Is AL supposed to take a person to the bathroom on a schedule when they show signs of incontinence? Even if they say they don’t have to go?

It sounds like mom needs a higher level of care than what she is getting now.
It may be possible that Skilled Nursing facility is likely OR if the AL where she is has "tiers" of care she may need more attention.
But if they "ask" mom if she has to go to the bathroom and she says "NO" they can not "force" her to go. They could word it like this..."Mary, it is time to go to the bathroom" and help her to the bathroom.
I am wondering though if she is experiencing any residual pain from the fracture? If so that may cause her to resist getting up or getting up as often as she should.
Ideally a person should have their position changes every 2 hours. If mom is in a chair or bed and pretty immobile they should be shifting her position. Getting her up tot he bathroom is one way to do this.

I would ask if they could take her every couple of hours. Tell them not to ask her, just say "time to go to the bathroom." I found the CNAs used me as a threat when the wanted Mom to do something "we will have to call your daughter" and she would do it. Never understood why, I was never mean to her. But I found when she was in Rehab that they asked "do you want to go to therapy" of course she would say No. The aide started to walk out the door. I told her "if this is this the time set aside for her, take her. No asking just say "time to go to therapy". Mom had Dementia. So when she came to live with me, I never asked I just said "time for..."

They won't force an issue, which is ridiculous when dememtia is involved. My mom constantly tells the housekeeper and laundry lady that she's fine each week because she doesn't want people in her room. And they listen to her! So frustrating.
What we did was set up her care plan for daily bathroom trash removal, and if there aren't two pairs of soiled briefs (her AM and PM changes) my mom is reminded to change her briefs by the staff and if she gets pissy she's directed to read the note taped to the bathroom mirror that goes into how she agreed to twice daily changes to prevent UTI's. The staff know to tell her it's the doctor's recommendation. Then she does it.

Since the move & the fracture are new, I'm wondering on 2 points.

Pain. Just too painful to get up? Especially if sitting a while. Hopefully any pain is being managed well?
Or, easier to not get up.

Control. I'll call it that - although that sounds bad, it'a reaspnable thing. To want to stay in control of our own life, own body, own toiletong needs.

Your Mom has lost much independance lately 😪.
She may not be ready to involve staff or give over control of this personal matter. Then once wet, pride won't allow her to speak up.

Mine does just this. Says no.
Then left sitting damp & stuck with her pride. Even with family, same. We've talked about it. I've said I'd rather wear pullups than be damp - wouldn't she? She *wants* to be independant & is holding tight to her control. Some small success was made in choosing the type of pull ups. More small success by avoiding yes/no choices. Not "do you want to go now?"
That would get no.
But "would like to go before your shower or after?"

Hopefully your Mom adapts to her new home soon. That she can enjoy other things she is still independant with.

My experience is that in assisted living they will assist but they won't "make" anyone do anything they don't want to do. Some of the aides have better skills in convincing than others and sometimes it really boils down to my dad's mood and if he likes the aide and wants to please them. But if he says "no, I don't want to get dressed today" then he just stays in his bathrobe. They really do try to allow the residents to have a lot of self-determination on what they do or don't do and will help them do those things. It sounds like your mom may need a higher care level. I agree with AlvaDeer that you should talk to the administrators or head of nursing about what care level she may need. I've found them to be very helpful in establishing a schedule for my dad, but with each little thing it does cost more. It may be that Memory Care can establish more of a schedule for your mom as opposed to having someone drop by asking if she'd like help and having her say "no, I'm fine."

In my experience - a lot of care facilities - at least in my area - are understaffed. AND you also mentioned that she is losing her mobility. Those two things could potentially be a bad combination. She may need incontinence underwear. Especially if they are putting down waterproof pads everywhere she sits.

It is probably too much to ask for them to take her to the bathroom on a schedule. Most of these places wait for the resident to ring for them or tell then they need to go to the restroom - they aren't likely going to force them to go if they indicate they don't need to do so. With the understaffing at his rehab - my FIL - who is currently required to call for help rather than transfer alone - has had to wait longer than he found acceptable a number of times because the CNAs are all being pulled in a million different directions, when he is ready - and frequently when they are in his room he doesn't need to go.

If she is getting to the point where she can no longer toilet herself AND she is losing her mobility, perhaps AL is no longer for her. They need to reassess her needs. And maybe you need to consider that your expectations are a little too high - you said "They told me they cannot “make” anyone go if they chose not to. Isn’t that part of it?"

When I worked in childcare when I was in college and even when I was potty training my own daughters - I could take a child and sit them on the toilet - but I couldn't MAKE them urinate. I suppose they could MAKE her sit on the toilet - but that could actually lead to toilet regression or fear if they force her to go when she either doesn't need to or doesn't want to. Unfortunately this may just be a new phase. It happens. And she may need to move to incontinence underwear to account for the change.

This AL system isn’t working for you or your mother. It’s true that the staff can’t force someone against their will, but there are ways that go beyond just accepting a “no thank you”. Mother should have a schedule that you agree with her, and is on the wall in her unit. Toileting may not be the only thing on it. M knows that these are the rules, and if she objects, she can’t stay in AL. She will need higher care that will be more restrictive.

Here are a few suggestions:
1) M may need to wear pull-ups, even if they don’t get saturated every time. Or are these her 'fancy pants' already?
2) Talk to the AL manager about their rules, and how staff are trained to get things done even if the client isn’t keen.
3) Check the rules in other possible ALs. You may find one that works better for you.

I’m not an expert on this (yet?), so I hope that you get more responses that will help.

You are new on the site, and it would be good to check the resources already there. Click on ‘Care Topics’ at the top right of the screen, then on I for Incontinence. You will find expert articles, many old questions and discussions of other posters’ experience. Best wishes, Margaret

It is sounding like she may need a move to MC?
I am assuming UA has already been done and there is no infection?

ALF patients are graded usually from a level I care to a level IV care. They have an actual care plan that assesses their needs regarding all things. This care plan is sometimes kept with the medication nurse.
The cost will go up if the client moves to another level of care. Eventually a level IV isn't enough, and memory care may be suggested.

I would speak with the admins and find out how to go about discussing care plan for your Mom's increasing needs, but do know this may result in increased costs and a new level of care.

I am a bit surprised you haven't been called about this increase in care needs, but proactively you can reach out now to discuss. Make an appointment day would be my suggestion.