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MIL called me said she pulled the string for help two hours ago. I went there, she was soaked in urine. I pulled the second room string, which was ignored. An hour later, I called the facility from inside her room and then they came.


Is this normal?

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It’s unacceptable
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My aunt had to move to a higher level of care. Her Assisted Living did not handle incontinence if the resident could not change themselves.
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MILHell, depends on the Staffing for that time of day, and if other residents were also in need of help.
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An hour is a long time. Too long. (I don't wish to ignore the 2 hours MIL stated but just going on what you actually saw yourself).

Staffing here is being impacted by yet another Covid wave - not just staff illness but staff burn out & staff leaving the sector permanently. Little immigration for 2 yrs now means less new staff into training courses & being ready for recruitment. It was on our news just last night.

Q Ask Management about the call time response & reasons. Q Ask about staffing level/issues.
Q Ask about her care level needs.

What I would do focus on what I could change for now.
* Could MIL be more independent with changing pads/pants if easier item, or easier to manage clothing?
* Ensure MIL can press her call bell (appears yes).
* Ensure she is provided with the most absorbent type of incontinence pads/pants.
* If this incontinence is new - seek medical advice (UTI?)
* If not new, but ongoing & MIL's needs are more than a few pop in visits a day, consider if the AL setting is still the right level of help for her.
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Thank you for your responses.

The Medicaid case manager will not approve a higher level of care facility. That is why we go there twice a day to give her insulin and treat a bedsore on her bottom.

I hired a professional cleaner to go in today to clean her room and steam clean her chair. The room is filthy and she deserves dignity. I am picking her up in a few hours to bring her home for the night while the chair dries.

Husband is out of town for work and will be back tonight until Monday. He plans on meeting with the facility.

Wish me luck today, it will be a long 24 hours.
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babsjvd Jul 2022
You can purchase washable pads for the chair on Amazon. I used that plus I put disposable chux on top of the washable. I bought puppy pads from costco … bigger
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I have another question.

She has a hard time eating and food falls out of her mouth. Some other residents complained so she is not allowed to eat in the dining area with others. The facility also will not give her items she asks for. The other day she asked for an apple, she was told no because it could fall on the floor. I brought her 2 and the worker dressed me down. Is this normal?
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PeggySue2020 Jul 2022
Her jello or ensure could fall to the floor. That is not reasonable. The apple can be cut up for her, some
pieces mat fall to the floor but so what?

Even prisoners get fresh produce in prison.
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Maybe she needs to be moved to a nursing home. I have my mother in AL, she is able to do for herself at age 97. The AL's I've been exposed to do not give the care that she seems to need.

Might want to check this out.
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Thank you but as I said, the Medicaid case manager will not approve a nursing home. I know she is not getting the correct care, the whole family knows it. I was asked by my husband to quit my job to take care of her but I can no longer do it. I said no which has caused some fights. She is going downhill fast there.
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bundleofjoy Jul 2022
"I was asked by my husband to quit my job to take care of her"

People love telling -- others -- to do the caregiving.
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No, I would say that this isn't normal.
How long has MIL lived here? Was service for the most part answered? What time of the day was this?
Time to talk to admins and time to consider whether or not to put a camera in. You need an explanation of what emergency was happening that prevented an answer.
Does MIL have a phone with speed dial numbers in it, because she needs a number to call if this happens again, I would say.
When you visit MIL and speak with other residents is this something you can ask them about--I mean their general experiences with needing help and not getting it?
Also do know that ALF do not have the staffing MC units and Nursing Homes do (or should have).
I hope that you will encourage MIL to keep a diary of when she calls, for what, how long it takes for an answer, and what her need was. I hope you'll update us after meeting with administration.
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Her room was filthy? Is not cleaning her room part of her room and board.

I may go above the case managers head. Sounds to me this is not the place for Mom and she needs to be evaluated for a different level of care.
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BurntCaregiver Jul 2022
Housekeeping is part of what AL is supposed to provide.
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No. A three-hour wait for someone to get a diaper change is completely unacceptable on every level wherever they are.
Assisted living may not be the right place for your MIL.
If she's in diapers and not allowed to eat in the dining room anymore because she slops food all over the place, she needs upgraded care. A nursing home or memory care facility. The AL is obligated to inform you of this and help you find an appropriate facility where her needs can be met.
As for the Medicaid case manager who will not approve a nursing home. Your MIL's doctor is the one who determines what level of care she needs. Not the caseworker. Also the caseworker has a supervisor. Go to them. Speak to your state's Ombudsman's office too if you need to.

As for the worker 'dressing you down' for bringing the apples.
Oh, no, no, no. You do not allow that for one damn second. Thr AL facility is not letting your MIL stay there for free out of the goodness of their hearts. They are getting paid.
Look through whatever paperwork was given when your MIL was moved into the AL facility. There should be documents plainly stating exactly what services they provide to a resident and what they do not.
After you have reviewed this, you and your family need to become a total nuisance to that AL and make the lives of the administration of that facility a living hell. Make them do the jobs they are getting paid every week to do. You would do well to take pictures of her filthy room before bringing in your own hired help to clean it. The AL staff is supposed to be providing housekeeping.
I worked in an AL years ago. In fact, I was a shift supervisor. Our policy was that the residents had to be able to independently dress themselves and be able to walk (canes were fine but walkers were not allowed). Bathing assistance was offered, but not diaper or pull-up changes. If a resident was at the point where they were incontinent and sitting in it, they were supposed to leave our facility.
The place got in trouble because the administration was allowing residents to remain who needed a higher level of care yet not providing the care the needed.
This could be what's going on in your MIL's facility. There is likely other residents who need as much care as her or more who aren't getting it.
This AL needs to be snitched on to the state and shut down until they clean their act up.
As for hubs thinking you should be taking care of his mother. Oh, HELL no. I don't think so. Please don't get talked into moving her in with you.
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sp19690 Jul 2022
Do you think it has to do with money why they are letting someone stay in AL who clearly needs more assistance than they are able to provide?
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You are going 3 separate times a day to your MIL's ALF? That's a lot! Even once a day, for me, would be a deal breaker. Your life is centered around her. Does DH go with you or are you expected to handle this on your own.

It does sound like MIL is requiring a much higher level of care than is being provided. Since DH is meeting with the head of the facility, I HOPE he can be tough and firm with his discussion as to the greater need for care. Probably she needs to be evaluated for a place that is more on task. She isn't capable of getting herself to the toilet, she drops food (and I daresay, a lot of other stuff) and she cannot keep her living quarters clean? She's definitely not cut out for independent living.

Good Luck. I can feel your anxiety for the weekend visit in your post. I hope things get settled!
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I go to the ALF 4 times a day. My husband does it when he is in town, he has been out of town the last month and for another two weeks.

It is very sad, she fell asleep while making jam. I toileted her when she arrived. She has a handprint on her upper buttocks and fingerprints around her arms. I am scared to bathe her due to the bruising.

She had an elective surgery and it did not go well, she no longer can use her right arm properly as in she cannot lift the fork to her mouth, she is limited.

Yesterday, I refilled a Glade dispenser in her room, this morning, it was off and the canister was gone. I am frustrated because I feel like they are stealing. The sunflowers I dropped off this morning were no longer in her room but in the common area. I am frustrated.
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I should add, we never exactly decided to place her. Her caregiver retired and the agency could not find a replacement. She was supposed to be in a 30 day respite. She just never left respite.
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It's time to call the ombudsman.
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anonymous1473280 Jul 2022
I called a few weeks ago, when you suggested it before over the $50 charge. They have not called back.
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There are 4 siblings, one is a junkie out west, one is in the military oversees and the sibling who helps father in law is in their home on hospice with cancer, actively dying. I would feel bad asking for help.

Husband should be here in about an hour. He said we need to discuss her care. I agree but she can not come back without care. I am dreading this discussion.
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