My mother is in an assisted living facility. She has dementia and hates the place. She tells me every time I visit her that the staff is mean and make her do things. Recently, I asked her to tell me what "they" make her do. Just then an aide opened her room door a little and gruffly said, "It's time to get to bed. Get your pajamas on!" The aide did not see me. When Mom did not answer, the aide opened the door more and saw me. She hurried to say, "What I meant was that I can help you get ready for bed now. If that is what you want?" We both told her that later would be better. After the aide closed the door and walked away. My mother whispered, "That is what I go through every night." It was 7:45 PM. Mom explained that they make her be in bed by 8:30 PM.
This bothered me. So, I went to talk to the aide. I asked her if residents could stay up to 10 PM? She said, "Oh, no! Everyone is in bed by 8:30." I asked her why? She said, "Well after the patients have their pills, they are tired." I told her that no one should be making my Mother do anything. She is able to understand and comply with rules if they are reasonable and explained to her. But, why is it reasonable to force everyone to go to bed at the same time? Not everyone needs the same amount of sleep.
My mother has always watched the 11PM news before going to bed. Now she does not dare to do that. Should I feel that my mother's rights are being violated? Is a set bedtime the norm at assisted living facilities? Should I be suspicious of the "pills" the patients get before bedtime? I never approved a sleeping pill for her. It is not on her medication list. What rights does my mother have as a resident in an assisted living facility?
Short answers: 1. The facility had state inspectors interviewing residents three days later. I did not call. Another family called about their issues. Mom refused to talk to them because she said she did not want the employees to yell at her. I found out about it a week later.
2. The facility has case managers who know how to say sweet, agreeable words, but never bring anything to a satisfactory conclusion. Their answer is always that Mom is the problem or telling stories.
3. I have found another AL residence for my mother. By the way it is almost half the cost of what she was paying for disrespectful care.
4. I am very grateful for all of the answers supplied. You all helped me gain perspective and courage.
I appreciate that you took the time to update everyone. Best wishes to you and your mom. I hope the new ALF is a good experience for both of you.
My head is spinning too much for me to begin listing what the facility is doing wrong.
My Mother has always loved watching the news, but she has Alzheimers and her meds fo cause her to fall asleep before the 10:00pm news as well as my step-father.
The staff makes sure that they are safely in bed and turn off the TV for the night.
Neither Mom nor Step-father are given sleeping aides whatsoever.
I've been there at dinner time, those who can eat together in the dining room, until almost midnight. Not 1 person is given a sleeping side, not 1.
My 1 sister gets upset and will text me and ask why Mom is always asleep when she calls. Not a difficult thing to understand sister. Mom sleeps almost 24/7. Sister calls at lunchtime when the staff is trying to make sure everyone is eating without difficulty. Or, she calls after 10:00pm and Mom's meds have kicked in so Mom is asleep. The 1 side tells me that she can tell what time it is at night because my sister calls at the same time every night. Yeppers, I was home for Mom's birthday and sister calls at 10:00pm. Bridget picked up the phone and said, this is your sister and it was!
She wanted Bridget to wake Mom so she could tell her happy birthday. I took the phone and told her that wasn't going to happen because Mom was sound asleep and waking her is not good for people with Alzheimers because they're already lost in their minds.
Get a list of the meds your Mom is being given BY THE HEAD NURSE. Is Mom being seen by her GP or does the nursing home have a contracted doctor? Have your doctor's nurse or any person who can legally draw blood form panels to go with you.
Yes, there are facilities that give sleeping aides so they aren't bothered during the night. Very similar when parents give their children Benedril.
I'm lucky our daughter is an RN, so she reads the panels for me to make sure that the list of meds given to Mom show up in the panels.
again, thank you for being present in your moms care.
I’m really glad you brought this up though. If I ever have to move mom in the future, I will know to bring this issue up.
You said your mom has dementia that does not mean she loses her rights! If your mom wants to stay up until 11 pm that is her right. If she has been declared incompetent then have her power of attorney tell the staff that she is to be kept up until 10 pm.
I would suggest you contact your local Long-term Care Ombudsman Office, they are the Federally mandated advocates for residents in long-term care communities which includes assisted living communities. There is no charge for the Ombudsman to help you resolve this issue.
If you are the power of attorney ask for a copy of her medication list. You have a right to see this as poa. You can also tell the staff that they are to notify you before any new medication is given to your mom. As power of attorney you ask for copies of her medical record anytime you need to.
Note: The home can charge you a "reasonable rate" for the records. This rate is regulated under the regulations, the Ombudsman can tell you what the current rate for medical records is, it changes from year to year.
You need to learn what your mom's rights are, the Ombudsman can give you a list. Another right your mom has under Federal Law is the Right to Refuse. She can refuse anything from medication, therapy, diet, activities, doctor's orders or any treatment. Families need to learn what their loved ones rights are so they can become effective advocates for them.
I can certainly understand that no one be in communal areas (TV room, Dining-game room) after a certain hour and that is the case where my bro is. A loud TV for a hard of hearing person would disturb the person whose room is outside the TV-Living Room, and loud game playing and raised voices would be hard for those outside the dining-game room. But as to telling a resident in her own room what time she must be in bed, seems a major no no to me. It may be a need in memory care, but cannot imagine it in Assisted Living. Don't know what the choices are but may be a good time to discuss with the supervisoral staff, and look at other facilities if they exist in your area.
There is also a way to approach people, and her approach was NOT good. And she got caught. The approach should be "I go off shift in another hour, Mrs. Breck; would you like help getting ready for bed, or into your night clothes, or can you do that on your own when ready.
ANY good place should have a plan of care. For instance my bro resents people entering without knocking; that is on his care plan. He also wants to be in his room when it is cleaned. That is on his care plan. For your Mom the care plan should say "Enjoys watching the 11 p.m. news and is not ready to get ready for bed until it is over. "
You should also be aware of each and every pill your mother is getting. Others in the facility do get sleeping aids or meds that make them sleepy, so they probably do drift off early in the evening. If you're mom is not on a med like that, she should be able to watch TV all night long if she wants to...unless...she is sharing a room with someone else. Then she needs some sort of privacy screen to block the TV light and headset to keep noise out of the room
At one time staff told me that the residents, despite dementia, still have rights. They have the right to refuse meds and medical treatment. Obviously most of these are necessary, so they work on coaxing the resident to comply. With skill, this can be accomplished.
It sounds like this place is oriented to doing what is best for staff, not the residents. If working with "higher ups" doesn't resolve any issues and concerns you have, I would consider finding another place for her. Moving is hard on those with dementia, so this should be last resort, but given the statement by the aide and then the backpedaling, I would also have concerns!
I have also seen some residents eating breakfast at almost lunch time, others eating at random times. For some it is difficult to stick to a "routine." However this is how it should be. It makes everything more difficult for the staff on one level, but trying to force someone to comply to strict routines is going to be more difficult. The comment about being tired after their evening meds IS a bit disturbing. If nothing on your mother's approved list is any kind of sleep aid or anti-anxiety med, I would get all her info, both from the facility and her doc.
When mom first moved in, they asked the doc for anti-anxiety, to help with the transition. I was aware of this because the bill was given to me. It was not renewed. Sometime later, mom got a UTI and was off the rails. We had to get this med again, to calm her, but ONLY while she was treated. It did generally result in her retiring around 9pm, but they didn't make her go. At some point that doc refused to renew it, citing it as a fall risk. It was a running argument for a bit because having her in that state was more dangerous than a small fall risk! We (staff and I) wanted it only "as needed", because she has a tendency to get these UTIs during non-office hours, like a weekend! Who wants to deal with a raving person for days?
At my mother’s Nursing Home, they start getting residents settled for the night around 5:30 for those who want to go to bed early (and there are many!). Wake up time is super early in a NH. The rest, like my mother go to bed around 8:00 to 9:00. Yes, they can watch TV as late as they like or even not go to bed at all, though staying in their room is encouraged. I have been there until late at night many times, and I usually see one of the residents watching TV in the main lounge. She is 103 years old, and everyone dotes on her. One night I asked why she wasn’t in bed like everyone else. The nurse told me that she refuses to go to bed until midnight most evenings and tells them that if they try to put her to bed before then, she will get out of bed by herself. They let her do what she wants!