Pardon the blunt post, but I feel the background is necessary to explain my questions:
We removed my mom from her AL community after only four months because she was having sex with another tenant. Before moving into this community, we met with the director and intake nurse regarding the level of care, reiterating her advanced dementia diagnosis. In this meeting, and because she was high functioning, they assured me that the add-on services would be more than sufficient to keep her safe and well: What I didn’t know then was that she could make decisions such as getting physical with another without informing me. This physical relationship went on for a few months before I was informed. When they did tell me, they labeled it as being cute. I explained to them that in my mother’s right mind, she would NOT behave that way and asked them to discourage it. It was then that I learned that they could not and would not intervene.
Long story short, I removed her that week and moved her in with me, which was a year ago. We are now hunting for a suitable Memory Care community. As a side note, on the day I removed my mom, one of the caregivers pulled me aside to tell me that she refused to shower the entire time she was there.
My Questions:
Once we find a Memory Care community, is it a legal obligation for them to force her to bathe? Further, is it an obligation of theirs to ensure that she is not engaging in questionable behavior?
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My daughter is an RN and has worked in NHs for 20 yrs. The thing I found that was frustrating was my Mom was asked if she wanted to go to therapy. Of course my Mom said No. I said to the Therapist don't ask her, tell her "Mrs E, time to go to therapy". I never asked my Mom, I told her. Time to shower, time for the bathroom. They become like toddlers you ask, they say No.
My daughter says you make them think they made the decision. "Mrs E time,p to shower" Mrs E, "no". "Mrs E don't you want to feel nice and clean and have fresh clothes on." Mrs E "yes" My daughter "so lets go" and Mrs E goes. Its really how much time does an aide have to encourage a resident to bathe when she has others who need bathing to and care for.
The sex, this has been discussed before. ALs are residences. Just like living in an apartment but with assistance with ADLs. I don't think there is any law that says the facility is allowed to keep residents of different sexs separated. My daughter says it happens in her NHs. One couple thought they were married. If you tried to separate them they would scream and holler. They had spouses too who visited. I agree if this stuff goes on then residents need to be separated women with women and men with men.
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My mom was in a NH with very caring folks. Once, after she returned from a stint in the hospital due to her CHF, I sat with her as the intake nurse went over her preferences for a variety of things.
'Do you prefer showers or baths, Mrs. A?" she asked.
"Oh, I can't have showers any more" my mom said, adamantly.
The nurse paused. I asked, mom, why is that?
Mom said, I would have to stand in the shower. I can't stand any more
The nurse said, "but Mrs, A, we have a chair you can sit in while you shower".
My mom looked shocked. "Really?"
Sometimes you need to ask really basic questions. And not assume anything.
are you asking, so that if they fail in doing that, you have a just cause to sue? the thing is, these facilities have hundreds of lawyers. they know exactly what to say, to get out of any legal or non-legal obligation.
regarding your 1st question, i don't believe it's a legal obligation, and even if it were, the facility will say, "she didn't want to bathe, and we couldn't force her because she resisted and it would have ended in violence. we had to let her be. unbathed." ...in fact, even if she didn't resist at all, sometimes they'll say that just as an excuse for why they couldn't be bothered to bathe her; it's less work for them if they bathe her less frequently.
OP, no matter what, the facility will ALWAYS try to say they weren't responsible for whatever happened. they know every legal excuse in the book.
regarding the 2nd question, they'll probably try to be careful that she doesn't do questionable behavior, but if she does, they'll say, "it was unpreventable. we don't and can't have eyes on her 24 hours a day."
regardless of legal or non-legal obligations, what you need is a facility that seems to genuinely care for the elderly people. look at the staff. speak with other family members if possible. do customers, family, look satisfied?
I think perhaps you need to consult an Elder Law attorney. Unless you have guardianship of your mom, you most likely won't be able to restrict her choices.
I wish the facilities that allow this would be prosecuted and the administrators and any aides who responsible be put in jail.
I would ask these questions of the facility, not of us. They vary a good deal. You say your mother was "having sex" with another patient. What evidence, I am wondering, do you have of this?IMHO the facility was wrong to accept into ALF someone in need of memory care. That is not fair to you, to your Mom, or to the other residents in that facility.I sure wish you the very best. The level of staffing is generally better in MC than in ALF, but as you can imagine, lest you hire a one on one aid (very costly, indeed) you can never be completely reassured that your Mom will be under scrutiny of staff at all times.Good luck.
Issue 1: my mom was always searching for a companion in 3 places where she lived. In the earlier stages they shared living quarters until he passed away. I am sorry you felt that late companionship caused your reaction. The only time I spoke on her behalf was when there was an aggressive resident scared her.
For bathing, MCs have different ways of encouraging a shower up to a point. If the resident becomes combative, then she or the caregivers can get hurt. You might want to speak to a gerantologist if this becomes the case.
You can ask those questions when you do your search. Are you having problems with her now? If she is compliant with you, then fill the MC staff in. Just remember as she ages these issues can get worse