Assisted living facility cut off communication. How do I approach a sit down with the staff?

You say you have had a great relationship for four years. Now it has gone wrong. Creating now an "adversarial relationship" will certainly not help. Were I you I would go in and ask "We had such a wonderful relationship here for four years; I hope I haven't done something to change that. Mom loves it here. I recognize she is getting worse, but I feel as though right now people are avoiding me. What can I do to make our communications better?"

Bedbound seniors require a lot of skin care, but bathing is overdone. If there is an indwelling catheter there may be more infections, but otherwise infection comes of incontinence often enough, or even just of aging problems and general debility. It is common both in in facility and out of facility care.

I think perhaps your Mom is progressing and becoming more ill and helpless and this is escalating your frustration, and I am so sorry for that, but I do think an adversarial relationship will leave them advising you that "if you are no longer happy with our care you may need to explore moving your mom". If you have a good place, try not to lose it. I am sorry things are going so poorly and hope it gets better for you and for your mom.

Your Mom is sounding now, like without extra help coming in, she is beyond assisted living care. She may require memory care. More staff there and of course higher costs.

Why do so many assisted living facilities keep seniors in their places when they are clearly well past the assisted part of assisted living? It it because of the money? It seems to me that a bed bound senior is not a candidate for assisted living and should be in a skilled nursing facility at this point? Has the OP looked into moving mom into a more appropriate place for her mom's care?

I am with SP, an AL is not equipped to care for your mother. They are not equipped to care for a UTI if she now has had two. Mom probably needs to be placed on IV in a hospital. A culture taken to make sure correct antibiotic is given.

"I don’t know how to approach a sit down with the staff" You don't approach staff you sit down with the director/administrator and voice your concerns.

"billing girl won’t file my moms insurance or respond to me asking why" My Mom was in a small AL. She had her own doctor so no billing needed there. Prescriptions were billed by the pharmacy. So no billing done at the site. Do u use their doctor? I think that the billing girl is obligated to bill on the day the service is provided. Or at least in a timely manner. I would call Medicare and ask that question. I may also inform the providers that billing is not being done and that you are not going to be liable for the bills.

This is interesting so please update us. We learn from each other.

You don't leave a forum because of one person. We have all been Caregivers. Some members are RNs and a few CNAs, some running their own businesses hiring CNAs.

We can only go by what you have written. Yes, we assume. You ended up making your situation clearer. The only way you approach the director is to go to his/her office and ask if he has time to talk with you about some concerns you have. Be ready for what he/she has to say. Don't take offence. I think the billing girl not billing the LTC insurance is a big thing. Maybe new Owners don't believe that is their responsibility to send LTC paperwork. Maybe since you pay upfront, its felt that you should send in the info to get reimbursed. The billing girl may have been told to stop. If so, she should have told you when asked u why she was not billing the LTC to seevthe director.

New management, new rules. Maybe its felt Mom is now too much care and she needs to be placed in a SNF. Because she is grandfathered in, they have to honor the contract she came in on. But this new management may not have a #5 tier. My Moms AL only went to #4. From your post, I think u know what is going on here. They want ur Mom out of the AL. Her care is now more than they feel they can handle especially with the aide shortage.

OP, I can see why the staff have been told to cut communication with you. You “speak with the medical director and staff often”, you are “there several times a week”, and you are a “trained medical professional”. You “know what they are up to”.

My guess is that they appreciate families who care, but your level of involvement may come across as that you think you are in charge and can tell them what to do. If you disagree with them, you can become a very difficult “customer”. You are probably pointing out things that staff have said or not said, as part of your criticism, which is why lines of communication are part of the problem.

Perhaps your expectations of Assisted Living are higher than they are actually offering?

Has there been a change in ownership or the upper level admins recently?

When was the last Care Meeting?

Have you spoken/emailed the Social worker and DON?

Is it possible that they think that mom needs a higher level of care?

She is in a facility that allows all levels of care, she was on Hospice for two years and is back on Palliative.

i am very hands on and speak with the medical director and staff often. She is 1/2 mile from me. I am there several times a week. I believe this is because of the infections and one of which is antibiotic resistant.

i am going to go the the directors office tomorrow but this sudden behavior is concerning

OP, it’s clear that you think you are a help, not a hindrance. You need to read your post again to remind yourself of what you actually said, which doesn’t seem to be what you now remember.

So why won't the "billing girl" but through your mom's claims?

I'm really confused by what you think might be going on. Please let us know when you resolve this!