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I admitted my 89yo mother to a stand-alone, "award-winning" assisted living/memory care unit with trust and hope. At the urging of my family, and allowed by state regulations, I installed a camera. I like the location and facility, and appreciate how I've seen caregivers communicate with my mother. My mother, to my surprise, is rising to the challenge and beginning to acclimate. I want this situation to work for us.


However, within the first week, my camera caught a male visitor entering her room 2 nights in a row. On the second night, he touched her on her shoulder and toe, waking her up, and causing her to cry out. After the first night, choosing to take a soft approach, I reported what I saw verbally to the Executive Director and asked her to assure that the door was locking appropriately as staff members left the room. After the second night, I sent an email message to the ED, cc'd to the Administrative Manager, reporting what I saw in detail, and requested that she assure me that my mother would be safe and secure. I received no reply from either individual addressing the concern and when I arrived for my 3:30 appointment and was escorted to the room by a caregiver, we discovered that the door was unlocked with no one in the room. I talked with a care supervisor and learned that because her unit had been a "model," the door handle/lock was different than those on the other patient units and that their solution was to orient all the staff to the handle/locking mechanism. After some discussion, I was eventually told that the maintenance man was coming from another facility to change the lock. I remained until that was done.


Two days later, when I arrived and was escorted to the room, the door opened without a key. I had yet to receive a return email reply from the ED, or AM, to my first email message. So, I sent a very direct but tactful message requesting an automatically locking door and/or move to a unit in a hallway away from the visitor by day's end. This time, I cc'd the message to the Marketing and Sales Director, as well as the ED and AM, and requested a return reply. I received a reply within minutes from the ED indicating that the maintenance man would "look at it" that day. The maintenance man called me himself to say that he changed the lock to one that would lock automatically as caregivers leave the room, taking the "human factor" out of the equation. I feel satisfied with this solution but am very disappointed about communication regarding this concern.


I hate that I had to start my relationship with the administrative staff this way but also know that I would never forgive myself if I did not report safety concerns and something happened to my mother. I am a well-educated nurse with extensive background, including a bit of experience in geriatric, mental health, and locked units. I know good care when I see it and I have read all the state regulations about assisted living/memory care. I know that the care delivered to my mother will not be perfect but have already noted many indications that standards of care are not being met - especially on nights and weekends.


I do not wish to use the camera as a "gotcha" tool but as a tool for collaboration to my mother's benefit. As a caregiver myself, I understand that this camera can be off-putting. Please help me learn how to draw the line between attempting to "micro-manage" her care, and picking and choosing battles judiciously as her advocate. I'm also open to suggestions about how to best communicate my concerns when warranted.


Appreciate your input!

Unacceptable with a capital U.

Request an immediate care meeting and ask why this lapse and lack of communication and followup should not be reported to the Ombudsman.

And to mom's lawyer.

I would not play nice.
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Reply to BarbBrooklyn
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TRLRLR May 15, 2021
I love this communication tool (why this lapse...should not be reported...) that you gave to me! I have added the Ombudsman's number and the lawyer's number to my contact list on my phone.
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Don't worry about micro-managing. Take care of your mom no matter what. If people are offended, too bad. You are her advocate and protector. Continue using email and cc in case you need a paper trail for documentation if needed.
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Reply to HomelyandBald
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TRLRLR May 15, 2021
Thank you. "Paper Trail" is my friend - I have to remember administrators are not - though they may be good humans - their loyalty is to themselves and their company.
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Well, look at it this way. I'm sure part of their "award winning" accolades are providing a safe environment for their residents. I'm sure you're paying top dollar so mom is in a safe environment. Mom's door being left unlocked is bad enough; the fact that a stranger entered the room twice, with one of those times being AFTER you notified them? Totally not safe.

It's bad enough that it happened twice - and thank goodness nothing bad happened to mom - but that you *politely* told them after the first time and they, in essence blew you off - multiple times!! - is not ok! You have every right to "micromanage" this, as it's a safety issue. It's not some complaint like the other residents are hogging the TV, or her laundry isn't being done the way she likes it, it's safety! Safety is never, ever a "micro" issue!

You shouldn't be upset that your relationship with administration began this way - now they are on notice that you're not an absentee child, that you are going to take an active part in caregiving, even though mom is in a facility, and you are going to advocate for her and her well being. That is nothing to apologize for, not to anyone here and CERTAINLY not to the administration of mom's facility!

You in no way, shape or form "crossed the line", so don't even feel that way.
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TRLRLR May 15, 2021
Thank you! Your response is so reassuring! Not only will I not be an "absentee child" but Mom is on hospice, and because the facility is still practicing COVID restrictions, we are granted more liberal visits, but by 24-hour appointment.
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Micro FREAKING manage! I am angry just reading how your mother has been treated. I would be down at my mother’s MC in a FLASH if my mother were being treated that way.

Do it until your mother is treated correctly.

I am a retired teacher. Parents who were on top of things for their special needs kids got the got correct adherence to their IEPs.

Keep that nurse hat on. It is an asset.

Be. That. Daughter.

I am cheering you on from here!!!
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Reply to cxmoody
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TRLRLR May 15, 2021
LOL cxmoody! No worries about me keeping on the nurse hat. My mother and sister are also nurses, and I shared this with the ED and Marketing and Sales Director before pursuing admission. I don't think they are intimidated by us - like teachers, nurses are one of the largest professions in the US - they've had nurse, doctor, and other healthcare provider family members before. If they are meeting care standards, they have nothing to worry about. In previous experiences as a patient and family member, I've found that it is usually best to be transparent about my profession and areas of expertise so that other caregivers do not feel "played" when they find out. As daughters and sons, we experience all the frustrations, guilt, and other emotions others have expressed on this forum. Yet, our family members are fortunate that we bring our nursing capital to their situation. I wish other residents had the advantage of a healthcare professional to advocate for them. :-)
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This gentleman may be in a level of care no longer appropriate for him and may require memory care. You say you are a nurse. I am as well. I think in most states that ALF/memory care facilities are much less regulated than are Nursing Homes. That may or may not be the case where you are as you say you have read the rules in your state. If your facility proves over time to be out of line in following the rules you have read you may wish to have your elder in another place; this may not be the place for her. However, if does seem that overall she herself is satisfied. She will not get the care and oversight she would with being in your home, you on duty with others around the clock concerned only in her care. I think you likely recognize that you are both adjusting to some of the realities involved.
I do know one of the complaints my bro had in his own VERY GOOD ALF in Palm Springs was that in an attempt to help people foot the bills and etc, sometimes people who really required memory care were kept in Assisted Living too long, and they could disrupt other patients as well as getting the care others might require. This could be happening at your own facility.
I hope that this will be the facility for you and you will find the care overall good. And that you will take your concerns to administration. They will let you know what they can do, and perhaps they will bump up your Mom's care level a bit higher (and unfortunately the price as well). Or they may tell you that they feel they cannot fulfill all of your expectations and feel you may be happier with another facility. I am hoping there are many to choose from where you live. I sure wish you the best. It is an adjustment and I had to laugh so hard when my brother (with his own VERY specific wants and needs and thoughts) said "Well, I think I am doing OK> It's a bit like when I was in the army. I didn't like it a whole lot, but I made the best of it".
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TRLRLR May 15, 2021
Thank you, AlvaDeer. I retired earlier than planned to take care of Mom for as long as I could in her home, with the help of technology. Then COVID emerged, and my new goal was to keep her in her home until restrictions were eased. Even as (or especially as) nurses, both my sister and I felt like huge failures because we couldn't get Mom to do what we knew she needed to do to continue to thrive. We were both very aware that moving her to long-term care would not be less difficult - only difficult in a different way. I wasn't thriving either, and I knew that things would only continue to go downhill. Now, after watching Mom in the MC, I can see that she was deeply entrenched in the habits associated with her home. Though she has certainly brought old habits with her, she seems to be more receptive to the MC caregivers, or should I say, less comfortable rejecting their nudges than those of her daughters. For example, she has changed her clothes more times in the last two weeks than she has in two months! She still has a long way to acclimate, but I believe she may even gain weight.

To your point about the potential that we may be encouraged to find a facility that can provide a higher level of care: Mom is on hospice for her dementia and chronic renal failure (about midway through Stage IV). This is the facility that the hospice social worker recommended most strongly. The ED indicated that several of their residents were on hospice to end-of-life. Mom is still more capable of communication and mobility than several of the clients. So, cross fingers, we don't get evicted for other reasons! Meditate, meditate, meditate!!!

By the way, a funny you will appreciate: During the last couple of years, whenever she had a doctor's appointment, I would very carefully plan my approach to get her to clean up and change her clothes before leaving the house. But sometimes, she would flat-out refuse! I would tell her that I did not want her doctor to think that I was neglecting her. my Mom, also a nurse, would say, "I'll just tell him that I refused to change my clothes so he can document it and you'll be okay." :-)
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I think your expectations are legitimate. We focus on health and safety ( including mental health). If my mom hates a meal, oh well, it’s going to happen. If the sheets don’t get changed on the scheduled day, it’s OK. If she misses a bath now and then, OK. It’s a very difficult job without much positive reinforcement.

Someone coming into her room is a safety issue.m for sure. My mom is in care and my son is in a group home. I’ve told them both, I am watching carefully to have their health and safety needs met, but I will speak my mind, and be kind and nice when I ‘complain. ‘

best of luck!
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Reply to Restlessremedy
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TRLRLR May 21, 2021
Health and safety, health and safety, health and safety...this will be my mantra. Thank you!
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You are picking your battles by balancing your concerns with the reality of what is humanly possible. You have the camera as well as the ability to effectively communicate and document problem issues.

If you micro manage, you can also
back off. If you make a wrong assumption, you can say “ I’m sorry, your right and my only concern is my mother’s well being.
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Reply to GAinPA
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TRLRLR May 15, 2021
Thank you, that's a good thing to remember. Going into my communication toolbox!
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I’m sorry if I’ve missed the obvious, but did you ever find out who the man was, and why he was in your mom’s room?

Before Covid, there would occasionally be a male aide or attendant on my LO’s floor, and they were typically decent men who had been thoroughly vetted by the facility.

I’m assuming that you had ample reason for your reaction but did you get a reasonable explanation too?
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TRLRLR May 15, 2021
Hi, AnnReid. The first night the male resident entered my mother's room, she asked him who he was, and he responded with his full name. Like all the other residents at this memory care facility, he has dementia, and he was looking for a bathroom. He seemed like a nice man, and I have avoided including information in my profile and messages to protect his privacy. I presume that, at least in part, the administration was also taking care to protect his privacy when communicating with me. Thank you!
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Seems you handled the situation the best way you could. Your mom deserves to be safe and the facility has a duty to ensure her safety. I am glad you kept on it until it was resolved. This will hopefully be the end of the facility safety issues.

Keep reminding yourself that you are ensuring that your mom stays safe and healthy. You're doing a good job!
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Reply to Taarna
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TRLRLR May 15, 2021
Thank you, Taarna. No harm was done, but I knew I could not live with myself if I didn't resolve the issue, and then harm WAS done due to the door not locking as the caregivers expected it to when they left the room. Not to mention, if he comes back, she might harm him!
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AL/MC, which unit is she in? IMHO, placing a camera in a resident's room puts the staff on edge and erodes the trust between the staff and the family. I'm not saying you shouldn't have done it, you have to do what you think is best for your LO and yourself, and it certainly can expose abusive care by the staff.

Wandering is very common, especially in MC. The man who entered your mom's room and touched her, may have thought that she was his wife. I'm sure it was frightening for your mom. When I came to visit my wife one day, she wasn't in her room and found her fast asleep in another person's room. Another time when I went to the closet to get some clothes out for my wife, as I opened the closet door, there stood Jimmy, one of the residents. Scared the livin' dickens out of me. I escorted him back to his room.

You brought your concerns to the staff early in your mom's residency, so they know now what standards they will be held to. I suggest that families don't over expect the care that a facility can deliver, but at the same time to express their concerns in a diplomatic, non confrontational way.
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