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Mom is 86. She was doing pretty good living on her own, but overdosed on pain killers from back fracture pain. This sent her into the hospital, then rehab. Once she got her mind back, she said she no longer wanted to live alone in her house. I moved her to new assisted living place. Beautiful place. Supposed to admin her meds, shower, etc. for a level 2 care. but could never get the 'service plan' that lists what services / frequency are provided for Lvl 2. First night ate the inedible food with her. Then waited for anyone to show up to give her meds. Nothing. A tech showed up and asked to make sure I close the gate when I leave because they have a memory care patient, even though they are only indy & assisted living. Then left and never saw her again. I realize there's no security cameras, the back door is never locked and her door is left unlocked by the techs. It took two days and two hours of arguing with the director via email saying she shouldn't get a call button even though it's part of the cost. there's no phone or fire extinguisher in her room.

The kicker was, the nurse said she shouldn't be on managed meds because mom said she could manage them, although when the nurse interviewed her, mom couldn't remember what day it was. I had told everyone that's the number one reason she's here - med management. the nurse had no clue as to why she had been in the hospital/rehab even though the doctors discharge papers spelled out the overdose. nurse claims hippa laws didn't allow her the ability to get the info. meeting with the director/nurse and ended up being talked over and accused of lying. I told them I'm giving the required 30 day notice. The nurse then tried to get my mother to sign the service plan, which again didn't spell out how many times she would get what service, but committed her to the care.

I found another place with security cameras, locked back doors, better food, a dead bolt lock for her door, larger apartment, and a little back patio. And less money. but certainly not as cheery or new as this place.

Mom kept telling me she wanted to get out of the place (and surprisingly) not move back to her home. But now is wavering on moving to this other place. I don't want to move her only to cause her to not be as engaged as she is this one. She's going to exercise class and eating in the dining room, which is all is a huge step for her. The last two years, she's been afraid to get out and vowed never to eat in a resturant again because of COVID.

What would you do? Keep her in a place you feel has a huge safety issue, and a staff you can't really work with or move her to a place that seems more secure?

This new place has had 0 COVID deaths. The second place has had 4, but they have a memory care section. The first place doesn't.

She is now wavering and saying she maybe shouldn't move.

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Generally in ANY ALF the client's care is dictated by her own MD assessment and the filling out of forms exactly as to what her mentation IS currently, and exactly what care she requires in how many checks, whether able to be mobile on own, whether to require assistance with any number of things, food, incontinence, bathing assist, medications. From THERE (and you should see these forms filled out in your packet and the ALF should require them) a care plan is done for the staff on that floor, in that cottage, or however else the care is divided up. For instance my brother did not want anyone entering without knocking, even at night for a night check and we had to do all kind of sign off on that one. It was quite extensive and he was only level one, did his own medications and GOT his own medications.
It is impossible to tell if this was a matter of new intro and confusion and poor staffing and staff overwhelmed in this time. It is impossible to know, for me, if your Mom is correctly placed. There were NO locks on my bro's cottage; he could come and go, just had to sign in and out.
Now Mom is happy and may already have friends? I would give this time, assume it was a matter of all getting off on the wrong foot, and would reassess as I went, telling Mom her safety comes FIRST. If this place cannot be safe for her then she would HAVE to move. She would make new friends at her new place. I know for my bro's place he loved the small cottages with 14 residents each, a common TV room and a common dining and game room, a patio front and back. The place he would otherwise have gone had better food but was more like an apartment house and no one seemed to go to common rooms to chit chat and so on.
It is on you to decide. I would just caution you not to rush.
Sit with admin when they have time. There should be a whole PACKET of stuff explaining levels of care and do on. That's what any good place has. And there should be time for you to help with the care plan. And most of ALL, where is this evaluation to say what care your Mom needs. So just tune down the angst and take your time, say that all may have got off on wrong foot and now Mom likes it there, you want her to be able to stay, but you MUST know what the care is, and how the care plans are done, and must be assured she is in a safe environment. Good luck!!!!!
And I will leave you with this, in the 2 years until my brother's death he didn't hear a harsh word out of anyone at the ALF where he was, toward anyone. His ex remains in care, and always tells me "I am their favorite. " You know what, I bet all the residents believe that. Good care starts at the top with good plans and rules and with insistence that they are abided by. Hard to come by. We found it and hope you will as well.
Feel free to look around meanwhile, as I know you likely are.
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Move her. This is a poorly run AL maybe because it is new. She will have exercises in the new one. If ur her POA you have a right to see what the cost of her care entails. I would actually call the main office. Most of these ALs are part of a corporation.

When it comes to unlocked doors, these are probably fire exits and need the ability to be opened from the inside. Can't get thru them from the outside. If someone suffering from Dementia continues to try and ""escape" they are ready for MC. My Mom tried 2x in 8 months. These doors only open if the bar is held down more than 15 seconds. The AL had a front door with a key paid so no one got in or out without knowing the password. Residents had to sign in and out. Those not allowed out of the building were caught before they got out.
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livingintx Feb 2022
That's the thing. the doors are unlocked from the OUTSIDE and inside. There's a key code gate that opens to the parking lot, but the combo is very easy to guess and the gate has a tendency to stay open if it's windy or if someone doesn't close it or props it open. And there's no one patrolling the grounds to ensure the gate is closed. So in essence she has no security.
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I'd move her, but not into Memory Care which is a LAST resort, imo. AL is fine until she actually needs memory care and the staff is insistent that she moves into that unit. Why? Because AL has lots of elders with dementia; it's just not BAD dementia to where they're roaming into other people's apartments and/or trying to leave the premises. My mother lived in AL for 3 years with dementia before she had to move into their MC bldg and it was really 1 year too soon; ideally, she'd have moved into MC one year LATER but she had mobility and falling issues in addition to memory issues that forced the move into MC sooner. In hindsight, I should have moved her to another ALF that would have accepted her WITH her mobility issues rather than send her to their Memory Care bldg b/c she was too cognizant to fit in well with the other residents at that time.

Memory Care is a much more shrunken down world for the elders b/c of their memory issues; no menus are used for dining; only 2 plates are shown to the residents; the rooms are smaller with no microwaves or fridges, no glass can be in their apartment, the activities are less and geared towards their dementia limitations, etc. Life in AL is more fun; more entertainment, more independence, just better in general b/c there's less limitation the elder is dealing with, so naturally, life is LARGER in AL than it is in MC. Mom loved it in AL, not so much in MC.

That's coming from a daughter who's been there and done that with her mother. MC is always a last resort, so if the new AL is secure, and mom is not wandering or doing unsafe things, move her into the place and forget about the 'nice decorations' that exist in the place she's at now. The fancy niceties don't really matter if the quality of care is no good and if the staff is calling you a liar and the meds aren't being administered properly, right? THAT is the most important thing, not the fabric the drapes are made of in the lobby.

Also, what is the Covid protocol at the new place? I can't tell which AL has had the deaths? The place she's in now or the new place? In any event, make sure the new place has good virus protocols in place to ensure mom's safety. My mother's AL has 125 residents between AL and MC combined, and NO deaths OR hospitalizations from Covid the entire pandemic so far, amazingly enough. They are very strict with their testing and quarantine practices for anyone who tests positive, so that's why.

Good luck!
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IMO, If she doesn't know what day it is, she should be in Memory Care now. Have you had her tested for cognition? You don't want her signing contracts or even being perceived as capable of signing them.

Memory Care is great, because they really keep the residents busy with lots of activities and attention. The ideal one will have the residents split between the more functional and the less functional so people aren't doing low-level activities until they need to.

Get her out of that place, but another AL may not be the right fit either.
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I would move my loved one.

Unlocked doors are an invitation for tragedy in this old world. I would not sacrifice her safety over an exercise class and bad food.

They have already lied and blown off responsibility. They refuse to put what services she is getting for her payment, a nurse is saying she can't look at moms chart??? WTH!

Does the new facility you are looking at have the same services and activities available?

Believe what a facilities actions tell you about them. This place is a pretty hell.
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