Assisted living doesn't do what they said they would. Is there a solution?

The issue is, IMO, that she is in the wrong level of care.

if she is in AL, she is expected to be competent and cognitive enough and able to do most ADL type of things on her own with assistance on occasion from staff. So can she do her ADLs or recognize what she needs to do to get her day going? If you were to ask her what’s on the activities schedule and when, could she answer you correctly? If not, she not suitable for AL, she needs a different higher level of care.

An issue w AL, is that if a resident flat does not want to participate in activities or go down to have a meal, that’s their decision. It’s assisted care not oversight care. The AL is not going to force her. That they provide for meals is in the contract. If she won’t get dressed appropriately and walk down to the dining room that’s on her. They will deliver a meal to her room but expect there to be a charge for this if it’s every day and most meals.

I suggest that you have a needs assessment done for her.

The AL should have someone they can refer you to for an assessment. It’s usually a duo of a geriatric RN and a SW. Please realize if it shows she needs a NH or MC, the AL will require that she moves out. If this AL has a NH or MC that is a sister facility, that should make it way easier to have her move.

6k is somewhat on the higher side for AL. But if it includes medication management (daily delivery of her meds to her in her room & oversight that she takes them as per script), then 6k seems ok.

If the assessment shows need for skilled nursing care and if she will run out of $ to afford it, I’d look at facility that have Medicaid beds in addition to private pay. This way she can segueway from private pay to Medicaid when she becomes impoverished plus you do not have to move her again, perhaps a yr or two from now when she is much more frail and lots less cognitive. If right now, it’s the situation that she is NOT paying herself for this AL, but it’s you and your siblings who are AND you realistically cannot afford to do this for years & years, please pls pls stop and get her assessed for NH and find her a NH who has open Medicaid beds ASAP and get her into it as “Medicaid Pending”.

My mother is in memory care for almost 3 years now.
It is basically the same as what you're saying. A lot of their time is spent sitting
in a room with a TV. When she first moved in, there were 2 woman who did the activities. One worked during the week and the other worked every weekend.
They actually worked 8 hours a day. They were great.
A new manager started and a lot of workers left because of her. She was eventually let go for not being qualified! At that point, the damage was done and it has not been the same since.
It seems like everyone is looking for a way to sit most of the day. It doesn't matter
who you talk to they give you excuses.

With a diagnosis of dementia she should be in Memory Care not AL.
I have no idea why they said showering 2 times a day would be done. Unless a person is VERY active I do not know many people that shower 2 times a day. (When my Husband was in rehab I found out to my surprise that the State standard and requirement is 2 times a week) You might want to check what the State standard is where she lives.
And they can not "force" her to shower, participate in any activities if there are any. They can not force her to eat a meal or come to the dining room.
I think she needs a higher level of care and supervision than she currently has. If this facility has a Memory Care unit I would ask that she be evaluated again to determine if she she should be in MC.

I assume your statement of being showered "twice a day" is a typo and you meant twice a week. Like the others said, a resident has rights and nobody can force her to do anything she refuses to do. AL is intended for independent seniors who require very little care so your mother is likely in the wrong environment for her care needs. The staff is responsible to make sure your mom is eating meals, however, and should be keeping track of such things.

Talk to the executive director and express your concerns and ask why there are no activities going on, etc. Vent to the ED who can actually address these issues although coming here is a huge help for most of us 😁.

If you move her to memory care, there is a higher level of care and attention paid to the residents there, although they also can't force showers on the non compliant. Dementia tends to make the sufferer refuse to want to bathe, in many cases, which creates problems for all concerned. I'm lucky my mother hasn't had that issue yet......shes had 1000 others, God knows, but still agrees to at least 1 of her 2 scheduled showers per week in memory care.

Anyway, speak to the ED and the nurse in charge to see what they think about where your mom would thrive best. I know how difficult and frustrating all these things can be between the AL and the non compliant mother, it's all mind boggling sometimes. You have my sympathy and I'm wishing you the best of luck with a difficult situation

My mom has mild to moderate cognitive disorder/dementia/age related memory loss/signs of Alzheimer’s. It depends on the day. However, in the 8 months I lived with her prior to her AL residence now, I found she loved to stay in her bedroom, keep the temp high, sit or sleep and come out for meals when I called her. With that in mind, her staying in her apartment is not a huge concern for me. She told me when she was in her home, that she enjoyed putting yarn into balls and then she got emotional and said “isn’t that pathetic?” We tried embroidery, sewing, listening to books, music and watching embroidery videos. She doesn’t like violence and bad language, so we got her Pure FLIX but we had to start it for her. While mom is in not a candidate for memory care, the AL does have programs and mom’s fluid sense of time requires she get verbal cues. I got her a Echo Show 8 and use. Alexa to verbally remind her (tell Alexa to speak slower and she will, I also set it to repeat 3 times) In addition, I linked her gmail to Echo Show so she can see her reminders on her calendar on the echo show screen. I drop in on her and visit mostly that way. This summer I told her that I would be working on Habitat for Humanity homes and that is my job. When i dropped in, i would show her pics of what I was doing or just talk about the job and the people involved. I haven’t seen my mom in person since May 1 and it is going well. She is getting more socialized. I prayed for her to have friends and it was answered. She has table mates that like her and one has a dog. Her med tech invites her to the evening movies and she likes that. I signed her up for PT when she said her hip was hurting and she likes the one on one attention. I also hired a semi-retired RN to be her friend and she has brought much joy to mom. She plans adventures of mani/pedi, a early dinner out and watching movies with her in her apartment. I got mom a DVD and the facility hooked it up. The extra cost of the reminder care was discontinued (it was 435.00 a month) and so mom’s care consist of medications or help with doctors order. She gets lotion applied ordered by the Derm doctor due to her excessively dry skin and the growth of skin that needs biopsies. The cost of the RN is less than 435/month or sometimes a bit more but it is worth it because mom has a friend who sees her and gets her into social situations. My mom is a painful introvert so I do not expect her to change and be a social butterfly but she is more social here than at her home prior to AL. Every day is a prayer opportunity for me to see what God is going to do for my mom. Mom could refuse the reminder care and she did…..she felt they thought she was a baby. My reminders to her don’t bother her and I go to the AL calendar (it is in an app) and put those on her events on her calendar and also in her Alexa reminders. It is a bit of work but I have it down now and it is something I can do weekly. They also have a menu daily and when I see an item that I don’t want her to miss (like eggplant parm or shrimp) I put that on her calendar. I don’t think she is showering as she should and I take that battle week by week. She does get her hair done at the salon weekly and that is a way to get her head cleaned! I highly recommend the echo show since i can drop in. She can call me by saying Alexa (pause) call Suzy. I did write the instructions down in big font so she can refer to that to make her calls and I taught her to look for the bubble that Alexa is listening. She used to talk to fast. She has done that successfully now because she doesn’t know how to use her cell phone anymore. Prayers for you and your mom and for Godly wisdom and mercy.

OK.,.. been a caregiver for almost 30 years. You CANNOT force or make someone take a shower --- get into the shower. Most dementia patients get to the point they are deathly afraid of showers so, here is what I do much of the time. Now remember, this is in the patient's home 99 percent of the time. They have to use the bathroom sooner or later. I have had these types of people and one lady in particular did stink and would refuse to change her clothes so, when she went and sat on toilet, which was never a problem, I always had towels, washcloth and change of clothes in there ready to go! A great majority of the time I could at least get her privates washed once that day and I was ONLY there one day a week for 4 hours. I would work "fast"; once sitting on the toilet, I would just start getting her clothes off. The top mainly at this point. Grab the wash cloth and start washing her arm pits, under breasts, and to help with this, you can get RINSELESS soap. Also, USE TWO WASHCLOTHS AT A TIME! ONE IN EACH HAND. You can get a ton done this way in no time. Another thing, you don't have to get EVERYTHING done in one sitting. When they are seated in "their chairs".. you can always bring a bowl of water to them with towel and washcloth and wash their legs, arms, face, anything you can reach while they are there. I have also washed their hair while they are seated on the toilet or even laying in bed. They can most likely bathe them once the go to bed at night...at least their privates should be washed well at least ONCE a day.

As many here already stated:
1: Assisted Living is just that Assisted Living. They cannot force the resident to do anything. They will ask if the resident wants to do the activity, they will provide the medication and manage the medication but cannot force the resident to take it. They will ask if the resident wants a shower or offer assistance but they cannot force them to take a shower. Unfortunately that remains on you as the family member to ascertain that your family member is doing so. At least in IL you will not find any AL that will force a resident to do anything.

2: the cost is way reasonable. Most ALs offers services and charges a la carte, meaning the resident is charged in tiers depending on level of care; how many medication visits your family member needs, 2 morning and night? 3 morning noon and night? Does the resident require supervision visits over night? All that is considered on the price. Hair cuts, outside outings, are all extra.

If your mom needs more supervision than basic medication management and engagement she is in the wrong type of facility or you will need to hire a private caregiver.

Also the pricing is some what malleable as well, but it has to be done prior to move in. You can negotiate the pricing prior to move in including move in charges. 🤨 as if we did not have enough to worry about 😝

Best of luck to you and yours

I've been enjoying the Little League games, too. There is precious little else to watch on TV these days, especially in the summer.

The thing about assisted living is that they tread the line between being available to help your mother and forcing her to do things against her will. The family usually has one standard (expectation) and your mother doesn't want to be bothered. I loved that they respected my father's wishes enough to ask him first (in memory care even), but you do have to communicate YOUR expectations and if you can put a written care plan in place, you and the assisted living staff have something to refer to. Explain to your mother that this is a service you are paying for so she needs to go along with it.

I have a friend who has just grudgingly entered assisted living. There is an adjustment period. Her daughter is knocking herself out to address each problem as it occurs and I am reminding my friend that she is lucky to have such an advocate but she also needs to put forth the effort to make it work. There is no question that she is better off having someone help her with meals and medicine than she was living alone as a diabetic. She has a network of friends who drive her to appointments and she has taken us out to dinner. They let her keep her dog and we are finding ways to incorporate her favorite activities. That may mean that she uses their bus to go to the movies or grocery or initiates an invitation to one of us.

Assisted living, long-term care, memory care, group homes - all these places were short staffed before Covid. Until they are paid better, with the booming labor market, this will continue to be a temporary job. You can help retain good people by helping them help your loved one. Consider yourself one of the workers.

Two years ago (August 2019) I moved my mother into a luxury AL and memory care center (private apt, even has private 10x12 patio with french doors and all glass that looks out on patio, even has 12x5 foot of dirt for personal lawn decor and flower planting) after taking care of my mother (as primary caregiver, and having full medical/financial POA). I just couldn't do it anymore (she has overwhelming medical issues (uncontrollable high blood pressure going from 150/norm to 240/high several times a day requiring clonidine pill 3 times a day and additional one each time it hits 180 ... adult hydrocephalus, having a valve in her head, draining from brain to stomach ... has had numerous strokes ... new heart valve... frequent dehydration, won't drink enough, causing unstable/zoning out/falls, sometimes IV at hospital to rehydrate, well as Lewy Body Dementia ... taking at least 24 pills a day at different times for all these issues). I thank God (using "A Place For Mom") free service I found Arbor House. The high level of devoted/loving care of all the care friends (as they call them), accommodations, chef prepared meals, small group of residents/only 40, plush movie theater, in house beauty shop, spa with jetted side opening tub, beautiful sunny dining room with fresh flowers on tables daily and tablecloths, and a activity director that keep her busy) are top notch. I visit her daily at varying times, having always found her being treated with respect, dignity, and loving care. Covid lockdown was so depressing for both she and I since we were very close ... but the staff did Facebook live with us (they would bring it up on her Amazon 10.1 tablet and leave us to talk for 30 minutes of so, then come in and sign her off). I have an outside service (Interm Health Care) come in 3 days a week to give her a shower, wash her hair, or help her with whatever else (her insurance covers this), I have had to put her on Interm Hospice a few months ago), can't say enough as to all the TLC with Hospice visiting her once a day/they are truly Angels of my mom. I just want you to know there are wonderful AL/memory care living centers out there, free services like "A Place for Mom" that will guide you to the best ones for your family member (I know I found the best with there help), home health care to further assist them with daily living needs (such as Interm, she loves her Interm assistants), and all those at Arbor House who treat her as if she is part of their own family. Don't put up with shoddy poor treatment of your loved one ... speak up, be the squeaky wheel, or make a change by moving her/him to a happy/cared for place.

My 96 year old mom is in AL here In NY. They do have activities, and the activities director is good about inviting her to the things that mom likes. If she could, Mom would stay in bed all the time however! She has moderate dementia and a myriad of health problems. I go to visit frequently and take her to my home every Sunday. My daughter and I are designated to visit for compassionate care, but no one else is allowed in her room. We do showers on her Sunday visit to my home, because she gave them such a hard time. The AL simply doesn’t have the staff to beg her to shower.

About a year ago, we bought mom an IPad and had it mounted on her wall next to her bed. The iPad can be set to automatically accept FaceTime calls; she needs to do nothing. The FaceTime simply pops on when any of us call.

The iPad has been a Godsend! We can check in on her anytime and we family members have a schedule to support the staff in getting her to meals or activities that she likes.

Of course the place must have wifi. We got the iPad for about $250 and a wall bracket with a lock was about 30. The maintenance man attached it to the wall. It was a great investment.