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So this will come as no surprise to any of you, not even me, but is this just another example of something that has no solution?


When signing mom up for AL, we were shown a monthly calendar of activities, told she would shower twice a day, etc. Of course COVID is a convenient excuse why there have been no activities since she moved in (Jan of this year) and probably never will be activities again. She has not showered since moving in, except when she was in the nursing home for a month-long stay. She "washes up" in the sink , but won't get in the shower. They don't make her, which I sort of understand, because it would be a battle and they can't manhandle her. Lately I've been taking wipes over there and encouraging her to clean herself with them. She doesn't smell and her clothes are always clean (until yesterday when I went and she had the same outfit on that she was wearing Friday and I think she's had it on for the last four days).


Anyway, the only way she gets her hair washed is if I tell them my sister is coming to cut it and then they will take her in the salon and wash it. WTH? I thought it was assisted living?


They have a hairdresser that comes every other week and charges $22 for a shampoo and style. So I have started paying for that since I know it makes her feel better and I can't take her anywhere with greasy hair. So on top of the place receiving nearly $6k per month, I have to pay for her medicine (through their pharmacy), Ensure, Depends and hair washing. It's a real racket.


But that isn't even my biggest complaint. All she does is lay in bed all day and barely gets up for meals. Because there is nothing to do! No reason to get out of bed. The only thing happening there is 3 meals a day and a snack or two. She is not eating all her meals anymore. We are all trying to visit and call more, but she won't answer her cell half the time (why is getting a "home phone" so much drama?). I went over yesterday and found Little League on TV for her, because thank God that is one thing she is interested in and at least she can sit up in her chair and watch it. But really! Is COVID going to be the reason the place is understaffed and not having activities forever? Is this the new normal? I assume all of them are the same and Mom is already in the nicest one we can afford.


I am tempted to put her back on Hospice because at least then she would have more visitors - the nurse, the chaplain, etc.


I just think there are things they could do there w/o having outside people come in. I'm just aggravated, y'all, and I am venting.


It's like they have us over a barrel, they know we can't afford to pay someone at home all day and night (still no activities but more than where she is now) plus the whole caregiver scheduling thing, and they know all the places are the same, so they can do whatever they want. It's just very sad. Her doctor mentioned putting her on an antidepressant, and I told him she is depressed because there is nothing to do! If you can change your situation, that should be the first choice before taking a drug, but I guess in her case, we can't change her situation.


And worst of all, none of this is going to change before I am 87! What in the world am I going to do with myself then?

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Sandola some of these thing can be related to covid. But to me there are excuses that you are being told that is not related to covid. Like being as they call it short staff. That is a standard excuss use a lot. The are only short staff because they don't want to waste their profit on staffing. As far as showering they are a care facility they are to be trained to know who to be able to get the residents (clients $$$$) to bath. That is way we pay them an out rages amount of money. But it is easier to say the resident (client) won't let them bath you loved one. When my husband was in MC they would not assist him with shaving. So I purchase a shaver and clippers to keep with me and when I visited him I took care of his grooming and washing of his feet. There was a time for weeks and weeks he wore the same socks. When I informed the director I was asked how could I tell. It was a never ending battle to have my husband treated with dignity and respect. One time when I visited him they brought him to me from the dinning room with fecal matter on his nails. That night they had sandwiches for supper. Again I spoke with the director and she asked me to text her the pictures so she can train her staff about hand washing. Five and a half months my husband lasted in the facility. Entered in 7/1/20 sent to ER 12/9/20 with pneumonia 12/17/20 sent directly to hospice 12/26/20 @ 1:06am passed way. Hang in there many prayers for all of you.
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My mom is in a Rehab place which is brand new . Yesi its expensive over 7 grand a month. Can't afford round the clock care at home though she wishes she could go home now as she sd its boring. Corvid changed everything. No more bingo or get together n art classes or eating in dining room with your friends. All were confined to their rooms. In May this year they opened it up to visitors with masks shields etc. Was good for 2 months n Corvid hit again.. doors closed for a few weeks.. doors opened again but we decided we stay away due to Delta n sure enough i get a call n a case has popped up. The way I see it they are doing the best they can. My mom has her knitting her books her pyzzels but she won't do it nor write letters or call people. Its her n CNN. She sd she misses sitting in dining room n her friends. They always had a hairdresser come in n she has always used that. I think thats a good idea you signed your mom up. At a rehab place they help with bathing though I was under the impression assisted living they don't as they expect people to do it themselves. That's one reason I didn't pick an assistant living. My mom even stopped using her laptop. So hang in there just call her on phone a lot
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I have worked with dementia patients for almost 30 years, some very close to the end of their life where they work totally against anything and everything you try to do for them, including bathing. They either put themselves on the toilet/commode or I do. Then, I have towels, washcloths handy and get busy cleaning them. They will yell.. maybe scream acting like you are killing them.... I also have a large cup handy and fill with water and pour down their front and back while they are on the toilet. May get the floor wet but, easy to clean up and they are cleaner than they were before! Just put towels on the floor around the toilet BEFORE you start bathing them. And.. you don't have to "clean" everything in the same sitting.
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I hear your cry and everything you say is l00% true - what should be and what actually does take place in assisted living are world's apart. I will be 88 and live in assisted living because I became disabled and can't walk. It was hell for me in the beginning (l3 years now) and I finally got wise. Even though I am in intense pain, I made up my mind I was going to look after myself and I do 99.9%. I do everything a normal person does (it is very hard, time consuming, painful and frustrating - but I force myself and succeed). I still work two jobs (51 years and 15 years as a Power of Attorney); I handle l00% of my own affairs; take care of my room (their idea of cleaning is l5 minutes); do all my laundry; often prepare my own meals so I get decent food, have lots of hobbies - I do everything. I even saved my life on four (4) separate occasions because no matter how I buzzed for help - NO ONE CAME. I saved my life in the worst one where I was 95% dead and unconscious for 24 hours. My dialing 911 and getting emergency heart surgery saved my life. They did NOTHING in any of the four situations even though they were critical. So if you live in a facility, YOU HAVE TO DO IT YOUSELF TO MAKE SURE IT IS DONE CORRECTLY AND IN A REASONABLE TIME FRAME. There is no other way I know of.
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Mom's AL was a very nice place once you understand what the differences between the different levels of care. She got a room and private bath, house keeping 2X a week, showers 2X a week, they administered meds (yes provided through their contracted pharmacy), 3 meals a day plus snacks, and provided daily activities and trips for shopping and sightseeing. All for $4300 a month in Central Ohio.

She was assessed by the nurse supervisor before being admitted to ensure she was able to live with minimal assistance. Because she was a fall risk one of the aids would sit in her room while she showered but didn’t help. Side note: some facilities like to assist in showering and dressing to watch for signs of injury or skin problems. The staff ratio was 2 daytime aids and 2 nurses for 48 residents, 1 aid at night with a nurse on-call.

Mom was able to dress herself, made her bed everyday, keep her room tidy, and using her walker get around the facility and out to the transport without help. Having them administer her meds was a huge help because she kept forgetting which ones to take when. She wasn’t a fussy eater and enjoyed the soups. The facility provided space for a stylist to work one day a week to cut and style hair for a low fee.

Just remember that AL isn’t a 4-star hotel, they provide supervision not personal care. Even hotels are starting to reduce rates and have a menu of added, for a fee, services so customers aren’t being charged for amenities they don’t use.

Yes, Covid put a halt to all activities but that happened everywhere. Good places were creative in getting around the isolation. Mom's AL had a fantastic, committed activities director. You might want to move her to a different facility.
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Please keep in mind that assisted living is supposed to be about elders who could be living independently, making their own decisions, but need help "assistance" to accomplish their ADL's. This is not the same as memory care or a nursing home.
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My mom has been in assisted living for 10 years and I have had to be her advocate. That means staying on top of her care because you cannot assume that your loved one is getting the care consistently. So much depends on if the facility has enough aides and if they are trained & supervised properly. The problem is the continuous turnover of aides. They are poorly paid and expected to work double shifts when other aides don’t show up for work. I have seen this too many times.

At my moms last care plan, the nurse stated that she is a 2 person assist and needs to move to a nursing home. Yet I am able to toilet her myself, shower her and get her in and out of a car to go to doctor. I have 3 physical therapists who evaluated her and agree with me that she does not need to go to a nursing home. She is able to wheel herself to & from the dining room, stand with help, and follow directions.
I have appealed her discharge and have a hearing with the State this week. I feel these assisted living facilities are happy to take your $ but not willing to provide the care you pay for.
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alzdone Sep 2021
I 100% agree. This was my situation with my husband. I had a nice that was a CNA and gave me a lot of insight to these facilities.
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some AL have a sort of walk in jacuzzi, which might sub for a shower. ask.
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my mother went into nursing home in april, had to be quaranteed for 2 weeks, so i did window visits and phone calls. then into a regular room with another woman. that was okay, but due to the timing, they were not doing any activities at the time due to covid and the short staff, which yes.......alot of places have short staff because no one wants to work when they are getting free money to sit on their butts. however, when the NH opened, i still had to wear a mask, but they finally started their bingo, church services, etc.............but now we are back to me having to wear full gear because someone tested positive......so in gown, gloves, N95, faceshield and sweating I can go see my mom. they cannot go out of the rooms.......they are protecting the residents. And yes it can be boring, but hopefully things will get back to a Little normalcy. I do my mom's laundry because they only have 1 person working in that department, so its easier for me to get it one day and deliver the clean stuff about 4 days later when i visit her again in full gear. do i like it........no........but i do it. I wish you luck and hopefully things will get better soon. hang in there.
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It sounds like the workers there are rather inexperienced in taking care of the elderly. I don't think it's covid that's causing the problem. I think it's probably understaffed and not enough experienced workers. You might want to redo your home and have in home care the closer you get to eighty.
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Have you talked to the facility to see if Memory Care would be more appropriate for your mother? It will cost more but more services and attention will be included.
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The best ace would be to let her live with you or a loved one and have her on Hospice.
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TaylorUK Aug 2021
How does that work when the author reaches 87!
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sandola: Imho, there exists short staffing across the board, e.g. in virtually all care settings.
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For my2cents: (or anyone interested in having an iPad auto answer FaceTime)
go to settings app
Select accessibility
Select touch
On the touch screen, scroll to bottom and select call audio routing
On the call audio routing screen, select auto answer calls
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My father is 96, I have him at home, I have 3 caregivers. and spent 800 hundred at week, he is never alone, and he seems content.
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Daughterllo2 Aug 2021
How much help does your father need? Do you have agency workers and are they working around the clock? $800 a week seems low
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For ourselves sake, we are going to have to keep ourselves as strong as healthy as long as we can. By the way you can get at home care, daily, even twice daily, with some insurances. Renew time is a month away.
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I hope that if we all complain and fight for better care it could change within a couple of years. Not completely but mostly. I have talked to the other family members of assisted living patients with their share of grief and frustration and has asked them to complain as often as needed. This is how change can come about. Don't act like a victim be a warrier.
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Sarah3 Aug 2021
Actions get results better then complaints- I agree about complaining but if families complain and continue pouring f their money into these institutions change won’t happen. Withdraw your loved ones, find alternate care - when you withdraw them let them know in writing the reason why
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I SO understand your post!!! Many times over. This is happening to my brother in a rehab, exactly the same thing. I thought it was just this place, but no they are all getting away with murder and the staff are all young girls with no experience. Cant even drop some food off without them loosing it. It's such a shame. They are not thriving they are just existing there and for a price of $6,000 its one of the biggest rip offs i have seen. You can talk to a higher up and think your request will be resolved but no, they don't do anything and they lie. I have given up, don't know what to do nobody will help.
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Bks105 Aug 2021
I totally agree. Mom was supposed to have assistance when moving around including going to the bathroom. We were told to just have her call her pendant. She called, no one would come and she would fall. She broke her hip with one of her falls. The payoff was one night that no one came after she fell and she called 911. The fire department picked her up off the floor and the aide showed up as they were leaving.
We moved her home after a year of this and trying two different assisted living facilities. We had to completely redo her bathroom and we now have caregivers come in. Very expensive but at least she is safe and happier.

We
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Although we now live in a "COVID WORLD" my experiences memorialized in REMEMBERING WHAT I FORGOT (2017) can help answer your questions in addition to educating you and other family members about the many challenges often experienced in todays assisted living environment.

K. Allen
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No place gives a bath twice a day. I’m sure it was meant to be twice a week which is what other nursing homes do.
You should be able to bring her food or have it delivered as a treat.
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It sounds like you are expecting a higher level of care for your mother than the level you signed up for. You may need to look into raising her level of care.

Ala carte charges for extra services are the norm.
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Sarah3 Aug 2021
Rip off racket— they start off with astronomically high cost for “assisted living” but they leave out 90% of what assistance many seniors need and then charge extra for assistance!
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My mother's memory care facility quaranteened as a facility, and continued a full schedule of activities. There were some changes of course: restrictions on visits that change with the pandemic status, a robust screening and vaccination program for residents and staff, and no outside activity presenters. But they did a great job of finding pandemic safe activities. It can be done!!!
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Cover99 Aug 2021
Watching TV
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As has been correctly stated in previous posts:
1. AL's, slightly understaffed in the best of conditions, are more understaffed now than ever. People would rather work for $15/hr at fast food chains, with flexible hours and free lunches or better yet at Amazon for $18 to $20/hr than in the senior living for $13/hr (kitchen aides start at a whopping 11.50/ in high priced). You better believe AL's, NHs and some hospitals are understaffed in the lower levels. Staff cannot force anyone to participate in showers or activities. Resident's rights and all that!

2. Depending on the situation in the individual facility, activities may be curtailed and dining rooms closed to protect the health of the residents. We have one 4 star facility in NJ that had opened it's dining rooms and started activities in June but closed them this weekend when 10 residents begin coughing and running temps. Everyone (staff and residents) has to be tested again but they are waiting for results before going back to "normal" dining and activities. Bummer for all concerned.

3. ALs are just that. They provide an "assist" to a resident, not full care; in some instances they are almost more geared for the independent living folks who just want a 5 star meal every evening. Hair cuts and styling are extra even in NH's. Housekeeping is usually 1 or 2x per week. I would look to see what level of care you at which you have your Mom. Some facilities include 1 med in the basic entry fee but many do not. Depending on the number of medications, your Mom may need a higher level of care (definitely has a higher cost associated with it).

All that having said I think you should know that the standard marketing tour of an AL is geared for the person (their family) who is ready and willing to move into an AL (you'd be surprised how many people who look forward to it. They are tired of mowing the lawn, getting service people in to check the water heater, cooking dinner for one or two.) The AL allows them to grocery shop more lightly as there is one full and sometimes outstanding meal (usually dinner or lunch) provided. Activities that they like and are interested in are on site. Meals and activities are provided and announced and it is basically on the residents to participate unless they have one of the advertised level of care (here go the rates on the upward spiral again!) in which case they MAY get more of a push toward participation.

You can call the Ombudsman office and your state DoH and report your issues; they may not find neglect or abuse but they will respond to you with their findings. You may need to search for another AL that more closely meets Mom's needs or she might be at the level of MC now; if you can come to an understanding with the current administration and they have good MC service on site you might move Mom there (with a new agreement in place for those services). In any event I urge you to closely ready the agreement you sign (never mind what you were told, it's the written stuff that holds up in hearings and in court rooms), I have even advised my clients who are considering CCRC to have that agreement read by their attorney. That big entry fee is just like buying a house.
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Perhaps think about this from another perspective. At about $20 per hour, you are paying for 300 hours of care per month. I doubt she needs 2 baths a day - most NH do a bath every other day. A whole week without a bath is not quality care at all. If they have no activities at all and she is just laying in her bed or sitting in her room alone, how often do you think they even come by to spend a little time with her. Probably not very often. Out of sight and out of mind. More than likely she sees someone 3 times a day for meals, maybe one or two more brief drop-bys to bring a snack. Overall, do you really think she gets anywhere close to 300 hours of 'assistance' in a month? I doubt she gets 200 hrs of assistance.

Based on her current activities and care she is receiving, other than being bored out of her mind, she is managing with a very solitary life. What if you found some in-home health at about $20 to 25 per hour to provide assistance to her in your home. Clearly she doesn't need 24/7 eyes on her every move - she's not getting that now. Maybe hire two different people - AM person to do bathing 2-3 times a week, get breakfast, meds and pick up around her bedroom. Start with 2-3 hrs for that shift. Afternoon or evening - another 2-3 hrs to prepare a meal, a load of laundry a couple times a week, etc. You may have enough leftovers from your own meals to have a lunch in the frig to heat up for her in the middle day.

I think her money would be better spent to get actual hands on care for her - and perhaps less than she's spending now. In your mind, you might be thinking that $6K a month is getting her 24/7 care and that's why you can't afford it at home. But, that is simply not the truth. She's not getting anywhere to close to that kind of care. That's why it's called 'assisted'. NH is for people who need 24/7, and you'll even find similar issues there. If her care actually reaches a 24/7 need, then a NH might be the better option at that time. Just doesn't appear that assisted living, where she is, is worth what she's spending.

You might also look for another facility. This one is just one of those who is willing to take the money, but lower the level of service by using covid as an excuse. Many facilities did as little as possible before covid was even an issue, but now they seem to blame staffing and lack of care on something that everyone sees on the news every day. Not saying covid is not real - it is - however there is no reason the can't have some sort of activity.
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rovana Aug 2021
Sounds like "assisted living" covers a range from "almost independent living, but with cooking and laundry done for resident" to "just about nursing home", with fairly heavy needs.
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My mom was in a nursing home last February for rehab after a broken hip. "A staff member tested positive for Covid for everything is in 2 week quarantine" was their excuse for everything. Nobody left their room and nobody was allowed to visit. Her 'rehab' consisted of her getting up in a walker & walking about 5 feet per day. Every time the 2 week quarantine was up, it was the same excuse. I found out it was a lie through this website https://data.cms.gov/covid-19/covid-19-nursing-home-data . The last positive staff case was 5 months prior to my mom's stay. When my mom asked to use the shower (a communal shower), she was told that the positive staff member was "in that area", so nobody could use it. Huh?

The final straw for me was when we were picking up mom to come home. There was a little old man outside with flowers in a little vase for his wife. He was asking when they would be able to leave their rooms because his wife was going crazy. She was the type to go all over the NH - dining room, activities, visiting her friends in their rooms, etc. and now she was just laying in her bed all day and he could tell she was getting very depressed.

Though mom was home already, I contacted the corporation that owned the nursing home and the ombudsman telling them about them lying about their positive staff cases and my thought that they were just using it as an excuse to keep the residents confined to their rooms. I don't know if it did any good, but I noticed that their webpage now has an daily updated list of Covid cases, so that argument can't be used by them anymore.
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theguardian Aug 2021
I'm so mad your Mom had to endure that, but the picture you painted of the elderly gentleman with flowers for his wife literally brought tears to my eyes. The crap these facilities pull are just horrendous! I sincerely hope there's a special place in hell for the owners of facilities like that.
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An assisted living facility can be godsend for everyone, but it works best when you remain an active participant in your mom’s care.

The reality is that practically all of these facilities are understaffed and only a few of them offer comprehensive staff training in everything from bathing to dementia communication.

So, what to do? First some practical things you can do right away: Buy her incontinence products yourself. Likewise her medications. Next: volunteer to help out with activities or if you're not available during the day, visit at dinner time in the dining room with your mom and her table mates. You can help them engage in conversations. You can offer to lead a weekly sing-along or an after-dinner chat group. - These are very simple things that will help your mom and also take the load off the over-burdened staff. 

And get to know the Ombudman volunteer. 

Don’t forget to acknowledge the staff. They are your “team-mates” - Share with them tips on how to help your mom, your concerns, and your pleasures. An occasional “thank you” note, box of chocolates or cookies, and bouquet of flowers will go a long, long way. 

PS. In thirty years, I’ve never heard of more than three showers a week, unless the resident has an accident.
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Sarah3 Aug 2021
“Only a few offer training in issues such as bathing and dementia”—- so true for most of these places and why I can’t understand why anyone would shell out that much money even if they’re a millionaire for almost non existent care
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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.
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DrLokvig Aug 2021
I love the iPad suggestion.
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I can feel your frustration and anger coming through the computer. This site is a great place to vent. My mother’s wonderful Memory Care facility is also not the same since Covid. Staff is trying. Perhaps a shift in thinking about most of your complaints will help. My mother was in a different wonderful assisted living four years before Covid. I always paid for hairdresser, prescriptions, depends, and Ensure. I never felt like that made the assisted living “a racket.” I also paid a private caregiver to sit with her four hours every evening to help her with sundowning. As for bathing “twice a day”, surely they misspoke. Normal procedure is two or three times a week for bathing aide. Before Covid, I was up there every day and witnessed many of the activities and found most residents chose not to attend.
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Sarah3 Aug 2021
If your paying for her to be in an assisted living it shouldn’t be necessary to pay additional cost of a caregiver to be with her ( I understand it is necessary though since most of these facilities don’t provide care and definitely don’t have what they need in place to care for seniors) that’s why a lot of people are saying it’s a racket
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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.
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Invisible Aug 2021
I did hire some companion care for my father, as he was not interested in participating in group activities. Our frequent presence sent a message to the staff that we were monitoring his care. I also ate some meals there to assess food quality. It was a newly opened place, so getting TV and phone were a challenge, getting and keeping a good chef was a problem, the new activities director took awhile getting a program going. If I had it to do over, I would go with experience. We could not get into our first choice.

Showering twice a day seems a bit much. I would think twice a week would be adequate. Ask her doctor what she needs.
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I hate to say it again but assisted livings for the most part are exactly as you said- a racket. They are all about making ad much money as possible so most of the thousands you pay each month go to the big shots in the office not the actual day to day staff. Some offer an caretaker assistant - they do some of the basic caregiving tasks you could easily do or have someone do for a loved one at home abd they pay these caregivers at the assisted living low wage. They have high turnover rate ( except for the office big shots who don’t do any hands on care)
To cut costs and appropriate most of the thousands you pay per month toward office big shots they cut corners on floor staff- even in memory care there’s a range of 1 staff person per 10-16 residents. The assisted part? Is that a joke- paying thousands a month you’ll need to pay extra for your loved one to have assistance dressing or in the shower etc. The food is cheap cafeteria food not fresh nutritional food — this is generally speaking. There may be the occasional assisted living that lives up to its name but most are predatory and greedy focused on making profits. If you ever call or go tour one they will keep calling or emailing you like car sales or realtors!!
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DrLokvig Aug 2021
I'm sorry to strongly disagree with you. Very few private-pay assisted living facilities are raking in the cash. I challenge you to do the numbers. I did just that and was shocked to see how wrong I was. I could not have offered anything decent for less. You're looking at close to equal numbers of staff to residents. If you have 24 residents, you'll probably need at least 24 staff to run a 24/7 operation; and that's without the frills.
Try it!
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