Is this just to be expected in an ALF / MC?
I am not going to do anything about this or run in to be the fixer. What I am asking for in this post is your perspective on whether you think what I have noticed with my mom's "care" in her MC is to be expected? My sister is POA. I have posted about this before so will not go into details again. My mom had me and my sister as joint POA, but just before mom moved to MC, my sister had our mother sign a revised POA where my name was removed. My sister arranged it, not my mom. I am unsure whether my mom knew what she signed. My point is not to debate the legality or ethics, but instead to say that my sister took deliberate efforts to be the sole POA. Relationships are dysfunctional. I managed contact with my mother as she aged but have had mostly no contact with my sister for seven years. With her being the single POA, I still maintained my boundaries. I know mostly nothing about what is occurring with my mother. If MC staff call, I refer them to my sister for decision-making. The only way I get a glimpse of things is when I visit or happen to get a call from staff when they cannot reach my sister. I visited mom earlier this year and noticed she had very few ADLs in her bathroom. I saw no toothpaste, toilet paper, shower soap or washcloths. I also saw no toilet paper and no towels out for use and had no clue how mom was properly bathing. I then looked around and saw no bedsheets. Her bed had bare pillows, and just one very thin white flat sheet with holes in it. She is incontinent, so for absorbency on the bed they had taken a towel and folded it across the bed. There was no comforter or bedspread, just two blankets for cover. Without sheets on the bed, I noticed mom's mattress was stained. When my sister moved mom, she moved a 40-year-old mattress from a spare bedroom.
It was a bit more than I could take. I took photos just for my own record. I did not want to turn myself into the Cinderella in this dynamic. However, I did ask to speak to the Director of Nursing. I told her about the lack of ADLs, bedsheets, towels and absorbent mattress pad. She said she was not aware of any of this. I told her I would buy some items for immediate use, but wondered for ongoing long term if possible to speak to my sister who is financial POA and arrange items to be placed on an auto-ship. She said she would talk to my sister. I left it at that.
I found it distressing that the staff never raised these needs to anyone. Did they think my mother's conditions were normal? Also, how did the DON not notice? How would my sister have not noticed if she just looked around? Last week I received a call from a therapist at the local hospital saying my mother was being released soon and they wanted to confirm her MC address. I had no idea she had even been in the hospital. I decided to visit her back in her MC. I noticed after several months passed since I raised questions on her ADLs, etc., nothing had changed. There were not any sheets on her bed. She was still sleeping on the same stained mattress. She did not have any towels out for use. There was no toilet paper. The same shower soap I purchased for her several months earlier was on a shelf half-full. I would have expected it to have been used up.
My mother seemed otherwise OK. I did not say anything to anyone about my continued concerns. I am somewhat afraid of becoming a problem to them, and wonder if I made them mad earlier for what I brought to their attention. They know I am not POA and likely do not need to answer to me for anything anyway.
Is this normal operation at a managed care facility?
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My dad's facility provided all the bedding, sheets, towels and toilet paper. Personal hygiene was on him or family to provide.
GingerMay, I am so sorry that your mom is not being treated with more dignity. I, personally, would contact the ombudsman for her facility and ask that they do a visit. If the facility is violating any laws it will be corrected by this government entity, either by them addressing it with the facility or them filing complaints against the facility.
When I spoke with the ombudsman he told me that there are some horrendous facilities out there and the only thing to do is report them to every governing body.
I know you don't want to step in, I agree, choices have consequences and this is what your sister has done but, i would make one call to get this on the radar of the authorities.
Can that be done when someone is in a facility?
Mom was hospitalized due to low oxygen levels since she has COPD. She is not bedridden. She does not take sheets off her bed. She does not hoard toilet paper. She is relatively still "with it". The hospital called me because they said they had called my sister 3 times, and she never answered or called them back and they were just trying to arrange PT for her after her release. They called again a few days later saying she still had not signed the paperwork to begin PT and that was 4-5 days after my mom was back at her facility.
I do believe it is neglect on my sister's part. I also think it is dereliction of duty of POA. I believe this is on her. I am appalled by her inaction.
I made a call two times to the local ombudsman's office, but was placed on hold for several minutes each time and just hung up. I got a bit frustrated because it just seems nobody cares, and no one seems to do anything.
One other thing I did not mention is that while I was visiting mom she touched her upper arm and said "something is there". I looked, and saw a round scab about the size of a dime. It looked a bit red, and I thought it might be slightly infected. I looked closer, and saw some small dash marks around it such as stiches. I then realized mom had a mole biopsy about 7 months ago. I have a bad feeling that the facility and my POA sister failed to do the necessary follow up care and have the stitches removed and skin has grown over it. Once again, I got ahold of the DON and showed it to her and also told the Executive Director. I never heard anything about how this was addressed. It is just one more thing that I find alarming.
Thank you again.
They are too few in number and are busy, being patient is a must.
This situation has so much going on. Your sister has much to be ashamed of. Hopefully, your mom is doing okay with her care and living conditions, even as dismal as they are. Maybe you can give her a bedding set for her birthday? Something that makes it look like someone actually cares, which does impact the care they get.
With this added information, I can fully understand the hands off approach. Somethings are not worth fighting for or over.
This is your sisters doing that mom has nothing! As evidenced by sending her there with a 40 yr old stained mattress! And not following up with staff to find out WHY mom isn't being showered? Mom may be refusing, Idk, but it's the POAs job to find out WHY. In my mom's case, she felt the shower floor was slippery. I bought her a pair of water shoes on Amazon and that fixed the problem. A POA cannot just dump her mom off w nothing at a MC facility and wash her hands of the woman, my God. You can send her supplies if it's within your budget to do so, or confront your sister about this level of negligence. For all you know, the MC has been after her about it for ages.
I'm so sorry this terrible situation exists. I wish resolution for you and mostly for your poor mom.
I just am beyond tired of my family dynamic where I am marginalized. I look on from a distance and see how things always become disastrous. Thank you.
Your mother is not in prison where the inmates have to buy their own toilet paper, toothpaste, soap, etc... from the prison commisary.
If I were you. I'd take pictures and show them to the state's Ombudman because this is not right not is it normal.
Yes, I am surprised the facility has allowed this. Tell the facility in your opinion, they should have called APS in because it looks like Mom has been abandoned by your sister. That you will be calling them to investigate your sister not them. I would ask APS to do this ASAP because you will be supplying her a new mattress and everything she needs. You also would like to know how your sister can be removed as POA and you put back on. Tell them about sister having you removed when Mom suffers from Dementia.
The AL I worked for supplied toiletries, linens, towels, washcloths, toilet paper... for our residents unless they shopped themselves for brands they wanted or their families brought it for them.
I've been in many memory care facilities and they looked just like any nursing home only the doors had coded locks on them. Most of the residents in the MC who were in a shared room had narrow hospital beds like you'll find anywhere. A few with private rooms had their own furniture but still had the hospital beds. This is for safety reasons. If a person has to be changed and washed in bed, that's not getting done in a regular bed that can't be raised and doesn't have side guards.
In care facilities you will find institutional brands of soap, lotion, toothpaste, etc... that you don't find in stores. One of the big institution brands is McKeeson.
About the mattress.
Your mother should have a Hospital bed with a mattress that is cleanable and a regular mattress is about as far from easily cleanable as you can get. The doctor should order a hospital bed if she does not have one.
Fitted sheets are rarely used as 2 flat sheets are easier to change and a flat sheet can be used as a "draw sheet" when needed. Also easier to change bedding you just grab 2 sheets and you don't have to look to make sure that one is fitted and the other is flat.
I also would not use a typical "waterproof" mattress pad as they are almost impossible to wash and dry in 1 day and the commercial washers and driers in a facility would destroy it in a day. The use of disposable absorbent pads is more common. Sometimes washable absorbent pads but they may find a home in another residents room even if you put mom's name and room number on it in BOLD lettering.
There should be hand soap and towels. But if mom is fully incontinent and staff is changing her you would not expect mom to use them. (they should still be there so staff can wash when needed but if it is staff the use of paper towels is preferred).
I think try to get clear what they DO provide.
After you do that, then find out how they handle marking and cleaning the things and returning them to the proper room. My brother, in his ALF, had weekly laundry done, but he chose to do his own because so often things went missing and were wrongly returned.
I think:
1. Get clear what expectation of laundry and the things you mentioned you should have when you come to visit.
2. Visit a bit more if able; the SAD TRUTH is that those with families are more clearly monitored.
3. Suggest that if things are needed that the facility should reach out to the POA, and that if the POA, with whom you are estranged, is NOT DOING HER JOB you would like them to refer to APS.
Sorry for all this. Very sad, and shows how when there is no one to watch, and no cooperation, things fall through the cracks in ongoing in-facility care. And they DO. As I often say there, there's no perfection in long term care. Even at best. And at worst it is really awful.
Good luck, Ginger.
Appreciate your good advise and insights.
I did confirm with a staff member at the MC that ADLs are "usually supplied by the family." I first noticed the lack of ADLs several months ago and notified the DON. I asked her if possible to have my sister with the POA put them on an auto-ship and she never corrected me otherwise, so assume my POA sister is on point to supply. I questioned the DON about contacting APS back then, but she just said she does not get involved in family issues. It was a complete dismissal.
I cannot believe my sister is getting away with neglecting these aspects, and I feel like I am in some altered reality where this does not seem to alarm anyone except me. I guess my next best place to raise this to is the state ombudsman. Seems APS will not do anything with mom in facility care.
Thank you to all.