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As a retired State surveyor, I can tell you this is not normal and should be investigated. Call your ombudsman or call the medicare complaint line. They will send in a surveyor to investigate the complaint. Residents have rights and bedtime choice is one of them for sure.
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No, this is NOT okay. This is not person-centered at all, and even CMS uses this as the standard of care to be provided. The staff should be grateful that your mom still has an interest in the news. I wonder if the director of the facility and the director of nursing know that aides are getting everyone to bed early--no doubt to lighten their workload, which may be obscenely heavy. If this doesn't change immediately, call your county ombudsman.

If the aides are ignoring your mom's wishes to stay up for the news, they may indeed be doing other things your mother experiences as 'mean.'
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No,
She has rights.
Talk to the horses mouth. Director!
Why waste your time here?
Research. Good Luck.
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Hi PrO!

I’m not offering any advice here but, I would very much appreciate what the AL folks tell you if you meet w/them about these issues. So, if you don’t mind following up w/an update, that’d be great!

Thanks, in advance, for sharing.
Lynn
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No! A.L does not strip residents of their rights and free will. Overstepping staff for sure.
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Mover her, if possible, once you verify the bedtime for everyone comment. If true, that is unbelievable.
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It's hard to believe everything a person with dementia tells you. So before you get all upset, do what you can do to get more information. Also, unfortunately the majority of people living in homes "hate" it. They want to be in their own home and most don't understand that their love one's may not have the wherewithal to help them in their homes. Just do your best to make your Mom's life as nice as possible. Perhaps, if she is able, take her for walks. Go out for tea and a snack on and on. See if you can get her interested in something....
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JoAnn29 Jan 2020
OP was there when the aide came in and told her to get ready for bed. She didn't see the OP.
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Yes - her rights ARE being violated.

The only reason I can think of for this early bedtime is to give the staff time-off of their duties to the residents.

AND, you heard her - she wasn't respectful of your mother. Speak to someone in authority and threaten legal actions if your mother isn't apologized to immediately!

Elder attorney time.
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You don't say if your mom is in MC or not...just that she is in AL with dementia.
MC is different than standard AL..where people are more able bodied and don't need to be prompted. They can pretty much do what their heart desires, though there may be quiet hours. In MC, there is often a standard bed time, though it is within your mom's rights to have reasonable adjustments to the norm. This would be part of her care plan.
Also that aide was rude and should be reported. No one should be talked to that way. The comment about the pills was likely just an excuse. However I would review your mom's meds when you review her care plan. There's an outside chance the staff had a prescription put in to a physician without your knowledge. best wishes
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thepianist Jan 2020
Sorry but your are wrong about persons living in memory care having fewer or weaker rights than others. They may not be as adept at exercising their independence but this doesn't give aides or anyone the right to dictate. The standard of care is PERSON-CENTERED care. Standard bedtimes and rising times and mealtimes are not person-centered. And if someone added a medication without informing the PoA, this is probably a violation of law. I would love to know the name of the place your mom is living.
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Assisted living is just that they should be assisting her when she needs it.
If she does not want to go to bed at 8:30 she shouldn't have to.
The problem is is she falls asleep in a chair it is difficult to rouse someone and help them get ready.
Also there may be a shift change a bit after and reduced staff would have a more difficult time getting everyone ready and into bed.
Possibly helping her get ready for bed but not "making" her go to bed until she wishes might be an option.
Many medications are given in the evening and some do make people sleepy. If a sleeping pill is ordered then it will be given. If your mom's medications do not include a sleeping pill then she should not be given one. You can ask to see what medications are being given. Each medication should be identifiable and each pill given must be by a doctor order.
And yes if she wishes to watch the 11 pm news then she should be able to do so. (as long as the volume does not disrupt others)
This might be worth a discussion at the next meeting you have with the administration.
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Are you sure they aren’t just getting her read for bed?
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One of the fundamental rights that a patient has is the ability to keep their own wake/sleep schedule. It was in the list of "patient's rights" in mom's NH.

Work with the SW and DON on getting the staff retrained. If they don't please contact the ombudsman.
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Those who need assistance getting dressed are going to have to be changed on a schedule because it takes staff time to get to everyone. Ask if it is possible that she be farther down the list, but recognize that it might be impractical if this is a large facility and that means staff would have to back track.

Unless she is in a shared room I can't see any reason that she can't watch the news or do whatever else she wants in her pj's, how exactly are they enforcing the 8:30 bedtime?

As medical proxy/POA you should have complete access to her medication charts and they can not give her anything not on the list, did she not take any medications prior to living in AL? Might these not just be her usual medications?
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thepianist Jan 2020
The staff schedule should not dictate care quality. We cannot accept this, we must demand, yes demand, adequate staffing so that the needs and preferences of the residents come first. Most care communities today say this in their lofty mission statements. They just don't walk the talk.
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My mother lives in Memory Care too. They get her ready for bed around 8:15 pm ...into her nightgown and washed up, etc, but she can stay up as late as she wants. You should know what meds your mom takes, as I do mine. The aide may have been speaking in generalities to you, saying that after the residents get their meds, they're tired....not necessarily that your mom gets meds etc.

With dementia, lots of residents tend to sundown and worsen at night.....they wander and roam the halls, knocking on other residents doors and things like that. The caregivers do try to get the residents into their rooms by a certain time to minimize the chaos. But your mom has rights, of course, and shouldn't be prevented from staying up as late as she'd like....even if the tv is loud. They're ALL loud!! Lol

Anyway, make sure you have regular care conferences with the staff and admin so you can express your concerns and get questions answered. You can call the nurse or the Exec Director any time, as I do, to chat or to ask for changes or whatever you'd like. Make your wishes known.......its always a good thing to do. Get a list of her meds, too, and be sure to ask for updates and calls from the doctor after a visit. That helps a lot.

The other thing to do is to fact check what mom tells you. With dementia, they tend to have LOTS of stories to share, many of which are fabricated. I've listened to my mother tell me about her friends boyfriend who comes to visit naked......I used to get my stomach in a knot before I realized the need to sort the bull from the crap. Obviously, there is truth being told also.....you just have to figure out when! 🤣

Best of luck
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Riverdale Jan 2020
A perfect reply. I can understand the time frame for helping a resident get dressed for bed but it is very wrong to have a bed time insisted upon and that issue should certainly be brought up. My mother in her present AL facility completely keeps her own sleeping times and is allowed to do so. I have even heard that some residents have the TV on late which I feel is a bit wrong if the volume is up so high that it keeps others awake. I would also be concerned if all residents are given the same sleep medication. They are not in psych wards.
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An Assisted Living is a residence. Your Mom is renting her apt/unit. Aides are there to assist. The one my Mom was in did get residents "ready" at a certain time. Getting them in their rooms and dressed for bed but not "in" bed. They can stay up and watch TV, read, go to the common area to sit in their PJs. The aides should have an idea when a resident is usually ready for bed. At that time they go back and help them get into bed. If Mom is paying to be helped to get dressed, that aide needs to do it. I think u have a lazy aide. RN, her boss, and is probably leaving by dinner. You know the saying "when the cat is away the mice will play"

Yes, I would question with the RN why Mom is getting a pill before bedtime. There has to be a prescription from a doctor for it. If you find it is a sleeping pill and she has never had one before, I would question it. I would also bring up the incident with the Administrator. Your Mom does have the right to get up when she wants, eat when she wants, and sleep when she wants. Yes there are meal times but she doesn't have to go. Just not sure if they have to feed her at any other time. She has the right to have her meals brought to her. My Mom had a kitchenette with a small fridge and microwave so she could cook if she wanted.

If you get no satisfaction, I would start looking for another AL.

By the way, a CNA cannot dispense medication unless they have training to be a Medtech. Otherwise an LPN or RN gives meds. If u find that a CNA is giving these pills, I would report it to the state.
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lealonnie1 Jan 2020
Not all ALFs bring meals to the residents rooms for a variety of reasons. Memory Care units do not have cooking supplies or microwaves/fridges at all. Memory Care sectors of ALFs do not function the same way regular ALFs do. For instance, my mother is brought out to the activity room in the morning where she stays until dinner time unless she's not feeling well. She eats there too. They don't want the residents holed up in their rooms all day and isolating, etc. The rules are firmer in a Memory Care environment due to dementia being SO tough to deal with. The stronger the routine, the better the resident thrives
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Pr0f3ss0r, one night I was visiting my Mom at her long-term-care facility and we were sitting in the common area. Around 8pm I saw the nurses and aides getting the residents at one end of the hall ready for bed.

Then as the nurses and aides were half way down the hall, some of the residents who were already in bed started to wander the walls. The nurses and aides once again put those residents back into their rooms.

Before the Staff had finished at the other end of the hall, it was like herding cats, trying to get those back to their rooms for the 5th or 10th time. I overhead one nurse say "Lord, give me strength".

So it is understandable why residents are turned in early. At my Dad's assisted living/memory care, he was in bed early but he could watch as much TV as he wanted, as long as the sound wasn't too loud.
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