What problems have you seen in Assisted Living?

By and large, the place where my parents live provides very good care, has a kind and well trained staff, and does things "right" as far as I can tell. My mom is less cognitively disabled than my dad, so I think I'd hear something from her if there were any mistreatment of him going on. On the other hand she suffers from depression and frequent headaches, and for more than two years she stayed in their apartment almost all the time unless I came to get her for an appointment. They allowed my dad to bring all her meals to her and didn't do anything to help her participate in life. The other problem that I've seen is that as a big company, they're less than understanding about financial issues. When they got behind in their rent they were actually served with an eviction notice, which the director said was state law, but it seemed very cruel to me. On the upside, she's been readmitted twice after hospital stays, and this second time, they've taken her problems in hand and are now escorting her to meals, persuading her get dressed and helping her take better care of herself. We are paying extra for all of that though. I think the bottom line is that if you can pay, you can get good care in a good facility. If you're not a high paying customer, maybe not so much. (We'll find out soon -- they are going to have to switch to Medicaid in less than a year unless a miracle happens.)

My mom didn't go to supper recently cuz she had snacks in her room.
Someone decided to "check" on her at 2 AM in the morning!...with loud turning of door handle, clanging of keys to open her locked door...saw her in bed, (mom scared to peices sitting up in bed from the sudden commotion), the CNA loudly left when she saw mom was "alive" , exiting without a word!! Mom couldn't get back to sleep.

Thankful my mom gets checked on but geewhiz isn't there a better way of doing this ?!?!??
Yes mom should of told someone she was eating in room I guess... ?.I don't know 🙄

... another massive issue is the money charged for elder facility care. Let's talk of the straight up neglect and ignoring of the very large, very "kept quiet' elephant in the lobby's of every facility and every government office .. and that elephant is theft disguised as "charges for care given" by elder care facilities. 

 Aged Care facilities are now being given freedom to be owned and operated by private persons and corporations.. meaning they for the majority are no longer regulated on a state nor federal level... and in the same breath are no longer required to respect prices-charged limitations (caps.)  Care facilities, regardless the amount of actual care provided, regardless the qualifying or competent care, are being allowed and are charging gross and excessive dollar amounts per elder resident to the point a majority of seniors are having to enter the government "waiver program" (tab picked up by American citizens) to even afford a place to go i.e.; care facilities. 

No one questions the charges? Why do you think that is, and why don't we see facilities being hauled into jail or charges being filed or pressed for charging these gross amounts to our seniors or why don't you see owners of these facilities being charged with neglect or fraud or wrongful death, etc ... Yet! you do see actual care giver family members of the individuals being charged and hauled in for theft and elder financial abuse if the elders monies are ever used for the care or responsibilities of/for the elder by their own family. 

Let's say the residents rent is late or not paid for a month or two in a facility because the residents family is poor and cannot afford it, or because the individual themselves have some payments that were paid before the facility was that month etc .... guess what the facilities do the very second the rent does not get paid, the facility picks up the phone, dials the state and files and begins to press charges of elder financial abuse against the family of the individual and begins eviction process against the elderly. The elders family is then hauled in and charges discussed of elder financial abuse, they are then subjected to an extreme and embarrassing investigation of all financial records and professional and private info is investigated of the family and either charged or dismissed. ..... 
But if a facility charges 4K to 9k per month (shocking numbers) of aged individuals, and if physical or mental neglect/abuses or even death occurs, the facilities are never investigated (in the case of neglect or death, I would not call what takes place in these facilities an 'investigation held by any authoritative entities) nor are charges pressed nor are investigations held against the facilities

See a problem? ... curious to know the reason? .. the reason is, the federal government (as well as state legislation) sees facilities as a place to put the aged and they are willing to pay (to charge the American citizen) extreme amounts to these facilities to "keep them" regardless the quality of care provided (which is why they are no longer regulated nor state ran.) 

Our government Closes is eyes and ears on any wrongs of care facilities for that very reason. So if the facilities don't get their "rent, the closest family or POA is charged and forced to cough it up rather than any facility lowering its rent to a rational and affordable amount... so between the no fault death no fault neglect and no price caps or regulations... these facilities are not what I would call anything close to integrity based companies across the nation.... which is why I say if you actually care about the-person iving in them, keep your eyes and ears open, for the sake of the one/s residing in them. 

If you are unsure of what I've said here, do your own homework, call you're state check their processes. Check what recourses (meaning actual steps you can take and what actual penalties and legal repercussions will (or will not) occur to your facility in the event something does happen) ... check for yourselves in your own area in case something does happen to your elder. 

See, that' right there is what's wrong. Why is a call light there, and are we not dealing with aged individuals who need assitance, yes. ASsited living means exactly that, to asssit in daily living... it is not independent living. (I need to disagree with meds being dispensed properly comment, when facilities have 5 to 7 hour windows per shift to dispense there's no way in the world medications are being dispensed correctly. An individual can end up  receiving meds that are prescribed for a reason to be given 3 times per day over a span of specific hours p, when they could actually be getting them very close together or very far apart ..and this occurs across the nation in these facilities. For instance "metformin for diabetics, needs to be given specifically approx. 30 mins before meals fir very specific reasoning, the facilities own "supposedly regulated window of dispurment per shift does not allow for proper medicating for that one medication, and that's one example.) ..

It's the facilities faults who begin to degrade and fail actual care to the individual and start using the excuse that an individual suddenly needs a higher level of care, when it's actually that same facility who had accepted the individuals under their  original needs specified. 
But it all changes when neglect begins to be found and brought up or investigations begin ... that facility then back tracks the initial accepted care when the facility itself is at fault for having poor staffing, poor or zero training, etc ...when complaints are filed that's when they start using the "the individual needs higher level of care story, when in all actuality the individual needs "competent care at any level ... there again, there is a difference between higher level and competency. 

Every Assisted living facility can be different then the next regarding a few levels of actual care provided. It's when the facilities accept individuals and their money under the original understanding and agreement of specific care to he provided, and then that same facility becomes incompetent of agreed-to care. 

Barb
I gather rocketing is toileting but I got a good laugh with the image of some pesky old man being sent to outer space 🚀

Assisted Living is not a place for someone who needs an instantaneous response, at least that's how I see it. AL means that your loved one's meds get dispensed correctly, that they get assistance with bathing, rocketing and grooming and that if they don't show up for a meal, someone checks on them. It's much safer than living alone, but less attention than your parent gets living with a 24/7 caregiver.

Another way I've spoken to others when comparing the "integrity and competency" of facilities, is this... I ask "would you leave one of your genuinely loved children there 24/7, and for years. Yes or no. I am not comparing our elders to children, rather I am comparing the actual feelings you may have for your elder and whether or not you "actually care of their "care ....

.... and in all due respect to the one commenting that " no place is perfect".. you are correct, but there is a difference between competent care and incompetent care.... and the difference is and can be between life and death. 

Any facility, no matter what title they give themselves be-it Assited living or Memory care or Nursing home, etc... if any facility claims to have training and experience in the needs of your loved one at the time they accepted and signed your loved one into the facility, then those facilities need to be held legally and morally accountable when the care of those needs is incompetent, period.  I for one find incompetent care to be illegal and so should everyone from federal to state levels... for if they did, we would magically see "excellent care being provided. 

The difference of care issues can also be seen at levels between trivial and dangerous.. such as a laundry (some see that as trivial) but a business who's laundry department cannot even keep track of residents clothing to rightful owner, I will show you that is a facility that does not care about the residents belongings. Period. And I can assure you that lack of care does not start and end with "laundry.  A facility that does not answer call buttons and I mean "answer them" and fulfill residents needs (rather than just walking in the room to shut the light off then walkout, only to keep their logs showing response time is within reasonable time frames) is a facility that does not care about the "actual and genuine care" of its residents, again, I can assure you of that.

..and lastly, I will head off any "well you should see what these facilities have to put up with" at the pass. The one response from me to that very lazy and irresponsible excuse facilities and families that do not genuinely care of the individuals so often use, will always be responded by me in question form yet pertaining strong meaning;  "... is the facility caring for these individuals doing so free of charge, yes or no." ..... 

I'm surprised how low the fines are too
The ombudsman has been called a few times recently to my mom's facility and licensing has made surprise visits agreeing there was sufficient evidence to substantiate the complaint
Fine $100

Keep in mind that although many are expressing they are generally "ok with the facilities, keep in mind that your issues (the known ones) ...are usually serious enough to warrant at the least meetings and then investigations into these facilities no matter how friendly staff seems. Such as call lights not being answered or long lengths of time before they are, may seem minimal to you, perhaps, but reality is, if a resident is in actual dire need and all they have is a call light to press and that call light is not being responded to, that can and has often meant life or death.  

You should probably learn now that if a resident dies because of a call light being delayed or not answered at all, are you aware a facility will very likely only be charged a minimal fine, in our state the fine for the death of a person due to unanswered call light is $185.00 fine. Did you read that. So facilities operate-without fear, one could go so far as to say they can cause or be involved in the death of a human and get away with it. Aging care facilities tend to have dual personalities, one when you're there and then the other when you are not. So even smaller issues need to be attended to regarding the ones you love or care about when in any facility, and if you do not take their issues seriously then they are not "actually being cared about. And that is exactly why we have very little regulatory statutes regarding aging care facilities.. because very few actually care enough about the one in the facility to ever first monitor the facilities and second do somthing about the issues when found. 

I have experience with a regular AL for a few months. Then, a Memory Care AL. I am more impressed with the MC, because they are more equipped to handle my LO's needs. They know how to manage dementia behavior and to take care of those who are not able to communicate their needs. I think that problems with a facility often arise if the resident is in a facility that does not provide the appropriate level of care that they need. 

My issues with the the regular AL was that they seemed to have a problem with medical transport and even though it was their job to provide her transport, they claimed they were not available, much of the time. (Already booked up.) So, I had to transport. This is huge for someone in a wheelchair and when I was self employed. I should have complained more, but, didn't have the time. lol

Regular AL was clean as a pin and had impressive daily activities, LIVE entertainment several times per week! I attended a lot of the performances. Awesome and varied meals. Downside: I got the feeling that their was miscommunication with the staff between themselves. They were very observant and caring to the residents, but, didn't seem to be well trained in handling dementia behavior, so would call me to address it. Too many calls for things they should be able to handle. 

Memory Care is also clean as a pin and more equipped to handle dementia patients. Laundry issues though. And, this sounds petty, but, I have arrived to find my LO's radio playing a station that she would not choose, EVEN though, I have made it known what music is to be played. I find that frustrating. But, she is kept clean, well nourished, well groomed, safe, and always seems to love the staff. She has told me that they are good to her. It's a small, family run facility, so, we are all on a first name basis.

Both places had regular volunteer visitors from churches and civic groups who visit, provide gifts, parties, etc.

No place is perfect, but, I think that I lucked up with some great facilities.

My father is very happy at his ALF. His big complaint is response time when he " buzzes" for help. Not enough staff.
I am going to meet with Head Nurse and review the time logs. This facility is one of the nicest in our town, and I am going to let them know what our expectations are.

... thank you for speaking candidly Madge .. I very much respect that

I have no
Experience with an ALF other than mom's memory care which is a specialty ALF

I have continually been underwhelmed by what they deliver versus what they promote

Several folks in the past year have been moved out by their loved ones following falls or other incidents

Mom is a handful and I have personal caregivers with her 12 hours a day

Her doctors recommend this place which is well known and say there are so few options

She's not ready for a SNF yet so I do what I can to see she is safe however I can't afford the private caregivers indefinitely so we take it day by day

Not sure if she needed oxygen I would attempt to keep her there

Moms stay at an AL was OK. I had my problems but I am OCD and have a problem with why people have no common sense. ALs are limited in their care. Mom is now in a NH. So r two of the former residents of the AL. Both are doing better than at the AL. Mom will not get better but is clean, fed, and well cared for.

Like any care facility, they r short on help. The one experience is really extreme. I would have reported that facility to the state. CNAs are not nurses. Maybe they were given responsibility they weren't trained for. There should be an RN in charge and an LPN as backup. Here in NJ Medtechs, besides the RN and LPN, are the only other people who can administer meds. Changing meds is a no no and should have been reported. What is to say the CNA was not using them or even selling them. Records are kept and it's serious if records are manipulated. The State oversees all care facilities.

Well, so far Ive hear nothing but sweetness about Assited living although the question is "what have been the issues, etc. Assited living facilities are not free of issues. Complaints against facilities depend on a few things; 1. How much care does your individual need or require. 2. how long you visit to whether you see the issues or not. 3. If you feel safer to not look for any issues because the person is being cared for elsewhere and you do not want /or cannot have that change. It's the pick your battles decisions... but when it comes to safety of our elders, frequent visits and open eyes seem to learn the industry is not what it claims to be.

My Dad lived in Independent Living which had some Assisted Living options while he was in IL. Every now and then I would asked Dad what would he change about living there to make life better. He couldn't think of one thing. He was happy as a clam being there.

Even almost a year later when he moved into the Assisted Living/Memory Care wing, he had no complains. Oh, except for the monthly rent, but he understood it took a village to take care of everyone.

My Mom was in another facility long-term-care for 3 months before she passed. She had accelerated dementia due to a head trauma fall at home, she wasn't able to reason out anything, so I couldn't ask her what she thought or how was her care. Dad and his caregiver would go at noon to visit my Mom and the caregiver would feed Mom... just not enough Staff to help those at the same time.

One time at the long-term care facility, it was later in the evening and the Staff was trying to round up the patients to get them settled into their bed. But 2 or 3 of the patients would climb out and start wandering the halls, and the Staff would round them up, again.  And a third time.  One night was extremely busy, I heard one nurse or aide say "Lord, give me strength".

..sunny girl it is quite disturbing ... and the actual factuality of many of those incidences were proven by other employees admissions of the facilities so I can deem them quite accurate. You know what the worst of it is,is knowing these things went down and only because I was there often was I able to be talked to and or questions of why asked. I think allot of those who are left in facilities and never checked on.  Now keep in mind an elder who needs little to no assistance (one who could actually live in an independent facility) are not going to experience the issues that those who do need help do. The amount of help needed clearly is the factor here within facilities. 

I don't have anything that approaches your situation. It sounds like there are major problems and there are so many of them. It sounds quite disturbing.

My mom loved her apartment in Assisted Living. She didn't get involved with activities much. She was always ready for meal time and always went down early. Just about this time last year she was moved to Skilled Nursing. She has thrived in SN, always involved in activities. Last week a few of the ladies were taken out for a ride and lunch on the facility bus . She gets great care and she loves the walk in bathtub.

..I'll start. Experiences my mother has had to contend in her history of Assited living facilities.1. Theft (Severe not petty) 2. Physically having her hand slapped by a director. An aid had exchanged her pain med for simple Tylenol (time frame of that is unknown due to the other aid that told us what was happening could no- longer talk to us), the one that had exchanged the meds did so by telling my mother "pain meds make you itch.  

An aid wrapped her oxygen hose tightly around her walker-handles in a puzzle type pattern creating the need to get to her knees to reach the 6 inches of hose they left for her to use to breathe with. An aid became angry and threw the breathing treatment mouth peice at her, then threw the remainder on the floor. Aids decided she walked too slowly to meals so they began to wheel her to all meals too and fro for 3 weeks. When they were discovered they then became angry and forced her to walk the entire distance (equal to length of a foot ball field one way) too and fro. (My mother stands 4'10, frail, 77 years old, suffers from COPD, short term memory lapse and 1st to 2nd degree dementia let alone having zero physical activity for 3 weeks at that point. She has suffered severe oxygen deprevation for over 2 to3 hours per event .. hypoxia began of purple lips and gasping for air no less than 5 times from aids not-changing oxygen tanks, also by their not operating oxygen apparatus properly by turning the tanks on or off causing oxygen to run out or causing zero oxygen to release .. when empty they have left her for hours at a time with zero oxygen, etc. 

They have caused extreme fall risk hazards by placing obsticals in front of her recliner (her seating of choice) including items such as up to 8 to 11 empty Oxygen bottles in her walk way while placing her walker in the other room. (My mother is mobile by walker assit only) so she is forced to sit until someone enters to help get her walker back. Sheriffs have been called on the family for the disagreeing that she was "not bowel incontenent. The facilty insisted she was, the family knew she was not and asked her records reflect truth of care needs. The facility responded by calling the authorities to intimidate the family to stay away. Certain aids Insist on "wiping her genital areas when she is not needing "toileting assitance. Again the family was degraded for interfering. Medications were left in room in cups rather than monitoring the ingestion of medication. The director "scolded my mother and insulted her for using too many urine briefs (although i was purchasing them not the facility. ... is that enough or should I go on.