I realize this past year has been hard on everyone, so maybe its just been that, and the fact that with the lockouts, there has been less available family support. My mom is doing OK, most of the caregivers seem to be helpful and do their job compently, if not always how I would do it. I believe most of the frustrations I've had have been pandemic related; comunication and missing items. Hopefully that will be better now that visitation has been restored.
But, when mom moved into Assisted Living in March 2020, this facility had been open just over a year. It has IL, AL and Memory Care. Mom now lives in Memory Care since June 2020, due to dementia worsening.
There have been 2 Directors, 3 Directors of Nursing, 3 Assisted Living Managers, and now I've been informed that the 4th Memory Care Manager has left (she was only there a month!) While there have been a few changes in the staff that works in Memory Care area, it seems there has been less turnover there, but its hard to tell, since most of that time I just saw staff ocassionally if they came in while I was doing a video call with mom.
I guess I should be glad that the place is nice, it's clean, and Mom seems well taken care of. Which I am, of course. Its just frustrating to meet with the manager to try to establish a rapport for good communication and then poof, they are here one day and gone the next. Only one other time did they say, so and so will be leaving us in a few weeks. The rest has been me reaching out to discuss something and getting told they don't work here anymore.
I am an RN. I will returning to the field, though not in residential care. ALL facilities are having higher than normal staff turnover. Some older staff are choosing to retire now. Some younger staff are choosing to return to school and change fields. Other are reevaluating how their administrations have treated them under stressful conditions. This pandemic has been very stressful for healthcare workers at all levels and types of careers.
So I keep asking myself:
Is my loved one safe?
Are staff attentive?
Is my loved one clean, well-fed, comfortable?
Are the majority of their valuable still in place?
If yes, seems like this may be a good fit for now.
Keep reaching out to the facility and just ask who is in charge of your loved one's care. If there are concerns, ask and keep elevating the question to higher personnel until you get an answer.
While there were some staff changes, some chose to leave, others were asked to leave, but most of the care-givers have been fairly consistent. When visiting was allowed, there were some new faces, but plenty of "old" ones as well. Having certain contacts leave, like the nurse in charge of MC and the person doing the billing, certainly put a damper on things, especially when there is no notice! Since it's personnel issues, they aren't about to say so and so quit or this one was fired. At the very least they should send out notice about the NEW person taking over the position!
Since you indicate your mom appears to be well cared for and relatively happy, that is a comfort. It is the one thing I could count on. No matter what time of day or what day I showed up to visit (before lockdown), she was always clean, well-fed and relatively happy. I never gave indication of when I'd be there, so they couldn't just "prop" her up.
Despite misgivings by a select few on this forum, not all facilities are doom and gloom for our LOs. It is incumbent upon us to give the selection of a place proper consideration and know what is provided, as well as be there (when it's allowed, due to virus) to oversee their care.
If they have your email, I would request the director of the facility to ensure at least the responsible family members to receive email introducing ANY new hires. It's not their job to report when/why someone leaves, but they SHOULD be informing you, the person overseeing care, when there is a new contact!
Since 2018 there have been 5 directors and each of the following directors seem to be in the position for less period of time. The 4th one was by far the best but was in trouble with CEO when she fought to get the best for her residents and got fed up and left. The newest one has been ok so far but isn't as qualified as the past directors were. The middle 3 were RNs. The first wasn't an RN but an RN was also on staff of AL. Law of MO only require an RN 8/wk. So this one isn't an RN and the RN assigned comes as needed. While she does ok where she is the facility isn't the best - but affordable. It was originally not for profit, but church sold it to a for profit just after they moved in and services offered have declined. To make matters worse no one can contact corporate.
I do know when my husband and I were shopping around to move mom closer to me before COVID that many of the places were viewed had turn over in staff - esp the director chair. I was told it was a growing industry with new facilities offering new opportunities. I don't know. But it is time for me to get off my backside and get to work getting mom placed in a better facility. I was told by a couple of places I contacted on computer she may actually be able to move back to IL as what she needs now is assistance with med set-up which would be an additional expense and laundry assistance, which if she was closer to me I could handle easily.
If the facility is clean and she is well cared for I'd just keep an eye on how things progress. But it's always hard to break in an new director.
Surprised that more changes have not been seen at the lower levels of care -- the CNAs, kitchen, laundry and maintenance staff. As other have very rightly pointed out ... the salaries are abysmal, the work is hard and long. Even with good salaries it is always tricky getting good staff and when the salaries are bad.... well, you almost have to take what you can get and sometimes that's just not good. Most staff will have to work two jobs to make ends meet and sooner or later they just burnout. You end up with some people who are lazy or who will call out with only an hours notice (because they are lazy or because the other job they have has called them in for a day with additional money); this means the staff that does show up has to work extra hard and possibly do a double shift (16hours) to keep things going for the residents. Sooner or later those good souls burn out too. Pay rates in the better facilities start at $14/hr but in some of the well regarded ones kitchen staff can start as low as 11.50/hr. Of course, if you raise the pay rate, the owners are not going to give up a % of their profits so they are going to pass the pay rate hike onto the residents and the monthly rentals will increase. It's a vicious cycle.
It is good that you will be able to visit in person soon. If you find that Mom is being well cared for it means those lower paid folks are doing their jobs in spite of management changes and that's a good thing. If stuff is happening that you don't like, you may need to anonymously alert the Ombudsman's office or if the facility is owned by a large chain, go above the head of the always changing administrator and contact the CEO. If you decide to install a camera in your LO's room to ensure that she is being taken care of, please consult your state laws first. In some states a camera in a private room is considered an invasion of privacy and may be illegal.
Wishing you good luck.
But it is by no means unreasonable for you to expect to know who is accountable and who is leading this community. Can you look whichever company runs it up online?
That's exactly what I've been seeing at the facility where my mom lives. First it was the head nurse. Then the activities director, business manager, and another patient care position.
Next time, ask not that you'll get the real answer but you may get an answer from someone else that works there.
You should install a camera in her room so you can watch how she's really doing.
The thing with dementia, your loved one won't remember who treated her badly.
Prayers
This could help the staff, and I’d imagine whoever calls stays anonymous to the facility.
This is akin to calling animal control when you’re not sure things are okay at a residence - people always think they’re turning someone in! You’re just asking the authorities to visit and see what they think, they take no action if things are fine.
Mom's doing OK, been cooperating with PT, participating in some activities, and I'm getting to visit again, so I'm just going with the flow, and keeping my eyes /ears open.
If you are happy with the care I would not be concerned, but you may get somewhere speaking quietly with those working on the floor doing the jobs in cafeteria care and so on, just to see if anyone says. Some little "I am a bit concerned how many are leaving this great place; it must be a really hard job, though". See if anyone bites.
Locally, it begins with a companies' hiring practices in selecting the right candidates and then offering a culture of retention. This applies to both management and direct care workers. This means providing a living wage, health benefits, paid vacations, a chance for continuing education and certification. No one wants to realize they'll never get beyond where they are today. For the first line caregivers, orientation requires more than a 4 hour video to be proficient in what you're doing. Training needs to be person centered and competency based. Employees want to feel that they're important and wanted. I'm sure the residents would appreciate a well trained, dedicated staff, also.
There is no incentive anymore to stay put. No pensions and businesses feel people can be replaced and experience working for that company is not considered when getting a raise. In my years working, I have seen people work at a job and told their salary is being capped. The person leaves to find a better paying job and the replacement starts out more than the person who left. It happened to me. I left for pregnancy making 15 an hr (35 yrs ago) and they brought in a replacement for 16 an hr with no experience.
Obviously, the longer the admin has been in place, the better run the facility. This is also true of day cares. My 2 younger sons went to a daycare where the lead administrator had been there 20 years and it showed (as compared to day cares where my first son attended). I picked this day care largely based on her tenure. My MIL is in a non-profit faith-based facility where several of the admin had been there decades, and it shows. The corporate entity under which it is "owned" manages several other facilities. In this same facility however, there is a certain amount of turn-over in medical and aid staffing. But as others have posted, this could certainly be due to the covid impact. In my mind an aid position is a stepping-stone to other types of jobs and so it would surprise me if an aid was there for very long. The floor or head nurses may change due to scheduling challenges and shift issues. Again, could be from covid.
New facilities have quite the challenge trying to balance expenses and care needed by residents.