My third question in three hours - new to this forum and my 89yo mother newly admitted to assisted living/memory care. So much help already!
I chose to install a camera during Mom's first week in the facility. I was told that residents are checked every two hours (that is a typical standard) but that some families request to spread that check out so that their loved ones can get more uninterrupted sleep. I think that may be a good idea but I have NOT discussed such an arrangement for my mother yet.
So far, based on what our camera captures at night, the 2-hour checks are NOT happening. In fact, there have been at least two nights in 9 days during which we did not capture the door opening for at least 12 hours and her meal tray was left in the room all night. One of those evenings she wasn't taken to the dining room, nor was she offered a dinner tray or bedtime snack. Fortunately, I had left protein drinks in her room.
I've noticed that one particular night shift medication assistant typically enters the room at 5:30 in the morning to give an "early am" medication on an empty stomach, flipping on the overhead light without warning. Mom is much annoyed by this behavior and has consequently refused the medication. I'm sure the medication assistant then documents "refused" and Mom doesn't get the medication that day (later, on a full stomach would be better than not at all). So, you see, this behavior has important consequences. This same caregiver has also entered her room several times over the last week, at various hours, flipping on the light without warning. One early morning she entered the room to give Mom her early AM medication with music playing on her mobile device.
Are caregivers required to turn on the overhead light to check on the residents? If not, why in the world does she think this is okay to do? Do you have suggestions about an alternative approach we can request that will be safe for the caregiver, help her achieve her purpose(s) for the visit, and be less disruptive to Mom? I thought about putting a small lamp just inside the room and encouraging Mom to leave it on all night.
I plan to address these concerns during the first care plan meeting, if not sooner. If decide to negotiate for fewer checks during the night, for how many hours without checks do you advise I arrange?
Thank you!
The flipping the light on without warning, let alone permission: that member of staff wants a poke in the eye and maybe some fine day a resident will make sure she gets it. Seriously, this is outrageous. You knock and wait. You knock and stick your head round the door. You enter the room, approach the resident, speak to the resident, if necessary place a hand on the resident's nearest shoulder and gently move to and fro (you note I wouldn't say "shake) to wake her. Once you get a response you then ask permission to turn on the light, first warning her to shield or close her eyes.
At least that's what I do; but then again I haven't got to give medication to - what, 20? 30? - residents by 7 a.m.
Still, there must be some happy middle way, surely, even if time is short, and a gentler light would be a good start. Also a word from her manager about residents' rights to privacy, dignity, and respect. And to not being startled out of their wits before sunrise.
My mother is in Memory Care. I expect her caregivers to give all of the care that I am paying for.
DEFINITELY, I would want the checks in the night. If my mother fell, I wouldn’t want her laying there all night.
I don’t think that it is reasonable for anyone to throw on the overhead lights. In the hospital, they try not to do that, if possible. They can certainly do it at a MC. A nightlight would take care of lighting the way for meds.
If I saw what you saw, I would be marching myself down there, demanding to see the Executive Director.
Big sigh on your behalf! Let us know how it works out!
ALF vary quite a lot. They are NOT regulated overmuch by the authorities of a state, and it is expected that residents are able to call for help when they need it. Some residents (my brother was one) refused to have nightly visits done. We signed a waiver to this affect as it was their policy to check at least once nightly. He also didn't want anyone entering his room without knocking. This was done. I saw his "care plan" instructions on the night crew medication nurse roving cart. These things were done to his satisfaction.
Memory care requires more care for residents. The memory cares that are a part of ALF have their policies. They may not be followed to the dotted line, but in general are followed.
Do know also that most ALF have "care levels" and if a senior is able to be independent then the level may be 400.00 a month (on top of the core fee) but if requiring a very specialized care plan and help may be 1,000.00 a month. I am certain this was explained to you on intake as you were given a generalized plan of expectation levels of what is normally done.
Do know that if your senior is in general well satisfied and well cared for, a whole lot of squeeky wheel stuff can go quickly from attempting to keep you happy to believing you cannot be kept happy and may be happier somewhere else.
As to lights on and off and etc. there is only so much individual attention and "wants" that can be done when there is at night often much less staff. If care has to be terribly specialized then perhaps a Board and Care is a better choice for this senior where there are fewer residents, say about 6 or 7 in a much more home like situation.
I wish you good luck in coming to some sort of happy medium where you and your senior can feel you are getting really fine care, if not always up to what they may get in your own home. Wishing you the best.
BTW, Alvadeer, that early morning med that seems to require the CMA to wake Mom by flipping on the light is, you guessed it, levothyroxine (Synthroid) for her thyroid. For some reason - I have no idea why - she crushed it and put it in chocolate pudding. ;-) Mom swallows tiny pills just fine. So, Mom - and rightly so - was mad the last two mornings and refused the med. Consequently, I'm sure the CMA documented the medication as refused, and it wasn't offered again.
Not wanting to wait until the care plan meeting to address this myself, I've asked the hospice nurse to ask the doctor to make an exception to the empty stomach recommendation for this med and prescribe it so the CMAs can give it along with her antihypertensive and breakfast. I figure sleeping another hour and a half absorbing some of the medicine is better than not absorbing any at all! I'm satisfied with this workaround. What do you think?
I look at Assisted Living is your paying rent and getting some assistance you need. Its your residence. As such, I can get up when I want and go to bed when I want. Yes meals are at a certain time. Moms room had a kitchenette so I could have left cereal and milk if she when she wanted something to eat because she missed mealtime.
Now MC maybe different they may have to stick to schedules and Dementia patients do better with routine.
Though Mom doesn't have a kitchen, I left protein drinks and her favorite juice in her room. Unfortunately, because she's not acclimated to the meal routine, and has no concept of time fo day, she has been taking advantage of those "snaks" and then, about 50% of the time, refused to go to the dining room. So, I hope to collaborate soon with the staff about putting them on the high shelf in her closet and if she needs the snack because she skipped a meal, they can help her get it. After all, one of the things we're paying for is chef-prepared meals!