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Not only does a (good ) nurse on duty help to identify and correctly address medical issues and falls , it can also be a deterrent to laziness by the other workers .
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CBuckle May 19, 2024
Good points
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I would never place a loved one in a memory care AL that did NOT have a nurse on duty 24/7. Period.
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CBuckle May 19, 2024
Not easy to find. Just one the the facilities visited so far.
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I think it’s helpful, also depending on the medical needs of your LO
for example, the other weekend I was out of town and on a sat my dad had a red and sore eye. There was debate about having him taken to ER, which would have been a big ordeal , especially without me in town. It turned out in the end to just be an eyelash in the eye. If there was a weekend onsite nurse , the nurse would have figured that out and solved it
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CBuckle May 19, 2024
Such a great example.
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Very few ALF or MC have an RN there regularly 9-5 weekdays. Almost all MC do have them on call and frequently visiting and checking things. Otherwise it is usually LPN/LVN and med techs doing the daily oversite, with the DON managing things, sometimes at more than one facility. So this is unusual. And I cannot to be frank, with good med techs and competent staff, imagine why 24/7 onsite would actually be REQUIRED or needed. I can see certain instances when there may be value in assessment of injury and etc. But nothing a trained LVN could not do as well. So were I to be paying a horrific amount increase, I wouldn't set much stock in it and I AM/WAS an RN before retirement.

Things vary WIDELY in MC especially.
So the question is one for you to ask each facility you explore.
RNs typically ARE present in SNF care.
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waytomisery May 19, 2024
Some have an LPN on duty at all times . I placed my LO’s in facilities that had a nurse (most often an LPN ) on duty on the unit 24/7. Each of these facilities I used had an RN director in the building during the week 8 hours a day 5 days a week and on call. This RN was not at multiple facilities, therefore she/he knew the residents well .
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The best care my mom got was in a very small home facility where the owners lived and cared for the residents. The other caregiver was an RN, who preferred that kind of work to her previous hospital work. She worked 5 days a week and was on call for weekends. There were a couple of part time aides who helped with bathing and cooking. The largest number of residents was 6. When my mom was there they had only 2 residents. Except for the nursing home toward the end, I always chose very small places for her. She and I did not like the corporate feel of many of the larger facilities. The problem with my choices was only that when she had to move from assisted living to memory care and then to nursing home I had a lot of work to do. But I'm still glad she was in smaller home-like facilities. In a memory care, different from the one I mentioned before, the nurse visited each of the 12 residents once a week and was otherwise on call. A dentist and a doctor came to the facility as well. Mom did not have to be taken out for those visits.
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TouchMatters May 24, 2024
These are called Board and Care. Homes where a person rents out rooms and cares for a small group of clients. They do not have medical staff on site. Although for all housing placements, it is necessary / important to ask about their services. Gena / Touch Matters
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Have you visited MC facilities? I visited five in my state and NONE had a full-time RN there at all! NOT required by the state. Memory Care is NOT a nursing home. They do not provide medical care, but you can hire medical(and dental for extra money, to come in and perform exams). All they do that is medical is give out prescribed meds. There are major differences between dependent care, memory care, and nursing home care. Hope you know the difference. Good luck.
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AlvaDeer May 24, 2024
I sure agree with you, ArtistDaughter, on the Board and Care model. For some it is wonderful. Often fewer people at 6 to 8, often family run and family in feeling, often better caring and better cooking and better all the way around.
My friend's Mom was in one and was very happy there.
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Give it a LOT of weight, but also check to see if there is an after-hours phone number that correctly connects to that nurse's desk. Many nursing facilities have an overnight nurse, but no way to reach her. Their phone number continues ringing at the front desk, which often closes at 5:00. It wouldn't even let me leave a message.
My loved one was suffering from delirium after very serious heart surgery and called me from his cell phone (in his room) eight times in a single night because he was panicked—he didn't know where he was and a lady across the hall kept screaming and making strange noises. I tried to calm him but couldn't. Finally, I got in the car at 3 am and drove 10 miles to the nursing home. I could see the nurse through the window but couldn't get her to notice me. And meanwhile my poor fiance was terrified but didn't call again so I guess he fell asleep. The next day I called the Manager and also out-of-town corporate management to tell them what had happened. They told me it is standard practice not to be able to call the nurse on duty after hours. If this is the case, that policy needs to change! They said the nurse made the rounds twice a night, but she didn't see my fiance and didn't calm his fears. It would have been so easy for me to call her and ask her to go check on him and try to sooth him, if I had had an after-hours number.
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24/7 RN is nice but you need to know if they evaluate before calling 911 and calling you first for complaints from your loved one. ALSO, it is really important to be able to have a video camera in the room of your mom so you can evaluate her movements and activities. It takes a team and I was very glad when my mom complained of chest pain, she was evaluated by the RN and they called me with the results-which were not indicative of heart issues. My mom has GERD and that is pain in the chest. I told them to give her a peppermint and she was satisfied and went to bed. THE last facility had 24/7 nurses but they did nothing preventative and I HAD to take mom to the hospital to get her evaluated. It was GERD!
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Is an RN there 24/7 or on call 24/7, big difference. At moms AL the nurse worked during the day 40 hrsva week. But on call the rest of the time.
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SueZ1250 May 24, 2024
AL is much different than memory care. I wouldn’t do MC without 24/7 nurse. Crazy stuff can happen in MC.
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Trust but verify. To verify, ask if the services they are boasting are in writing. If not, that’s just hot air. If in writing, you can refer back to it later if nothing is carried out as advertised. One of the places I looked at for my husband bragged that they would assign a caregiver to be with him in the yard whenever he wished to go out. I pressed how that would be possible when one caregiver was responsible for 10-12 patients a day? They didn’t have an answer. I crossed that place off my list pronto.
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strugglinson May 24, 2024
agree. often there have a "residents handbook" and they may give you a copy ahead of time, before you sign up/ sign contract. Take a look through those details
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