My LO (She's my cousin and I'm her POA and only one involved) has significant dementia and has been there for a few months. She recently took a fall and it's been very difficult dealing with them, but there were problems before the fall too.

I've discovered that a lack of communication is causing problems. For example, I have spoken with the resident coordinator about a matter at length and then then the next week she calls me making recommendations and informing me of things I have never heard of. When I request details, times, dates, etc., I get none. When talking with various staff members, I get different answers on most everything. Also, when I provide information about medical appointments and other matters to the nurses, it doesn't get passed to anyone else.

I feel like I'm spinning my wheels. It seems that the left hand doesn't know what the right hand is doing there.

I don't think any of them use E-mail. Maybe that's due to confidential issues. Does anyone else communicate that way with ALF staff? I would like to send updates in writing on all matters and copy all departments. I guess I could fax it.

Any suggestions would be welcomed.

My cousin tells me she is happy there. She says the staff is kind and really take care of her, so I really want this to work.

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All assisted living facilities and nh have staffs that are overextended. It's taken me several months to get communication with staff here smooth. Initially, I was calling mom's nurse once a day to find out how she was (yes, way too much, but she was aphasia and delusional at the time and couldn't talk on the phone). I know try to save up questions for a once a week email to director of sweet which is copied to the unit manager. I agree with everything Jeanne said, but it's also true that when we tried mom in AL after her stroke, this sort of communication problem was making me crazy. Just when I was starting to figure things out, mom broke her hip and is now in a nursing home. Truth be told, she probably would have been better off in nh from the getgo, since dementia was not her only issue.
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I'll try all suggestions. I do wonder if they may be over extended.
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NH: Your cousin is relying too much on the wheelchair.
You: What is your plan for correcting that?
NH: We are trying to walk with her more often, for example to the dining room.
You: How can I help?
NH: Could you not use the wheelchair with her when you visit unless she is very tired?
You: Yes, I can try that. Can you store her wheelchair somewhere out of her room?
NH: We've talked about that, but that would be too restrictive. There are times when she does need it. We just don't want her to always use it when she doesn't have to.
You: Oh. Can you make sure she has shoes on when she is dressing each day? That would make it easier for her to switch to using the walker.


Communication is a back-and-forth, talk until you both understand each other kind of deal. It is not them telling you there is a problem and then you trying to figure out how to solve it. It is not you telling them what to do and then being frustrated when they don't/can't do it. When they present a problem, always ask how they are dealing with it and what they would like you to do. And feel free to tell them if you can't provide the help they are requesting. "I'll walk with her to lunch on the days I am there, but I don't think that is enough. Can you have an aide walk with her each day?"

Nursing homes have large staffs and word doesn't always get around quickly. Something may be put in a resident's file but the young lady dashing into Cousin's room to answer a bell and hearing another bell going off down the hall doesn't always take the time to check the file. We found it helpful to place a large sign on the room's cork board. Mom had a catheter and pulled it out several times. We suggested that she always have pants on (no night shirts, etc) so the tubes weren't accessible. The aide I suggested it to thought that was an excellent idea, but that evening's staff didn't put on pj bottoms. I put up a big sign saying "Family requests pajama bottoms or pants at all times." That did the trick! I got a call several weeks later. "Now that your mom's catheter has been removed, is it OK for her to wear night shirts?" I confirmed that was OK, and they took the sign down.

Your role can be a very frustrating one! I hope it gets better as you and the staff get to know each other better.
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I appreciate your comments, but they are the ones calling me. They called me and said they had called her doctor about going to the ER for a CAT scan. I explained that she had already seen an Orthopaidic specialist last week and had an MRI scheduled in two days. They then said, never mind.

They called me on Friday and said she was relying too much on the wheelchair, so I went by, helped put her shoes on and walked with her with the walker to the dining room and back. I folded the wheelchair and asked them to come and get it and take it away.

Two days later, they call me and tell me she is not getting out of the wheelchair. I didn't even know they gave her the wheelchair back again. How did this happen?

They tell me one thing, but in a few days, they report things that seem longstanding that was never mentioned in the previous conversation.

Believe me, I wish they would handle things and leave me out of it, but they haven't.

I called to scedule her transportion for her visits, which they are supposed to provide, but the transport person is on vacation. I'm told to call back next week. When I call back next week I'm told there isn't enough time to fit in her schedule. For dates further away, I 'm told she doesn't work on Fridays. So, I have to arrange to transport myself. You see what I mean?
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Addendum: Updates in writing and copy all staff? Sounds like you're too involved in their day-to-day operations. Imagine every loved one writing and copying all staff. They don't have time for that. Relax.
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You COULD be having problems because you're not telling the right people -- people that you can hold accountable. Or not telling them at appropriate times, like when they're "on the fly" and they don't write it down.

I don't know what kind of communication you're having a problem with. It was my experience that you're not going to get ongoing daily details of your mom's life at the facility. You'll get notified when she falls, when she's being difficult, when there's a problem they need your help solving, when she needs medical attention.

When you give them information about medical appointments, give it to them in writing. Get the name of the person you gave it to, and, if they miss it, come down with a hammer. That's inexcusable.
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