I'm wondering how to find out what's reasonable and understandable versus carelessness or neglect in memory care units. It has been a real education since we got my 95 y.o. dad into one in January. I've spent my life trying to be understanding, and yet I find myself privately angry at this fancy place we are paying 13k a month for. I understand that working as a caregiver on a memory care unit can be like herding cats. I understand times are hard with staffing and there is turnover. I understand I understand I understand. But how much should you excuse? What's important and what do you let go?
I stopped by on my way home from work tonight and saw my dad sitting alone waiting for supper. Everyone else had eaten and had gone off to watch TV in the group area. Dad often orders something other than what is served everyone else, because he doesn't like the food there. I was told he had ordered fish and chips or a cheeseburger. They kept saying it's coming, it's coming... and 40 minutes later it still wasn't there. I went down to the kitchen to check and they were harried and didn't know what I was asking. I came back upstairs to let my dad know they were still working on it, and he looks so pathetic sitting there off in the dining room by himself with his elderly head hanging down still waiting for supper so long after everyone else had eaten. It broke my heart. I went down to the front desk in tears asking the concierge the best way to schedule a family meeting in the next week with the manager, and he encouraged me to do so.
I went back upstairs to tell Dad it should be here any minute and they finally came around the corner with a very cold plate of fish and chips. Another caregiver told me that staffing had been erratic that day and a person who is telling me food was coming had gone on her break.
What do you make of something this? I know plenty goes on when we're not there, but I can only work with what I witness. I know things happen. I know there is a possibility of displacing my feelings about his decline onto the care facility. I don't want to rant and have them mistreat my dad either.
What would you do?
I would definitely complain. Say it that you understand that they are busy but 40 minutes is a long time for a person to wait. Or maybe suggest that Dad come to the dining area 20 minutes before or 20 minutes after since he is making a different request. When my daddy was at his facility one client did not like sitting at the table he was assigned and would wait about 20 minutes to show for meal times. The personnel would know this and have his meal waiting for him upon arrival.
Check in regularly at different times of the day and week.
I don't know how close you are but I was practically next door. I checked in three times a day 7 days a week. And until the pandemic happened my daddy was fine - two months into the pandemic my daddy had to have a toe amputated. Never went back and would never recommend that facility. Blessings to you
The facility's staffing problems are not the fault of your father or any of the other residents.
They are collecting $13,000 a month from every resident in that memory care. So there's no reason why they should be under-staffed or have erratic staffing at any moment day or night.
Their shareholders being greedy for money is not a good enough reason to excuse anything.
You need to make your face seen and your voice known to them all the time.
Do not tolerate any excuses. Your father's meal should not have been 40 minutes late and served cold. If the facility allows the residents to have meal choices then they offer that service and damn well can properly serve up what a resident orders in advance.
Getting the meal served hot and around the same time as everyone else's is pretty basic and I would not overlook that is wasn't.
Your father should be kept clean, in clean clothes. His space and bed should be clean too.
His meds should be given as directed and in a timely manner.
His meals should be served the same time as everyone else's if they were pre-ordered. If they weren't then maybe there's some waiting time. Not 40 minutes. The kitchen isn't hand-breading the fish and slicing the potatoes fresh to make the chips. It's all frozen pre-made stuff.
Always keep the staff and administrators on their toes, my friend and never forget they're collecting $13,000 a month to take care of your father.
I dealt with this although in a nursing home and not paying as you are.
There are two ways I would suggest you handle this:
1) Talk to the administrator. Get answers. Write them down; ask him to send you an email with specifics - procedures, i.e., for meal ordering if not on the menu.
(It doesn't surprise me that it takes a very long time for the kitchen to prepare a special meal-find out the specifics by talking to the kitchen / food manager and/or the administrator of the facility.
* Find out the procedures for special request meals ...
* See if you can provide menus to them for the week - so even if different food from the status quo, they could be prepared to have it available.
The issue likely is staff - it takes one extra person to prepare special meal(s).
I was told that I could bring meals in and they would be kept in the refrigerator or freezer). Check to see if this is possible. Not an ideal situation, but perhaps better than how things are going now.
2) Document everything --------------------------
3) I worked with an Ombudsman for a long time.
I wanted care to be improved, not just report them. Others there couldn't speak up for themselves (and most others there didn't even have visitors/visits from family).
- I went 3-5 x / week to see my friend of 20 years. I was like a lion protecting her cub.
- After 'trying' to work with administrator, I finally told her (Ombudsman) to file a complaint with the licensing board of these facilities.
- Bottom line: I was also on the Complaint and they called me.
They do two unannounced visits and see what's going on. If everything appears in order at those two visits, there is nothing else they (can) do. Procedures in a private facility that your dad may be under a different jurisdiction of 'some' government agency. Find out which one it is.
3) Put your complaints / concerns in writing and ask for a written response from the administrator. First try to talk 'nice' although this is hard with knowing what is going on - this is why I initially asked the Ombudsman to intervene.
While it is (critically important)/ good to create a rapport with the aides who do the 'hands on care,' you also need to speak to the manager(s) / administrator. Aides do not make the rules. Some care, some don't. Unfortunately, I believe that this is true no matter where they are employed / even at $13,000 / month facilities. Facility charges does not translate into the aids making more hourly wage.
* I believe it is a national problem / dilemma to hire 'good' help AIDES / CNAs.
I would start with asking the administrator :
"What Can I do?
What can you do? Educate him (or her).
From my experience, there is little to NO communicate and/or NO Accountability between managers and line workers (or administrator and managers).
Good people leave facilities like this. I've seen it over and over again.
I hate to be the bearer of bad news.
You are in a position to move your dad to another facility (I couldn't do that).
Ask for references first (from residents' families), talk to social workers.
The breakdown is 'likely' with the manager of the aides - and their training (and lack of caring). For most, it is a job. Period. And it is hard work. There seems to be a national shortage of qualified aides / cna's, and this shortage is all over in other industries.
Yes. For $13T a month, you 'should' expect a good meal. Find out why it is taking so long. And, if you cannot go to check on things, hire someone for an hour 2-5 x week to check in to observe what's going on. And, contact your local Ombudsman.
Gena / Touch Matters
I took photos every time I went and saw situations that were inadequate.
Bottom line: Licensing Board of care facilities said I was a 'third party' and all of my documentation was not concerned evidence or - obviously - even considered.
I spent close to 7-8 months taking photos and sending them to the Ombudsman so she would have this documentation. I wasted so much time and energy although I really wanted the care to be adequate. I wasn't asking for anything special. Just water available ... change him ... help with eating as necessary. Basic stuff. gena
He may be doing short order meals, but tell him to go to the cafeteria area to do the order and to wait on his food. May help him get it quicker and still hot.
And, yes, a lot of things go unchecked when no one is observing - can even reach the point of neglect. Drop by at random time and see what's going on. You can bring up issues in a kindly manner because we all know starting off with anger gets you no where.
Now that mom has died, with all of my second guessing about placing her, I have looked back on my notes and it has helped me come to terms with my decision.
When you are in the moment, you do the best you can do. It is so easy to second guess when the stress from caregiving is over. So the notes helped during and after my caregiving ended.