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It has become very clear that my dad's needs are bottomless and far beyond my capacity. I have serious worries about my sanity and mental health from this situation. His assisted living place is happy to take his money but does nothing to engage him. They'll give him meds 3 times a-day and he gets housekeeping once a week. But when I walk in there's always diarrhea on the floor or in the shower, and open food containers all over the counters. His fingernails are super long and nobody cuts them except for me. I'm tired of worrying about him and wondering why I thought assisted living would make things easier when it's made it hellish. He gets sick because he eats spoiled food. He was isolated in the hospital and his apartment for 10 days due to covid and his mental health really suffered. Since he's already got parkinson's that's a huge challenge, and he's got metastasized prostate cancer, is 94, can't hear anymore and his vision is bad. The ALF doesn’t seem to have the staff to help with other things that he needs, or to even notice that he might need more. It's always something: the main nurse is on vacation or the building superintendent is on vacation and can't fix the broken whatever....How can I get someone else in there to help? Would it be a social worker, engagement specialist, another house cleaner,... and would his private insurance pay for it. I am fed up with his ALF. His air conditioning has been broken for nearly 3 months, the whole time hes lived there, and it's always almost 80゚In his apartment. They are trying to fix it but having a hard time getting a replacement that fits. I passed the end of my rope a long time ago, I can't even begin to type all the other crises that have been going on in the family. But suffice it to say those family members are not able to really help with this problem. They do what they can around their own crises. Sorry for typos this is a bad keyboard.

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No, insurance will not pay for a private caregiver. Sounds like time to move dad. His needed care is beyond what assisted living is able to provide.
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I pay someone to spend time with my mother in her nursing home twice per week. They've developed a good rapport over the past year. She is also authorized to speak with the staff about her medical condition. When I am not around, she is my eyes and ears and will advocate for my mother. It's worth the extra expense for this service.
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Sounds like a move to a nursing home may be a better option as it sounds like his needs far outweigh what an AL can do. You could pay for a private aid to help but that cost adds up, so it depends on finances. With a NH either you private pay for a while if he has the funds,, or apply for Medicaid. My dad is 90 with Parkinson's and a host of other issues, and any health crisis, like a UTI or surgery or anything can make the Parkinson's progress rapidly. That's what's happened to us, and at 94 unfortunately your dad is not going to improve in that sense. Sounds like this AL is also lacking in cleaning and sanitizing. You'll still need to be his advocate at a NH but he'll have more care, more consistently.
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Typos are fine; care facility for you dad isn't so fine.
(What I did / do).
Be sure to have in writing what the AL facility offers and is required to do.
Speak to facility administrator (as needed, personally, I would also notify by email some / all of the board of directors). Hold them all accountable.
* Ask administrator what procedures are for you to hire personal care / giver. Be SURE that facility isn't slacking off (more) due to another outside agency being paid to do the work this facility is supposed to do.
* Get everything in writing.

* document everthing: take photos, keep a journal of your visits and observations.
* contact your local Ombudsman - work with him/her, i.e., send your photos and notes for their records.
* Find out who is the reporting agency (and person) for the licensing board of these facilities.
* Hold facility administrator(s) / management accountable. Call and send them emails - regularly noting your concerns.
* Consider if another facility is possible (financially and otherwise). Do research to see if it is actually better.
* Have friends / others visit your dad to check and see what's going on - report back to you for your records.
FYI: I've been doing this for 8 months now ... for my friend in a nursing home. Most in a nursing home cannot / do not speak up for themselves. It is up to us to report and hold facility management accountable.
Gena Galenski
Touch Matters
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Good Morning,

As I said in a previous post--I repeat, Assisted Living is real estate.

Everything is a la carte, out-of-pocket. You basically get a room, studio
type apartment, fancy le foyer, good meals, usually after the 3rd day the
senior wants oatmeal and maybe a grilled cheese.

They are not government regulated and you have to check the ratio of RN
to how many elderly residences live at the facility. For example, if there are 65
seniors up there in age, what are the chances that a few with take sick at the same time and the the RN's assistance? It's pretty high.

The brochures always look lovely and yes we will treat your loved one like family--until their $$$ goes.
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"metastasized prostate cancer" ????????????????????

I believe he would qualify for a nursing facility with Hospice. Please call Adult Protective Services to get a more suitable placement and please ask the Health Dept. to visit the facility for hazmat issues.
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Not sure how the legal side of this works but in my LO’s progression of care, she went from AL level to MC level a matter of weeks after entering geriatric residential life, and although some of her self care abilities were above those of her MC peers, it quickly became clear to us that she needed MC.

It sounds as though “I am fed up with his ALF”, places you on the right track, with the right perspective about your dad’s care.

Specific to your question, “our” MC always solved problems quickly WITHOUT needing extra help. There ARE some good ones around.

Your father is lucky to have a diligent, “dutiful” daughter.
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First, its the AL in some respects. If they could not fix the airconditioner, they were obligated to put one in there that works. The aides should have cleaned up the bathroom and the open containers. I would not go thru the expense of hiring someone either. I do think your Dad is beyond an AL and MC which is just a step up from an AL. I think you need to find him a nice LTC facility because his Parkinsons will only worsen.

Its illegal for aides and nurses to cut fingernails or toenails. Medicare pays for a Podiatrist to cut toenails every 10 wks. My Moms doctor went to her AL to do hers. LTC facilities have a Podiatrist come in. So when it comes to fingernails, you may always have to do them.
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TouchMatters Oct 2022
Perhaps states have differeing regulations.
Nursing Home nurse cut fingernails for my friend. She didn't clean them though. Check out requirements for the state you are needing the service.
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Most ALF state that the residents must not be incontinent or be able to clean themselves and change their own depends. Occasional accidents are allowed and should be cleaned up by the aides, but continued issues around toileting makes it seem he should be in memory care or nursing home. Simply leaving food with an elder without company or help is cruel. This AL should be telling you he needs more care and helping you find a place, or at least letting you know who to contact. They should also have a manicurist and podiatrist come for nails. They aren't doing their job. Are you speaking to them about these issues?
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My dad was in AL in 2019. We had to bring in extra care 3 days a week. Out-of-pocket. It became very expensive and it still really wasn't enough. He ended up in MC which is actually less money for a much higher level of care. He is doing so well now with more attention. All services are brought to him. I think it's time for a move. AL is not meant for what you are trying to use it for. Also look at private care homes.
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