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Jem813 Asked December 2014

Should I let my Dad's facility temporarily move him?

They are presenting this as a choice...the dining room is being renovated. He's in a memory care facility and has dementia, recently diagnosed with kidney problems and may require surgery or catheterization. Otherwise healthy and ambulatory, but he's been losing weight (about 10 pounds) and gets worked up over the smallest things. I worry that a move, even temporary, will be stressful and disorienting but I'm getting a lot of pressure to OK it. I haven't talked to him about it (he is still very coherent and conversational). If he doesn't move, all the memory care residents will have to dine on a non secure floor during renovations and they're worried about that (although there's a receptionist at the front entrance and lots of CNAs would be always accompanying them).

Jem813 Dec 2014
I guess if my Dad got like that I would move the cat back to my place. He's very high functioning and in fact scores like you or I on a standard memory test (the 30-point MMSE). He kept her in his room on the memory care unit at a Sunrise Senior Living facility for six months, no issues.

Sunrise has a policy where they like to have one facility cat and one facility dog at all times and it seems to work. The animals have to be pretty even-tempered though it's true. This cat is good that way, about as non-neurotic as they come. She does great on planes, in carriers, etc. Very easy going.

Sunrise was cool with it, this place was not, it's just "policy" (read, relative lack of experience). I think the animals are great therapy for seniors especially those with dementia. But just like with children the situation has to be controlled to some extent. My Dad has had a cat all his life so he hasn't yet lost the ability to care for her. See everydayhealth/alzheimers/how-animal-therapy-helps-dementia-patients.aspx.

Sunnygirl1 Dec 2014
Oh, I also forgot to add something else about the cat. A Memory Care unit can be quite stressful. People may pace, shout, cry or act out. I would think it would be pretty stressful for a cat. I would look into that before you place your dad's cat there. My cousin had a cat that she adored, but her dementia made her act so obsessed, that it stressed the cat and made her very anxious. Just something to consider.

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Sunnygirl1 Dec 2014
Good luck with getting things taken care of. I hope your can find your dad a good place where they are kind to him and don't resort to saying things that are hurtful.

I appreciate your goal of your dad keeping the cat, but I really don't know how that would work. I can't envision a cat being able to stay in the Memory Care facilities I have seen. The residents need constant supervision. They aren't even allowed to keep shampoo, lotion or soap in their rooms, for fear they will eat it. I don't think it would be safe to have a cat in the ones I have seen. Most of the people in Memory Care need assistance brushing their teeth. Maybe your dad is in a higher level than my cousin. Maybe those who are higher functioning are allowed pets. I hope it works out for you both.

Jem813 Dec 2014
Wow Sunnygirl that sounds like an easy transition. I'm hoping the next transition with my Dad to a new memory care goes as smoothly. I think he may like the facility I have in mind much better, especially if they let him have his dear cat, who is the most loving and interactive cat a person could want. The facility in NJ offered to keep the cat on the premises as a therapy cat if I couldn't take her to San Diego, that's how good she is. Also with his college friend there, who drives etc, that will be nice for him. I have known her my whole life and she's "good people" and has acted as a caregiver/POA for her late husband as well as a man with HIV/AIDS at her church.

I still haven't heard from the facility ombudsman but I looked her up. She seems like a real advocate for seniors and kind of a tough cookie. That's good. I look forward to speaking with her after the holidays.

Sunnygirl1 Dec 2014
It's good that you reached the ombudsman. Maybe they can help. That place really needs some attention. Don't they realize that just because a person has dementia, they still have a bill of rights that includes the right to be treated with dignity and respect.

If it helps, my cousin, who has dementia, was in an Assisted Living facility for about 4 months, when I had to move her to a Secure Memory unit in another town. It was very easy. The Memory Care Unit was much better suited to handle her needs and she seemed to feel comfortable there immediately. She never mentioned the place she lived initially and when I asked her about it, she doesn't seem to remember anything about it. I'm so glad.

Jem813 Dec 2014
For instance the head social worker has to have each new memory care resident wear a tracking device for a week. She clearly had no idea how to broach the topic with my Dad and handed me the tracking device to place on my Dad, in front of my Dad. It was weird. Like here, you do it because he's not going to listen to me. Talk about awkward. So I said Dad, do you want to wear this for me? Please it's just for a week. And of course he said no, so I handed it back to her. I mean, I'm not going to wrestle my own Dad to the ground...

Jem813 Dec 2014
Yes if Yelp is any indication it seems so. It looks like there is some trouble in the admin. This is kind of my suspicion and is why I often withhold judgment of the CNAs. Many but not all of the CNAs are fantastic and love their jobs, it is clear. Some of the administrators have said or did things that I cannot believe mainly because they are so openly unprofessional and yet have risen to such a high level.

lindaz Dec 2014
Jem it is possible that you are not the only one who has expressed concerns over this problem, or others at this facility. It may be why the ombudsman very interested.

Jem813 Dec 2014
Linaz, I'll be speaking with the facility ombudsman hopefully next week, although I understand with the holidays that it may not happen. I got through to the CA state ombudsman right away though so they are already aware of the situation, as well as the local Alzheimers Association. I'm not looking to get them into trouble necessarily but let's just say that the CA state ombudsman was "very interested" in my situation and willing to help.

Jem813 Dec 2014
One reason I chose to move my Dad to San Diego...lots of senior care choices.

lindaz Dec 2014
This really doesn't sound like a place that will be telling you the truth about this move. They lied about the move in and it appears consistently since then, either to you or to your father....a missing check is no small thing! I wonder what other things have gone missing ? You have been way too forgiving with the staff and the facility and I agree with sunnygirl a new facility for your dad should (if you can afford it) be in your future.Is there someone who oversees this place? Like the Board of Health? Because if they lie over the little things what else could be going on there? Also it appears that management is aware of this and that could mean way bigger problems.

Jem813 Dec 2014
Thanks for the responses, I am looking into another facility but it's brand new and the construction hasn't been completed yet (scheduled to be done in June). It's a bit farther away from me (maybe 15 min instead of 10 min) but it's located in the same community as one of his college friends (from Pittsburgh!) and her husband just died last summer so they might like visiting one another. She's the one who suggested it. She just raves about the place. He would be in the brand new memory care facility while she's in assisted living on the same site. Also they may be able to accept his cat living with him. It's a non profit run by the LDS.

Unfortunately that doesn't help me with the current situation because this is happening next month (January).

So far his kidney condition doesn't warrant a SNF but he will go to the closest in-network SNF if he has surgery/catheterization. There are nine in our area. As far as I know I can't exactly reserve a spot this far in advance, but I will probably go with the closest one with availability.

Sunnygirl1 Dec 2014
OMG. It sounds like this place really needs some help and I don't mean just with renovations. There are better ways to deal with the patient. Saying you didn't pay the bill is cruel and disrespectful. I would be enraged. That is totally unnecessary and no wonder your dad mistrust them. They are being mean to him. If they are too busy to care for your father, they don't need to be messing with his mind. Saying nothing or how about saying the tv isn't working right just now, maybe it will soon or how about saying someone must have accidentally picked up his newspaper? I would strongly object and forbid them to lie about me paying for things. It's obscene, IMO. They sound like the sick ones.

Sorry, now that I'm over that. I would mistrust anything they told me about what their renovation plans are. I would expect them to not act in your dad's best interest and I would look for guidance from the people you have contacted. I know how difficult it is to find Secured Memory Care. I placed my cousin in one, so I get it. But, unless some big changes were made, I'd be looking to move him to another facility permanently. I wish you the best.

BarbBrooklyn Dec 2014
What they are doing is NOT called therapeutic fibbing. What they are doing is lying outright and creating mistrust of you. This is very, very unacceptable. Therapeutic fibbing would be to say "oh, the delivery person got changed this week, we'll look into that". I would be very, very wary of what is going on there.

It also sounds as though your dad may need a skilled nursing facility sooner rather than later. Have you started to look?

Jem813 Dec 2014
And I also notice this overuse of therapeutic lying by the staff, which creates a lot of mistrust, is always to make the staff's job easier. For instance a newspaper goes missing or TV doesn't work. Much easier to say that your daughter forgot to pay the bill than to investigate what actually happened. I totally get it that they have higher priorities but it creates this sense of mistrust which ultimately makes the interpersonal relationship with residents almost nonexistent. The residents talk to each other and it's Us against Them always. Not good.

Jem813 Dec 2014
So I've contacted the ombudsman for the facility and I'm waiting for a response. The Alzheimers Association suggests I draw up a written plan with the facility, since my Dad's move in experience to the facility 1.5 years ago was very unorganized.

For instance: they said they'd coordinate the furniture delivery and didn't, meanwhile I was 3000 miles away in NJ picking up my Dad and his cat so I had to have my boyfriend take the day off work to coordinate the furniture delivery. They said they'd coordinate the cable hook up...not...so I had to do that myself too.

They said they'd present the idea of my Dad having his cat to the committee, since he had a cat at the facility in NJ, and instead the head administrator himself just changed his mind about presenting it to the committee and decided it was a bad idea himself. So now I'm the involuntary owner of my Dad's cat.

Oh and they lost the deposit check and kept on asking me for it and then found it in their own possession after all...small thing but just another hassle.

So I didn't complain much through this whole thing, just made a mental note to get it in writing next time, since the default attitude seems to be to promise everything and deliver nothing. So that's where it's at, waiting for the ombudsman to call and waiting for any other good ideas from the Aging Care community.

Jem813 Dec 2014
My Dad is currently in a locked memory care facility. They would like to move him temporarily to another room in same locked memory care facility. Here's the deal with the dining room renovation: they plan to use his room temporarily for dining. To do this, they will move him out to a nearby room. When the renovation is over, they will move all his furniture back into his room and he will move back into the room.

He gets upset at the staff only. He's fine with me and others he's close to. So if there's an antidepressant that specifically deals with his moods towards the staff, that would be great!

He doesn't trust them as it is...this move will potentially be a huge stressor for him in that way. It's because they reflexively use therapeutic lying for everything. For instance, if they want to take him down to the lobby because I will be arriving in 10 minutes, they say I'm already there so that he'll rush. If he gets to the lobby before I do, then he gets really upset that they lied to him that I was already there. If his newspaper goes missing, they say that I haven't paid the bill, when in fact it's just being taken by another resident, and when he discovers this it angers him that they lied; when he can't switch the TV back from DVD player to TV, again they say it's because I haven't paid the bill, and when I come over and switch it back for him, he gets mad that they told him something else. So he trusts them less and less. I think they are underestimating his memory loss. It is a very specific type of memory loss, where he loses track of where he is and goes wandering for days sometimes. He also forgets that he can't drink alcohol while driving and got 3 DUIs and had his license permanently revoked, but he forgot that he doesn't have a license and wants to drive anyway. Those two things landed him in the facility. He's been diagnosed with moderate dementia by one of the top memory docs here in San Diego so this is not selective forgetting or anything, he really has a problem where everything seems familiar even if he hasn't been somewhere before and he has trouble putting two and two together (e.g., he'll think I know all his friends from college...weird).

BarbBrooklyn Dec 2014
Agitated

BarbBrooklyn Dec 2014
Are they suggesting moving your dad to a less secure part of the facility because he doesn't require a locked facility "yet"? You make it sound like depending upon which way you choose, all the other residents will be affected in where they dine, which I'm not sure would actually be the case. Perhaps I'm reading this wrong.

What meds is your dad on for agitation. My mom also used to get Gita Ted over every little thing, but a new combination of antidepressants has done wonders for this.

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