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Mom is restricted to bed unless one of the aids assists her. 9 times out of 10 when she rings for assistance to get to the toilet, she pees her pants before the nurse/aid gets there. This is not acceptable to me, but is it the norm?

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Yeah, that sounds about right. Nurses will have 4-5 charges they take care of. If the nurse is bathing someone...she could take a hit of time to get free.

Unless this is an acute care hospital trauma unit, then they will typically have each nurses only cover two rooms.
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Same thing would happen to my mom and it would frustrate the bejeezus out of me. Once I was there and 15 minutes had passed - I couldn't help my mom as I had had recent major surgery - mom required assistance from getting from her chair, everything in between and back to her chair - but I couldn't leave to get help because she was trying to get up and do it by herself. So since I couldn't re-ring the call bell, I pulled out my phone and called them - three people came within a minute. I then had a talk with the Director. The thing that kills me is I would think helping someone to the toilet would be a hell of a lot easier and less time consuming that having to fully change an adult diaper and more than likely her cloths as leaks would have occurred from sitting in it during the wait - plus the chair pad etc. - but that's just me.
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Unfortunately it is probably typical. In my mom's NH they measured how long it took before someone shut off the call button. But often the aide would dash in, shut off the button, ask what was needed, and promise to come back as soon as possible. So the response stats might look pretty good, but the time to provide service was much longer than the stats would suggest.

My mom was a two-person transfer, and the person who came into the room first could not assist her alone. Sometimes he or she got another person immediately, and sometimes there was a delay.

All of the staff had very helpful, caring attitudes. I never got the impression the delay was because they were yacking on the phone or gossiping in the hallways. They did their best, but delays were difficult for Mom, of course. If I was with her I'd remind her that she had on a disposable pad so if she leaked a little before they got there it wouldn't be a big deal. This helped a little, but I don't think she'd remember that if someone wasn't there to remind her.

I think 1/2 hour 90% of the time is too long. But is that an accurate count or just an impression? If you have evidence, I'd bring it up at the next care conference, and ask what the standards are.
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If the Nurse and/or Aide is tending to someone who is having a medical emergency then, yes, the wait will be some time. To many of us the time the pendent was pushed might seem like a long time, but I bet if we actually timed it, the wait probably was a lot shorter.

I realize with some elders they are unable to hold their bladder very long so usually it is seconds between feeling they need to go to the bathroom and actually having to go. It took my Dad awhile to understand that he can go into his Depends/Guard.

My Dad would rather not bother the Staff and he will try to get to the bathroom himself... sometimes the Aide will find Dad asleep sitting on the toilet.
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I think 1/2 an hour is too long. But most of the hospitals I have been a patient in took far longer. One aide popped in and said she was too busy to help me. When the patient survey came a couple of weeks later I told them that in the survey.
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Some nurses/aides could also be having a conversation among themselves and/or on their cell phones.
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We must remember that the U.S. Dept of Labor says as per the Heath Care Industry "Rest periods of short duration, generally running from 5 minutes to about 20 minutes, are common in industry. They promote the efficiency of the employee and are customarily paid for as work time".

I know where my Dad's lives, the nurses/aides have a nice break room but it is in another building in the basement. Thus, if an aide will take the pendent call, it could take her time to get to the next building, take up the elevator and get to the resident's room. And at night, the entry to the building is on code [or they can walk through the basement area to the next building as the buildings underground are connected], and the elevator or stair way are on code. Thus time used to punch in an entry code.
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When I was working as a CNA there were 60 residents and we had 10 residents each. In NJ 3 minutes is the response time for call light. If we were giving care to a resident we wouldn't leave someone on a toilet etc. now if we went out in the hallway to get a washcloth and saw a light, we went in the room, if it was a need that couldn't wait we could get someone to help. There was no " not my resident".
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What I have seen is that everybody has to go about an hour after a meal, so if they feed everybody at noon (for example), they all push the button at 1:30. With ten to one aide ratios, there is no way to answer in time.
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The nurse/patient ratio is much worse than those mentioned above. They have 97 beds and only 13 nursing staff on the day shift, less at night.
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dorindarose, 97 patients and 13 aides is better than 10:1 it is closer to 8:1. Yes, the aides counts from 11pm to 7am are much lower, usually one aide to a full wing of patients (30-40) because they are all tucked in. Bear in mind that a nurse is present also.
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Pam
It's those overnight stats that are scary especially when mom gets up to pee sometimes 3 or 4 times

In her 5 star rehab the one CNA would be asleep in the hall while buzzers went off and folks yelling nurse nurse
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CNA on overnight duty should not be sleeping. I guess that goes without saying.
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Shouldn't be, no, but...

My MIL hired one-to-one 24/7 nursing care for her mother in her mother's home; then called in one lunchtime and found said nurse asleep in the spare room. I'd have loved to have been a fly on the wall for that scene.

Culpable she may have been (and, I suspect, moonlighting), but I should think that poor nurse wished she'd never been born; and the more regrettable outcome was that Grandma-in-law was moved shortly after to a nursing home. I suppose MIL felt she had thrown as much money at the situation as it was possible to throw, and still her mother wasn't safe. It was one of the rare occasions when I have genuinely felt sorry for her.

Dorindarose, I agree with you that a thirty minute wait is unacceptable. Unfortunately it is almost impossible to avoid its happening sometimes: the staffing ratios needed to prevent it totally would be unaffordable, but it isn't only the money. If you had sufficient staff to ensure that no resident was ever kept waiting for more than a few minutes, most of the time some of the staff would have literally nothing to do, and people don't thrive on hanging around being useless any more than they do on being overworked.

So I'd say it is common, rather than normal. That sort of delay was also one of the deciding factors in my bringing my mother home after rehab. If doing that isn't an option for you, then another suggestion might be to ask for training in transferring your mother so that you can safely take matters into your own hands when you visit. I'm sorry, I know this is an agonising thing to see.
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I waited 1 1/2 hours one night when I was too ill to move and my call bell fell to the floor, thus after the first call was unreachable. Finally I started tapping SOS on my locker not that it helped much as a plastic cup is not very loud. However by the time someone arrived my bladder and bowel had taken matters into their own hands. This was in the ICU of a large regional teaching hospital. Did not mince my words in that survey either!
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The other day my Dad, who is in the hospital, was trying to reach the Nurse but he was trying to push the red button on the landline telephone instead of the control for the TV which also had a red call nurse button. Both controls were similar in design and color.

The reason Dad wanted the Nurse was the TV volume wasn't loud enough.... [sigh]. He's 95 so it is normal for him to be very confused while in the hospital.
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Thank you all for your responses, suggestions, and personal experiences. I'm happy to report the situation has improved (after I made complaints) and so has my mother's health. She is reaching new goals every day and regaining her independence. It appears that she will be coming home on Saturday. We are all so happy.
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