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Judysai422 Asked February 2019

Any suggestions for placements that are between memory care or skilled nursing and assisted living?

My parents are both in their 90s and are in assisted living in Tucson, AZ. In most ways it meets their needs, but not all. Both of them are supposed to be on low sodium diets...mom for heart disease and blood pressure, dad for kidney disease (he also has diabetes which is a whole other nutritional issue).


AL does not offer meals that are designed to meet residents' nutritional needs. They do not needs ongoing medical care so skilled nursing is unnecessary and mom's dementia is not bad enough for memory care.


They are so limited in what they are offered by way of food that they constantly complain there is little they can eat.


I have spoken to management multiple times, but they don't care. The state of AZ has a low bar for nutritional standards in AL, which I did not know when we moved them here. Is it that way in other parts of the country?


I have looked into other facilities and none provide meals that are designed to meet dietary needs of residents.


Am at a loss as to what to do. Moving them in with me is not an option for multiple reasons and is not what they want either.


Suggestions?

Judysai422 Feb 2019
Thanks, BarbBrooklyn. So far county ombudsman has been useless. Seems like rules are so minimal. Have reached out to several national and state organizations to see what can be done at legislative level.
Mom's doctor wrote low sodium in her orders, but there is no follow up. They are not helped to make food choices and my mom is not capable of remembering her needs. All I get is that they can suggest but not require her to do anything. Dad is capable, but he has so many needs they can't be met...plus he also chooses to ignore. Maybe when he has to go on dialysis he will regret those choices.
My fear is that if I keep pushing it, they will be kicked out because their needs cannot be met. And honestly, I don't think they can be met anywhere except perhaps a small specialty home, but my dad won't go there because he wants a 2 bed 2 bath unit with other men there to talk to. So many requirements led them to this placement... so frustrating. The whole system needs a reboot.

Ming06 Feb 2019
I live in Tucson as well, put my Mom in AL last summer in Michigan near my sister so I can have a break. My Mom was a mess when I went to get her. I have given up and have a caregiver 6 nights a week so I can cook for her. I looked at places here but gave up.
Judysai422 Feb 2019
When I start petitioning the legislature I will let you know. The whole system needs to be changed.

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cwillie Feb 2019
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cwillie Feb 2019
I hate to say it but I'm not sure that you could count on their dietary needs being met even at the nursing home level. I'm in a different country and different system than you but I helped my mother with at least one meal a day and the only food that was served came out of the same hot cart for everyone - residents who were with it enough could ask if there was dairy or nuts or something else unacceptable (but 99% of the time they were reassured it was OK when it clearly wasn't). The only real difference I saw was that Diabetics were flagged and denied a second dessert and juices were limited. As I sometimes tasted mom's food I know that it was well seasoned too, so I know that low sodium wasn't a consideration either.🙄
IDK why it was like this, I think there was an attitude that once you reached a nursing home you were essentially palliative and it just didn't matter. (I'm sure it made life for the kitchen staff easier too)

BarbBrooklyn Feb 2019
https://www.azdhs.gov/documents/licensing/residential-facilities/article-8.pdf

These are the regs for Arizona AL. It seems to indicate in the "food" sections that meals must be provided which meet the needs of the residents as outlined in their care plan.

Are your parents' food needs part of their care plan?

Do your parents need help identifying which items on the menu are suitable to their diet?

When my mom was in Independent Living, I always felt the "complaining about the food" should have been listed as a daily activity. The food was delicious!

I think you'd be within your rights to make a formal complaint to the corporate office and to the State Ombudsman if you can't get this resolved by the on-site manager.
Judysai422 Feb 2019
Thanks, BarbBrooklyn,
My mom's doctor wrote orders and they are not followed. I keep being told they can suggest but not force anything. They don't even suggest.
Dad refuses to have AL handle his meds or to allow doctor to send food orders, so no leverage there.
The county ombudsman has been useless...says AL can't be required to provide dietary meals.
The whole system needs a reboot.

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