Response time from staff now that Dad is in memory care. What to expect?

By law, facilities are required to hold a quarterly status meeting. You can call in the local ombudsman, the nurse representative from your insurance company, or anyone else as the subject dictates. Go there everyday, take notes, verbalize your concerns to the charge nurse on duty, copy the administrator on emails to the Director of Nursing. If problems persist and it is serious, contact the ombudsman, file a claim with Department of Health Services, etc. - be the 'squeaky' wheel.

That being said, these facilities have been become huge money-making machines. They are hiring as few staff as they can get away with and even then, they are probably under-staffed.

I work with a client in a memory care division at a facility.
If I were you, I would call and make an appointment with the manager for a 'sit down' face-to-face meeting. You will have their undivided attention.

They DO NOT want you to move your dad to another facility.

I wouldn't email with this initial list of concerns / your questions.
Yes, as a courtesy, emails are provided. However, this is all new to you / your dad so it is understandable you have questions.

Make a list so you can be sure to get most of your questions answered in person. While there, ask the manager how best to communicate if / when you have further questions.

Do you need help in what questions to ask? I might be able to help - not sure. I've been working with this facility's manage, department supervisor, and occasionally the administrator for 1-1/2 years. I am the liaison for the family who live out of state.

Gena / Touch Matters

Please call. Staff change and so do their email addresses. Most routine questions should be answered within a few days to a week. Longer seems like there is some communication issue that needs to be addressed; do so.

I do whatever it takes....

1) If communications requires a document (e.g. copy of the flu shot confirmation), that goes by email.

2) Since I provide all the supplies, they text me and I text them back about supplies, let them know when I'm going to take my Mom out, etc.

3) If they need to get some action from me, they will text first, then call me if they don't get a return text.

4) If it is something long-winded or a discussion, I talk to them in person and text them with the subject ahead of time. No email unless you want them to do research ahead of time.

Yes 24 hours is long enough to get a response to an email, assuming that there is no research that needs to be done. If there is research that needs to be done, plan on multiple correspondence and most probably a in-person followup.

With emails being traceable, I figure they are going to give me the "sanitized" and official answer. The "real" answer or unofficial answer will be verbal. When I was in Customer Service, we were required to use "blocks" for certain topics. These "blocks" had gone by the lawyers to make sure they had all the appropriate legal wording. If I knew the person well enough, I would call them, we would chat, and then I would follow up our chat with the official "sanitized" email.

I visit nearly every day and I would suggest if you can, that you do too. If you are a frequent visitor, you get a pulse for "things" and after awhile, you will figure out when and who to direct your communications to, and who is going to give you the real scoop versus the "spin".

Remember, the more they are dealing with you, the less they are dealing with the residents. I'd rather have them spend quality time with the residents.

One more thing: I notice more people on staff during the weekday than the weekend. So if I need something, I always aim to do it during the weekday. The fact that the weekday is more staffed than the weekend, is something that I notice only because I am there more often than once a week. Last time I asked about it, they claim weekdays and weekends are staffed the same (HAH!)

Keep emailing and calling as often as you need to. They should respond, even though it might not be instantly. But keep emails short, just one or two points or questions. People just don't seem to fully read long emails, not in any organization. Make sure the email heading has a new, relevant title each time, instead of re: re: re: etc.

Kablooie: Perhaps you can schedule an in-person meeting OR a virtual meeting. Good luck.

I hate to say it - but most of these places, including "upscale" ones (like where my mom was for 8+ years) are not much more than warehouses. 1. You must be there regularly and at all hours to see what goes on, and subtly or not so subtly let them know you are observing. 2. When you go, help out - this is something the aides and other staff will appreciate and help enhance the rapport. 3. Email responses were hit and miss for me; some replies were quick, others took far too long. At the VERY LEAST there should be an auto-reply that gives a timeframe within which you should expect a reply (but I know that is dreaming).

Bless you and bless your day. In the meantime, consider exploring other facilities that may be a better fit if this one doesn't work out. It's good to be prepared. Some Elder Law attorneys and geriatric case managers will be willing to provide suggestions - but you still need to decide for yourself. Get a list of questions together.

I would echo katepaints’ answer, that the family who visits often gets more attention and their family member in the facility is treated better. I visited my husband with dementia in rehab every day and spent at least 5-7 hours. I strongly advocated for him and even with all that there were times the staff sloughed off on care.
it isn’t just that the facilities are short staffed but that the staff aren’t always trained enough and willing to meet the requirements of the job. Despite that it is much more likely that the care will be much better if the family and friends visit often.

I am not going to apologize with what I am going to say. I do not trust anyone in these homes. I have no confidence in their ability to care for someone's else loved one. If they don't get back to you with-in 24 hours, then you have a reason to complain. You are paying for a service and have the right to expect to receive what you are paying for. We are talking about you Dad, not a lawn or pool service.

Even the best facilities are stretched to the max. I would visit often so the staff gets to know you and you can figure out who to ask questions when you visit. My brother was in a 84 bed facility but because they knew we showed up a lot, they were very responsive to us and never hesitated to call me. A resident with a family coming around often gets better attention. I was contacted for quarterly care conferences with the social worker. See if you can make an appointment with the social worker and write down all your questions as they come into your mind so you are well prepared. Try to dial back the impatience--it'll be easier now that your dad is in a facility and the crisis is over. They have a very difficult job and you don't want to be known as the family that they dread hearing from. There are enough of those folks in the world. Good luck!

Not sure how many residents are in the facility your Dad is in, but I look at things in the big picture. What is all the residents' families expected quick responses to frequent questions and requests. Any you mention family members going to visit, so they already address questions and issues with those members, so figure you are getting the updates. My Dad is in an ALF with memory patients mixed in with the population. About 40 full time residents and 6-8 respite. I visit at least 3 times a week. My siblings also visit, so Dad has one of us going there at least 5 days a week. We also pay for over night private caretakers as he is a fall risk. We realized fairly quickly that no matter how caring the staff was, there is no way one resident can have constant care and he was a nighttime fall risk. But we have a Sibling Text group and whenever anything of importance comes up on a visit we all share that info so multiple family members aren't asking the same questions. When I have a number of more serious concerns, I set a time to meet with the director and have a list ready with questions. There is no facility that is perfect. Dementia is a terrible disease, one you know ahead of time will only get worse. So our goal is to just make sure Dad is safe and taken care of and happy in his way.
The facility has the daily menu posted on a wall near the dining room. Frequent visits help you get an idea of what he is eating. The caretakers also work in the dining room so they know which resident needs to have his/her food cut up for them. I also know which caretakers are more knowledgeable on things and take time to stop and visit with them, and then ask about his days (showers, eating, bathroom accidents....) Some are always eager to talk. Especially if you bring the group treats from time to time.

Schedule a meeting to address your concerns.

You are dealing with a lot of people who are probably not true experts in memory care, but general nursing. They will likely be swamped, although in an upscale settting you expect less of that. It is best to establish who are the best ones to contact. Each will have different priorities, such as a charge nurse, the floor manager, the shift manager. They should be glad to let you know who and when to contact, or to arrange that you are called and who would do that, when they would do that. With 100 patients, that seems a lot, because you multiply by 100, but each case is different and each family request is different, so you may stand out easy for them to contact all things considered. So discuss it as friendly as you can with them, showing you are considerate of their time and try your best to avoid any negative situations or dealings, so seek empathy in bad situations rather than make accusations or demands, is very important so that you are not stereotyped as "here's another jerk". Bend over backwards for your loved one's sake, where needed.

The fastest response you will receive is via a camera(s) in the room. Pay to have them installed or request a room with cameras. 24/7. Homes SHOULD appreciate cameras for all the good reasons. They can use curtains if privacy is needed to dress and bathe patients. Due to it's a facility, the responsible way is to install professionally by their preferred provider. If it's upscale, they should have the means and wherewithal to have cameras already installed 100% of the rooms, to facilitate the nursing stations and possibly to allow a patch line for families to log in to view loved ones. More eyes is a good thing. From my experience you may have already signed a document about camera usage, like if you allowed it or not, or wanted it or not. Contact the administrator about that and say you want to do the cameras in his/her room.

If you use a sitter in addition to the home, or a family members spends much time there, it is beneficial for them to have camera access via their telephone so they are freed up to do some errands and just check in by Internet access at those times. KWIM?

Good luck.

I’m guessing staff members only answer emails at the end of the day. During the day most are very busy, and most are very short-staffed. If you really need to ask questions I suggest you visit. Also, when a facility knows the family visit often the resident usually gets prompt care!

ask if you can install a Wyse camera in his room.
ask how to contact the person in charge on any given day.

Any hands on care your Dad needs is a priority over answering your emails. Facilities are typically struggling to find enough staff, so office duties and emails may not be the first order of business. I would allow at least 48 hours for non-emergency responses.
If you feel your father is receiving good care and adequate attention, be thrilled with that and work out questions and answers as time allows.

what is the patient to care ratio,,,,thats a problem these days no matter what kind of facility it is. in a perfect world 10 mins.

Moved my aunt into a beautiful AL situation that answered most of the requirements (pets allowed, beautiful surroundings, well-paid staff, great reputation, medical staff on site & within the area where she had lived so friends could visit her.) All that being said I had a terrible time getting answers to serious questions from the Head Nurse. I looped in the Sales/Marketing lady who had helped us initially and she suggested we let the director know. So next email I cc'd the Director and low and behold we had some answers. Was it annoying that I couldn't rely on her to respond to direct questions within a week or longer using any option she'd prefer? Yes. Did getting the Director involved have an immediate and positive response? Yes. I tried to be understanding - they have many responsibilities etc but in the end they are being paid to provide care and you deserve a timely response via email/text or a phone call, if you are not getting it take it to the Director.

I am the bursar (student financial officer) for a small private college. I am also the office person for the maintenance department and over IT. Not the same as healthcare workers by any means, but I might shed some light on how to handle email sent to a busy office. During registration week and the weeks before and after, I am slammed. I work around 70 hours a week for those weeks and never do I work less than 50 hours a week. I spend virtually all of my office hours on the phone so I do most of my follow up in the early mornings and late evenings - that being so, I much prefer email communication.

I have one lady, a student who recently moved on campus. She's actually an old friend of mine, but as a student, she is very, VERY needy. As I read your question, I could envision her saying about me and my office the same things you are saying about your dad's AL. Yes, we did do an all out push to get her apartment ready to move in. Yes, we bent over backward to help her get back into the community and we made sure she had everything she needed. After we got her settled, we had to back away and tend to all our other students as well, especially since she moved in right as registration was beginning. From her perspective it may well appear that all we wanted was her money and once we got it, we were done with her. From my perspective, it was time to let her tend to her own business so I can attend to our other students who were banging on my door.

I got email from her every single day, each of them several paragraphs long about a variety of topics with details about why whatever she is asking about is important to her. I KNOW she is trying to be friendly, but - during peak times I simply can't respond to her every question about her apartment (i.e. can she get maintenance to key the front and back doors the same?) or her professors or her classes or her job hunt. I found myself avoiding her, this woman whose friendship I have enjoyed for some 20 years or more. I finally invited her to go to lunch with me and we caught up with each other personally, and I asked her to help me help her by doing a few things.

I asked her to send one email for each topic she needed to go over with me. If she needed help with her apartment, put a brief note in the subject line saying "Lock not working" and then BRIEFLY describe what it is doing. I could then easily forward her email on to the most appropriate person who could help her. I also asked her to consider how urgent each request is and to put that in the subject line. If she could not continue without hearing from someone on staff at the school, put URGENT in the subject line, followed by a brief description of what she needs. In essence, I encouraged her to engage in a little self-triage instead of puking everything she needed off into an email, hitting send, and then watching her inbox for me to respond. In the body of the message, don't dump every detail you know into it. Give a brief description of what is going on and invite your recipient to contact you for further details. Since I had this sit-down with her, our communication has been going much better and she is much happier and I no longer dread seeing her name come across my screen.

Ironically, I was in much the same position as you. I move my mom from AL to MC at the end of September and it was just not the same. Where I had known the director of the AL, I knew no one at MC. In fact, MC was in a completely different town so I couldn't even just drop by. They also prefer email so that they don't have to drop what they are doing with one client to answer questions about another. I tried to send blanket emails and got very slow response, but as I was sorting things out with my friend, I realized I needed to take my own advice. I started framing email as I described above and the response time went up dramatically!

I finally had to have a face to face with the Executive Director and the Care Manager for my mother. After numerous complaints from my mother on her response time to calls and other issues. It did help in having emailed the executive director and the next in line when issues were not handled by her care manager. All of a sudden, I am receiving emails within a day. I do visit her at least three times a week to check on her and the situation. Patient to CNA was an issue that will probably not be resolved. Two CNAs per 26 patients and when one needs to be hoya lifted it takes two people. Mom had a stroke at 92 in June of 2022. Her left side was affected. All daily living, taken in or out of bed, toileting, dressing, etc. needs to be addressed. It has certainly turned into more than caring I am an advocate for my mother. Some days it's tough but then I remember that she really does not have a voice and how difficult it must be for her.

I would ask for appointment … to hash out your questions .
when there’s an email I would think
a day or two is reasonable for them get back … but you know best is
to visit often … that’s when you see what’s going on … have questions answered and most of all they’re more accountable when there’s an involved family member.

This has been discussed here before, assisted livings are a industry that was created to take advantage financially of seniors by charging exorbitant prices for “assistance” which in large part isn’t there ( for example if your loved one needs assistance in the shower many of them charge additional fee on top of the already astronomical fee for them to be in ASSISTED living!) you seem to have made the connection with how their interest in responding to you slowed down significantly since they received the first payment. What I would expect for the sum of money for the sole purpose of my loved one to live in assisted living is for them to be personable and show a one to one interest and concern in your questions or concerns - not directing you to send email- if you prefer to primarily communicate thru email is fine but if they’re directing you to email and discouraging personable communication I would not feel confident w my loved one being there. How can I when their primary interest at that point seems to be my loved ones finances ? The very thing people rail against often times innocent people for doing - I’ve seen so many posts about how people want to pay caregivers a very low wage and if they ask for a living wage become upset at the caregiver as if they’re doing something wrong— yet will turn around and hand over their parents bank account to a facility that shows minimal interest IN their loved one. This is addrsssing in a general sense the topic of how society undervalues caregivers or relatives caring for a senior but is glad to lower their expectations drastically for what they pay ten times more for. Again I would have high expectations and standards for a facility that’s charging such exorbitant fees literally to care for my loved one- if they can’t bother to communicate other than mainly email I would be looking at other options such as a dedicated caregiver or small residential home that is not all about the money.

Thanks everyone for sharing your experience. It's helpful for me to know how things go for different people. Since posting this, I straight out asked the general manager with a cc to the move-in manager what I should expect in terms of response times to my emails. They said 24 hours.

It was clear they forwarded this to the care director, who then responded immediately to my two emails that had piled up.

Hoping to get to know staff better now that Dad is settled. I will visit once a week. I know everyone works hard and I want to be able to appreciate them in the way described by one of you. And for 12.7k per month, even though they are busy and short staffed, I have become pretty no nonsense like lealonnie. 😁 I do fret about making a nuisance of myself (in life in general), but there have been questions about how they operate, since admittance was very hasty.

A funny example: dad tells me all they serve is coleslaw. I know that's not true ... but I want to find out what they ARE serving him. If they tell a visiting family member there was an act of aggression but they don't let me - the health POA and first contact - know just what happened, I'll be asking and expecting an answer pretty quickly.

DON'T MESS WITH US MIDDLE AGED WOMEN 😆

I also tended to email early in my mom’s care or spoke, to the right person, while visiting. Responses were not always timely. They were always busy. However, I noticed, random conversations seemed to be unsustainable in terms of her care. Things would get better but would not remain sufficient. In my case, the ALF changed owners so I was stuck in the middle of many merger changes. I ended up writing a document and had a personal meeting with the head nurse/care manager. I expressed what was going well and what I noticed needed attention. I dated it and we spoke about appropriate expectations. This seemed to be more effective in my case.

It also gave both of us a record of the care so that when formal care reviews were done, they were efficient. I did use white dry erase boards inside the room to communicate thank you notes, suggestions on menu’s and other topics that were related to ADL’s. The staff seemed to like that.

Since I did transition my mom in the middle of a merger, I faced staff changes mid stream. I kept the notes from each meeting and shared them with new staff.

I did learn what to address to whom. It helped to learn what each person was responsible for so I did not waste my time or theirs. The change in ownership certainly added more frustration than most would face in a transition.

I wish you all the best with this transition.

I would call the Administrator/director saying what you did here and asking if you could have a care meeting with him and the head nurse. IMO, these are the only two people you would need to ask questions of. The Nurse oversees the LPNs, CNAs and Medtechs.

Make a list of your questions. I was able to see Mom everyday. So any questions I had I asked while there. I was told by my daughter, RN, who worked in NHs for 20 yrs, not to make a nuisance of myself. I never needed to email anyone and was told not to leave too many notes for the CNAs. Mine were usually to inform me if they needed anything to care properly for Mom. I had a white board on her frig for notes between me and the aides.

You want the staff your friends.

I think this is an excellent question for the administration at the facility, as each differs from another. What we may have experienced will be different than from your facility. I don't know how busy they are, how much they are having to "triage" things in terms of crisis response or otherwise, or how they work to divide out responses to differing areas responsible for the "type of questions" you are asking. For instance, asking about diet is different from asking about billing is different from asking about the MC itself, its staffing and care levels, is different from asking about your Dad as an individual patient. Say you ask about the latter, the admin must forward questions to the MC cottages, await response, or ask THEM to respond and then you are down to "them".
Answer I guess is "it all depends".

K,

I think MJ has the best solution. Schedule a meeting.

Write any important questions down before hand.

The meetings I had with staff when my mom was in a facility for rehab were timed.

As FF pointed out, the staff is going to be very busy. They may not have a lot of time to discuss things leisurely.

Others should see your question and help also.

Best wishes to you and your family.

It depends; if I emailed the Executive Director of the Memory Care, I'd normally get a response w/i a day or two max. Unless she was on vacation, then I'd get an email saying "I'm out on vacation until X date."

If I emailed the person I was supposed to email (and I forget her title tbh), I was lucky to get a response w/i a week. Then I'd get POed and email the Executive Director and/or call and leave a voice mail. I'm like you, nobody to fool around with b/c I am impatient and a no-nonsense human.

Mom lived at this AL for 4 years, then segued into their MC bldg and lived there for nearly 3 years. The entire staff knew me and they knew both of my parents well. They also knew my personality and not to aggravate me TOO badly or I'd be seriously irritated and unhappy as a result. Which is not a bad thing for the staff of YOUR dad's MC to know. Which is not to suggest you should be a loud/obnoxious/crass daughter or son; just that you should make it known you're a NO NONSENSE HUMAN who expects to be dealt with PROFESSIONALLY b/c that's part of what your dad is paying an ASTRONOMICAL MONTHLY FEE FOR.

Conversely, I was very appreciative (and made my appreciation known to the staff) for all their kindnesses and how well they did care for mom *and my parents beforehand* I gave gifts and tips at Christmastime and always spent time getting to know the staff, etc. That's also part of the process in managed care; the POA/daughter/son has to be kind and firm at the same time, which creates an atmosphere where the staff WANTS to be helpful.

Best of luck to you!

Kablooie, I remember back when my Dad moved into senior living. Any email I would send I didn't expect to get an immediate reply because I know how busy it can be in a senior facility. Eventually I would get an answer that covered my question. Otherwise, I could request a meeting with the Staff if I have any concerns.

I noticed in today's world with cellphones, more people have become impatient because they want an immediate reply. I had to give up doing texts with my grandkids because they would go into panic if I didn't answer a text within a couple of minutes. I am surprised they didn't call the police for a welfare-check.

Seems to me you should request a care conference with the administrator, so you can have a calmer conversation. Once you get your questions asked, you can follow up with emails, but request a face-to-face so they can explain to you how things work there.