Who to believe? Mom or staff?

Isn't this situation awful? My mom does NOT have dementia. She tells us the same things about her NH. When I address them with staff AND administrator, they try to tell me my mom is not really aware...but she is and I see these things happening myself when I visit. My brother used to be a second and third shift supervisor in a plant. He told me that if I think first shift at NH is slack, I do not even want to know how staff on second and third shifts ignore the patients. Wish i could give advice to you, but cannot even solve for my mom.

If you witness this happening, go to the Charge Nurse and ask why her staff is not responding to a resident’s needs.

Who to believe? With early dementia the truth is going to be somewhere in the middle, take everything she says with a grain of salt but watch for real evidence that you can act on. And in case you aren't aware, most AL's only have a sketeton staff in the middle of the night so they aren't likely able to keep on top of things if more than one resident need help at the same time.

You answered your own question. Your mother is in early dementia, and you know when she is "with it." You've witnessed the staff ignoring patients and defending themselves by calling their accusers impossible to believe. Find a better place!

I live in an upscale assisted living facility with my husband. I do not have dementia as he does. PLEASE believe your loved one! I have seen all of this and worse. If you don’t live there 24/7, you have no idea what goes on. Staff and administrators will tell you anything to shut you up. You can report to them all day long, but what you get is excuses, denials, and empty promises. You need to report to the state officials first. Even The Ombudsman is useless because they have no authority. And many times they are buddy buddy with the administration. Get yourself a good lawyer. Document everything. Put a camera in the room. Talk to the other residents when caregivers are not around. SPEND MORE TIME there. We have a crisis in this country. Yours is. It the only facility where both subtle and blatant abuse is occurring. It needs to be exposed. Talk to your state senator. Encourage him/her to push for legislation that will protect residents in these facilities. If a facility decides that you are being too vocal in your complaining, they can just send you a letter saying , “We can no longer meet the needs of your loved one. “. They will tell you you have 60 days to vacate. They do not have to give any reason for their decision, but can just make up anything they want for the record. If you can afford it, get your loved one out of there and bring them home. Hire private caregivers to help you. Put cameras in the home. Even if you have done a background check, if the person has never been caught and prosecuted, you don’t know what they might have done. We have a broken system in our country, and it needs to be fixed! These places are businesses, and their top priority is making money. PLEASE help all of us!

I would send a letter to the administrator with specific occurrences that you have witnessed, include the information from mom and be as specific as possible with information, generalizations will be ignored. Approach this with an attitude of belief that they didn't know that this was happening and you are bringing it to their attention, as you know that they would never allow this neglect knowingly, be sure and name the people that have been told by you and how they dealt with it. Be specific and name names when able, keep your feelings out of it, don't say it made me feel, say this is exactly what took place when I approached nurse xyz, based on her response I decided to notify you of the situations that I have personally seen and have been personally told about. We all know you would never allow this type of treatment to the residents. This type of approach usually hits their pride and I have found it to be more effective then other approaches. If you hand deliver the letter, ask whomever you give it to to sign your copy and print their name with date and time, so you know who to say signed for delivery. Nothing more frustrating than I never received that letter, can you resend.

Another poster said that they may kick your mom out and that is true, so be prepared to have another place willing to take her and get her records as soon as you see there is a problem, they would stoop to falsifying the records.

In the mean time, spend as much time as possible during the problem times, ask for help when you see groups of employees and write down their names so they can see you are taking notes.

Send a letter to the Department of Health Services and ask them how you can get help addressing the neglect of these residents. Explain that you have approached the proper line of command as you understand it and they deny what you have personally seen, blaming the residents medical condition on the neglect.

Please let us know what happens.

I have witnessed staff at SOME of these facilities congregating and chatting and laughing loudly while the needs of the residents go unheeded.

Please believe your mother.

The loud laughing particularly irks me. Some of the residents are in dire needs. Laughing while working at one of the home's stations should be kept to a minimum.

I say believe your loved one. When Mother went to NH for rehab after breaking hip, I stayed with her day and night for three at because the first week she fell twice and I was not informed. When I said she needed to go to the hospital to be checked, the staff doctor, head nurse and administrator did everything they could think of to talk me out of it. One of the more ridiculous comments by the head nurse was that the hospital would probably want to do a CT scan and "those post a risk of brain cancer." I told her, "Okay, so we can risk her MAYBE getting brain cancer years from now, or MAYBE DYING in a couple days if she has bleeding on the brain and we didn't know because we didn't have a CT scan?" They had her transported.
During those three weeks I witnessed residents asking for by help and being ignored; residents being moved roughly; residents being spoken to with disrespect...
I'm sure they were glad to see me leave, because they knew I was watching, and the time I was there they had to be more mindful of their actions.
Believe your mom...

Wow. This is awful. I get upset over small things I notice in my mom's assisted living because I'm there visiting every day at different times. I let them know what I've seen and they fix it, but they have been taking away and cutting back on some of the care, such as pedicures, entertainment, massages, haircuts, cleaning of the rooms, etc. because the rooms are not all filled right now. They don't tell me they are cutting back. I just notice. At this point I would not be able to believe what my tells me, but it seems you can believe your mom. Perhaps you do need to find a different place for her? Some larger places seem to have the most problems as I understand. The caregivers are not paid enough. Someone else is making the money, not them, so I suppose that might make them feel they should not do their jobs. I hate this sort of thing! I do think questioning first the caregivers, then keep going up the ladder of responsibility until you reach the top person. In our city there was an accounting for all care facilities because one place was found to be abusing the residents.

I'm so sorry, Renesmith!! Let's keep in touch, lift each other up!

I’m guessing it’s some of both. Obviously, do some research into the facility but my mother says all this and more and none of it is true. She started it long before she went to this facility, complained similarly about the last one ( til she had to move then it was the best place that ever existed lol) and about us when she was living in her home. It was one of the first thing I noticed about something being “ different ” about her personality . I spoke with her dr who told me it’s common. Not only with dementia but often just basically a play for attention from family members. It kind of reminds me of middle school behavior, us against them with the us being residents the them the staff. It adds a little spice to an otherwise dull day.

Staff gets breaks and are allowed to laugh. Do you see them really neglecting people or is it maybe they aren’t doing what you imagine they should? How do they treat the residents?

Early dementia also means they are able to communicate, and the possibility exists she is simply telling the truth. Nursing homes are horrible..families do not like to face the fact and like to believe they are getting quality care, but they are not there 24-7. Staff is not going to air their dirty laundry when visitors are around. Despite what people claim, institutionalized care is awful. One CNA for an entire hall of patients represents poor care due the amount of time it requires to adequately care for a single patient. The more patients one CNA has, the less time they have. Baths and meals are hurried, and if they cannot feed themselves, they simply chart "refused" so they lose weight. This is also how contagious diseases are transmitted from patient to patient so it is not uncommon for nursing home patients to have head lice, scabies, c-diff diarrhea and other illnesses. I personally believe all nursing homes should be shut down and family should care for their own kin. If your loved one is unable to get up and toilet herself, chances are she is not in assisted living, but in a nursing home.

You can either be there nearly 24/7 for Mom, Or Put her in another spot where she might get the Kind of Kind Care tha tis Known to go to the Residents that would Go There. My Grandma who died of Cancer, My grandpa was there all day and into the early dinner hour for her, Was treated Genuinely like a Queen and with the rest of the Family going all of the time, Never DARE a problem. You don't know what goes on really behind closed doors but I do know when Grandpa went to a different floor when sick(Same place as my Grandma)He was Not given the Kind of Care She had, And we caught them in the Act, of Not putting on the T-shirts Mom had bought him and even Snapping their Gum, Hun, And not caring where they left his eye glasses. Try going when No one would even Suspect you Going, Different times, Find out if You Can Catch Anyone, Hun, In The ACT.

My answer would be to collect some hard data that you can see before accusing anyone. When I would visit my father he would tell me all sorts of things and I would tell him that I will address it with the AL and he wouldn't want me to. I was glad I didn't because I later found out that his version of the events was not quite true. One time he told me they left him at a doctor's appointment for HOURS before they picked him up. The truth was he went to the ER (not a doctor appointment) and it can take hours to get a transportation service to run you back to AL. His concept of time can also be off, so an hour may have seemed like 5 to him.

I think what your mother is describing sounds perfectly believable. And you've seen it yourself.

I also, on the one hand, think "what about it?" There is always going to be a time lag before calls get answered. There is nothing especially wrong with staff interacting with each other, though if I were their line manager I would probably want to "have a word," as they say, about how.

But on the other hand what *would* worry me, a lot, is that the resident nurse is not listening. And is brushing absolutely everything under the rug of 'your mother's away with the fairies.'

So who is next in the chain of command? Up you go!

I believe your Mom. Memory Care homes often attribute residents' complaints of poor care to the person's dementia. While at times it may be true that the person with dementia may not remember correctly, way too often they are telling it like it is. If you come to the home often enough and at varying times you will see for yourself. Staff do sit and socialize among themselves when they should be attending to residents, this is a chronic problem. And these homes are short-staffed, therefore residents' needs go unmet for too long. Request that the home establish a family council so that families can compare notes on care issues. If the home won't do this, contact the county ombudsman. Please don't let this drop.

If you have witnessed the happenings at the facility that your Mom has mentioned to you, then these are probably realities your Mom are sharing with you of what's going on. I have had to speak with the managers of various facilities about my father's care. I have removed him from one particularly bad facility (which incidentally had an excellent rating and won an award)and I had reprimanded quite a few times two other facilities he was in for their lack of care and concern for my father's well being.
These facilities employ people who are sometimes apathetic, underpaid and "worn out" from the exhausting, routine and sometimes "thankless" job they are doing in caring for our elderly. They aren't perfect, but as long as our family member is not having bed sores, neglected, in danger or abused we may have to sometimes cut the caretakers some slack. Sometimes we don't have the time, energy or skills to care for our elderly and we put it off on others. They are doing the work and care that our parents did for us in our youth of wiping our butts, feeding us, helping us walk and bathe, etc.
If we can afford in home care for our loved ones, then we should let them stay with us. If we feel we have to place them in a home, then the best we can do is go visit daily or work out a schedule where relatives, friends, or church members visit on a regular basis. This makes the staff more apt to do their job better.

Believe your mom. You stated you have witnessed some of these events also. Your mother is very detailed about the occurrences and if she is able to repeat consecutively, it's happening. I would speak to the facilities administrator about the concerns voiced by your mom, visit her more often to observe operations, if more of the same continues, file a formal complaint.

I'm sorry to say but I do believe your Mom...Try going in on the Second shift after the supper hour is over with. There are some very caring Nurses and Nurses aids but believe me there are some that should not even be there.. I know this for a fact because I work in a facility and have seen it with my own eyes. If your Mother is starting dementia then she still has some of her faculties and I believe she is telling you the truth. everyone needs and advocate in a NH.. Good Luck

A long term care ombusdsman can access the logs and see if they are responding in a timely manner, and will get it corrected. Check with your state to find one.
not sure how to insert a hyperlink so copy and paste the URL below:

https://acl.gov/programs/protecting-rights-and-preventing-abuse/long-term-care-ombudsman-program

Weero and PiperLee have some good thoughts on this, as do others. If your mom had advanced Alzheimer’s, I would be a little skeptical but, even then, not totally. I am sure many of us have seen this problem. The CNAs have a very tough job, so I try to be charitable in my assessment, but, frankly, some CNAs absolutely should not be doing this work, as they simply do not possess empathy, and empathy is a must requirement for this type of work. The main thing for you is to be there as much as you can for your mom. And, go in at different times. That will keep the less professional CNAs on their toes, if you get my meaning. The head of the nursing facility where my mom used to be before her passing was recently fired. He was lazy and nothing more than a bean counter. Little to no empathy. Enough complaints were filed that he was fired. Sometimes that is the only course of action. If some lazy CNAs get fired, the hard-working CNAs will be grateful for that, as it gives an opportunity for more dedicated ones to come in. But, please always remember that the wages of a CNA are very low and the work is very very hard. Always try to be an encouragement to them. I even took some of the work load off of them when I could and would encourage you to do the same.

I have had a great deal of trouble with this very same issue. My mother will call me with remarkable stories of what is going on at her memory care facility. At first I believed every one of them and would bring them up to the staff, asking that something be done. They always had some logical explanation and I started to wonder whether the stories were just products of mom's dementia. However, I did happen to witness some things that bothered me when I was visiting. Dining room staff manhandling patients and yelling at them, pleas for help from patients that were going ignored, and staff congregating in their break room so they wouldn't have to deal with patients. I let it be known that I was noting issues like this and was not afraid to call the Health Department if need be. However, I have noticed that my mother is being treated with a little less kindness. It was wordlessly made clear to me that if I continued to complain, she would suffer for it. The latest issue is them charging an extra $2000 a month on her bill for "helping her choose her clothes and dress properly." My mother is not in need of this kind of help and I know for a fact they aren't providing it. My next move is going to be putting a nanny cam in her room. I know it's illegal, but so is billing residents for services that aren't being provided. Of the two transgressions, I'm thinking a judge would be more likely to be angrier about the overcharging.

Place a hidden camera in her room. Then record for a couple of days and see what happens. If what your mother says is true, it needs to be reported to the state ombudsman. Then look into moving her if at all possible to another facility.

If I had money to bet, I'd bet on mom. And I'd be very concerned and pissed about the nurse or whomever is blowing it off to Alzheimer's. How convenient. What it means is that those that person is responsible for supervising or covering for isn't or it's hard to find good staff. YOu can also get in touch with the long term care ombudsmans office.

I've had similar issues when Mom was in AL. There is a log that is kept when the emergency buzzer is pushed, or cord pulled. Insist on seeing the log - it should show you when (and how often) Mom called for help, and when, how (and who) responded.

Do not believe the staff over your mother just because they blame it on her medical issues. I witnessed it myself at more than one facility where my mother was rehabbing and tried to blame it on the paid meds (the same ones that I had told them to no longer give her).

Well, she happened to call me in the wee hours of the morning to tell me she had been waiting a long time to go to the bathroom and no one was coming and she thought her sugar was too low. The staff member showed up in the room and didn't realize I was on the phone. My mother was telling her she called me and the lady replied in a very nasty way - I told you not to call anyone and we' re busy - there's nothing wrong with your sugar. I told my mother to put her on the phone. The tone changed when I told the lady (and I use the term loosely) that I had been on the phone for quite some time waiting on someone to show up and that her sugar needs to be checked.

The sugar was low and she was finally taken to the bathroom, but by this time she had peed in the diaper they put on her when she came in to the facility. While they insisted there was two women working that floor, the one and only young girl that was there in the late evening told me, confidentially, that she was the only one on that floor for bathing/toileting each evening. After the state did a visit, I noticed all kinds of people working and the young girl explained they are always allowed full staff when state people show up. They also keep a sign out front they are hiring - again, this was to show state they are trying, but can't get help. This young girl was very believable because a day after state was there, all the adequate staffing went away and the young girl was told hours were reduced again for her as well.

I often found employees congregated at the desk while call buttons went off. I kept a notebook in the room and would write down what time my mother pushed call button and length of time for staff arrival. Quite often it was 30-60 minutes which is entirely too long for older people who cannot hold it that long. I took these notes to the management folks.

They even dropped my mom on day 2 that she was there and denied it. They did admit that she went from standing to on the floor, but said she did not fall. In my books, if you go from standing to the floor without intending to do so is a fall. This fall was not in her chart and never reported until I did so. The state came in after I reported it.

It is time for you to get some sort of camera/audio in her room so you can see what's going on when 'sane' people are not there. For confidentiality reasons, the camera cannot pick up another patient in the room. You will need to be creative in where you place it so no one knows it is there. Have some people stay entire days to time the call response. Also, ask for a copy of the med list and compare it to what she gets each day...look inside the cup and see what is in there, ask for names of drugs in the cup. Compare it to the list. Wrong meds and over medicating is another real problem and most patients don't question what is in the cup.

If you are lazy to begin with, this is a pretty good job to get paid for 8 hrs and only put forth a little effort for about half that time. No one is going to believe those patients who have some memory loss due to medical or medicinal issues so there is very little chance there will be an investigated personnel problem.

Medicare.gov lists all ALF's in every state and their inspection ratings. Check the rating of the one she's in now and find a better one. In the meantime, document and believe your Mom. Good luck

The other thing I would add here, not necessarily addressing this particular issue, is if you see drastic personality changes, insist on urinary testing. It is one of the most common reasons that facility patients appear to be out of their head. And for people diagnosed with dementia, my bet would be it is the last thing facilities test for because it's easier to just blame the diagnosis. Always rule out bladder infection. Don't assume everything is the dementia.

My mother has been in three assisted living places. All are very nice, but yes there are some bad apples, negligant, lazy, etc., ones. Usually staff turnover was high as good management got rid of the drift wood or they left because they couldn't or wouldn't make the change.
Always listen to your mother! You can tell what is real and not real. With dementia comes hallucinations, etc. Memory of past tramaus, fears, etc., can surface & connect with their present physical & emotional world.
For a while increase your visits. Make them short (couple hours) at different days and different times. Probably weekly.
So, you may visit on a Monday one week then Tuesday next week. Coordinate you visits with what activities they have going on. Be a part of that. Switch up every month where you may visit on one, then return next day at an earlier hour. Staff does put their best foot forward and play the PR thing to make it appear a great environment is present or over play act by being extra loving and nice to mother, etc.
Be very observant of things and other residents around the place, Ask staff questions like how is mother doing. Does she need anything. Of course you will ask mother, but by asking staff you will see what they know.
We always make notice of mother's fellow residents and we say hello to them and take a couple of minutes visit with them. Not all of them just ones who may make eye contact or wave to us or especially the quiet ones who look at you. Main thing is interact with them, give them attention and see where they are. We ask if they need anything...do they need water, etc. We may ask them how they are doing. Most time they tell us. If resident responds and needs something else that we can't do we ask a nurse, or go to nurse's station and ask for the resident. This pulls the staff's attention to them.
After a while the residents would willfully interact with us each time we came to visit. Amazing what they would tell us about the staff, persons, things, or just their lives....without us asking. We never ask them about the staff.
In our state it's law or mandatory, resident's loved ones have access to them 24 / 7. That is, if you wanted to come at 2:00am to check on mother for any reason, you should be able to do so. Additional, for review there should be a binder or some folder available to the families, visitors (public) which has record documents of outstanding complaints, infractions, violations, inspection results, etc. Read through this. You can get a good snap shot of core problems the place is facing or has faced. If staff happens to see you reading it...well, it does have an positive affect.
Most importantly, your relationship with the staff is vital. By getting to know them you will get a picture assessment of how they function professionally. Every place will have a difficulties even when the staff is doing their best. We have found that slack manangement is obvious for bad hiring and attitude of the staff. But most places with good personal management it still slacks of solid in house training / experience, which is core. They need to be given things to help them to be successful. Too many staff bring bad habits & experiences with them from other places they have worked. Our goal is to be what ever we can to contribute to their success in caring for our mother, in turn, to the rest of the residents. It's one big family! Having a relationship with staff they will accept our suggestions in how to care for mother and we can become a strength for them. Even with mother's dementia alzheimers her personality still comes through. Helping staff to get to know her is key. Another final key...getting to know the staff, you will come to realize ones who really care and those who it's nothing but a job. One thing is priority with us. We do not tolerate incompitance, rudeness, any abuse (verbal or of any kind), harsness, anything that intrudes or violate there will, dignity, physical person.

Karen in Texas,

If you know that things aren't right it may be time for you to move your mother to another facility and also report the negligence of the facility she is in.