Question about call buttons at memory care facility. What do other memory cares do?

My mom's place takes everyone to the bathroom two hours in order to avoid having the caregivers running around whenever someone needs to go.

They also have no call buttons, as I assume half the resident would be pushing them all the time, and the other half (my mother) wouldn't have the slightest idea what they're for.

Edit: I am surprised if his MC facility wouldn't have a red *pull* cord.

The head nurse station is your best bet. OR a hired CNA on the side-- perhaps paid for by the VA if he was a soldier and has at least 3 ADL issues-- assisted daily living ( I think--) My mother got around $1100 plus ( now $1144 ) for anything she needed help with-- an Eldercare CNA would come over and sit with her for more than a few hours. We used the whole thing on the nursing care. Also it is wise to visit at staggered hours to see if anyone is doing their job-- and--- eat with him once or twice a week -- lunch is best. See if her needs help while eating or if his plate is being taken before he finishes. A lot of times they end up spacing out and not finishing their meals. A CNA always sat with my mother and sometimes even fed her.

Imho, I would be flummoxed that your dad's MC facility would not have a red plug cord or other such device to alert the staff for assistance.

Can he use a male urinal in between the hourly checks?

Can he use the phone in the room to call front desk?

Once a person needs to be put in "memory care," they are past the point where they would understand how to properly use a call button or keychain alarm.

These places do put continent residents on a "toileting schedule." But as others have noted, they are chronically understaffed and cannot always adhere to it.

Can you, or another family member, stop by twice a day to assist him to the bathroom? That would at least help.

Usually residents with continence issues are put on a schedule. This means they are assisted to the bathroom every 3 hours while they are awake, Those who require incontinence clothing are usually checked throughout the night as well.

They may have just been to the bathroom, but seeing you they forget and it is one way to keep you with them for awhile. Also they may have not forgot how to use the bathroom. I know one who between 11 pm and 3 am would be up to the bathroom every 20 minutes before he finally got tired no matter who told him he had just been there. Some fear wetting the bed and finally get tired enough to sleep 2 hours.

Even if he has a call button it is doubtful if they would respond readily because most residents in those places just push the button because it's there. Most long-term care facility institute toileting schedules; however, due to high patient loads (like one CNA to an entire hall of total care patients) it is doubtful they are carried out.

Not a single one of my dozens of clients in memory ever used the call button.

Marydys, you have accidentally trodden on a very tender corn of mine!

The day before yesterday a client took one look at me and called out to her husband to come and help her mobilise. "Problem?" I asked. "Look at you. You'll never get me off this bed." I sighed inwardly and got her off the bed.

The point is that if mobilising requires "a strong guy or two strong women" you are doing it wrong (and potentially putting your client at risk, never mind yourself). As a matter of fact I am a lot stronger than I look, but that really isn't the point: moving and handling are all about technique, and nothing at all to do with physical strength.

Supporting a client with standing and walking progresses thus:
verbal prompting
minimal physical support with assistance of one person (AO1)
minimal physical support (AO2)
plus use of mobility equipment such as profiling beds, riser-recliners, bed sticks, stand aids, turntables and so on

So that until your father loses the ability even to maintain a standing position with his bottom resting on paddles, it will be possible to transfer him to a wheeled commode. He can then either use the commode, or the commode minus its bucket can be pushed to the bathroom and positioned over the toilet.

And in fact, I myself used a hoist to transfer my mother to a commode. So that, in fact again, as long as your father is continent and able to ask for support with toileting in time, there is no reason for him to be forced to "go" in his pad.

I'm also going to vote for the toileting schedule.

They had a lanyard with a button on it as well as pull cords in the bathrooms, but those only work for someone who can 1) get to them and 2) still know what they are for!

My mother wasn't totally incontinent. We had her in briefs just in case, but when she was still mobile, she'd go herself, and with the rollator she would go herself. Once she ended up in a wheelchair, she was more reliant on them. I had been there several times when a staff member came up and asked her if she needed to go. She would know and respond. Other times she would ask. She wasn't left alone in her room, so chances are some staff person might be passing through between tasks.

They gave her that button several times, but she had NO idea what it was. Typically when I was there, she might happen to notice it, inspect it a bit and then push the button, having no clue what it was for! The poor staff person had to respond and reset it to turn it off.

Actually it is hopeful to hear that they wanted the name of the person suggesting he go in his briefs. It could mean they do care. It is one of the benefits of having a good facility, because they will typically get rid of those who don't meet standards. With home care, unless you live there, how does one know what that aide is doing all day every day?

It also sounds like they are willing to work out the situation. If he still knows what the button is for, that might help. In time, that won't work, so having a standard toileting time for those who aren't mobile is the way to go.

I've never known any ALF not to have pull cords or call buttons available to all the residents. In AL, my mother had a call button she wore around her neck AND emergency pull cords in the bathroom and by the bed. In memory care, she has a pull cord by the bed and another by the toilet. Plus, all the residents are checked on every 2 hours to see if they need toileting or food or help of any kind. Your father should not have to yell for help, nor should he be told to use his adult brief instead of the toilet. Ever.

If your father is that wobbly while walking and unable to stand up by himself, he should be using a wheelchair for safety reasons. Staff should be toileting him regularly, and installing either pull cords that are accessible or call buttons for the residents. It's ludicrous not to!

My mother also has a bed cane near the top of her bed. While it's not a bedrail or a restraint of any kind, it's designed to help her pull herself up out of bed.....but also acts like a bit of a guard to stop her from falling out of bed. Go to Amazon and search "bed cane " to see what I'm talking about. If your dad's MC would allow 2 of them, that could help a lot with fall issues.

Thank you, I will ask for a toileting schedule. Yes they have buttons up high but no strings attached. I was told they are choking hazzards (similar to the dumb rules about bed rails). There is one in the bathroom but the problem is he can't get to the bathroom by himself.

I appreciate knowing what other places do while the patient still feels the urge

Question to put to MC: how will my father be supported with bathroom transfers? He is not incontinent, and he is able to call for help in good time, but he can't mobilise independently.

If the answers aren't satisfactory, argue!

(How does he mobilise, by the way? - what does he need help with?)

When mom was in rehab they had this attitude. It’s very degrading to the patient. Bottom line is that they are short handed. At least that is the explanation that I was told. You’re right, who wants to ‘go’ in a diaper and have skin issues?

You need to take this up with the facility. It makes me angry when they advise someone to “go in your diaper” leading to skin breakdown and bedsores which can further become infected.

Are there not emergency pulls in the bathroom? Even my mom's INDEPENDENT living facility had pulls in every room.

Huge red flag.

They use a toileting schedule at my dads memory care.

Second vote for “toileting schedule”. It may not work completely but it will be much better than nothing. Can your dad go about 2 hours between bathroom visits?

Suggest whatever time interval you think will be manageable/comfortable for him.

This worked quite well for my LO before Covid ruined everything.

Ask for a care plan meeting to address this, if he is in a facility where the attitude is "just go in your diaper" that's a big red flag. Is there not any kind of call button in his room or in the bathroom? Is there a toileting schedule where he is taken routinely?