Is anyone else afraid to be the squeaky wheel?

I agree with GardenArtist... you are asking admin to help you problem solve something together. It matters how to say it to them. My preference is to communicate it in email form (and always copy someone else who may be appropriate to receive your email). Writing prevents the "discussion" from devolving into emotional territory because you can edit it AND it gives you a "paper trail" that you can point to with an ombudsman if your concerns go unaddressed. Confirm in the email that they are the appropriate person to speak to about your concern.

My personal philosophy is to never complain unless I can offer at least 1 realistic solution. At the very least this will provide a springboard to other ideas for solving the problem, whatever it is, and shows you've given it thought so are not really "complaining" but looking for feedback. Make sure to end the email complimenting them on what they are doing right. It is diplomacy and a little positive reinforcement goes a long way. You are your LO's advocate and it's an important responsibility. Be confident in this role.

Dear Sandola,
My mother was Director of Nursing at a Skilled Nursing Facility for many years. We were all taught if in the future there was a problem where we observed a friend or family member not receiving proper care, First, ask to speak to the Floor Supervisor, if you don't get help there, go to the Director of Nursing, if the DON is not helpful or willing to take action, go to the State Ombudsman for Nursing Home Licensing. Most every state has an Ombudsman, or State Licensing Board where you can reach out for help.
I would make notes of the deficient care that is not being addressed, and names of people you addressed the issues with. Yes, there are poorly run facilities, but most States move pretty quickly when it comes to Elder Patients not receiving proper care. I hope this is helpful, and I wish the best for your LO who is not getting the care they need. I was diagnosed back in April with a declining state of ALZ, from Early Onset-Moderate and Severe Dementia, so I am very sensitive to this issue.
God Bless your LO, and yourself,
John

I do understand the concern of retaliation against your mother, but if there are issues, they should be addressed now.   The approach that there's no point in complaining is key.

Don't view the situation as complaining; view it as problem solving, for you and for the AL staff.   Re-evaluate your approach, learn to view it as working together to create a solution that benefits your mother, but also the staff b'c it allows them to provide better care.  

I really think the key to working out issues is to work together, which may require attitude readjustment on both sides.

If you want more suggestions, more detail on the specific situations would help.

My dad was in a very good MC for a short time when he experienced 6 falls in about a 9 day period. I came unhinged, but like you didn’t want retaliation on him. There was also one nite aide who either wouldn’t or couldn’t change my dad so he woke up in a soaked bed smelling like pee. I called a meeting with the owner, director, RN and key players in the facility. I had typed up a Team Teg (Dad’s name) agenda. I began by thanking everyone & then explained there were some major concerns that we, as a team, needed brainstorm & address right away (with consistency). I used the Oreo approach: start with good, list the bad, then end with positive! I had some possible solutions listed, but we added others as the meeting progressed. Communication was ultimately our biggest problem. When all his staff were made aware of his needs he got two people transfers, they routinely sent someone in to change him, and my questions about meds were easily answered. Dad blew out his knee in the early mess which was very unfortunate, but his care dramatically improved. The director also knew I meant business and was documenting things. Dad got A-list treatment and we were able to keep a professional relationship. I will say that after lockdown with covid, things went to crud and we pulled my dad out! Worked beautifully for almost a year though! Good luck-

If you are unable to discuss an issue with the director without fear of retaliation, it’s time to figure out how to move her to a better place or find an ombudsman of some sort.

I live in assisted living and am l00% high functioning - just can't walk due to my spinal problem. I see and hear far too much here and it is often horrifying. What amazes me is that out of almost all residents, they complain among themselves, but not a single one goes to the proper person in management who can fix it. Why? Who knows? Fear? Background? Control? I am the only one in the entire building who will speak up when needed - I do it in a calm, professional way making the facts known, offer some suggestions, enlist their cooperation and inquire what and when will something be done. Then I follow it up in writing with copies to all concerned. I give them some time before following up but I do NOT go away until it is solved. On occasion I have had to call the ombudsman from the county in and very seldom asked the state for help. State the problem, suggest some solutions, ask for cooperation - never, ever be nasty or threatening - be a pro at all times. I think you will get some cooperation. Try it.

If your concerns are related to safety or actual physical care, you can ask questions in a calm, specific, nonaggressive manner and expect specific answers.

If you are concerned about non essentials, it’s probably not worth your time.

If you want, let us know what has concerned you up until now. I asked a caregiver yesterday about what I thought was a bruise on my LO’s head (it wasn’t).

I showed the caregiver what I was talking about, and notified her after I realized it wasn’t actually a bruise.

Communication is really important. If you can communicate in a calm pleasant way, your LO will benefit.

Would you want to move her if you could? How serious are these concerns?

The kind of aides who are so spiteful that they would treat a resident worse because they resent her relative's interference are going to be spiteful anyway. You'd better just hope the staff aren't infested with any of these vermin.

But assuming that at least some of your concerns are about everyday preferences and personal routines, by not raising them you are expecting the staff to be mind-readers. Say, for example, they've been making her bed a particular way for a month, and neither of you has told them that it annoys the bejasus out of her when the top sheet isn't tucked in. You don't like to say? - then how do you expect them to know?

I have no problem speaking up for the benefit of my mother. I certainly have in the past and have no regrets. I think they all brace themselves when I take my mom to the ER. I have reported quite a few staff members. Never the doctors because they were just fine and professional. One example my mom was bleeding profusely from her rectum after having a biopsy. She was putting out thick clots of blood, it was terrible and the nurse just kept cleaning her for transfer. I told the nurse she will die if she does not go the the ICU.He said her vitals were good. I told himI don't care about that.They took her immediately to ICU . The doctor came out white as a ghost and said the surgeon severed her artery. They let me sleep in the nexct bed in ICU that night.She then went to Mass General in Boston for a Sigmoid Colostomy. She survived. I called the nurse in the ER and told him about it and he said he know already and I reported this incident to administration. For the benefit of your mother speak up it could save her life some day as it did mine.

If you don't address issues, your mom still receives poorer care.

Rather than consider it "complaining", consider that you are a partner is "problem-solving." Bring up your concerns to the administration - verbally and in writing. Stress that overall you are happy with your mom's care, but you want to help in resolving a few concerns. Be specific about the concern, what you are willing to do to help, and that you would like an appointment to talk with somebody to help resolve the concern.

When a "concern" is addressed and it is better for your mom, please make sure to thank the staff and send a written note of thanks to the administration. Too often family only contacts staff and administration when there are problems. If you contact to "praise", your infrequent notes of concern may be addressed more quickly.