Memory care facilities. Do I report these concerns to public health?

Please understand that there is a severe labor short right now. My MIL's well-run facility is having a hard time finding/keeping staff and recently sent out us a letter outlining how they have raised wages and are giving signing bonuses (this will translate into higher rates for residents). Mandating covid vaccination is also an issue in hiring people. As best as you are able I would keep a closer eye on your LO for the time being. Yes you should report the concerns (but not sure it'll go anywhere if they can't find eligible staff).

Public Health can't solve staffing shortages. There are shortages everywhere.

I don't see anything the facility is doing wrong. Why would you report them?

Don't confuse your distress with his natural decline with mistreatment. If you have issues with him being constipated and having skin issues (tears, I assume), those are for the hospice nurse to address. If he's dehydrated, the hospice nurse needs to address that with the MC staff.

Your concerns should be discussed with the Hospice Nurse. Hospice should be a separate agency not part of the NH. She should be seeing him 2 to 3x a week and available 24/7 by phone. The things you describe happen as the person's body starts to shut down. The person may not feel thirsty or want to eat. And if they do, its very little. And the skin breaks down. The nurse should be able to answer any questions and concerns you have. She is there for you as much as for ur husband. They should have grief counseling too.

Rainbo

I am sorry for your husbands decline. It’s so good he can still see your face among all the others. I hope you are feeling better these days and that your health issues have stabilized.

What level of management did you complain to? Was it while in memory care or before he was moved? Did they follow through on any promises made?

If the public health department is responsible for overseeing the facilities then a letter expressing your concerns might make you feel better and assure that department that their over site is especially important in this time of labor shortage. They are keeping their staff up, just not the consistency of the same nurse you would like to see. It could be that they are already following the state mandates, just not the level you know is best for him.

The agency care might not be what you signed up for but at least it’s care. I’ve seen it suggested that a gift of refreshments can brighten the staff of facilities and might be something you could manage and see more immediate results for your husband. Maybe take a photo of him and position it with the treats. “From Paul, Room 12B”??

I spoke with a woman opening a new bed and board home a few weeks ago. She was mentioning how the local fire department had restrictions that were more strenuous than the states and was delaying her opening. I thought about how good it was to know that the fire department is plugged in to that degree. When I asked about staffing she agreed that she could only open a small number of beds until she could increase her staffing. The problems are plentiful for all concerned and it must be a fine line for authorities to manage to monitor and not impede needed services. Oh and the owner of the B&B wasn’t complaining so much about the local fire department as just wishing she had known earlier that the state guidelines weren’t sufficient for her location.

I deal with a bit of the same thing as you on the changing staff. My DH aunt, 94, dementia on hospice at home seems to have a change in her RN fairly often. However her CNAs have been fairly consistent and she reacts much better to the weekday CNA than the weekend ones who are on rotation. They come daily so it’s hard for me to complain at this point. The nurses get a bit of push back as she doesn’t know them and only sees them once a week.
She has two private aides that she sees daily that she much prefers. We also have to deal with constipation which she has a long history of but being mostly bed bound and on occasional pain meds contribute.
They all note on a file if and when she has had a BM-S.M. Or L. They pretty much leave it to me as to what to do about it. I monitor the water but notice that she is very good about staying hydrated.
As your DH is on decline his system may be slowing down. So you are juggling a lot of factors.
Make it a point to get to know his hospice nurse. Did you choose the hospice or were they recommended by the MC? The problems you are having seem more hospice related but then I have very little experience with facility care. Maybe a conversation on who is responsible for what would be helpful.

I hope your husband gets the care he needs and that you realize that you are doing a good job advocating for him. You didn’t create the circumstances and have little ability to change them but you have him in your heart and that’s a wonderful thing for the both of you. It must be hard not to do more as you watch his decline. He is so lucky to have you.

Thanks everyone for your thoughtful and helpful replies. I think I'm still working through the guilt and sadness and your feedback helped me put things in perspective.

If you think they are actually being negligent, you should get in touch with your state's Long Term Care ombudsman.

Unfortunately, when we see our loved one's decline, it is not always somebody's fault. But it is heartbreaking, nonetheless.