Assisted Living - how does your facility Dr. see your resident?

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Assisted Living - how does your facility Dr. see your resident?

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Mom fell 5 weeks ago, Dr was not scheduled to be a facility, so off to ER we go. That next week still in pain so we call him, they’re not coming but we can bring her? Appt was a joke said they’d follow up in two weeks. Nothing. Since then she’s developed second UTI and on second round of antibiotics. Still has not been seen at the facility. We’re told by visiting nurse she can be “fired” by Dr if she continues to be a problem? I’m at a loss now, we’ve not had a full time nurse since May, but ones starting Monday. How do others work?

Assisted Living Care Team Emergency Care Medical Care

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Around here a lot of ALs advertise that they have an in house physician but that sometimes isn't all you might expect, in one place I know of the doctor will only see people by appointment once every 6 weeks or so, this is obviously not helpful for those with acute needs.

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Right, they have access to dr. He’s got quite the route he “services” four large facilities. Doesn’t spend anytime with residents unless an emergency then sends to ER. Basically monitors meds, PA and Dr charge Medicare same rate. They are not required to write in chart each time they see them so there is no record.

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Does Moms contract say she has to see their doctor? Their doctor maybe just for convenience. So, take her to one u chose. One that has a Nurse Practitioner who usually does the visitation.

Assisted livings are not prisons. Your Mom is a resident. Just like paying for an apartment but with some extra help. ALs are limited in what they do. This not having a fulltime nurse at the facility is not right. Even though these places are private owned, they report to the state. My impression is that an RN has to be there 8 hrs a day and on call the rest of the time. An LPN can back up but they are usually limited in what they can do.

You may want to consider moving Mom if things don't get better.

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Moves are very hard on her but not having confidence in her dr is going to be an issue. Getting to know people the routine etc takes a toll, but that’s what everyone knows. We will see, thank you for your response. She’s not in jail people!

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See them every Tuesday, the problem is they don't tell the doctor what is wrong with them, they just sit there, never ask any questions.

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AT1234, the Assisted Living facilities in your area must be different then in my area. When my Dad was in Assisted Living, he was able to visit all of his doctors, there was no facility doctor. Of course, that meant I would need to set up appointments and we would take Dad to his appointments. The facility did have a Nurse on duty around the clock for minor issues or to assess a situation where 911 would be called.

On the other side of the coin, my Mom was living in a Nursing Home. Thus she would be seen by the facility doctor. Her primary doctor was now out of the picture. Wish my Mom's primary doctor could have been part of her care, but that isn't how it works for Nursing Homes in my area. The facility doctor was there daily to see patients.

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ive taken her to all appointments in the past, I’m not sure this is going to work for either of us.

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My brother's assisted living has two physicians groups involved with it. One, we were kind of hinted, better than the other as the nurse practioner shows up often, even if only to check blood pressure on someone worrisome. My brother has not joined with either group and keeps his own MD outside the facility. They have a van and there are two days a week that are appointment days. He goes on those days when needed. Any Emergency would be either a van visit if able or, yes, the ER. I have never heard of a facility with onsite RN at all times, unless a SNF or a Rehab.
If Mom is getting frequent UTIs please investigate D-Mannose. It works much like cranberry in that bacteria cannot adhere to the bladder wall. I swear by it. Was getting more than 4 a year, went on D-Mannose (over the counter and at health food stores or Amazon about 30.00 for 120 capsules) and have had no UTI in decades. Worked the same for two friends. As a nurse I am a western medicine gal and don't like vitamins and supplements, but I swear by this and started it when Doc threatened me with daily prophylactic antibiotics after two infections went into the kidney. It is certainly worth the try. Warning that the capsules are large, so should be given broken into glass of something or get the powder. And of course won't be given by nursing staff unless your doc orders them to be. But are otherwise otc

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Thank you, so much I will get her some.

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My mother’s PCP has a nurse practitioner who comes in twice a week. I call or text her if there is a problem between times. If it can’t wait she goes to one of her drs or the ER. They aren’t really for emergency care. Is there a nursing Director? At my mother’s ALF the director calls me, the dr or NP if the daily nurses suspect a problem

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Does your mom still have a PCP in the area? It doesn't sound like you can rely on this facility for much in the way of medical care.

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In our area pcp washes hands as soon as they can.

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My mother lives in the Memory Care annex of Assisted Living. She uses the in-house physicians who come in regularly; the doctor and the PA who we particularly like, who comes in monthly, or more often if called. These docs have always treated mother for whatever ailed her, pretty much, including ordering urinalysis, blood tests, xrays and other assorted tests as required. She's fallen about 3 dozen times and has never needed to go the ER yet, believe it or not. The nurse at the ALF checks her for injuries, checks her vitals, calls me, and determines if there is a need for treatment. If so, there are traveling lab companies, traveling dentists, and traveling xray companies too, who all visit the ALs on a regular basis. Mother's Medicare pays for all of it, with a bit of a higher co pay if they're out of network. They do NOT pay for dental work of any kind, to the best of my knowledge. A couple of times the PA has ordered xrays for mother after a fall when she complained of pain (but where the PA did not feel a break had occurred). At the AL, in both annexes, there is a full time LPN on staff 24/7. My mother is wheelchair bound and it's pretty difficult to get her back & forth to appointments, so the docs who come to the ALF have been a lifesaver for us. I do take her to the ER sometimes, and to the dentist, and to the ENT for vertigo treatments, which is PLENTY.

I'm confused by you saying your mom can be fired by the doc if she 'continues to be a problem.' What? Are elderly people in Assisted Living Facilities supposed to be healthy all the time? I don't get it. Of course they are going to continue having problems, continue declining, and continue to need medical attention until they pass away! That sounds to me like an off-the-wall comment, if I'm understanding it correctly. If the doctor considers your mother a problem because she requires medical care, then something is rotten in Denmark.

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My mom has a driver any weekday, but I also drive her. This is not about transport it’s more about not being satisfied with answer dr gives, it’s been this way for many years, but since being in AL I guess we both expected better.

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The “fired” comment could have meant that your mother may need a higher level of care than what she is currently receiving & may need to be transferred to that level.

On another note, visiting nurses often shouldn’t say things like that with no explanation to whoever they are speaking with. Being a nurse myself you catch yourself before saying anything & think through your responses because anything said can be interpreted differently and/or cause unnecessary panic.

My MIL (95) is in an AL and is followed by their doctors. The only thing she goes out for are corneal injections for macular degeneration. My SIL takes her.

If it is getting too much to take her to appts she may have to reconsider. Maybe she will get too weary to commit to dressing up & going out.

Usually counties have their own senior/handicapped transportation buses that residents can apply for and use. In that case if you enroll your mother, you can request a wheelchair van and either meet her at the doctor appt or ride with her on the bus. Lifting a w/c and a senior into your vehicle can be physically difficult for us.

Wishing the best for both of you.

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MIL is in AL and uses it's medical team. According to the Medicare statements, a nurse practitioner sees her about twice a month. Not sure how often the doctor visits.

Assisted Living - how does your facility Dr. see your resident?

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