How much am I supposed to participate in Mom's care at the memory care center where she was just admitted?

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My mom was admitted to memory care yesterday, has moderate dementia. Tonight was her 2nd night there. The nurse had just been in to see her when we arrived at the facility and said she was doing fine, was going to bed. We got to her room to find her lying on the floor next to her bed with blood everywhere...she had fallen and hit her head on the dresser next to the bed. Long story short, she was taken to the hospital via non-emergency ambulance, where the head scan was fine and she had 3 staples put in her laceration. While we were there, she had to pee 3 times within about 30-45 min. They checked her urine, which was fine and then discharged her. The ambulance service was coming to take her back so I went ahead of them to the facility to update them before she got there. I had also called before I left and spoke with the nurse in charge who, from what I could understand through a heavy Caribbean accent, said he would tell the staff she was coming back. When i got to the facility, the CNA assigned to her answered the door and I told her my mom was coming back in a few minutes and that she had been peeing all night. I told her that if she continued to need to pee and tried to get out of bed throughout the night, the CNA would need to keep that in mind and check on her more often, to avoid another fall. The CNA said she had been told I was staying the night to take care of mom(I assume in the room that is rented out per night for visitors, since Mom has no room for anyone to stay in her room???)...I told her that was incorrect and didn't understand who told her that. She proceeded to say that she had at least 10 other patients so couldn't stay with mom all night...I told her I didn't expect her stay with her at all, as she is not a private nurse, but that she may want to keep an eye on the sensors and stick her head in when possible to make sure Mom wasn't trying to get up all night due to the weird urinary frequency. She said she would try. I left furious...we are paying these people upwards of $6500 a month due to the fact that Mom needs more care than I can give her and I am fast approaching burnout (if not there already) and they assume I am going to stay to keep an eye on her after a fall?? If she were deathly ill or injured I would be there but otherwise it is their job to monitor them...that's why Mom is there, for their 24/7 assistance. The fact that it is just her 2nd night there should be duly noted by ALL staff and they should be monitoring her more closely anyway to avoid these things as much as possible until she at least somewhat acclimates to the change. I texted the DON to please call me ASAP tomorrow to discuss this...I am disappointed, concerned and downright angry. Thoughts??

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Gladimere, your and my facilities have the same protocol...if the patient is a danger to herself and others, more assistance is needed from private caregivers and/or family, which is understandable. However, my mom is not a danger to anyone besides herself when she falls!) so that is why I was upset that they acted like they needed my help.

Sandwich42plus...I agree with you about the cultural differences but it is the staff's job to take care of our parents...we put them there so that would happen, as we can no longer carry the load alone. And we pay through the whazoo for it! A friend suggested that the CNAs, in order to lighten their own workload, probably do infer to new families that they need to stay esp with a patient who may need a bit more attention (as in BRAND NEW to the facility!). I am sure alot of families fall for that but I know more about the industry than most people and that just didn't ring true to me. I thought I had overlooked a crucial "clause" in the paperwork I had signed and I was near panic. And, like I said, if that was the case, what would they do with patients who have noone to help or whose family is out of town?? Anyway, I am glad this issue has been resolved...I know more issues will arise but we will take it day by day.
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I have found that in every facility - no matter how fancy - there will be staff who want to offload work to the family. YOU have to know the terms & conditions better, and be willing to let the administration know when someone is pulling that stunt. It hasn't happened a lot to me, but it has happened.

I also think that there are cultural obstacles in play. In other cultures, the elders stay home and there is a lot of family around to share the load. There are no memory care/nursing home facilities, so doing that is basically unthinkable. Only people with no family end up in a facility. If nobody has done training on cultural differences in America, then I'm sure we look like a cold bunch of mean people.

I had to patiently explain to a nurse one time that my husband & I both work full time - just like she was doing. And due to my mom's psychiatric problems, she would not have been safe in our home. Neither would our children be safe around her. Was I supposed to quit my job to care for her, and then lose the house? What good does that do?

What I didn't say out loud to her, but to her supervisor, was that staff can't presume to know the whole story about any resident or their family. I am not going to go around telling everyone on duty I had an abusive upbringing at this woman's hand, and that for my own sanity, I have to keep my distance from her and her issues. They don't need to know that. I don't want their care to be affected any - even unconsciously - because of that knowledge. I also said that I don't need hassles from the staff. I have enough, thank you.
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TSM, the policy is the same at my mom's facility. They keep closer track for a couple of weeks. Sometimes for those with dementia it takes much longer, the reason my mom was required to have a 1:1 agency caregiver for six weeks. My mom's behaviors were very difficult. She was a danger to herself and others. And the private caregiver became necessary after a hospitalization that became a psychiatric evaluation to try to get her behaviors stabalized with medications. That hospitalization occurred after mom had been there for three days.
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TSM, I'm glad you got answers. These transitions are sometimes hard especially at first. Great advice from Babalou and gladimere. I hope today goes better. You are a great daughter.
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Babalou, the rooms have sensor that goes off at night if the resident gets up in their room BUT they are being worked in at present so not working correctly. And, yes, they checked her urine and it was totally fine.

LadeeC..thank you for that info. I did discuss the level of care they supposedly provide for Mom when I admitted her and they told me that barring anything like IVs or feeding tubes or needing to be hospitalized, they take care of all her needs. Noone EVER suggested that I would be expected to stay for any reason...that's why she is now living there.

Gladimhere...we paid extra for an increased level of care for Mom...I do not expect 1 on 1 but we are paying them to fulfill her needs at the level of care she requires. I was just told by the DON that the policy is more frequent monitoring the first 2 weeks. She's been there TWO days. I totally understand that falls are common, esp when they first move there. I do not fault anyone for the fall...my concern was that they expected me to stay after the fact..that is their job, that is why she is there(what if I was out of the country when this happened??) I would never hesitate to stay if my mom was really ill and I felt I needed to be there but not for 3 staples in her scalp....I was with her at the hospital, but it's the facility's responsibility to care for her once she returns. And, I know that it could be some time before they find her, as they DO have other people to care for..my point is that she is brand new to the place...that should be utmost in the assigned staff's mind for any new resident.

UPDATE: DON called me this morning and assured me that my thoughts ARE justified. it is the policy of the facility to provide more frequent monitoring for the first 2 weeks after a resident moves in and they DO NOT expect family to stay with them after an incident or illness. The only time family is expected to step in is if the patient becomes combative and dangerous. The CNA relayed incorrect info to me and will be spoken to about it...hopefully, it is a matter of miscommunication. I feel better after talking to her. Thank you all for your input.
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TSM, I do have one suggestion that you keep your cool when you speak with the Director of Nursing today. Getting angry with her will not help. Give her the opportunity to explain their policies. Those polices are in place to protect your mother.

And a question. What if Mom had fallen again in the night and someone was not there with her, but found her say an hour or two later because they have other residents to attend to? Would you have also been angry then? Falls are very common upon moving to a faciliity and if falls are already a problem the 24/7 care and oversight is necessary.
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The difference between assisted living and memory care is only a locked door to curtail wandering. Continuum of care communities also have skilled nursing areas where many go when their needs require closer monitoring with a higher ratio of staff/resident. In the facility my mom is in there is an additional charge scale based on level of care required. It works on a point system and is not standardized across the industry. Upon entry my mom was at care level one, then was moved up ar level, and now on the verge of being moved up yet again. She has only been there six months. These care level increases allow for the facility to hire more staff when necessary. A personal 1:1 or 2:1 care is not common in any facility. It is not at all uncommon that a facility will request a family member or outside caregiver to be with a resident, especially a new resident, 24/7 following an ER visit or hospitalization. So many things can and do happen and facilities are commonly not staffed to provide oversight necessary following an emergency. This is why some will remain in their homes though it is costly about 12k a month in my area but may be worth it to provide the personal level of care.
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I believe you'll find this was a misunderstanding. "The daughter will be coming back with the patient" means something different to different people.

Can they put an alarm on your mom's bed? Did they do a urine culture at the hospital, or a quick urinalysis? I learned the hard way to ask for a culture, which takes longer.
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This is a quote from the ALZ.org site:

Alzheimer special care units [(SCUs) also called memory care units]
SCUs are designed to meet the specific needs of individuals with Alzheimer's disease and other dementias. SCUs can take many forms and exist within various types of residential care. Such units most often are cluster settings in which persons with dementia are grouped together on a floor or a unit within a larger residential care facility. Some states have legislation requiring nursing homes and assisted living residences to tell exactly what specialized services their SCU provides, including a trained staff, specialized activities, ability of staff to care for residents with behavioral needs and fees. When you visit a facility, ask for their Special Care Unit Disclosure form.

My first action would be to contact the administrator of the facility and get a CLEAR description of the level of care you can expect for your mom, in general, and then specific actions they'd take given changes in circumstances.

THEN, I'd contact your state or county agency for elder care and the health care omsbudsman for your region. Every facility I've been where I helped to care for Edna had a big, bold sign near the entrance that advises who can be contacted when concerned about the level of care at a facility.

Best wishes for a happy resolution.

LadeeC
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Memory care doesnt provide provide 24/7 care? How do they not provide 24/7 care when the residents live there??? I am not expecting a private nurse but it is THEIR responsibility to look after the residents 24/7 when they are under their roof!! Why else bother to place our parents there? May as well leave them where they are if we are still expected to provide care. It is supposed to be a closely monitored environment...monitored by THEM....thats what we are paying for...NOT for us to have to be there to provide the care. WTH????? Totally disagree.
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