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Hi. I have a resident I care for in a facility who I believe is being neglected by family and possibly being financially abused. I have no proof of the second but the first I believe I have grounds for. She has end stage CHF and because of it increasing anxiety, more incontinence, more depression, and greater fall risk. Also her memory is deteriorating. She believes it's the 1970's. Family never visits. They drop off what she needs and leaves, which wouldn't bother me so much if the POA, the same family member, would answer her phone during emergencies. The care director is pushing to have her moved to memory care wing because of all the issues she's been having, but family won't answer phone calls to sign the paperwork. She hasn't seen a doctor in over 3 months, and has no more than 10 dollars on her at any given time (usually less), so she cannot go get her own things when she's running low or out. She had an emergency and family wouldn't answer their phones then either. Family only lives 15 minutes away. She's not getting any mail, and her meds are dropped off sometimes weeks late by family. Who should I call? Any advice? Any experience? I work for the facility and everyone just kind of thinks I'm crazy to want to have someone investigate and get her the care she needs. Thank you all! (I tried to keep details at a minimum but there's more that makes me suspicious)

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Report what you see to your supervisors & let them handle it.

In my experience Assisted Living directors hunt family down when fees are due or care levels need to be increased.
So for you to get involved is not appropriate until you have discussed your concerns with management.

AL’s have attorneys in place and will take action if they feel the client needs more care and the family can’t be reached after a reasonable amount of time. They will apply for guardianship legally if need be. AL are not going to place themselves in a vulnerable position or one that may cause them costly liability.

If your supervisors don’t give you a reasonable response and the care of that senior is compromised then it’s your duty to call APS.

I’m not sure why you think you would be privy to everyone’s family information. I also feel you shouldn’t judge anyone (the daughter for just dropping off stuff & leaving). Family dynamics are complicated.

Report it it to your supervisors first& document everything in a notebook so you can easily refer to specific dates and examples.

Thank you for caring & the job you do.
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Reply to Shane1124
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Just scanned posts.

I agree, the Adminstrator should be calling APS. He should be able to contact the POA. Usually that person handles the financial and medical. He can call APS and tell them there is a vulnerable resident. That family has seemed to just dropped her off. That ur facility does not deal with pharmacies so meds are not given in a timely manner. That in an emergency family members cannot be contacted. The best thing that could happen is the State gets guardianship. They will take over her finances. Maybe ask for an accting from the POA. If found she has been stolen from, the State can bring charges.
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Ginger, I have not read every response, but I believe that every person that works with the elderly are mandatory reporters and that you should report to APS.

This is a problem because they are not providing her medication in a timely manner, some medications are dangerous to miss doses. That they are not responding to emergency calls is another problem. I know from personal experience that my dad might not receive proper care if I didn't authorize him being sent to the hospital, it was part of the contract.

I believe that you are responsible to say something if you see something. Getting the authorities involved to get this woman the care she needs may be the only way to get her family to respond. If they don't fulfill their POA fudiciary responsibilities it may be time for the state to step in.

Good for you that you care enough to do something to help this woman that has been abandoned by her family.

Thank you from the bottom of my heart for being more than a paid aide. Hugs!
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Reply to Isthisrealyreal
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Gingeriffic Nov 7, 2019
Thank you so much. All of the staff I work with care so much. We do. We don't even get paid a living wage in California but we love our residents, even the mean ones. Most of my fellow staff doesn't even realize that we can do something. I just have been unsure of what or who to talk to. If I talk to much to staff or supervisors, there will be rumors and I'll be seen as a whistle blower for everything, so this was place was really my only anonymous place for advice. I have the local ombudsman's number. I plan on calling her and asking some questions and giving her my account of what I see going on. If it's not her territory then I'll know for sure APS is it. You're right, I am a mandated reporter. Thank you.
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Try calling the cops or APS. Maybe they can help you. I don't know. It's worth a try.
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Reply to elaine1962
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Unfortunately, it's not the family's 'responsibility' to come visit their 'loved one', nor is up to them to do anything but pay her monthly rent bill. I had my mother in a SNF rehab in May and the DON was telling me about how they can't even get family members to answer the phone when the resident is dying and in need of hospice care! Consequently, the resident will die screaming in agony with no comfort medications being doled out, thanks to uncaring family members who want NO involvement. Sad but true.

To those saying it's the 'facility's' fault, what fault is it, exactly? What's being neglected? She's being cared for, it sounds like, to the best of the ALs ability, w/o any help from the family. So I don't know that there's more they CAN do. Mail should be sent directly to the resident at the AL facility, that is the norm.

It seems to me that you should follow the direction of your supervisor; if she feels APS should be called, then that's what should be done. Is it up to YOU to do that? You'd have to ask your supervisor about that directly. What does policy dictate in such a situation?

In this line of work, your heartstrings are going to be continually tugged at. While it's great to care and to feel compassion for your residents, it's never a good idea to internalize TOO much of their life's misery. Leave the job at the job when you clock out so you can refresh yourself and come back to do a wonderful job for the residents again tomorrow.

Bravo to you for caring, my friend. You rock!
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Isthisrealyreal Nov 7, 2019
Lealonnie, if the family has chosen to pick up and deliver medication then they are responsible to ensure that she gets them before they run out.

Being POA is a fudiciary responsibility and it does have legal consequences when they are just ignored. It is not just about sending the rent check. I recommend that everyone should visit their attorney generals website and read what exactly the responsibilities are when accepting a designation as POA.

You are accepting that you will always act in the best interests of the person, this family is obviously failing in that.
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Gingeriffic, I think you just answered your own question. We can't do anything more than the family has already agreed to without their sign off. And they won't, despite the fact she clearly needs it. Unfortunately, there is nothing you can do. The family has ALL the control. Unless the family will give up the control to someone else, there is nothing you can do. It is very sad and unfortunate.
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Isthisrealyreal Nov 7, 2019
You can report the situation to APS and that will get the family doing their POA responsibilities or the state will step in to ensure that this woman is receiving the proper care.
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Ginger, I've read some of your responses now, and its more clear. I think in this case, yes, I would contact APS. It sounds like someone needs to take action and maybe pursue guardianship over this lady.
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Gingeriffic Nov 7, 2019
Thank you. I will talk to my care director (supervisor) to see what she also thinks. I just have been debating even bringing it up, and getting some varied answers and advice gives me a few different perspectives and more to take into consideration. Thanks for your patience with me.
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This is not a nursing home or a skilled nursing facility. She is currently in assisted living which leaves a lot of responsibilities to families. My job is to care for her basic needs. Incontinence, meal reminders, just being a friend. Providing basic first aid (which is even a stretch legally to do despite my certifications). The care director has been trying to contact family because she NEEDS desperately to be moved to the memory care wing, but legally we can't force her to move without family sign off. Her health is declining and we have no right to send her to a doctor unless it's an emergency. We have zero ability to order and pick up medications because that is family's duty unless they apply for a specific med delivery program which gives the med technicians permission to legally reorder and have medications delivered. I don't care that family doesn't visit. It's the fact they don't even answer their phones during emergencies, don't come to any care evaluation meetings (which happen when the care director believes it's time for a higher level of care which happens when the decline is so rapid she needs someone with her more often than an "assisted" caregiver can supply). I'm upset because this has been going on for several months and it's only getting worse. Legally, we only have so much power. It's kind of confusing if you've never worked in an assisted living/memory care "community". We can't even have CNAs work here unless they don't use any of their licensed training. It's just a lot and I don't know who to call to get her the care she needs. I can't spend half my shift with her when I have 20 other residents to take care of also. I love her dearly, ive grown attached, and I've struggled for about a week deciding if there really is any grounds for me to get her help, and my gut says yes.
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mstrbill Nov 7, 2019
I'm not sure its the family's legal responsibility either. What if there was no family? What if she's estranged? What would happen then?

What does your supervisor say?
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The facility has its protocol to follow. It is your responsibility to follow that. Everything you stated is the responsibility of the facility to get sorted out since it sounds like she is in assisted living. That may not be an appropriate level of care for her any longer so facility wants to move her to memory care.

You are not privy to discussions that director of others have had with the family. Having a very small amount of cash is not unusual as elderly often tend to give it away.

But if there is a wide spread problem with the facility then start by calling the licensing agency. Have your ducks in a row, document, document, document. Is this a whistle blowing situation?
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Gingeriffic Nov 7, 2019
I don't believe it is the community's fault, nor the care director. She cares as much as we do and is trying. She is very open with her Care staff, as much as she can be. I realize little money is usual for some elderly. Last time this happened to a resident, where her needs weren't being met by family as required when they moved in, another caregiver had to file a report with either state or APS to get some action because the family refused to supply us with basic necessities and medications. I'm a mandated reporter according to company policy, and there's a lot of policies that are unclear. We are all just very sad and frustrated because we can't give her more care legally and we can't force her to a different floor legally without family agreement.
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This isn't for you to take up. If the facility's managers and administrators are having problems with the family, it's for them to sort it out.

Your role is to keep documenting and reporting day to day problems such as medications running out, personal items she needs and can't buy for herself, and difficulties contacting the family in emergencies. It can get frustrating, but just make sure it gets done so that this lady's records are accurate and complete; and then if there is any future dispute about responsibility the facts will be down in black and white.

I'm just glad that this lady is in the hands of caregivers who actually do care about her. What you're doing for her is important, so don't get downcast because you can't solve everything else for her.
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Gingeriffic Nov 7, 2019
Thank you. It is hard because I hate to see no action being taken. I care about all of them. I have another family abuse issue which is more black and white with another resident. That one is clearer on what needs to be done, but this one has me stumped. I plan on talking to my care director to see if there's anything I CAN do according to policies and laws.
Ive been blessed with a great care team. We all care so much, even about the residents who have kicked us or called us names. We don't get into this work for the money or glory, I'll tell you what. It's for the residents.
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I'm confused too. It is the facility that needs to be investigated not the family. The family is under no obligation to visit her. Maybe she had a strained relationship or toxic relationship with her family so they don't want to visit her.
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Gingeriffic Nov 7, 2019
Its not a visiting issue. It's a care issue. Like I replied to some others, we aren't a skilled nursing facility. Family signed a contract, usually the POA does, that once the resident is moved in, they are responsible for certain things. Like doctors appointments, medications, supplies, etc. There's ways for the POA to be very hands off if she wants, that's fine. But she won't even answer phone calls. Once a month she drops off a few things for her mom's fridge, has depends auto ordered on Amazon and she leaves. Won't even speak to our director or Care staff regarding her mother's decline physically and mentally. I don't care if her family never wants to see her mom again, but when she flat out won't even let us upgrade care or move her to a memory wing, our hands are tied unless I get a third party involved. It's very very tight situation. There's no black and white answer, apparently, so far. Not one I can live with on my conscience anyways.
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Ginger, if she's in a "facility", its is the facility's responsibility to properly care for her. After rereading your post, I'm very confused, what kind of facility is it? Nursing homes take care of the things you are describing that aren't getting done.(Dr visits, medication). It is the facility's responsibility to properly care for the resident, not the family's.
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Gingeriffic Nov 7, 2019
Its not a nursing home. It's an assisted living community. This one does not provide skilled nursing. The family is responsible for medications, supplies, and doctors appointments unless the resident is put on hospice or on a med delivery and order program. It sounds a little confusing, but I'm considered a caregiver. I'm not a CNA, and we have no certified staff other than the med techs. Our legal rights to help the residents or get them what they need is very very small, especially because of the licensed floor she is on. We can't do anything more than the family has already agreed to without their sign off. And they won't, despite the fact she CLEARLY needs it.
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