My SIL is on Medicaid and has been in a LTC facility for over 18 months. We know she is mentally unstable and manipulative, and we work hard to separate ourselves from her to preserve our mental and fiscal health. But she is claiming her facility is abusing her, she is in constant pain and is not getting even minimal care. She lives 2000 miles away in NY. We are only wanting to make sure her care is meeting standards, by no mean do we expect anything more than legal minimums. How do go about learning this without being brought into her everyday drama. And if she does need to be moved, how do we help initiate that?
Is there any other family member that would step into that role?
He could step down from being POA and she would then have to have a Court appointed Guardian. This removes your husband and you from all aspects of her care. Not the ideal solution but one to keep in mind if all else fails.
Is the facility one that would allow cameras in her room? If so you would be able to observe what is going on in the room. It will not help when she is outside the room.
Have you (rather your husband) talked to the staff? Asked what is going on, how she is adjusting, if there are any problems that they can identify?
Are there any family friends that can pop in for a visit once in a while to check on her and report back to you? And if she has a Case Worker have you discussed concerns with them?
If she has to be moved is there any way that she can be placed in a facility that is closer to you so that a visit once in a while would confirm that she is being cared for? this might be tricky since it is Medicaid and that differs from state to state and many facilities have few Medicaid beds for people that are current residents let alone ones moving from a different facility/state.
Full disclosure - my FIL was a text book narcissist - his picture could have been next to the DSM-5 criteria. We spent years dealing with manipulation and lies and the whole nine yards. He had zero ability to consider the needs of others because he wasn't even aware others had needs. And he was physically, emotionally, mentally and verbally abusive of my DH and his sister until they were old enough to make trouble for him and even then only the physical abuse stopped.
So when we were finally unable to keep him home and stood together as a united front to move him to a SNF - it was game on. He pulled out all of the big guns. He was most certainly in the early stages of Dementia no doubt. But he had ALWAYS lived in his own reality - so now he just lived in his own reality and it was layered like an onion and he even forgot what the told people.
Let me be clear. My FIL agreed to go to the SNF. He wasn't happy but he agreed. HE signed the papers.
But the attacks began soon after. They were not taking care of him, they were not coming into his room for HOURS, they were not feeding him, they were ignoring him. Between the 4 of us we were fielding upwards of sometimes 25+ calls a day. Day and Night. At work. At home. At church. He didn't care. And then he got his sister - who was 10 hours away - involved. And she decided the thing to do was call the State Ombudsman.
All for nothing. NOTHING that he was saying was true. We were seeing him every other weekend. We were making surprise visits. We knew none of what he was saying was true.
From experience. I'm going to tell you - if you already KNOW that your loved one is manipulative - even the least manipulative people tend to behave like that when they go to SNF - because they aren't getting the type of attention they are used to. They think that manipulating their family will get them OUT of the SNF.
Do your due diligence certainly. But guard yourself. Know WHO you are dealing with. And remember why she is there.
If the facility is not meeting these regulations then you call the NYS Ombudsman found on the NYS DOH website.
I am in NYS and also my uncles Healthcare proxy and MPOA. The SW assigned to him must give status updates at request. She also encourages a bi-monthly or quarterly meeting (can even be via Teams or Zoom depending on personal health information criteria safety) to discuss any declines or progress medically and socially.
That would be the person who will be required really to travel to your sister's facility.
That would be the person who would discuss all this with the administration of the facility.
I think that the everyday care of someone with severe mental deficits is not only difficult, but it is an absolute crucible. Not only that, but managing care and intervening, even if you live right there, is next to impossible given the notoriously unreliable reporter that the mentally ill almost always are.
I will be honest with you. You are 2,000 miles away.
Not everything can be fixed or made perfect and that is definitely the case LIFELONG for someone with severe mental deficits.
There is NO WAY to check for the veracity of what you are hearing.
The POA may wish to discuss the possibility of cameras in the room that can be monitored by one family member.
Other than my advice above I have not a CLUE of what you might do, other than drive your OWN self just crazy with all of this.
And have you tried calling the facility to get their side of the story?
If your SIL is mentally unstable and manipulative, I can only venture to guess that even if you were to move her, that the same or at least similar issues would continue at the new facility.
i don't know how much the facility will be able to share with us. We sent them a letter letting them know she has family and requesting rehab and increased care. We are hesitant to ask for hippa consent from her. As this might drag us In Too deep