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I live 75 miles from my mother and I have Amazon Echo to check in on her. I am noticing that my mother is drastically declining because she is lonely. There is no real interaction with staff and residents. Is this a common concern for families in most facilities.
In addition, I notice that they are not helping my mother with putting pajamas on and there is decline in her oral hygiene because they are not assisting her with brushing.
Should I speak to the facility administrator about increasing the level of care or do I get help from a home health care provider. If the facility does increase the level of care. Can I hold them accountable?

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Why not move her closer to you so you can check on her once a week? Of coarse speak to the administrator and outline the problem and ask the activities director to encourage your mother to go to the many activities that are offered.
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Jamey, I am curious, are you hearing what is going on 24 hours a day via the Amazon Echo, or is this device only to call your Mom or Mom to call you?
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jamey178 Jul 2019
I use the Echo JUST to call her so we can see each other. However, there have been times she was sick and I was able to see what was going on with her. When I talk to her I can see what is going on in her room as well.
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You are entitled to a Care Meeting at the facility every three months or whenever you have concerns about the care Mom is (or is not) getting. I’m about to call one for my husband because he’s had only one shower in a month. Not good.

Arrange one through FaceTime or Skype if you can’t be there. Share your concerns and give them a week or so to make good on any promises. If nothing changes, then go to the administration.
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jamey178 Jul 2019
Thanks!
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My mother lives in memory care and it is NOT normal the things you are describing. At moms MC, they are dressed and groomed every morning, then brought out to the great room where they eat, socialize and do activities All day. There is also a secure garden they have access to. In the evening after dinner, they're taken back to their room, cleaned up, changed into a nightgown, and settled in to watch tv or whatever. They also have access to their rooms during the day, of course. The beds are made up daily, turned down nightly, and mom is showered twice a week religiously. There are 2 pull cords in the room, one by the bed/chair and one in the bathroom. The staff responds within 2 or 3 minutes if the cord is pulled. This is what should be expected from a MC facility, and anything less requires an explanation from the executive director, in my opinion. You may want to move her closer, if at all feasible, so you can pop in and check things out on a regular basis.
Best of luck!
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The thing is, the facility can’t force her to get up and interact. They can’t force the residents to interact with each other. The staff is there to take care of her, they can’t come in and hang out talking & interacting with her, there are too many patients and too much work to be done. I think you should have a care meeting and ask them how they can help. Do you think your mom wants to get out and interact? Have you considered that perhaps she is depressed? Depression is very common amongst our elders.
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lealonnie1 Jul 2019
In mom's memory care, there is TONS of caregiver interaction with the residents, it's part of the village feel the residence promotes. While they can't force a resident to interact, they can go in her room many times a day to see how she's doing. There are about 10 -12 caregivers to 24 residents at any given time which is probably why the rates are $6400/mo. The hygiene and pajama situation is unacceptable, imo. It's hard to say what's going on there though, with only Echo checks. For me, if I see something amiss, I can run into the EDs office and chat. I think your idea about getting her mom checked for depression is a great one, however. My mother has been on anti depressant meds for years after I recognized her symptoms in 2011.
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Have you talked to anyone at the facility about encouraging her to participate and how they handle self isolation? I think that you have to advocate for her care, no matter where she is. It is important that you clarify what help is expected for her ADLs and how much you want them to push her to participate. As her POA you can say how much they can do to get her out of her room. They can't force her but they can encourage her and they can gently push her wheelchair into the community areas, even if she says no, if you ask them to do this.

Such a difficult journey and so hard to know exactly what to do.
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jamey178 Jul 2019
Great answer, thank you!
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Hi jamey! In my opinion, there are excellent MC facilities and then the other ones. I agree with one of the other replies that the resident should be helped on a daily basis to get up, dressed, fed and exposed to other people whether it be socializing or just eating a meal with other residents. But I also realize that some facilities are severely understaffed and have caregivers that are inexperienced in handling residents with dementia. Also things like whether the resident becomes aggitated or combative plays a part on how their day goes. It's hard to say what is going on in your family members situation. One thing to consider is that her declining could be naturally onset to her health condition. Keep me updated, best wishes.
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jamey178 Jul 2019
Thanks so much! I am having a meeting with senior staff this Thursday and asking for their opinion and help. You are right when you state these facilities are severely understaffed. I am considering in getting outside help if the facility can't up the staffing. I would like someone to interact with her more than what they do now.
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