My mother-in-law is in a nursing home. She hates it! How do you know for sure your loved one is getting treated properly?

Minstrel, there is much truth to what you say.......but--
There are some folks ( and of course this includes some people with dementia) who can always find fault with their living situation. They would be unhappy living with their child ( I'm bored, I'm lonely, I don't like your cooking) and they are unhappy in care centers ( I don't like the people here, I don't like the activities, no one pays me any attention).

As children of adults with dementia, it's important to find out what is actually happening and to separate fact from fiction.

I clearly recall sitting with my mom in her rehab center, where she said the aides were having sex in her bathroom, that she was required to pay for any help and that they were always transporting dead bodies around the facility. I was very concerned and spent the day. With a nurse sitting in the room, who had just given my mom her afternoon pills, my mom said testily " I have to manage my own meds here, as you can see". I sputtered a bit and pointed out that she'd just been administered her meds by a kind and caring nurse. Mom arched her eyebrows at me, gave me a "significant " look and pointed to her water pitcher.

I have NO idea what my mother was thinking. Clearly, in her mind, she wasn't being cared for. No amount of extra staff made a difference. No amount of reassurance did either. Dementia sucks.

How do you know she is being treated properly?

Well, let's start with the kind of grievance she's raising.

Use of a phone.
Early bed time (?).
Therapies not taking place (really? Sure? Sure she isn't saying 'not now'?)
Husband not handing over the money.
Being stuck in her wheelchair.

She is angry and annoyed at all of these things; but you know very well that the reasons behind them are not anyone's doing. They are part of the rough deal that old age is handing her.

If the staff were unkind or abusive.... If your MIL were somehow fading, in unexplained pain, withdrawn, fearful, over-sedated... THEN you might worry. The fact that she is so vocal on such a variety of subjects, all of which you know the background to, kind of proves that she doesn't have anything more sinister to worry about. But no harm in checking. Pop in to help with her next PT session. Have lunch with her one day. It doesn't hurt anyone for there to be extra eyes on her.

Just in case your husband doesn't already know this: this better NH she's so keen on. You can be sure as you're born that if he were to move her there, by sunset she'd be demanding to go back to the nice NH he just "forced" her to leave.

A good way to see how your MIL's being treated is to visit at odd times of the day and evening. And scatter your visits so there's no pattern to them. This might give you an indication of how the NH's treating her.

For example, go in the morning one day. The next day go after lunch. Then go around dinner. Skip a day or two. Then go after dinner. Skip a day. Go in the late morning. Etc.

Is she supposed to be getting therapies?

Do you or your husband attend her care meetings? What do the therapists tell you about her progess?

What time does it say in the notes they put her to bed? Your mother should be able to request a bedtime! That is clearly stated in the nursing home patient's bill of rights.

Please have your husband watch Teepa Snow in Youtube. He needs to learn how not to argue with his mom and say "we'll see what the doctor says", or " I'm working on it mom".

She has Dementia. Everything you wrote are signs of Dementia. To me it's sounds like she is bedridden. Agree, and it's hard I know, your husband has to stop arguing. With Dementia little white lies are good. You should be getting care meetings every so often. If you haven't, request one. Tell them you want more than 15 because you have questions. Good for ur husband he sticks by his guns. Until her Dementia gets in the last stages, she'll always want to get out. Keep in mind, they become like children. The brain is dying.

The five star rating that CMS gives to nursing homes means so little it makes me want to cry. I'll go out on a limb and say that no nursing hare is providing the care needed by persons with dementia, because they simply don't have the staff. They may mean well but look at how many aides are on duty to care for residents with all the needs of a frail elderly person with dementia and other medical problems. Nursing homes will tell you they meet the Medicare and State requirements for staffing--and they do, because these standards are so low, thanks to lobbying efforts of owners of LTC homes. I don't have a quick solution but I beg every family member to notice what is going on when you visit these homes and lobby your legislators to do whatever it takes to make these homes places where residents feel secure, cared for, happy.

Just to add to the above cautionary tale...you know what DID help? Getting mom evaluated by a geriatric psychiatrist. She was already on one antidepressant, which had been started just after her stroke. I believe once she was diagnosed with dementia, they upped the dosage and eventually added a second antidepressant to the mix, along with a low dose of an antianxiety med.

Mom was not doped up. She became calm. Not agitated and not set off by any little thing. She still had delusions that there were floods and that there was a union taking over, but she was calm when reporting all the terrible things that were happening.

My mom is in bed between 6:30-7:00, she’s tired. She attends most activities and is always strolling around in her wheelchair. When she was going to PT the Therapist always told me if I had any questions to call the Pt Dept. When I was working we (CNA’s) were called jailers...We were to have all Residents in bed by a certain time. We started with the Fall Risks. You could always ask if they could not put her to bed so early...

Grandmas suggestion about a camera made me think of something. My mom is still living in her home so I'm not sure if the NH will allow this or not but when she was last in the hospital with heart issues we set up an Amazon Echo Show in her room. We have tried Face Time with her but since her stroke she just can't answer the FT call easily and reliably (doesn't help that they keep changing the process), the Show allows us (people given the permission) to "drop in" like popping in for a visit in person. It was great in the hospital because it enabled me to be present from 300 miles away and my brother who lives closer to leave without fearing missing a doctor visit or something important since she isn't able to communicate well under stress or remember everything she is told if she hears them. It also seemed to be a great comfort to my mom who really liked having one of us there with her even if it was by video for lack of a better word. For several nights while I was preparing to make the drive to CT I stayed with her on the Show, not necessarily talking but just company like it would have been if I were there physically but she wasn't as concerned about my comfort or "putting me out" by being there in person. Lol, I remember one night they decided to move her to a different room, my brother had left for the night and I was hanging out with Mom on the Show, I was talking them through how to move me (the Show) which they did carefully setting me back up in the new room and adjusting things so I had a good view of Mom in her bed and she could see me as well. The staff including the doctors that came around each day seemed to really like it as well because it gave them someone who could answer questions and take in info readily available. My brother and I were able to check in to see if she was awake yet each morning too before ordering her breakfast and heading up to the hospital, the nurse or PCA would let us know if the doctors were even on the floor yet and when they were expected so we didn't rush up for nothing but we also had the back up of being there by video too so we never missed rounds which is really the key time for getting any info when you have someone in the hospital, I mean other than the nurse when you have a good one of course. I'm wondering if maybe one of these Echo Shows might help your situation Deej62 not so much to check up on the staff and how they are treating her, though it certainly works for that as well but maybe having family "drop in" often would give her the sense that you are around more and she isn't alone with these strangers who aren't treating her well. It might give you the ability to converse knowledgeably about things that happened during the day as a gentle reminder before she gets set on how negative it was or make the suggestion she might be tired and want to get ready for bed (or the person visiting with her does) when it's time, the problem may be that anytime feels early to her when someone from the NH is saying it's time to get ready for bed, you know that reverse psychology thing.

Anyway once out of the hospital we set the Show up at home and have since gotten a second one for the kitchen because everyone was liking the ability to drop in and see each other so much. Mom really like it too and for us it gives us the ability to check in on her visually if we can't get in touch with her to check and see if everything is ok. I have popped in and seen that she is napping on several occasions or found her asleep and used my voice to wake her up because she was over due for meds or needed to get ready for an appointment or something and the phone ringing wasn't waking her up. Sometimes it takes several modes because she's deaf in one ear and she is sleeping on her good one (which only has about 50%). I'm way off on a tangent, sorry. Maybe check out the Show set up and see if that might help you out, it might just be too foreign for her to get comfortable with too but my guess is it would be more easily received and acceptable to a NH then a security camera but I may be wrong about that.
Good luck, I know nothing about this is easy.

One thing I discovered in my mother's NH is that when I pressed the call button to get her some help, I discovered that the light in the hallway didn't go on, and the light on the panel at the nurses' station also did not go on. They suggested trying the other call button in the room (currently there's no roommate), and that didn't work either (only the small light where the buttons' cords are attached to the wall goes on). I mention this because one may believe the staff to be unresponsive when the real problem is that the "message" isn't actually getting to them.