Frustrated with assisted living facilities calling the family to do everything they should be doing.

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My mom lives in ALF but has been in SNF/Rehab on and off over the last 8 months (more than 5 times) not counting the hospital trips inbetween! These facilities call me constantly to do things they are supposed to do. Having missed so much time at work and with family obligations, I'm trying to keep my job and family together. How do get these places to stop calling me so much and do what they are supposed to do?


Hi momcareadvice, exactly what are they calling for? I know I was frustrated when my Parents went into NH care, I mean it was worse than Schools calling from the Principals Office! Dad, fell, Mom's very anxious about X,Y,Z. Dad won't eat enough, Mom won't allow A,B, or C. Then there were the complaining phone calls from Mom.

I was the bad daughter for explaining to Mom that the NH has rules which she knew of when she ASKED to go there, they are not going to break the rules because you showed up!

I understand the NH calling for health and safety issues, but I was so tired of it all and was going go ask if they could just update me on a weekly basis...I don't need to know evertime Dad falls because he won't listen. If he knocks out or something ok but really?

My higher power knew it was getting too much for me, or perhaps after the NH came to know me, I'm available, I'm there 2-3 times a week, maybe they felt sorry for bombarding me with all of the calls of repeated non emergency incidents.

Never the less, I think I can understand where you are coming from. It's over wheming to say the least. Fortunately, I have a very understanding and sympathetic Supervisor, when I had to take the many calls away from my desk he gave me no grief. But I often wondered how I could handle all of this by myself had I worked else where.

Perhaps you should talk to your Supervisor and explain what you are going thru and talk to the ALF/SNF and say hey! I appreciate what you are doing but please can I get the calls on a Wed at 6:00 for example unless it's a matter of life and worse. It's worth a try. In the mean time, screen the calls and call back as soon as you can deal with it.( maybe I should have done that for myself earlier!)

This too shall pass! I wish you well.

Hi Sumlerc!
Thanks for responding to my post. To answer your question, "what are they calling for?"......Many of the things you mentioned, but my mother has fallen quite a bit as well and each time she wants to go to the hospital or needs to go to the hospital and ends up there for a day or two depending on the injury from falling. She was told to wait for a caretaker before trying to stand or go to the bathroom by herself but she feels they don't get to her soon enough (10-15 minutes) and she attempts it on her own. She also is determined to wear these shoes that have rubber bottoms that cause her to 'stick' to the carpeting and so on and so on. Even if she falls and does not need to go to the hospital, they call me and tell me to come and see if I think she should go to the hospital!! If she gets a cold or sinus infection, she obsesses over it as to whether she should go to the doctor and wants me to call her 'in-house' doctor to come and see her even if the nurse has already done that. If she is unhappy about waiting till the next morning to see the doctor then she requests they send her to the hospital via ambulance and my husband and I end up picking her up in the middle of the night. The county Fire Marshall apparently has questioned the validity of all the trips to the hospital and the falling. Here, the ambulances for 911 are under the fire department, hence the fire marshall being involved. He was concerned that the frequent rides would stop being paid for by Medicare. It is suspected she may do this on purpose but the fire marshall has never contacted me. She does have COPD so breathing is difficult at which point she obsesses about that and calls me SEVERAL times per day to talk about it over and over. In the last 7 months she has fallen 4 times and broken the same ankle twice. As it turned out, it did not heal properly and she said she needed ankle reconstructive surgery and that it could not wait and must be done before Christmas. (two weeks prior) That landed her in rehab only to have the surgery done all over again in 5 weeks cause the incision did not heal properly and the plates and screws became contaminated. (certainly not her fault) She needed to be transported back and forth to the surgeon for follow up and the SNF cancels/reschedules the appointments, stating they don't have the staff to take her......
The ALF also avoids taking her to necessary doctor appointments. There is always an excuse as to why they cannot, yet they advertise about all the things they can provide to entice people to live there. Since June, she has been in rehab 4 times for her ankle, UTI's and COPD. Each time she needs me to pack her suitcase and deliver it before she gets there and unpack everything because the ALF worries something will be missing enroute in the ambulance???. Then, when she is finished at rehab, I have to pack everything and take her back to AL even though the SNF is supposed to transport and unpack everything only to be told they don't have enough caretakers to spare. I understand it's difficult to staff facilities, I really do but I know that when I provide a service to someone and fall short from time to time, I have to figure out the solution....not the customer. She does not like the food so the staff at the SNF asked I bring her meals EACH DAY for lunch and dinner!! Is it me, or is that ridiculous???
As for my supervisor, that would be me. I am a one woman show with customers that are starting to lose confidence because I'm falling behind. People have to work. I tell my mother this and her only comments are that they should be more understanding and that something will happen so I get to everything and if she could do this stuff herself, she would. I think that a customers' understanding can only go so far. I'm literally handling an "emergency" with her once per week; not including her constant phone calls or the staff constantly calling as opposed to the facility handling these things. My mom takes care of her own affairs, I don't handle any of that stuff, yet they call me just the same. the hospital calls me when she is being discharged, they call me if they increase or decrease dosages, etc., etc, etc.....Yesterday, they called and left a message stating she has a dr appointment today and that I needed to be there at 11am.!! She has been in a couple area SNF's due to when a bed is available and they all do the same thing. It's very frustrating indeed!!
You are welcom mommacare...

Gesh our Moms sound very much like one in the same with my Dad filling in the rest. My Mom wants to go to the hospital every 3 months it seems for a “full check up”and can easily convince the NH that she is in dire need of hospitalization however, both she and my Dad suffers with Sundowners syndrome when they are away from the NH. Mom wants the Docs to work on her schedule…yeah right! She wants just an overnight stay, well on the last trip (Christmas 2011) she tried this and they kept her 3 days…she almost gave herself a Stroke trying to be released.

I told Mom and Dad both, hey cut it out! I can’t continue running to the hospital because of their stubbornness, the NH and Hospital will call me and keep me up to date and I’ll see you guys when you return. Dad¸bless his heart wants to walk and I understand that but facts are facts, he hasn’t been able to walk un-assisted since 2010…how many falls does it take before he either accepts it or causes something worse to happen.

I’m not so sure how you can manage your Moms meals, does she have refrigerator and microwave access and able to warm up meals? Fortunately my Parents don’t complain about their meals very much, if Dad could have it his way, all foods would come sodium or sugar loaded.

Have you spoken with the AL and NH about the Dr’s appointments? That this is a service that you are paying for they need to resolve it. Sounds like a little more communication with the NH and AL with a more organized way of managing your Mom's care can be just the relief you need.

My understanding is "we" are the Responsible Party (R.P.) so they call us. I'm thinking the only way out of the phone calls will be to remove yourself as the R.P. I've thought about removing myself but I can't! I need to be in the know about my Parents care...I just dont need to know e v e r y s i n g l e detail! These places are protecting themselves so I guess too much is better than a surprise!

Mom's phone was disconnected because it was "costing too much" costing me with her phone calls any time of day or night because of a paranoia attack or is she was ticked off about this or that and that was most of the time. The Nurses allow her to call me a few times a week at decent hrs. Other times I call for her in between visits, It's working like a charm! We must become creative.

I forgot to mention, before mu mom went into NH care, she was calling me and the EMS because of her neuropathy attacks which led to her panic attacks. I told her the EMS and her Ins. Company may not continue to provide and pay for this service. AL wasn't a viable option, Dad was already in NH care and Mom cade the decision to move in with him for 24/7 care. She made a wise decision.
I tend to beat myself up because my dad lives with us and we are exhausted. After reading your posts, I feel really good about myself.
Hello Sumlerc----she does not have a refrigerator in her room at the NH but does at her AL room. Even when she was in her room at AL, we would bring her snacks or homemade soups or stew and she would have me put it in the frig and when I came again a few days later, it would still be there and not safe to eat anymore. So, I got tired of making and spending money on food that she requested and let spoil. Any food that I bring now are things like cereal, chips, crackers and stuff that doesn't spoil. She will then tell me that she is bored with that and want something different.
I understand we are the RP's but the reason I chose these particular places is because they advertise transport (with reasonable notice) along with multiple menu options and other activities. I'm fairly happy with the ALF but they are so resistant to transport when my mom has a doctor appointment, that it's ridiculous. They either don't have a care taker to go with her or the day is not available or the van is not working that name a few.
The NH has two wheelchair vans and also is very resistant which I think is even worse because they are in the business of "temporary" care for folks in rehab and I don't know why they would think that someone with a hip or knee replacement would not need regular follow up visits to their doctor. The vans sit constantly and does not move yet they too, advertise how they give "expert" physical and occupational therapy services for the elderly recovering from joint replacement surgery......the operative word being "recovering" from surgery or an illness causing a weakened state to their bodies. Recovery requires follow up visits to the doctor that wrote the orders to have them receive care. 99% of the reason people go to ALF's is because they either don't have family near or their family members work and can't take off 2/3 times per week for various routine needs. When my daughter was in daycare, the center transported the kids via bus back and forth to the area schools before and after school; the parents didn't leave work in the morning and afternoon to do the transportation and then go back to work everyday!!!! No one would keep their jobs.
Obviously, if my mom had to have a procedure done, I would make sure I was there for that, but routine stuff should be done by the facility as they advertise and entice the public to bring their family to them. I do realize my mom is a part of this issue too. She will call me, drama included, stating "they just told me they can't take me to my appointment today, can you do it sweetie?" obviously, I can't just walk out of work with no notice and I will suggest that she tell the transportation coordinator at the facility to just kindly reschedule the appointment to when they have someone available. Then the drama says, "the doctor won't wait that's long, he says I have to be seen today...that it's imperative I be seen ASAP and it can't wait longer...." yet, the doctor actually rescheduled the last appointment himself due to being in surgery and the facility agreed to the next day. A few hours later they come back to her and told her they are short-staffed and can't take her tomorrow and asked if I can do it. (according to mom) and I just told her they should not have committed to the next day without coordinating the staff schedules properly and they need to call back and explain the same and reschedule. Well, mom starts the drama again and says, "my doctor said I have to be seen ASAP and it can't wait till later this week....he told them no already!" My response was, "we'll, mom, if it was soooooo critical, the doctor would not have changed the appointment and this is really on him. The NH is doing their best, I'm sure, and he will need to understand that. Remember mom, it was his idea you go to rehab in the first place and I'm sure he's familiar with how they schedule appointments...etc,etc,etc...." she was just relentless and I finally offered to call the doctor myself and clear the matter up and she said, "DON'T YOU DARE, he is too busy to be bothered with logistics....."
So, I think you see what's going on here and it goes on all day with the calls back and forth. Mom told me that the staff kept asking why the daughter (me) wasn't taking care of it and then offered the dept of aging (through the county) wheelchair van and she agrees to it and calls me again to tell me what is happening and it looks like all is ok now. About 45min's later she calls me AGAIN to tell me they can get the county van but they won't have a caretaker to accompany her..."what should I (mom) do? I mean, the doctor is so disappointed I can't come tomorrow" I just told her I wish I had an answer for her but they will figure something out, not to worry cause they EMPLOY a transportation coordinator to handle these things. She took that answer and hung up only to call back AGAIN 1.5 hrs later to say the transportation coordinator has not come to see her and they are really gonna effect her health negatively if they don't get me there. THEN CONTINUES TO ASK, " should I try calling the coordinator again"? I reminded her that this is all stemming from the doctor changing the appointment and that if he had kept his schedule, they were ready to take her. She was kind of quiet and doesn't like me putting this on the doctors office but it is the source of the issue. She said the appointment does not take long; maybe a half hour at the most and I told her that if it was that critical he see her immediately, he could have seen her for such a short visit and still done the surgery in the same day!!!
As you can see, this issue went back and forth while I'm working, from 10:30am until around 3pm or later and it's just ridiculous. Later in the week, she was telling the resident doctor the food was so poor that she felt her nutrition was compromised and that they do bring her gluten free food but it has no flavor and she just can bring herself to eat it. She told me that the doctor suggested I make and bring her meals EVERYDAY, THREE TIMES PER DAY!! I really don't think the doctor would suggest such a thing so I called him to discuss the meal situation and left messages in his voice mail but didn't get a return call. Again, this goes in all day when mom is determined to make me do what she wants. I'm afraid she is going to be picky and complain so much that they will ask she be moved elsewhere. Just so frustrated......
She moved near me to AL about three years ago and since June, has been in and out of rehab 6 times for multiple reasons. All of which started because she ended up in the hospital from falling, UTI's, viruses and of course two ankle surgeries on the same ankle since 12/5. So I'm running to the hospital constantly, only to take her to rehab and missing so much time that I have been talked to at work. I also have to pack and unpack clothes for her for all these visits at both places; rehab and the ALF. She just recently asked I bring her different clothes because she was tired of wearing the same ones. Half these requests come from the nurses cause she asks them to call me and make these requests. All during work hours, which i just can't do anymore. I told her I would do it over the weekend and she does not like the answer but it is what it is. I've let her know my situation at work and told her if I lost my job, i would only be forced to find another in which case she would not even be able to call me since I would be new at that point.
Hi Momacare,
I understand about the foods, my Mom does the same with food, I go in there looking to see what I’ve wasted money on because she let them expire for future use. I’ve stopped investing so much $$ but I thought maybe the foods/fridge was a good idea for someone else.

But right now Momacare, I’m more concerned about you! You’re stressing out and I understand that but you’ve gotta take hold and make this situation work for you; Are there community resources available that are free? Where I live, there are agencies that will take Senior Citizens to Dr appointments. A couple of years ago, I signed my Mom up for it but I soon knew that with her paranoia and high anxiety….it wasn’t going to work but it’s a great service. There are companies that offer a more personalized service but at a cost.
Your Mom sounds quite relaxed, I’m sorry but you sound frazzled and rightly so. Sounds like you’ve got the world on your shoulders I’m hoping you can do an assessment of resources and put them to work for you and your Mom.

Due to a workforce realignment, I am starting a new job this Mon, I’m very concerned about being the newbie and having to take off or take phone calls from the N.H. but, I’m going in faith.
Come on Momacare, we’re cheering for you, you can turn this around!
Hi I am new to this forum, but can relate to all topics! My mom is 85 and fell last Sept 2011, she broke her wrist, had surgery, went to a skilled nursing-rehab facility, there until Dec.22, thought I'd have her discharged before Christmas so she could go back to her AL and friends, I did a trial run with her and the therapists and the Al admin, to see if she qualifies to be there in the condition she was in. The admin was sure, she can ring for anything we'll assit..etc... it's all rosy... come to her moving back in, (after paying for 4 months w/o her there) they said , yeah... its not working out she's too much no can do,...etc... I was flipping out! it was right before Christmas, she had been there 1 week, no one helping her, no one assistd her to shower, I had to go and do their job, which I thought I was paying them to do! We found another AL facility that would take her, I prayed she would pass their health evaluation, and she did!! I felt relief, moved her in Jan 2, 2012. In the two months we were there, I would see mom, 3-4 times a week, the therapists would stop me, and tell me how uncoopertive my mom would be, I would apologize and explain, I can only do so much. Seemed like every week it was something or someone reporting to me, like having a problem child and getting reports from the teacher. I would do my best to coach my mom to cooperate, then she developed a pressure sore on the heel of her foot, she had been under her doctors care for the wound treatment weekly. Last week, Thurs. We got back to AL from her appt for wound care, I take mom into the dining room for lunch. I didn't even get her coat off and I was beckoned to the office, informed that due to the level of her wound, mom could not remain there and she needed to leave by 4PM that day!!! I was stunned, shocked, trumatized, and had to tell my mom she had to go back to skilled nursing. She was so upset, they said they would come and tell her, I stayed with mom as long as I could made many phone calls to see if this was right and what to do. I had to leave to get my child off the bus, and soon as I left the AL they call me and ask me to come back that mom was refusing to leave. No one came to explain what was happening, They came and wisked her out of he room, threw some clothes in a bag and took her to the skilled nursing facility. I tried consoling her and tried to tell her we had no choice. I sobbed. I felt like I abandoned my mom in hour of need, and the AL didn't care how upset she was and couldn't wait until I could be with her for the transition. The stress was unbearable. The emotional toll immense. She is settled somewhat in the skilled nursing, insurance willl not cover this, stay , so we have to apply for Medicaid. Home health was willing to come in to the AL and treat mom's wound, inbetween Dr's appts. and she could have stayed, but the AL said No to home health, and thought it was far better for mom to be uprooted, and thrown into a nursing home against her will, and unable to get insurance coverage without a hospital stay first. We had to move her things out of the AL completely, risk losing her room, and made her dependent on Govmt assistance. I'm bitter! I was stated in teh contract at the ALF about pressures sores and certain levels cannot be there, I get that. But to throw an 85 yr old woman out on 3 hrs notice, when there was other alternatives I am still reeling .
Hi Canhaft,
first let me say I'm so sorry for you and your having to go thru this, No one should be treated like this but our elders, they should be held in higher regard in our society; That says a lot about us as a nation doesn’t it?

I recall how I felt getting all those phone calls, and reports of my Parents behavior it was heart wrenching! I hated seeing the caller I.D. because it was either the N.H calling to complain ( state their concerns) or Mom calling to complain. After many, MANY conversations with my parents and prayers too! The calls have diminished 10 fold. Most of the issues were about control…or the loss of it. My Parents were used to doing what they wanted, when they wanted right or wrong, my way or the highway. Either they’ve gotten used to how the NH operates on a schedule and not my Parents schedule or they’ve stopped trying to control everything.

Losing or giving up control when you’ve had it most of your life must be one of the hardest things to do. I try to put myself in my Parents shoes, we as care givers really do care, It can be difficult to be the lovable carefree care giver and the loving no nonsense care giver. At least for me, it's been a real juggling act! I do realize everyone is different.

Do you think a different approach with your Mom might help? Does she have a clear understanding of when and how appointments etc are to occur? My mom wanted a schedule and it would be H.E. double hockey sticks!! if they were late or if P,T. or Smoke time took 5 mins longer than what she was told….I mean OMG!

SHAME on the AL for not doing what they promised and were paid to do, and to release your Mom like that, SHAME!! they should be reported, at least given a write up. I really hope that it gets better for you and your Mom soonest, like NOW.

Sumlerc: You are so kind and patient!! Thanks for the encouraging words. I think I have been "careful" with the description about my mom and her behavior because I don't want to appear to speak negatively about her and how she strongly contributes to the problem. I just think it would be wrong of me to do; so, that being said I think my "frazzled" tone in my posts are not just from my frustrations with the SNF avoiding their jobs, it's highly compounded by my mom and her actions that I fear are perpetuating the SNF avoiding helping her. I also feel that no matter what her personality is like, if they advertise certain services that people need and ultimately choose to go with them for those highly advertised services, then they better provide them!! Elderly folks are two ways about it and they don't want to be there either. In this situation, my mom has had this demanding personality since I was born. It has nothing to do with her age and once the staff figures this out, they tend to be resistant. Yesterday was a very good example; she called my 6 times. The reason is because when she asks for water, she tells me she "is insulted that it takes them almost 10 minutes to get her some more ice water when she asks for it!!" So, each time she asks for it, she calls me to sit on the phone with her and wait until the patient care tech finally gets it to her and this way she can grumble and complain and prove to me how awful she thinks that is and how she is not getting the proper care all the while we are waiting on the phone. Sometimes it takes 4 minutes and sometimes it takes 8 minutes. I know she asked for water more than 6 times but I think she when I told her I didn't think it was that awful at all (cause I really don't think that 4-6 min's is allot of time to wait for ice water) she became irritated and hung up on me and didn't call back. My mom does not drink that much water, she just wants ice water so when she is thirsty, it is immediately available at that moment. She detests water that has become room temperature. She was very particular about always having ice water when we were growing up and expected myself and my siblings to bring it to her when she asked. So, I think you get the picture; she calls me multiple times per day for very unimportant reasons and then I have the multiple calls from the SNF about fairly unimportant things daily (ice water is not just the only demanding requirement my mom has) and then I have calls from both about more important things like transportation issues (that I can't do anything about...especially at that very moment) or that she must go to the ER again, which happens 2 or 3 times per month.
Now, I have the issue of her Medicare benefits being exhausted and filing for LTC and all the absolutely ridiculous requirements they have only to prove that most people cannot afford $16,000+ per month for rehab and skilled nursing. All of which, must be approved by the SNF even before they will agree to send the application off to the state..........did I mention that her supplemental insurance benefits run out on or about 3/15/12....cause I don't want to leave that out or the fact that I encounter "road-blocks' from every direction with the records that are needed. Example....I had to drive to a neighboring state to obtain the Sale Deed and settlement sheet from the sale of her home in 2008. They would not provide it online and would not mail it!!!! AND, it still cost me $35 for the copies!!!!

Some days, I don't freak out from these issues and other days, I'm not so strong or unaffected (sp?). Then there's the days, weeks and months like now, where it's been a steady diet of opposition from the SNF, ALF coupled with the constant complaints from her like, BUT not limited to, ice water taking 4-8 minutes to arrive. I have called the Dept of Aging and tried to recruit all that I can and I have contacted the county to utilize their transportation services, which my mom actually likes, but they require a caretaker from the SNF accompany her to these appointments because they only provide the wheelchair van and drivers. The drivers do not get off the bus to help the passenger in any way as it is an insurance liability to the county and forbidden. So, simply put, the driver will not push her wheelchair into the dr's office and come back when it's time to take her back to the facility. They literally stop at the front door of the building and the wheelchair lift lowers her to the curb AND THAT'S IT!!! If she does not have a caretaker, they refuse to take her. This is where I'm frustrated with the SNF because they will come to her an hour before the appointment to let her know that they are short staffed and no one is available to accompany her. Yet, this service in particular is highly advertised and always, always a problem. I dont care if the patient is the worst patient ever, this is part of the job, it's a service promised, figure it out!

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