What do I do about my dad not getting changed by overnight staff at his assisted living facility? They change him only once in the morning.

Thank you so much :)

Hoyer is thankfully very easy to use so I'm glad we have him home now.

What's weird is that they never said that they don't change residents; instead, they said that they do checks every 2 hours to see if someone needs to be changed. So my complaint was that they actually do not do checks every two hours as they say they do.

You are right: the staff are not skilled to do anything beyond assisted living.

Thank you for your reply; I hope you and your family are doing well.

Thank you for your reply. When Dad first arrived, he was walking and using the bathroom. Within weeks, he quickly deteriorated. He was extremely disoriented and it turns out that they were not giving his meds (I found out much later). Then staff called the ER to take him to the hospital for behavior problems/aggression. At the hospital, they restrained him (legs and arms) in the bed for a week while trying out meds. It was one of the most horrible things I've ever experienced. Without being able to move, he lost the ability to walk. So when he returned to the facility, he was heavily medicated and in a wheelchair.

From the beginning, we were never told the stipulations for living at the facility. I actually didn't know it was assisted living...it seems so strange to have assisted living for people with dementia/Alzheimers. When we first met with the director, I remember her saying that residents can stay until they pass away. If we knew they couldn't care for more advanced needs, we would not have chosen the place. Like I said, there were plenty of residents that were in wheelchairs, incontinent and not able to eat on their own.

I feel like I was very naive at the beginning and didn't question anything because I thought that these were all professionals. It causes me great pain to feel like I let my Dad down and didn't protect him.

I have spoken to facility admin, state inspectors, hospital admin...the only thing that happened is that the original director and nurse were fired. But ultimately little changed.

You are right that they should be shut down for a variety of reasons. But I think they are protected because they are one of just a few facilities in a small town...so it seems that no one wants them to close because then they would have to find places for residents elsewhere. That's my guess anyway.

Thank you for asking your question. Technically, yes. However, this assisted living facility had many people who were out of the range of being "assisted living" and were being accommodated for their needs as well as could be expected. Many in wheelchairs and many needing incontinence care, just like my dad. Many of them were in hospice, as was my dad...with promises that hospice provided extra support, but the day-to-day care was still up to the facility. Mom and I looked at many other skilled nursing facilities, both in our small town and in neighboring towns. Skilled nursing was more than twice as expensive and the environments seemed pretty depressing (like a hospital...with small rooms, shared with another person). My dad doesn't have any overarching medical issues, except he is in a wheelchair and is incontinent. He has dementia, but is mostly perfectly joyful, except for getting grumpy at times. I think the main problem is that his weight was such that it made it hard for staff to get him up and down. Strangely, they allowed us to have a hoyer lift even though the staff weren't allowed to use it. I learned how to get him in and out of his wheelchair using the hoyer lift and was able to do it by myself. I also learned how to change his brief both using the logroll method and using the hoyer lift with Lavin leg lifts. I taught my mother and sister how to do it as well and we were able to continue at the assisted living facility with family helping but finally the facility asked us to leave at the end of March. We actually decided to bring him back home because it seemed like the best thing for all of us since he has a limited time left and we had learned how to take care of him. We got a different hospice group which we like a lot and have a male CNA who comes in everyday for 5 hours to help us (which our long-term insurance pays for). We actually are having a lot more time for ourselves even with him being home because many times he is quietly "working" on some items at the table or napping or watching TV and we can do our own things in the house. It is nice to share meals, sit on the porch, and have visits with friends and family who come by and he is included in everything so it feels really special and natural to have him a part of it. Of course, some times are hard because, at times, he is in a bad mood or wakes up at 3am...and we know that at some point things will take a turn for the worse. But it feels like that is just how life is and we are learning how to deal with it at each juncture. Thank you to you and to everyone on this forum who responded back to me; it feels so good that you all were thinking of my issue and took time to reach out. That means a lot to me -- thank you so much!

Thank you for your thoughts on this; I am in one of the states that does not allow cameras, which I think is unfortunate. I even think that it would even help the facility to have cameras in the hallway for safety of the residents and also so that staff would know that it would be noted whether they are doing their tasks or not. It would've provided transparency and accountability. For overnight changes, there was a checklist on the computer that they simply click on if they have done the 2-hour room check that they are supposed to do overnight. I think they simply clicked all of the marks at the end of the shift.

The facility ended up asking us to move Dad to another facility, but we decided to bring him back home. Our long-term insurance pays for a CNA to come in 5-hours a day. Because we are in hearing distance we know when he needs to be changed at night and have also learned how to adjust his sleep time and the last liquids of the day so that he doesn't have to be changed at 3am. During the day, we change him every 2-4 hours. Usually every 2 hours though. So usually 6-8 changes a day.

Thank you so much to you and everyone else who responded back. It means a lot that others were willing to take the time to show they care and to offer their thoughts. I hope you and your family are doing well.

Yes - I totally agree with everything you said! It is surprising to me that many of the staff appeared to have not been trained on incontinence care or on preventing bedsores. I spoke to the administrator several times about the issue. She would talk to the overnight staff and they would claim that they had been checking on him every two hours (which is what they are supposed to do with all residents). I think the administrators didn't know what to do since there was no easy way to check for accountability and since hiring staff for any shift was difficult, much less night shift.

Dad is back home; we have a male CNA coming in 5 hours a day and hospice comes in several times a week. It is working out well and I no longer feel helpless and angry all the time.

I hope that in the near future all staff at facilities get paid much more than they do now, because I think that would really attract more people into these jobs to know that they will be properly compensated. These are our loved ones who only have a limited time left with us -- they do deserve the best!

Thank you; I did report it to DON and administrators and it maybe was one of the reasons we were asked to take Dad out of the facility. I'm glad though because it does feel good to tell the truth and keep telling the truth despite what you may initially think are bad consequences (such as being asked to leave the facility). We brought my Dad back home and he is doing well here. We have a CNA who helps several hours a day and we are taking good care of him the rest of the time. The facility might've made some changes based on the things I said...they did start an "incontinence program" after we left. Also, we had become friends with other family members with loved ones at the facility and when we discussed things we were all having the same problems. Some of them also spoke up; some of them transferred their loved ones to other facilities. Anyway, dragging things out of the dark by saying the truth makes things happen and I'm glad that we spoke to as many people as possible about something that is not right.

Thank you so much for your encouragement and advocacy. I hope you and your family are doing well!

Thank you so much for thinking of us and reaching out to help. I wanted to have the cameras, but it is not allowed in our state. Seems like cameras give transparency and accountability.

Thank you so much for reaching out to help. This is very good information to know and we still have an unresolved issue that would be good to run by the ombudsman.

Thank you so much for this advice; I like the idea of the extra inserts to increase absorbency. He is back with us at home (with help) and it's going well but it would be good to explore ways to extend absorbency at night. We thought about catheters but we think he would pull them off...but we might look at that again.

Thank you so much; I agree that everyone in care facilities need an advocate! The baby monitor is a great idea, even now that he is at home. Thank you for your help, Holly

Thank you so much for responding and for this perspective. I wish staffing ratios and requirements were different because it does seem too hard on staff to have so many residents. Wishing you the best! Thank you

Thank you so much for thinking of us and reaching out with guidance. We have him at home now and it is actually going well with a CNA helping us for several hours every day. We care for him the rest of the time and it is going well thankfully. I hope you and your family are doing well!

Thank you so much for your heartfelt response. It was very difficult and we did talk to DON and facility administrators but were asked to leave. He is now at home but doing well. I still feel glad we spoke up and maybe there are ripples that we don't know of that will make a difference...

Thank you so much for your advice. I hope you and your family are doing well.

I'm sorry to hear that you are also going through something similar with your mom and I know what you mean about it seeming like the "norm." Are things still going okay with your mom (with having the cameras)? I hope so. I hope you and your family are well. Thank you for caring and being the first to respond when I sent out my question. I was so upset and not knowing what to do; it was so wonderful to get empathetic reactions and good advice. Sending my best wishes to you and your family