I admitted my 89yo mother to a stand-alone, "award-winning" assisted living/memory care unit with trust and hope. At the urging of my family, and allowed by state regulations, I installed a camera. I like the location and facility, and appreciate how I've seen caregivers communicate with my mother. My mother, to my surprise, is rising to the challenge and beginning to acclimate. I want this situation to work for us.
However, within the first week, my camera caught a male visitor entering her room 2 nights in a row. On the second night, he touched her on her shoulder and toe, waking her up, and causing her to cry out. After the first night, choosing to take a soft approach, I reported what I saw verbally to the Executive Director and asked her to assure that the door was locking appropriately as staff members left the room. After the second night, I sent an email message to the ED, cc'd to the Administrative Manager, reporting what I saw in detail, and requested that she assure me that my mother would be safe and secure. I received no reply from either individual addressing the concern and when I arrived for my 3:30 appointment and was escorted to the room by a caregiver, we discovered that the door was unlocked with no one in the room. I talked with a care supervisor and learned that because her unit had been a "model," the door handle/lock was different than those on the other patient units and that their solution was to orient all the staff to the handle/locking mechanism. After some discussion, I was eventually told that the maintenance man was coming from another facility to change the lock. I remained until that was done.
Two days later, when I arrived and was escorted to the room, the door opened without a key. I had yet to receive a return email reply from the ED, or AM, to my first email message. So, I sent a very direct but tactful message requesting an automatically locking door and/or move to a unit in a hallway away from the visitor by day's end. This time, I cc'd the message to the Marketing and Sales Director, as well as the ED and AM, and requested a return reply. I received a reply within minutes from the ED indicating that the maintenance man would "look at it" that day. The maintenance man called me himself to say that he changed the lock to one that would lock automatically as caregivers leave the room, taking the "human factor" out of the equation. I feel satisfied with this solution but am very disappointed about communication regarding this concern.
I hate that I had to start my relationship with the administrative staff this way but also know that I would never forgive myself if I did not report safety concerns and something happened to my mother. I am a well-educated nurse with extensive background, including a bit of experience in geriatric, mental health, and locked units. I know good care when I see it and I have read all the state regulations about assisted living/memory care. I know that the care delivered to my mother will not be perfect but have already noted many indications that standards of care are not being met - especially on nights and weekends.
I do not wish to use the camera as a "gotcha" tool but as a tool for collaboration to my mother's benefit. As a caregiver myself, I understand that this camera can be off-putting. Please help me learn how to draw the line between attempting to "micro-manage" her care, and picking and choosing battles judiciously as her advocate. I'm also open to suggestions about how to best communicate my concerns when warranted.
Appreciate your input!
When they could not figure out how to put her new hearing aids into the charger, I created a laminated sign in color showing EXACTLY how to place the aids in the charger and what went where. I stuck it on the wall above the nightstand where the hearing aid charger case was kept.
When they lost some of her clothes (fully labeled) in the first week and somehow never found them, I started picking up the laundry several times a week when I visited and would bring back the clean clothes at the next visit.
I have a camera in her room that records and, 10 days ago through this camera, I was able to view the recorded video and see how she fell and broke her hip. While watching her fall was horrendous for me, the doctor who repaired her fracture found it helpful. I sometimes call her facility at night to ask the caregivers to please remove her hearing aids when I see on the camera that they forget or to please go turn off the light or the TV when they forget to do so. I also saw via the camera one caregiver (no longer employed there now) walk into Mom's room and sit on Mom's recliner and talk on the phone while Mom was alone in the bathroom. Not acceptable!
I always try to state my concerns in a polite, non-threatening way, but sometimes going to the ED is necessary. Even then, changes are not always made.
I even went to the trouble to write out a whole "introduction to Mom" explaining a little bit about her history and her likes and dislikes. I posted this on the inside of the door into her room in case any of the caregivers wanted to know about her, but Mom was curious and removed the document from the hook on the door and carried it around in her walker basket for a week while trying her best to figure out what the heck it was describing!
One of my biggest fears is that one of the male residents in her facility might enter her room against her wishes. I would prefer she be in an all female house, but that did not happen. So far, so good, although there is a new male resident who I learned about first hand when I went to her facility today to pick up some clothes for her to wear to the rehab facility she checked into today after being released from the hospital. The house residents (about 10 of them) were sitting at the table having lunch when the new guy started yelling at the caregivers shouting that they were "worthless" and for them to "get out of here" etc. Then he started yelling at the other residents calling them "stupid" and telling them to "get out of here"! I had the door to Mom'a room closed but the yelling was still so loud! I am sort of afraid for my frail little 100 lb. mother to go back to that.
Anyway, I totally sympathize with you and identify with being THAT daughter. Tough if they don't like it! I am my mother's advocate and will do everything in my power to be sure she is safe and well cared for. After all, we are certainly paying a pretty penny each month for good care!
Now it's time to leave things alone and let the staff do their job. If you're going to watch what goes on with her 24/7, you may as well have her move out of the MC and in with you in your home. Otherwise, trust that she's getting the care she needs from this award winning facility.
When you go visit, if she looks clean, well dressed, well fed and fairly happy, you can believe she's doing fine. When I visit my 94 year old mother in her MC, I look for those very things. Her room is clean, she's clean and looking quite overweight sitting in her wheelchair, so I know she's well fed and well tended to. I see the caregivers joking with her, kissing her on the forehead, and just looking after her in a genuinely caring kind of way. I know they like her, and she likes them, so what more can I ask for?
Is everything perfect over there? No, of course not. But I try not to bring my aggressive type-A New York personality out too often and pick my battles carefully. I would definitely have picked the door-lock battle you picked as well. In fact, when she first moved into the MC, there was an old fellow named Denny who was rattling mom's door a lot, driving her crazy. It wasn't dangerous or a big deal, except to HER. She's very nervous and OCD, and made a HUGE fuss about it, so I called the ED. She and I discussed ways to keep Denny away from mom's door. We settled on putting a large easy chair in front of her door which prevented him from getting close enough to it to rattle the door knob or knock on it (he was in a wheelchair). So he lost interest and moved away from her door and onto someone else's. We arrived at a resolution between us, the ED and I, and fixed what could have been an ongoing nightmare (b/c my mother is a drama queen.) Things like this happen on a regular basis and some things I just ignore and others I take up with the ED and we find a resolution together.
That's my suggestion to you: leave well enough alone. Pick your battles. Ignore the small stuff and focus only on the bigger things that you feel warrant the EDs involvement. Not answering emails or phone calls rates right up there with things that irk me the most, too. For the amount of $$$$$ you're getting paid every 30 days, the least you can do is ANSWER MY PHONE CALL OR EMAIL PEOPLE.
Good luck!
I wish that every single resident in all facilities had an advocate like you. BRAVO!
I was absolutely thrilled when our governor allowed cameras to be used in our facilities.
Why on eartwould anyone object to the use of cameras or even be offended in any way? Think about it, there are cameras everywhere! People look at us all day long, everywhere we go, stores, banks, casinos, gas stations, restaurants, traffic signals, parking lots, schools, facilities, etc.
Aren’t we used to cameras by now? Geeeeez, I automatically assume that a camera is pointing on me. It doesn’t bother me in the least. I have absolutely no objections to cameras. Look at how many crimes are solved due to cameras.
Anyway, I applaud you thoroughly for staying on top of this issue! I would have done the very same thing as you did. When my mom was in rehab for physical therapy an LPN double dosed my mom with her Parkinson’s meds. Mom knew exactly what her dosage was and immediately told her that she was giving her twice the amount. Guess what this nurse told her? She says, “Just take it, so I won’t have to make a second trip back to your room. We are short staffed and this will save time if I give it to you all at once.”
Mom was part of the generation that wasn’t comfortable questioning doctors or nurses because she saw them as ‘voices of authority.’ Still, it made her uncomfortable and asked her nurse if a double dose would hurt her. The nurse replied, “No, it won’t hurt you.” So, mom took it.
The next day when I went to see mom, she told me what happened. I was livid! I called the pharmacy and asked if mom was in danger from taking a double dose. The pharmacist replied, “Not if it happened only once but if it continues, it will be a problem. If she did this to your mom, chances are that she is doing it to others, so please report her.” I did report her to the DON and social worker. They handled it. Mom was concerned that the nurse would treat her badly because of being reported. The DON said that the nurse admitted what she had done and was written up for it and he ordered her not to enter mom’s room for the remaining days in rehab.
Incidents do occur at times. I am fully aware that the staff works very hard and are short staffed but there is no good excuse for a resident not being treated properly. I am extremely appreciative of all caregivers, nurses and doctors for their service but I don’t hesitate to speak up when it is necessary.
Most of the time the care is good. Some medical staff go above and beyond their duties and are angels. I found this to be true in the hospice house where mom was. She spent the last month of her life in the hospice house with end stage Parkinson’s disease. She died with dignity and free from pain. I will forever be grateful to them. The care was excellent from the entire staff. The hospice house has cameras placed to oversee everything. I love having cameras. Pictures don’t lie!
Your mom is blessed to have you in her corner. Keep up the good work! You not only helped your mom but all others receiving care at the facility.
Wandering is very common, especially in MC. The man who entered your mom's room and touched her, may have thought that she was his wife. I'm sure it was frightening for your mom. When I came to visit my wife one day, she wasn't in her room and found her fast asleep in another person's room. Another time when I went to the closet to get some clothes out for my wife, as I opened the closet door, there stood Jimmy, one of the residents. Scared the livin' dickens out of me. I escorted him back to his room.
You brought your concerns to the staff early in your mom's residency, so they know now what standards they will be held to. I suggest that families don't over expect the care that a facility can deliver, but at the same time to express their concerns in a diplomatic, non confrontational way.
Someone coming into her room is a safety issue.m for sure. My mom is in care and my son is in a group home. I’ve told them both, I am watching carefully to have their health and safety needs met, but I will speak my mind, and be kind and nice when I ‘complain. ‘
best of luck!
A clause in the law, which I consider critical, is that retaliation for having a camera is unacceptable. The clause even provides examples of retaliation.
You might contact the long-term care ombudsman for your state. They should be able to point you to the relevant laws. :-)
I do know one of the complaints my bro had in his own VERY GOOD ALF in Palm Springs was that in an attempt to help people foot the bills and etc, sometimes people who really required memory care were kept in Assisted Living too long, and they could disrupt other patients as well as getting the care others might require. This could be happening at your own facility.
I hope that this will be the facility for you and you will find the care overall good. And that you will take your concerns to administration. They will let you know what they can do, and perhaps they will bump up your Mom's care level a bit higher (and unfortunately the price as well). Or they may tell you that they feel they cannot fulfill all of your expectations and feel you may be happier with another facility. I am hoping there are many to choose from where you live. I sure wish you the best. It is an adjustment and I had to laugh so hard when my brother (with his own VERY specific wants and needs and thoughts) said "Well, I think I am doing OK> It's a bit like when I was in the army. I didn't like it a whole lot, but I made the best of it".
To your point about the potential that we may be encouraged to find a facility that can provide a higher level of care: Mom is on hospice for her dementia and chronic renal failure (about midway through Stage IV). This is the facility that the hospice social worker recommended most strongly. The ED indicated that several of their residents were on hospice to end-of-life. Mom is still more capable of communication and mobility than several of the clients. So, cross fingers, we don't get evicted for other reasons! Meditate, meditate, meditate!!!
By the way, a funny you will appreciate: During the last couple of years, whenever she had a doctor's appointment, I would very carefully plan my approach to get her to clean up and change her clothes before leaving the house. But sometimes, she would flat-out refuse! I would tell her that I did not want her doctor to think that I was neglecting her. my Mom, also a nurse, would say, "I'll just tell him that I refused to change my clothes so he can document it and you'll be okay." :-)
Before Covid, there would occasionally be a male aide or attendant on my LO’s floor, and they were typically decent men who had been thoroughly vetted by the facility.
I’m assuming that you had ample reason for your reaction but did you get a reasonable explanation too?
Keep reminding yourself that you are ensuring that your mom stays safe and healthy. You're doing a good job!
If you micro manage, you can also
back off. If you make a wrong assumption, you can say “ I’m sorry, your right and my only concern is my mother’s well being.
Do it until your mother is treated correctly.
I am a retired teacher. Parents who were on top of things for their special needs kids got the got correct adherence to their IEPs.
Keep that nurse hat on. It is an asset.
Be. That. Daughter.
I am cheering you on from here!!!
https://www.agingcare.com/questions/can-you-help-prepare-for-the-first-care-plan-meeting-sans-resident-handbook-in-assisted-livingmemory-467312.htm
You are not a nurse at this facility, you are a family member. My mom is a nurse and holy crap, it about drives me crazy and you have described some of her tendencies. How would you feel if a family acted like that with you?
I think you need to learn to separate your nurse cap from your your current situation. You are not the only person with a family member in the facility.
As for the other question, your out of line. I this and I that, really look at how you wrote it.
We don't know the intentions of the man who went into the room, but perhaps he has been going into other rooms startling people or worse, or maybe stealing items.
It's bad enough that it happened twice - and thank goodness nothing bad happened to mom - but that you *politely* told them after the first time and they, in essence blew you off - multiple times!! - is not ok! You have every right to "micromanage" this, as it's a safety issue. It's not some complaint like the other residents are hogging the TV, or her laundry isn't being done the way she likes it, it's safety! Safety is never, ever a "micro" issue!
You shouldn't be upset that your relationship with administration began this way - now they are on notice that you're not an absentee child, that you are going to take an active part in caregiving, even though mom is in a facility, and you are going to advocate for her and her well being. That is nothing to apologize for, not to anyone here and CERTAINLY not to the administration of mom's facility!
You in no way, shape or form "crossed the line", so don't even feel that way.
Request an immediate care meeting and ask why this lapse and lack of communication and followup should not be reported to the Ombudsman.
And to mom's lawyer.
I would not play nice.