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Ex. Number of staff on duty/Activities/Excercise. My mom has dementia, however it isn't advanced at the present. Her memory has been a very slow but steady decline the last 12 years. My sister put my mom in memory care 2 years ago when my dad, her full time caregiver, suddenly passed away almost 2 years ago. I was not in agreement that memory care was the best placement in her current condition-I won't go into that now. Her major and really only issue currently is her short term memory. Before moving to facility she walked a couple miles daily and was always working on new craft projects and helping around the house. However, after moving to the facility she doesn't get to go on walks unless a family member takes her. There is no kind of excercise program at all in place. They do have "craft time" maybe once a week and that is usually coloring only. They do not have them help at all with any menial jobs at all either. The facility does have entertainment and activities on most days for the assisted living side but rarely any entertainment in memory care and no activities. My mom being aware as she is still thinks she is in a "crazy house" and being around advanced Alzheimer's patients, she is aware of the constant deaths of fellow patients. She has gained well over 50 lbs since being there also as all she does is sit in her room and watch tv with her door shut. She's doesn't like being around the "crazy people". And the staff rarely engages at all with her except at meals and meds! The unit many times only has 1 worker in back. Sometimes 2. There are approximately 8-12 patients at a time in mom's unit. I think that isn't adequate for that type of unit-but Idk what regulations are in Missouri. However it is lacking enough that on a couple occasions my mom heard someone in need and went to help the person until a worker finally arrived. One occasion a woman was wanting to use the bathroom and after waiting for a worker, mom decided to help the woman which ended up with my mom falling and was on the floor with the woman falling on top of my mother! I happened to get there right after the incident to the worker reprimanding my mom for trying to help the lady! I was livid! My mom should not be put in that situation to begin with! How is it my mom hears the call of a woman 2 doors down with her door shut over a worker-and actually that day there were 2 workers. The unit is not that large. Why weren't they answering the woman's calls? I agree it was a very dangerous situation and my mom should not be helping other patients like that. But my mom is a caring person and if she hears someone in need she will respond. She should not be getting reprimanded like she is a child. The workers should have been there and there would not have been the incident to begin with! This facility is about 2 years old. The turnover is huge! Which I know most places do have a problem with turnover. Although I am there as much as possible and have gotten to know many on the staff pretty well. In the last year they have had 4 outstanding workers there that went above and beyond what I am sure is the basic job description! One I'll even go as far as to say one of the best of the best! She took it upon herself to bring her dog up on days off. Had made up activities for the people and went the extra mile to get them to participate. She made every day be a different persons "day" where she found out there favorite things and music and where they were from and incorporated activities all day around that person. She was there many times on her day off to organize all the different activities she had planned. Sadly the facility took advantage of her enthusiasm and put her in charge of other jobs until finally it was all too much and she left! I am just giving a couple instances as examples of what I have witnessed. There are so many more I could tell. My worry is the number on staff and watching my moms health and lack of mental or physical activity-realizing what effect this is having on her. Where do I find out the minimal regulations for memory care in Missouri or nationally? I want to go talk to someone about these matters but I want to educate myself first. I have no legal saying currently on where my mom is due to my sister having poa and her not wanting to hear my concerns or opinions. So I think the only route is to speak to someone that manages the facilities and try to talk to them as far as my concerns. Hopefully if they see I am wanting to make them aware and not reporting them-maybe they will listen and make some changes. That's my hope. If not I will make reports to the state if there are any violations. Thank you for any and all information you are able to provide!!!!

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My friend mother does not wander at all. So she sure wouldn't qualify for that. .She is only 2 yrs younger than my mom so she is in her late 70s.Healthy + fully cognizant of her surroundings, has only 1 or 2x forgot where she put a key,or fountain pen, or buck of two,then would turn around and find it,as she is so clear on 99% of things,so she is not suffering from it,thank God. My dad has it, but in light doses, mild dementia,diagnose back in Jan.Feb.of this year,after a light stroke.Doing so well, praise God.
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Dr. once told me this year that ,"Just because a parent elderly forget things here and there is not necessarily Dementia/Alz, et.al., so not sure what to tell you,but i am sure you're going to get some more answers, in this very nice supportive forum.God bless your mother.
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My husband goes to daycare in a fabulous facility and really enjoys it. When it cimes time for long term care, that's where he will go. It isn't cheap but well worth the extra cost. There are so many activities throughout the day and the staff is very attentive. Keep liokung until you find the right I've. They are out there. Good luck to you. Your mom is lucky to have a daughter who cares so much.
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Sandii, I appreciate what you are going through. It might be time to look for an alternative placement for your mom, if the current facility is not able to meet her needs. A place which focuses upon her needs and is more patient centered rather than the resident trying to find into the facilities schedule.

Also it might be worth speaking to an Ombudsman at Health and Senior Service in Missouri about some alternatives and your mother's rights. I have found them to be a useful source of information.
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Sandii I just want to praise your amazingly constructive and sympathetic approach to working with your mother's facility. I really hope you make progress, because I think you're absolutely right; but might it also be a good idea to discuss other options with your sister at the same time?
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You can google your state and find the regulatory body and look at their staff/patient ratios. I know CMS has evaluations of nursing home surveys and inspection results, but I don't know which regulatory body determines staff patient ratios for AL.
Good luck!
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SAndii,
Even substandard facilities usually meet the letter of the law. It's a lot more about management. I sounds like it's time to move your Mom to another facility.
Blessings,
Jamie
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Sandii, a few thoughts. You may call the department of aging for your state. They issue the regulations for staffing of assisted living (and memory care if it differs). I will say that I had my department of aging email me their regs. Out state's mandate is a ratio of 7 residents to 1 aide. The ratio changes for the night shift.
Does your Mom wander? If not, most facilities that have regular AL and memory care can keep someone in regular AL as long as they aren't wandering. Activities are likely to be more interesting in that part of the facility.
Most facilities are understaffed at least some of the time.  Anyone who has worked with those with dementia understand how much time some residents can eat up.  They need help doing just about everything.  The quality of the aides is paramount in selecting a facility.  
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