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Unfortunately facilities are short staffed and the caregivers are paid all that much. When mom and dad were in AL there were some good caregivers. One of the night and one on weekends; the day workers were ok then gone and they got one terrific day person - the rest were not so great. I would ask the staff questions, but if I had a problem I took it to the director and kept the staff out of it - I let the director then work on it. Dad's been gone 2 years now and mom is in a new facility in IL.

If you are getting different answers you may want to climb higher up in the food chain and take your concerns there; include the social worker as well. If you are not satisfied then look for a different facility that fits your mother's needs better.

I've had kids I grew up with that were downs or otherwise mentally challenged. Two of them went to live in group homes and from there went to their jobs. If there a possibility of your brother fitting into a situation such as this. One boy I grew went back to live with his parents when they got older - I believe he assisted them in some areas.

You have a lot on your plate and you need to find the time to care for yourself. Once you get your mother settled either where she currently is or in another facility, please take some time off for yourself - pamper yourself and take a deep breath.

I pray you and your family is blessed with peace, grace and love.
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TouchMatters Aug 2021
Your mean "the caregivers AREN'T paid that much"
Yes, this daughter must find time for herself.
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Sometimes it is actually hard on a resident to get them out of bed without a sit to stand or hoyer lift. Since they can't use those there, apparently the staff has been told they do not need to pull on your mom' arms, etc. to get her in & out of bed- ? Maybe it hurts her. If she is pretty much dead weight, staff may injure themselves. Happened to me!
As a former cna- it wasn't up to us to just leave someone in bed all day. There must be a reason, maybe she is resistant? Also with dementia, she may happily pop out of bed one day, and be fighting (for lack of a better term) w staff the next.
You, as family can request a meeting at any time. Or speak with the nurse manager. You will not be "hated" for wanting the best care! We respected families who spoke their piece, more so than ones who never came. If you want her out of bed daily, say so! Most likely tho, skilled is probably in the cards. And that's ok. Same activities etc. Not very different from AL.
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Countrymouse Aug 2021
I agree about respecting families who make their wishes and expectations clear.

I'd go further and say that even when a family member (perhaps because of stress or bad experiences) is being unfair, unreasonable and unpleasant, it only increases our sympathy for the care recipient - the poor client actually has to live with this person!
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Since you have problems with your mom getting consistent care, you should have concerns. Generally, every client in long term care should be encouraged to do as much as he/she can do for himself/herself. Since there does not seem to be a consistent plan of care for your mom, it might be a good idea to start researching other places.
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My Mother's behaviour changed a few weeks after the initial stroke. I could not tell if another stoke or what - an extention to the stroke, maybe additional micro bleeds, situational depression, emotional liability or now vascular dementia (I looked into it all). The nurses didn't know, the Docs didn't know. Still don't know.

Your Mother's UTI would have scrambled her thinking & behaviour. This may have started a negative snowball effect. Grumpy with staff, staff less joyful, refusing to get out of bed, staff insist etc. Without ability to clearly say no, or express my wishes, physically resisting being moved out of bed is how I would probably communicate too. A professional CNA would know this & look to re-establish trust & connection.

There is a world of difference between someone marching into your bedroom, pulling open the curtains, booming "Time to get up now", covers pulled off, being turned to sit & expected to participate... and being allowed to wake gently to the sunlight, being alert enough to smile hello, being asked to sit in a chair & agreeing to that plan.

IMHO you either got it or you don't! Common sense & a caring manner. Many CNAs do it because they love to care, but others just need a job, it's temporary, pays the bills etc. The culture of a place will trickle down from management. Maybe meet with the Nurse in Charge/DON (whatever title) for a meeting, with aim to improving the resident-staff relationships?
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I don't blame you at all for questioning why she is being left in bed all day. I think the others gave you great advice on finding another facility. A move may be easier in the long run then having to worry if she is getting adequate care. Sounds like a bit of laziness. It's much more difficult that she is non verbal. All the more reason you have her in a facility that you know the care is five star. Must be a really tough situation to be in. Welcome to the forum! It's a great platform to ask questions, get advice and just vent as needed! We all are really here to support one another through the caregiving journey!! Best of luck:)
Love & light, Kelly
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Don't say anything to them at the facility she's currently in until you have found her placement in a different one.
Unless you can be there all the time or have other people checking in on her all the time, complaining could make it harder on your mother being in her facility.
Find a better quality place and then have her moved. You do not have to give the facility she's in any warning or even tell them until the day she gets moved.
This is what I did at the NH my father was in. They weren't providing adequate care to him and weren't even decent. He had to be hospitalized and when they discharged him he went to a different facility. Just do it like that. Don't complain and do not tell them anything.
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lealonnie1 Aug 2021
Good advice, except the OP needs to keep in mind the facility will charge her at least 30 days rent upon leaving (plus a cleaning fee, most likely) b/c they require that much notice of a resident leaving, if not more. She'd need to check the resident agreement beforehand.
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Hello, I would move her to a new facility if things do not get better. Be upfront with the facility. You have every right to queston the care your mother is receiving but I would talk to the person in charge and if you do not get anywhere with the charge person I would go to the director. I have reported a few aids, doctors, nurses for poor care of my mother in the ER and on the floor. Most of the health care workers were great but there are always a few bad apples which I will never tolerate when it comes to my mother. Do not apologize for being a good advocate for your mother.Good luck.
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So, my mother has moderately advanced dementia and lives in a Memory Care ALF for the past 2+ years. The rule there is the resident is not allowed to stay in bed UNLESS they are on hospice care!! Yep, true story. My mother is dressed and out of bed & helped into her wheelchair by 9:30 am every morning so she can have breakfast by 10. If she's sick, she can stay in bed later than that, but even then, they try to get her up before lunch; otherwise, the pity party gets going and it can be very tough to get her out of bed at all, plus the meal schedule gets thrown off & they're not allowed to eat in their rooms. I like that rule, actually, b/c then the residents can't hide out and hermit themselves away in their rooms, either, which they tend to do from time to time. The idea is to keep them active and involved with one another; socialized, in other words.

As far as 'short staffed' goes, yeah, all of these places are short staffed, what else is new? The answer to that little problem is Agency help. Any and all MCs should be using agency's when and if the regular help are sick or call in sick for the day. It's unacceptable for the excuse 'we're short staffed' to ever be used. My mother's MC also uses a big white board for the caregivers where they post notes and updates on each resident's care notes. "Today make sure JoAnn gets a snack at 11 am with her meds" and things of that nature. So everyone, including agency help, are all on the same page regarding care needs and communication.

If you are going to move your mother, look for a NON FRANCHISED MEMORY CARE facility, that is my suggestion. The franchises are all after the $$$$$ as their bottom line goal. Privately owned MCs are after quality of care for their residents as their bottom line goal. I've had my folks in both types of ALFs and had to get them OUT of the franchise (Brookdale) when things went downhill in a hurry once the buy out happened. It went from a lovely place to a nightmare in a New York minute, where the only thing I saw were increases on the monthly bill and a turnover in management where none of them would take responsibility for the sinking ship!

Last but not least, make sure the new MC can handle your mother's needs; not all of them are capable and she may actually need a SNF. Don't ever be afraid to speak your mind to the staff at any of the facilities you are involved with. If you can't do that, something is wrong. You need to have an open line of communication with ALL the staff from the CNAs and QMAPS all the way up to the Exec Director and the nurses.

Wishing you the best of luck finding the best possible living arrangement for your mom. I know how hard it all is, honestly.
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BurntCaregiver Aug 2021
lealonnie1,

That is true about many nursing homes, probably most of them, charging a month's fee for moving a resident somewhere else or for cleaning services.
The nursing home my father was originally in certainly tried to shake me down for that money. They never got it though. Sure, I had to put up with threatening phone calls, voicemails, and very intimidating pieces of correspondence for a while. Didn't bother me one bit. I was an in-home caregiver to elderly people for many years. In that time I've developed the ability to completely ignore something. My father will be gone going on five years. That nursing home never got a penny of that money they tried to collect upon when he was moved out.
Sometimes the occasional piece of mail from them shows up. I don't open it and just write 'Return To Sender' on the envelope and put it back in the mailbox.
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Chiming in the UTO piece of things, as we've had lots of experience with my mom on that. My mom got so many UTI's that eventually the oral medications were no longer effective. The doctor told us that over time one builds up a sort of resistance to them. (I think that's the right term.) Anyway, from then on, she had to receive treatment through an IV, and I wonder if even that over time loses it's effectiveness. Just one of many reasons that I always tried to get my mom to drink plenty of water, but she just wasn't.

The only other thing I'll say in gentle reminder (please, nobody lash out), is to take with a grain of salt that sometimes places may be short staffed due to all the issues with COVID. In Maryland at least, if a staff just tests positive, they have to quarantine for like 10 days. So picture that happening with several staff at your facility, and they're still trying to meet everyone's needs. My dad, before he passed, was very heavy and also weak, so that had to use a mechanical device to get him out of bed. And it took two staff. So we understood if somedays that just wasn't possible.

I wish you the best in whatever you decide to do.
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Dragonfly39 Aug 2021
Thank you for your kind reply! I have set up a care plan meeting to asses moms needs for next week. I am hoping I do not have to move her but her needs just might be too much for the staff to handle. She is currently in Assisted Living and they cant have machines or lifts to help them in that facility. We may need to move into skilled nursing care. Again thank you for sharing your experience.
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Update: So yesterday afternoon when I went to visit and of course was not expected mom was in bed. Probably had been all day. I find out that after my talk with the director the staffs response to my concerns were to leave mom in bed for 17 hrs. I am at a loss!!! I've cried and cried everyone knows moving someone with memory issues is very disruptive but obviously that is what has to happen. There are not very many memory care places near me so visiting will be made more difficult. I hate everything about this!!!
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Momheal1 Aug 2021
I hate this for you and for all the other families whom have to actually request over and over for ways to bring quality of life to their loved one.

The only thing I can suggest to help you feel more comfortable while you address the matter and or research other places (because I know how busy your days are and how limited your time is) is that you call an agency and hire your mom a private care person to be in there over the coming weeks - (this person can be an advocate for getting your mom up and keeping her engaged) so she doesn’t decline and may be able to give you feedback on what she is seeing and what is lacking here while giving you time to look at other places or address all issues with management. That may help you and bring you peace of mind and buy you time to look at other places?
I know you said your mom had UTIs - did they retest her after the treatment? My moms UTI took over 4 months and several antibiotics to finally clear it. She then did a 180 once the infection finally cleared after 4 months and her behavioral/cognitive changes reversed and she was able to get back all her strength and begin rehabilitation therapies again.
I would have sworn my mom was slipping into severe dementia and I was losing her but in fact a UTI on a stroke brain can mimic severe cognitive decline. I’m just sharing what I learned that one dose doesn’t always clear infection and my moms NP waits a good 10 days to retest after UTI. I think many places and even drs make their conclusion and write of behavior or cognitive slowing as dementia when many times changes are strictly from infections or imbalances. By NO a means am I saying your mom is the reason she isn’t out of bed as this is their job - I just know how much I had to be on top of infections as places like this put you in a little box and often don’t see the bigger picture isn’t “always” dementia.

Im so sorry what you are going through - I know how exhausting it is when nobody hears you. But we all agree your mom deserves better than what this place is providing.

I know how hard is it to think you have to start all over again so for this moment I think hiring a private aide to be there when you cannot will allow you to breathe a little and give you time to find and research a better place.🙏🏼
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Get her out of there. They aren't dedicated to giving your mom the best care -- they're taking the easy road for them.

While I can understand the wheelchair part -- it's often what is resorted to in order to avoid falls -- the bed is not OK. My mother was only bedridden the last 2 1/2 weeks of her life, and that was at my request because her skin had become so fragile, the sling for the hoist was tearing it.

Memory care is all about stimulation, and if Mom is in bed, she's not in the common area getting that stimulation. She's isolated, and she's going to decline rapidly.

That place should be ashamed to call itself a memory care facility -- they aren't doing the most basic thing a memory care should do.
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Dragonfly39 Aug 2021
Thank you!!! :-)
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What are the three explanations you've been given? Bear in mind that none, one, more or all might be true at different times. And there could be other factors too.

I do not envy your position.

How much is it possible to gather from your mother about what she wants included in her routine?

What does it say in her care plan (or support plan, or whatever it's called in this facility)?
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Dragonfly39 Aug 2021
Thank you so much for your response. You guys really are great to have for information and things I haven't thought of yet.
The 3 explanations were given on the same day all of them within 15 minutes. One was the nurse told me to only keep her up for one hour a day, another was she had a covid test she has to isolate. (everyone on her unit was given the same covid test and non of them were isolated they were all in the common room. And the last one she told her director was mom was in pain she needed to lay down.
She was fine when I say her and when I asked her if she wanted to get out of bed she said one of her few words "Yes" But she was already in bed so no one went and got her up. She stayed in bed all day yesterday as well. :-( it makes me so sad.
I will have to find out more about her care plan at my meeting next week. I didn't know I needed to ask until the last few days because everything was going ok. I am learning more and more everyday.
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Your one and only concern should be that mom is getting the care and attention she needs and deserves. And if it's not at the facility she's in now, then you must look for another. I'm glad that you've changed up your routine, and are now going at different times of the day, as that really is the only way that you can find out exactly what is going on.
Because your mom cannot speak for herself, you now must be her mouth. My husband had a massive stroke at the age of 48 which left him unable to speak but a few words and a few short sentences, and any time he would end up in the hospital or rehab, which was often, I made sure that I was there from early morning until about 8:00 in the evening, so that I could be his mouth.
And no you do not want them to keep her bed all day if she is able to sit in her chair or even a wheelchair, so she can go down to the dining area, or even outside. If they keep her in bed all day she will decline all the more rapidly. You are now moms advocate, so don't be afraid to stand up for what is right for her and her care. I wish you the very best.
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Dragonfly39 Aug 2021
Thank you so much!!!
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I have walked this road - and my heart saddens as I had to take my mom out of stroke rehab for this reason - I was living at her rehab - my husband was taking shifts it was so hard. My mom was the one who paid the price by not getting the acute more advanced rehabilitation in the first few months and made her recovery much slower. But I am not here to discourage you as your Mom deserves to have access to quality care and quality of life and for her that is in a place that can offer her safety as well as activities and a staff that cares about her.
If you cannot find a resolve with the management of a better routine (other than leaving mom in bed) then I would suggest that you may have to move her - but where she is comfortable and likes it there maybe you can come to find a better way for her.
It is so hard the not knowing and not being there - I do know some states will let you put in a camera? I have seen people post about it here - maybe that would be an idea to look into.

Utis can change their personality so severe it’s awful to watch them go through that (I too had to learn about the signs which are usually behavioral) but staff should know what to look for and be on top of that as well - they are trained to do so.
I would again attempt to request a care team meeting - and even speak with the doctors and ask to have a team of staff at the meeting. Ask specifics and lay out what you want for your mom for daily activity and ask them to describe her daily routine. Another thing I have seen here is people report if their parent was asked if they wanted to get up and refused that the staff can not make them - so maybe ask that if mom does decline early in the morning if a few more attempts and encouragement are made in effort to get her up and involved in activities?

I feel for you as I have a very difficult time trusting those with my mom now after witnessing things as you have. At the start of my moms care it was for rehab after a stroke - she too was non-verbal and at that time wasn’t able to tell me what was happening - it is such a hard time when I realized and began to witness these things.

maybe even speaking with other families in there to see if they have any issues and maybe even looking into a private care a few hours a week to stop by when you cannot and make sure mom is up if you can afford to do so.

My best wishes and hope you find a resolution for her 🙏🏼🌷
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Dragonfly39 Aug 2021
Thank you so much for your answer. I have a care meeting set up for next week but I fear that this is only going to make the CNAs more mad. How do you get the best care for your parent, and not feel like if you call them out they will be mad? I think this feeling comes from my moms years of "don't rock the boat." I am also switching up my routine so that they never know when I am going to show up. I also asked about cameras because I had them in her home when I hired In home caregivers. I was told you cant have cameras due to privacy laws.
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