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I do not eant to anger the staff.

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Most contracts with assisted living only offer certain things, but you are welcome to hire in-home agencies to come in to give more care. Assisted living is meant to have help around if someone falls, offer meals and social events and generally keep an eye out. There are some, of course, that offer more care. But many don't. However, none should object to you hiring more care.

I'd check the contract to see what is included and go from there.
Carol
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As the executive director of an assisted living residence, I encourage to look carefully at the contract/lease you signed. Check out the option for any extra service packages at a higher price. Some facilities offer services ala carte and some have bundled or tiered service packages. In my facility, I welcome the opportunity to resolve customer service issues without angst or anger between a family and my staff. I would hope that the executive director of the facility in which your mom lives would feel the same way. Every state has different regulations for assisted living. Assisted living residences are different than skilled nursing facilities and most are intended to provide up to a certain level of personal care assistance and assistance with medication reminders in some fashion or another. In Massachusetts, we are defined by regulation as residential settings with supportive services in the form of personal care assistance and medication management. We are expressly forbidden to allow our nurses to perform skilled nursing services. Whenever one of our residents needs more than we are able to provide, we offer the option of assisting them to find reputable/dependable private duty supplemental caregivers/nurses, or to assist them in their quest for a higher level of care. I don't know where you live or what of the suggestions I have offered you may already have tried. I hope this helps.
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You may want to look into residential care home, group homes or in some states they are called afc homes. Most of these homes are state licensed and they are smaller residential homes in regular neighborhoods, they can provide a more homelike setting and a lot of times the fee is all inclusive, the best part it is more personal and there is usually a 1 to 4-6 staff to resident ratio.
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In our area, some families hire a caregiver though an in-home care agency to give one-on-one time to the person in Assisted Living.

Assisted Living facilities are only staffed to give some help and charge additional for this added help. Their staffing is limited and may not be able to meet the needs of someone that is declining.

You could hire additional private help for as many hours as you think may be needed to keep your parents safe.
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Thanks so much, I talked to family and this is the way we will go. It's hard because my father-in-law does not think they need the help.
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Hire a "professional" (I use that term loosely when referring to the healthcare field) to be there in the mornings - evenings; 2) wrangle your whole family - nuclear and extended (all the cousins, kids, uncles) and try to come up with a schedule where everyone lovingly shares a day in heis/her life every two weeks or whatever (depends on how big your whole family is); 3) be there with your loved one yourself; 4) bring your loved one home; 5) pray. The 7 months my mom was in 3 hospitals and 2 nursing facilities for rehab, i was able to be with her 24/7 (except for the hours I would come home and let our t and take a shower). The quality of help and care provider WHILE I WAS RIGHT THERE AT MY MOM'S SIDE at all these different facilities (including the "world renowned CLEVELAND CLINIC FOOUNDATION) was below fair. AND THAT;S WITH ME RIGHT THERE! Granted, there are a handful of AMAZING people in the healthcare field who will be wonderful to all patients and not just your loved one because you are there with them, but for the most part, those STNAs and LPNs and all the way up that little ladder - really DON'T CARE. again, i am not saying ALL OF THEM are like this, BUT MANY ARE. it is D-I-S-T-U-R-B-I-N-G. so for you to expect or think you will get extra help for your loved one from the staff that is currently there - forget it - move on to some other solutions. AND DOCUMENT EVERYTHING. EVERYTHING you or anyone in your family sees that just doesn't seem right. if you don't have family that will support you in taking a shift once a month, perhaps the particular gift God has blessed you with could be used as a bartering tool. Maybe you are an artist, or a seamstress, or a childcare provider, or a great reader - you could rally a team of volunteers who will help you to help your loved one by "paying them" with your abilities (stay with my loved one once a week, and i will wash your clothes for you). whatever - but you need to brainstorm and come up with another solution - even COMPLAINING or ADDRESSING to the owner of the facility won't make a difference. and i write this and share this all from experience.
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Yes i would check with the contract that you sign. sometimes there is small print of what they will do or are able to help out with. There are even some nuring homes that have special rules on the elderly what they can handle. Do check aroung before you do any kind of change. you may find yourself in a worse place for your loved one. The way a place looks is not what it appears, visit at various times. write down what you see are they clean, are there bathrooms clean, is there a smell. what does the food look like. It is your right to speak up. make sure that the place you have you loved one, is a plaee you would like to visit at anytime and the care is the same. Sometimes hospice can help.patrica61
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Had mom in a NH for 2 weeks while we went away. I hired people to stay a few hours a day, friends visited, checked up on the staff. It is the only way she got good care. It took one week to straighten out everything so that I could go away one week.. Moral of the story: Do really good and deep investigating when choosing a home!!!! I had to do everything for her for 5 days before I went away just so that they would know how to take care of her special needs!!!
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This was a tremendous help. I have found an assisted living situation with 3 levels of care. Right now my mother is able to do a lot for herself but at almost 87 there are some issues. I am meeting with the director tomorrow to go over the contract. Thank you for the information.

Marie
Utah
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