Assisted Living Memory Care Hygiene.

Sounds like all good advice. Glad to hear they "finally" gave your mom bath & shampoo. At my Mom's home I know that some of the residence will refuse to shower, change clothes, etc. The aid's do their best and the home contacts family if it gets way out of control. Even though the facility my Mom's in is old, I believe she gets excellent care. She is pretty mentally with it & "watches" out for other residents. She is a retired LPN and keeps on top of most things. I do hear toenails & fingernails. She is diabetic but must check her own sugars. Has had a couple Low sugars and I took her to her primary care Dr. & am working with him on this. This is a minimal care facility so probably things are handled differently. Once they become to hard for them to handle they help with arrangements to move to skilled care.

mom was 87 in aug.,and my brother moved her from nyc to nh in mass. near him-never allowed me to be recognized as her med poa and caregiver(which i was for the last 12 yrs since mom and i lived lose to eachother in nyc)
her last ac1 report was in march- and i was told they do not do any kind of blood test unless dr feels a need for it- i was told by the nurses that she no longer will need blood testing-that makes no sense- to me---they now take b/s 2 x a day 1st one is in the 100's, the 2nd is 2-300 and has een for months-which the just give her insulin- she is given antipsychotis-zalprexion(?) which say not good for elderly with dementia-raises b.-and she never was examid=ned by a neurologist- because he said she was too medicated(was on haldol at the time) and needed to have her meds lowered)shes had diabeties for about 20 yrs-i was her advoate and went with her to all appts., when she was still in nyc.i was opposed to her being taken away to mass- where she would be isolated from her many friends-and me- and i was also told i no longer was her med poa, and that i had nothing to do with her care anymore-
which is rididulous-since i new the most about her history-my brother lied to me, since i finally was able to find out and got permission to see the POA medical- (which he never would show me -duh- it never existed -!!! i should have listened to my gut)so i found out i wasnt taken off, not the whole time-until she was moved to mass-where he has taken over everything-and make it difficult for me to be taken seriously or be respected- "i was refused info for months ,being told i was not authorized- which was outrageous- and finally after many calls to the dotor- who was very sympatheric to me, but since brother was acting as poa of everything, financil payments and info- which btw, i have never been allowed to know anything about ie-- ins.finanaces,and now cannot get info on her will,legal documents, or where any of the things that were moved out of our apt.55yrs mom lived there-and i was never told or allowed to participate in the closing of the house.but -sorry for ranting- im just so angry and frustrated with this situation for many many reasons- i feel abandoned,dismissed,degraded,like i no longer count as part of the family- and we both know that isnt what mom ever asked for- although i was made to believe different by my revengeful ass of a brother- sorry- sometimes i just explode with pain , how he has managed to exclude me- and try and tell people i muts and make himself sound so wonderful-he doesnt have a clue about so much-
did i metion for the first 6 or so months, her bs was tested 1 time a week? tuesdays i was told-
what happened to every day- 2 x ?i remember we always watched her bs levels-
someties i feel like he is glad she put away-and not longer his burden - and that he couldnt wait to put her away-he just plays the role of concerned- but doesnt seem to have any insight or creativitiy about what to do. mom and i were closer in med beliefs-
she has aphasia- but i still can make sense at times at what she is trying to say- i understand her babble- i am her 1st child -of 63 yrs, and we have a special bond, which has been put in jeopardy-
again, i apologize for going on and on- but i do feel a bit better-
thank u sweetie- i needed to vent- now i am ehaused-its done such a job on my health- moms move and his takeover-
at least i managed to get the elder abuse omsbudsman -at some mass aging office- in the state of mas-to agree to chk on her 1 x a week- they cant do much- because of their time,and her aphasia and dementia is advanced-no one understands her- but me- and i think the staff at least knows someone is very concerned about her-so i guess i need to speak in length with the doctor-
it just is so draining- and i dont think i will ever get the anwers i need to know-
its a situation i have to just realize i cant do too much about- and that is hard-but i still try-u know-
it brings me to tears - the frustration of the managed ment of aging,- but thank u for replying-i need a break-i just so exhausted -
love to u
k

Krnhersh:

By law, your Nursing Home has to keep a copy of Inspection Reports for you to look at. By law, they also have to have a toll-free number posted for you to call if there are any problems in the Nursing Home (Ombudsman). You could also call your local Aging Agency and Health Department for more info and help.

By law, you have the right to look at your Mom's Nursing Chart.

krnhersh, how old is your mother? Do you happen to know her most recent a1C results? (The test that measures blood sugar levels over a three-month period, rather than the immediate blood sugar level.) Is the second reading by any chance shortly after a snack? Does your mother feel any ill effects from those high readings? I would think that the goal would be to prevent the reading from getting that high, rather than giving a shot after-the-fact. But I wouldn't necessarily panic until I knew the other factors I mentioned.

Some medication does increase blood sugar. But if the medication is the most effective for whatever it is treating and there isn't a good alternative, then doctors may have to pick the lesser of the evils. Treat the problem. Deal with the rise in blood sugar. Unfortunate, but sometimes there are no perfect answers. Is Mom going to be on that medication indefintiely, or is it for some condition that is expected to clear up?

My suggestion would be to educate yourself a little about diabetes and its treatment (American Diabetes Association website is good) and then schedule a meeting with the Director of Nursing and ask about your mother's treatment plan with regard to her diabetes.

Krnhersh:

Nursing Home has to keep a copy of Inspection Reports for you to look at. They also have to have a toll-free number posted for you to call if there are any problems in the Nursing Home. You could also call your local Aging Agency and Health Department for more info and help.

By law, you have the right to look at your Mom's Nursing Chart.

sorry major spelling error- but i forget to re read before i send-and i tend to get a bit emotional when dealing with moms care-

(pressed send too fast) who to address my concern of moms high blood surgar levels at 2nd checking- late afternoon i thing-- ishe is diabetic- and its een over 200-300 for months- all i am told is if its high she will get a shot-
but long term effects are what? medication she takes ups blood sugar- why hasnt that been chked- should it be? or do they just go along and consider it her normal
and onl get upset if there is a major crisis????
k

who do u contact to get the results of inspections -the state -city-county depts of the state they r in?shouldnt there be someone on staff in the nh facility that can supply that info?otherwise how would anyone trak or be aware of whats going on withthe inspections?
thanks
k

Thanks everyone for taking the time to answer. This is a Memory Care unit housed in the same building as regular assisted living and a nursing home, but separated from them with locked doors. My Mom calls it "jail". Lol.

For the most part all of the CNA's are wonderful. There are a few "bad apples", but most are very good.

Bathing/showering, dressing, tolieting, medication administration by a Nurse from the Nursing home are all part of what my Mom pays for and why the cost is so much more than regular assisted living. When we brought Mom here a year ago, they were doing all of this, but in the last six months, care of the residents has been lax. The 3 meals a day have improved though, after they received a bad grade from the Health Department!!!! There have been some medication errors also, which I caught , and worries me constantly.

We are looking at a newly opened facility dedicated exclusively to dementia/alzheimer's residents. I have heard good reviews this one is top notch with individualized care plans for each resident, nurse follow-up meetings, many more activities designed specifically with the resident's likes, dislikes, and abilities. Am keeping my fingers crossed and will let you know how it goes.

The good news is looks like the Nurse/Supervisor I complained to finally got the message, as when I picked my Mom up on Saturday to go out to dinner, her hair had been shampooed and she was clean. It's a good thing as I had an appointment this week to see the Administrator (her boss). If she had not been bathed on Saturday, I had also planned to take her to my home and do it myself, which is not easy as all baths, showers are on the second floor. So, I am happy they had done it. I trim her fingernails and toenails frequently too.

Thanks again for listening.

Very good insight, TheirDaughter. Thank you for sharing.

This is a difficult issue for everyone. My parents are in a wonderful AL facility, but they really struggled to get my mother bathed! However, they were good enough to talk to me about it so we could come up with some ideas. At first I was appalled to see my mom in dirty clothes and her hair a mess. But, soon I realized that I needed to get a bit more involved and now things are a lot better.

My mother also has dementia and it was a challenge for me to get her to change her clothes! At one point I got her to change her socks and almost fell over when I saw how long her toenails were!!! Everything I wanted her to do that had anything to do with personal care was unbelievably difficult. I felt like I was walking through quicksand.

I'm not excusing poor care, but I cannot imagine having a lot of people to care for in that situation. Also, finding good help is difficult in most situations so I can only imagine trying to find people who are willing to deal with the elderly who are pretty much like children, but bigger and stronger!

We're in a situation where people are living a lot longer. We're good at keeping people alive long past the time when they are functional and as their relatives, children and friends we feel guilty for not making this time in their lives totally comfortable and acceptable to us. We are putting ourselves in that situation and seeing how horrible it is, but to be honest (and I know this sounds pretty horrible) how unhappy are they?

I'd be a lot more worried if I found my parent sitting around in dirty underwear and sheets. I'd be upset if my parent was in pain and left lying on the floor, etc. You also have to remember this is "assisted living" and they are not going to be there for everything at the exact moment your loved one needs it.

I'm telling you this because it's easy for me to get upset, too. I've been concerned a number of times because I felt as though my parents weren't getting enough attention. On the other hand, my dad fell one night and they tried calling me. I didn't hear my phone so they took him to the ER. Then they brought him back and he fell again so they took him back to the ER. They left me four messages I'm sorry to say, but I'm so grateful that they made the right decision without me.

Before getting upset with the staff, I would talk to them about what they need from you. What can you do to make it easier for them? I could be totally off base on this and maybe you've already done everything and more to make things happen. This is just my own experience.

Nancynurse, in your mother's care center, if a resident refused to shower on her shower day, what would the procedure be?

I'm sorry you are having this experience with are deplorable lack of proper hygiene. The home my mother lives in costs considerably less and all residents have a shower day and get a shampoo at that time. Other Hair care must be done by resident or by appt at in house salon or at the individuals private one. As to in between care residents are expected to do this on their own. Also aids only are in attendance at showers, but resident does her own. Find out what the procedure is at her home. It was made very clear that this was "assisted " living that the resident would be provided meals, but has to go to dining room on time, would be helped with shower and hair for safety, but had to do themselves and would be given oral meds, must do own injections. Many people think assisted living is the same as skilled care like a nursing home and get upset by the seeming lack of care. Be sure your mother is in the right type of care for her needs. If this is the case,(improper care) your state Health dept. should be informed so corrective action is taken.

You don't have to browse too far on here to see that bathing and shampooing seniors, especially (but not only) if they have dementia is a huge challenge. If residents are getting good bed bathes and dry shampoos, that may be the reason. Seems unlikely, though, that the entire unit wouldn't have some people who are willing to shower.

I think the first time I went to the head hancho I'd try to keep my indignation in check, and simply ask for explanations. Why hasn't my mother been showered? What do they do instead? How about shampooing? Hear their side of it. That doesn't mean you have to accept it, but first gather information, from the top.

How is the care in other ways? How is the interaction between the staff and residents? Is the staff patient? Do they wait for the resident to gather her thoughts and give her plenty of time to respond to a question, or do they always seem rushed? Do they pay close attention when they assist with feeding (if needed) or do their minds seem to wander? Are they sensitive to expressions of pain? How do they handle delusions?

If the standards of care seem all around dreadful, then looking for another place seems a better investment of time. But if they are pretty good except for this issue, then advocating for improvement, at least for your loved one, will be worth the effort.

Good luck.

Is this for just alzheimers patients? If it is, then getting them to take a shower might be really hard. It would be like wrestling a bobcat and giving it a shower. If your mother is pliable and willing, then that's a different story though. If I were you, I'd start rattling some cages there. Start at the top since everyone seems to be intimidated by their immediate superior, and go to the scary ones boss. Find out if it IS too hard to wrangle one of the people into washing, because that really could be the case. Doesn't mean it's right, but it might explain why they're dragging their feet so bad. But also, I personally wouldn't wait for them to wash my mother's hair. I'd be doing it myself, either in the shower at the sink or at the beauty shop. And you're right, she's paying a boat load of money so you should be getting some answers.