Hi all.
First, thanks for the advice so far.
HOW do you find a good memory care facility?
Mom has had some medical issues, culminating in me calling 911. She had diarrhea thanks to enema given her just before discharge from a hospitalization for a blood clot.
She needed changing and was fighting me tooth and nail. She got a brush from the bathroom vanity and was hitting me with it while sitting in her wheelchair in a pool of waste.
I was a wreck.
Got her to hospital (bless the 911 crew) and told staff she needed placement. She had been hitting me and this was it.
She wound up someplace awful!
The hospital arranged placement, and when we got there, the staff literally snatched the medication list the hospital gave me on discharge. I had taken photo with cell phone so I would have it with me. (This is important later.)
The unit was locked and I made a point to visit daily. I did not observe a lot of staff interaction with patients.
On the plus side, she was getting physical therapy and was managing her walker and wheelchair better.
Had to be alert that her clothes did not go missing. Was doing her laundry at home because I had heard of trouble with patients' things at other places.
Mom told me at one visit that one of the staff "pinched" patients who vexed her. As I was not sure what was happening, I filed it.
Then there was another patient on the unit, a young man with some sort of mental disorder. I saw him masturbating out in public. The female patients were afraid of him. Then family photos I had put in mom's room kept disappearing. I would mention it, the photo came back, only to vanish a day or so later.
I filed this as I was told some residents "shop" other's rooms.
Had a meeting with the staff and we went over progress, medications. I specifically asked about the Xarelto mom has been prescribed for the blood clot. I was told she was taking it.
THEN mom's $3,000 hearing aid disappeared. Arrived for a visit and she could not hear me. Without it mom is stone deaf. I immediately alerted the only nurse on the floor and several aides.
To say the response was lukewarm is an understatement.
I went to the director of nursing's office to discuss what was happening. The aid was found, but every time I came over, it was locked up in the drug box.
Made the decision to bring mom home. When I got her med list from the facility, no Xarelto. She had not been getting it for two weeks.
On the plus side, the antidepressant they started her on has eliminated the hitting.
BUT two days after discharge she was back in hospital with gastritis. The diarrhea was incredible. The blood clot was reforming. The gastritis was due in part to blockages in abdominal arteries, something the Xarelto was supposed to help.
She's home now, Things are better. But the writing is there. I am partially disabled and don't know how long I can handle her.
How do I find a GOOD facility for mom?
Try to avoid the huge for-profit chains of care homes. If you can find a faith-based place these may be a little better. But in the end you will need to be your mother's advocate. In my experience, the more care the person needs (and over time more care will be needed), the less ideal things get because none of these places and I mean NONE has enough staff to give residents the care and attention they need as they become more dependent. They will tell you that they meet the state's staffing standards and they do, that is the underlying problem. The states' standards are woefully low. Forget about those CMS five-star ratings; it's all relative and CMS doesn't do a great job of monitoring the quality of care that they mandate.
I'm sorry to be negative but the biggest factor in ensuring good care is your new role as your mother's advocate. You will find aides who are very caring; but they are run ragged and are often exhausted themselves, so they may not consistently give the kind of care they would like to and that you want for your mother. Work with them, let them know you appreciate all they do, and make sure management knows when they are doing a great job and when someone is not. Get to know other family members and work together with management for high quality care. All the best to you and your mother.
Trust your gut. When you tour a facility, you will be able to tell in a few minutes if it’s a good one or not. After you place her, visit at different times of the day and different days of the week. Get to know the staff. Call care meetings for her regularly and ask for a monthly rundown of her scripts.
Good luck. Let us know. .
Adult Family Homes, are seriously, the way to go. My Dad went from assisted living (fell & broke his ankle). From the hospital, a couple of my siblings thought that the "memory care" (why don't they just call it what it is "Alzheimer's Unit") facility that was connected to this assisted living, would be the 'real deal'. NOT!
Residents come & go in others rooms, residents propped in front of the TV all day, residents are zombies during meals. My dad stayed there for 3 days before we got him the heck outta there. (me & my sisters have a name for this "asylum". We call it the "house of horrors"). HORRIBLE. I feel sorry for the people that have to live in this environment.
Anyway, get your Mom outta there. Please research Adult Family Homes, in your area. My Dad FINALLY is living a in loving, caring environment. Yes, expensive (his LTC insurance pays some). Yes, there goes our inheritance but we've MUCH have him live clean, secure, peaceful, happy in this adult family home we found.
I wish you the best!
Sorry you're going through this. It can be really hard to navigate for our parents.
In reading your letter, it's not clear if your mom needs skilled nursing or memory care. Has she had a thorough cognitive evaluation? Does she actually have dementia and, if so, what stage?
Memory care facilities come in all shapes and sizes. Some are stand-alone communities, while others are part of a continuum of care that starts with Independent Living, moving through Assisted Living and then Memory Care or Long-term Care if needed.
We've had my MIL in three different Memory Care communities and none of them worked out, mostly the way her Alzheimer's is progressing, she doesn't know she has dementia and she can't tolerate the MC environment. In the end, she's in AL with a night-time caregiver to make sure she sleeps. The AL community allows her to move and engage with people and activities as she desires during the day.
Most important is to determine what your mom's needs are for medical care, management of dementia behavior, social interaction and leisure interests. Then start researching communities in your area to see if there are any matches. And get ready to pay quite a bit of money.
One of the most critical pieces to this is staffing. It is essential that a community have enough staff to meet the needs and care requirements of their residents. This care includes medications, self-care, feeding, activities. Especially on the weekends. It doesn't matter how pretty a place looks if there isn't enough staff to adequately take care of residents.
A good place to start is with any elder services her community has. They may be able to provide you with a list of MC communities. From there, you can research them and tour any that seem like they would be a good fit. Visit at all hours of the day if you can. Especially on weekends, because staff often call off, activities aren't as available as during the week and although families often visit on weekends, it can get lonely and boring once those visits are over.
Regarding the medication list - my MIL has been in the hospital twice in two weeks. Both times, the medication list from the HOSPITAL was wrong. We had to correct it before she was discharged, and then correct it again at her community. I don't know where the drop-out was with your mom's Xarelto, but my advice there is to always, always check the hospital's medication list for the dosage and duration of each medication. And then make sure you're checking it twice/month at any community she lives in.
Wishing you all the best.
This past time I reviewed online reviews (which cannot always be trustworthy either as some one had a bad experience once and bash the place like its the worst ever) and call and ask friends whose parents have been in them.
My mom got in a rehab last time which wasn't the best, but only one open at the time her insurance covered, but we found out from other patients there it was not the worst in the area either, there were ones worst.
I think bottom line is there are no perfect ones. You try to avoid the really bad ones.
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