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My Dad has been in a nursing facility since he had a stroke 2 months ago. When he first went in the facility, they insisted he have 24/7 sitters because he is a fall risk and exhibits dementia-like behavior (agitation and combativeness). At that time, the facility said we would only need to employ the sitters for a week or two. It has now been 8 weeks and the facility is insisting the sitters continue indefinitely. The sitters are extremely expensive and we can't afford them. Has anyone had experience with this type of situation? Is there a place for someone like my Dad, where he can get skilled nursing care (which he needs) without the sitters? Please help.

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U have lawyers to thank for this! NH is just trying to cover their butts so they won’t get sued.
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Same happened with my mom. The sitters were on and off depending on mom's behaviors. Yup, it is expensive especially on top of other residential care.

Is the facility short staffed? They have others to care for too.

My mom was moved to a care home many fewer residents that worked better for her.

Talk with the facility about cutting back hours for starters. Maybe a geriatric psychiatric assessment to adjust meds to find something that will keep him more comfortable.
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lm1984 Aug 2018
The facility he's in has one of the better staff-to-patient ratios in our area. We would like him to have a geripsych evaluation, but can't find a facility with a bed available for him. The social worker at his current facility has been searching for a geripsych facility for three weeks! Two facilities in our area that previously offered geripsych evaluations have stopped that service. Is this a liability issue for the facility? The whole ordeal is extremely frustrating!
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The only time I heard of this was in an AL while they waited for a bed in the LTC section. If this is a NH you r paying big bucks to be there. I would just tell them, no can afford.
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my step dad just had his 3 rd stroke , worsened dementia and still has been able to get up and fall , all the time . Finally he went to a Geri psych and it’s only been a week and they are sending him back. He’s better but not good and you know they will decrease his meds and we’ll start all over again . We can’t afford sitters either and the facility has not mentioned having them yet . It is definitely the most frustrating situation that I have encountered in my lifetime . We have been lucky with having availability at facilities close to us so far . Prayers for all of you and your families . One day and one breath at a time .
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The reality is we can't expect assisted living to care 24/7 for our loved ones. Families have to step in no matter how hard and inconvenient it is. There are mpeople entering into senior years and living longer and we as a nation are not prepared for the experience until it happens. The assisted living facilities are a convenience for those family members who can not be there then we expect the best. It does not happen. They depend or expect family to help out. Very few if any people want to change diapers or clean an elderly patient. Things are only going to get worse as more of us are aging
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Harpcat Aug 2018
I think she said he’s in a nursing home not AL. So he should have the care already in place at the NH...that’s the point of long term care facility.
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From what I've read about your situation, it seems you need a multiple-phase approach, such as: (1) contact the state agency that oversees nursing facilities and file a complaint (maybe not your first step -- try 2, 3 and 4 first); (2) talk to the Council on Aging people in your area about spend-down and getting him qualified for Medicaid as you have NO OBLIGATION to pay for any of this, except as provided under his insurance policies and Medicare/Medicaid; (3) engage an elder care attorney -- with Dad's money -- about your rights and his rights; and (4) talk with the Doctors, social worker, and other care facilitators, over and over again, about how to get the problems under control. You really do need a skilled elder-care attorney most of all. Be one of those people who asserts your rights and your father's rights.

You might private message me what state, city and facility he's in, and I may be able to find a referral for you for an elder attorney.

I would also say that, there are laws that protect patients from being over-medicated, so the care facility has to be mindful of those regulations, as their license could be at risk. And, if he is in an assisted living facility as opposed to a skilled or long-term care facility, then he is in the wrong place. Again, if you get an elder care attorney, you are likely to find that you will suddenly be able to find a bed for him in a more appropriate level of care -- as well as more appropriate care for him.
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I think its time to research other facilities. I mean what is their staff there for.
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The NH (not AL) and the hospital she was discharged from insisted my mom have a daytime sitter when she first got to the NH as well. That was $1500 of her money totally wasted. She wasn’t that far along her dementia journey yet and did nothing to endanger herself or others. The sitter just sat there and watched tv with my mom. If she did anything at all for my mom it was only for show and not necessary. This is the one thing about the facility that angered me. I finally told the Agency and the social worker enough was enough and cancelled the sitter.
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Ismeraldo Aug 2018
Sounds very familiar!!!! Had the same experience!
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The nursing home is short staffed & it’s your fault? Lol Go to top & have meeting w Nursing Director.
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My brother made a suicidal comment so he was 1:1. Take in mind he was Medicare then Medicaid. Facility wanted him off cause it was costing them extra money. In order for that he had to be seen by a Psychologist. Oh, yes he’s had two falls before his 1:1. Seriously. If he’s private pay take him home then read it him to a facility that can care without 1:1. If he’s not private pay then take advantage of situation. Actually I did that; made his personal CNA provide whirlpools nightly, play cribbage and take him for walks. Good luck!
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Check with your Aging Resource Center or Ombudsman
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They all short stuffed, I mean NHs, I came to visit my mom on sunday and she was sitting on her bed without pants, because nobody was around to give her pullups and she was confused and disoriented, and it took for me at least 10 minutes to find a CNA who finally brought pull ups to her room...who knows how long she would waited if i did not come...unfortunately we have to hire some additional caregivers even in NHs....may be those who is ONLY private paid are better in terms of stuff numbers but who can pay 15K per month?
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Both of my parents are in a NH in Florida. My father recently had surgery and, unfortunately, the hospital shipped him back to the NH while still needing a sitter as he gets very fidgety and confused and tried to rip out his Foley catheter. They said it was a bloody mess! Having a sitter was "medically necessary" as the anesthesia and stress on the body from the surgery enhanced his confusion and agitation. I asked our attorney, the NH business office and DON, and even contacted the Medicaid Case Manager and no one was able to identify a single source to pay for this sitter service. My parents receive Medicaid as they cannot afford private pay (few can!). The NH is a good one, but cannot pull a staff member from the floor to sit and watch and redirect my father all day and night.

So... I hired a home health agency who charged $20/hour and had a sitter for the first night/day. I then took over and missed work to look after my father. Luckily, he recovered fairly quickly from the confused state of mind and after I urged the CNA to shower and dress him (the doctor advised using a leg bag), my father did much better. I was able to leave later that day and did not need a sitter, thank goodness. The cost would have been $480/DAY!!!! I don't even make that much!

So now I'm worried as he needs to have a sitter after 3 upcoming treatments for cancer. They will need to provide 1:1 supervision for 6 hours after each treatment. Of course, if he needs more surgery or if something happens with my mother (now 98), I am at a loss as to how to pay for any such private services such as a sitter? How do other people do this? What is the "secret" for families who are not wealthy? I am self-employed and when I don't work, I don't get paid and can lose clients for cancelling work. One person said that some family members take out a mortgage on their home to pay for home health fees!!! I cannot do that. My boyfriend recommended getting a credit card and putting the cost on that and pay it off slowly using their resident accounts... but you are limited then as to how much can go on the card and risk damaging my credit by having huge credit card debt. Open to ideas or suggestions!
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Have him discharged to a facility that has a locked unit and specializes in dementia. Also a facility that has Therapy for his stroke; like Physical and Occupational
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Lm1984, your post was from back in August...how did you make out with your Dads sitter problem? I’ve just started to hire companion care for mom in her NH for 3 hours a day, when I can’t be there. ($22/hr). Luckily she only needs it a few hours a day when she’s up and about. The rest of the time she’s either sleeping or one-on-one with an aid in the dining room. Maybe just a few critical hours a day would work for your dad?
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lm1984 Nov 2018
rocketjcat. Sorry it has taken a while to reply to you. We are still struggling with the sitter issues. Dad only has them 12 hours a day now vs the initial 24 hours a day, but it is still financially unsustainable. The sitter hours could be reduced more and even the NH agreed. But, mom is insisting on keeping the sitters the full 12 hours. She also wants our help with figuring out how to pay for the sitters and is asking us to "pitch in" on the costs.

Something I've seen increase over time is the NH's reliance on Dad's sitters. It is ridiculous to pay for the facility to take care of Dad and sitters! ARRRRGGG! It is so frustrating.
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