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John, another problem is the patient, may not swallow the medication given. My dad will sometimes keep it in his mouth, and it slips out on the bed. I am pretty sure it is not on purpose, but with mom watching, she knows and cares. Like any business, a Nursing Home has employees that really care about people, and others who have other things on their minds, than doing the best job. Hospitals are the same. Being around sick, often crabby, people for a whole shift is not an easy job. Those that do it well should be appreciated, and rewarded. If you talk to the people who care for your loved one, praise them when they do a good job. When they don't, tell them nicely what changes need to be made. A gift, or a gratuity, and maybe a note to the management when they do a superior job, will make them feel appreciated. It will also make you feel better when you are not there to watch. Ken B