners of these establishments are the ones we should focus on. The employees are probably like everything else, some good and some bad. These corporate owners see these people as numbers like cattle. They will bleed them dry and then theyll bleed the medicare system. Its concentrated capitalism in one of its sickest forms, exploitation of the elderly for pure profit. Its become part of this nation to throw morality and compassion out the window for profit. The economy is not the only thing we should be focused on in our society. Its everywhere, from the corporate companies that operate these facilities to the family members just waiting for the loved one to die so they sell off their homes and entire lifes work like it was nothing. I think WE are our own worst enemies and if WE dont do something about it soon, were doomed as a society.

Anonymous said...

Some people are misunderstanding Far From Home.

She (likely, but maybe a he) isn't condoning the neglect of the "alone" elderly. Simply stating a fact that is true about hospital stays, too.

Patients with family looking out for them will get better care because they have an advocate who will give staff hell otherwise. Talk to hospital personnel -- they'll tell you the same thing...

Have an advocate to help fight the system and ensure attention because the system pulls a limited staff to the point of them going bonkers.

Far From Home's comments were intended to help, not to say that anyone should EVER be treated like "a potted plant."

And the more human you treat staff, the more human they will be with you and your loved one. It's not intentional spite. Health care is a high, high burn-out profession.

In fact, if you just give a smile to a weary grocery store clerk, it'll make a difference in how well they cope, too.

For this New Year, could everyone PLEASE just try to be a little nicer to everyone on both sides of the counter, the car, the table? All human beings get tired and sad, so when you're not, give some of your good feeling and energy to someone who's used up all theirs on other people.

Anonymous said...

THIS IS VERY INTERESTING THAT ALL THIS CAME ABOUT AT THIS PARTICULAR TIME. I SAY THIS BECAUSE, MY FATHER HAS BEEN IN THE HOSPITAL HERE AND ACROSS THE BRIDGE FOR THE LAST 3 MONTHS. WE ARE NOW AT A POINT DO WE REMOVE THE MACHINE THAT HELPS HIM BREATH OR DO WE SEND HIM TO A FACILITY THAT CAN HANDLE ALL HIS MEDICAL ISSUES. I DO KNOW THAT HE WAS TAUGHT GROWING UP THAT IF YOU WENT INTO A NURSING HOME, IT WAS TO DIE. I CERTAINLY AM NOT READY TO LOSE MY FATHER YET. ONE COMMENT STATES THAT IF THE FAMILY IS AROUND AND ACTIVELY INVOLVED, THAT THE PATIENT WILL BE BETTER OFF. IN OUR SITUATION, THERE IS NO FACILITY ON THE EASTERN SHORE THAT WOULD BE ABLE TO TAKE HIM. WE ARE TRYING TO STAY INVOLVED, HOWEVER FINACIALLY AND EMOTIONALLY IT IS DIFFICULT WHEN YOUR LOVED ONE IS A 2 HOUR DRIVE AWAY. SO EVERY ONES SITUATION IS DIFFERENT, PLEASE KNOW THAT I ALSO HAVE 2 DAUGHTERS' THAT ARE IN THE NURSING FIELD AND I HAVE THE UTMOST RESPECT AND ADMIRATION FOR ANYONE IN THE NURSING AND MEDICAL FIELD. THEY HAVE TO PUT IN ALOT OF LONG HOURS JUST TO GET INTO THE FIELD AND THEN TO TAKE CARE OF OUR LOVED ONES AT THEIR MOST VUNERABLE TIME IN THEIR LIFE. THANK YOU ALL

Anonymous said...

The stimulous package that were about to get from Obama should have money alotted so families could add on bedroom and bathroom addittions so they would be able to keep their loved ones at home. Their are some that would not be able to but I bet alot of elderly folks could with the visits from care companies. If the grand-parents were around the family circle would be around. The kids today could learn alot about life and themselves from these elderly folks. Are their any goverment tax breaks or loan systems to help the average working family build on addittions if they wanted to keep their loved ones at home? Seems like it would not only provide a higher quality of life in your last years but would also help families stay involved to the end. You would create alot of jobs for construction trades as well.

Anonymous said...

As a nursing assistant, some of the comments i've read are horrifying, and i can fully understand your disdain for the assisted living practice. HOWEVER... I can honestly say I am and excellent nursing assistant and i leave work every day knowing i put a smile on their faces and took damn good care of every one of the residents i came into contact with that day. For the residents that need assistance with their ADL's I make sure their faces, arms, armpits, and privates are washed (in that order).their teeth get brushed, hair gets combed, glasses get cleaned, their clothes match, men get shaved and women have on makeup. And it all gets done before they leave their room for breakfast. For the residents that don't need any assistance, I make it a point to knock on every door to say good morning and make their beds. All scheduled showers get done, and nurses are notified immediately of any changes. I am exhausted when i go home and i am definately underpaid for what i do. But, it is worth it. I have never worked a day that at least one resident or family member hasn't thanked me for my kindness, and willingness to go the extra mile.
The truth is, not all of us are mean, lazy and heartless. And understandably most of you family members are looking only for faults, you need to do your homework and find the good aides in the facility and plead your case to them. As in my facility, we get the occational aide thats only there for the paycheck and does the bare minimum. Trust me it doesn't take long for the ones that take pride in their work to single them out and set them straight or send them packing.
I give 110% everyday to make sure the residents feel safe and cared for whether they have family members that come in 4-5 times a veek or haven't had a visitor in weeks. They have all earned the right to live their last days in comfort. For those family members that haven't yet found the right facility for your loved one, i wish you luck, and God Bless.

Anonymous said...

There's always the choice to take care of your own which is best, however many just don't have the time and don't want to be bothered with changing diapers and telling dad he just ate lunch ten minutes ago and will have to to tell him 15 more times when dinner will be ready.

People literally throw away and kill their own children, you think everyone cares about their parents that they can't deal with but expect somebody else to do it for $7 an hour? The state can walk into any state regulated property at any time unannounced, they are required no less than twice a year. More complaints, more inspections.

Anonymous said...

doug wilkerson said...
The stimulous package that were about to get from Obama should have money......

3:19 PM

LMFAO

Dougie boy you never cease to amaze me. Here's your Kool Aid. LOL

Anonymous said...

Perspective is a bitch...

Anonymous said...

Not an intentional mean bone in my body, good night,sleep well.

Anonymous said...

7:30 pm,
Thank you. Family need to take care of each other. Young or Old. That's what's wrong with society now. Famalies think someone else should watch there children when they are at school. Babysit for their children. Take care of their parents when they get too old. All for the dollar bill. If these nursing homes are not meeting your standards, take your love ones home and you take cars of your own.

Anonymous said...

It's not possible for every family to have their elderly family member move in. I'm a state employee, one of the hard working ones who just took two mandatory furlough days, and my husband and I have our own business. we are both gone 9 - 12 hours a day, b/c we need the money to pay our bills. So dad would be home alone all day....not a good solution. mom is deceased. We can't afford to quit work, Dad has alzheimer's and it's not safe for him to be alone for long periods of time. Don't want him alone with one person in the house either, who might or might not show up, b/c then he's more vunerable. at a facility their is more than one person around so looking through personal papers or abusing the patient is less likely but I know it still happens. We are at my dad's facility 2- 4 times a week, depending on needs and our schedule.

to the family who has the loved one across the bridge with special medical needs....please contact deer's head center 410-543-4000 and ask for admissions. i worked there for 20 years and they do provide good care for a difficult population.

Mrs. Tom

Anonymous said...

If a family member could take a medical leave to take care of a parent would be ideal. However unlike having a child the parent may live a long time needing 24/7 care.

It would be a lot cheaper than putting the elderly in a home were they wouldn't get the kind of care they would at home from a family member. It would save the family $70,000 a year versus a health care facility. You can get a nurse to come daily or periodically depending on the needs.

Anonymous said...

My father who was terminal stayed right at home with my mother. My husband and I gave up our house to move in with her so I could assist in caring for my father until he died. There was no way he was going anywhere but home with us. The sad part is the CNA's who have the certs are often people who were on welfare and the state paid for them to get their certification, they don't want to be there but they can't continue to live off the system. I wanted to get my CNA because I hate seeing these people in homes who are neglected and treated very badly, but I didn't have the $$ to take the classes in addition to my current college schedule. The people who want to be there because they have a heart are stomped out and so many rejects take the job just for the pay check. It is really sad to see people mistreated and neglected but it happens every day.

Further more on the CNA topic, my daughter was a patient at Dor Gen with a fever of 105 and she was being medicated and treated by CNA's!! They have no right to give meds but when I contested it they told me if you dont like it leave! I was scared to leave the hospital because my daughters temp was so high, we got her temp. down and hauled butt out of there. When the bills kept coming I took it to court and tried to explain to the judge they charged us for critical care but she was only seen by a doctor when she was being discharged, the judge didnt want to hear a word of it and after admitting he was buddies with the lawyer representing dor. gen. he ruled we had to pay massive bills even though our daughter was not handled properly! Out right wrong, that the hospitals and nursing homes can get away with such neglect. What if my daughter would have died because these morons wouldn't give her a doctor or at the never least a registered nurse!

Anonymous said...

11:24
We have gotten sitters 24/7 for my elderly uncle so he can stay in his home. He wants to be in his own place in comfortable surroundings but cannot be left alone. In about six weeks, over $16,000 has been the cost. I'm not sure how much longer this can continue.

Anonymous said...

Rumor has it that when the mare's father got old and didn't know where he was, she just got him a kennel cage, worked for her i guess, just remember to leave water