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My mother in law is 91 and has developed Alzheimers in the last year and a half. My brother in law has been living with her for the past 2 years and taking care of her; however, he recently underwent surgery for throat cancer and is temporarily unable to care for her. Since my husband and I both work full time, we had no choice but to put her in a nursing home, planning on a one to two month stay. She has been there three weeks and we have been called at least a dozen times, demanding that one of us come out there and stay with her because they "can't handle" her and don't have the staff to do "one on one" with her. By "can't handle her", they mean that she won't stay sitting in a wheelchair or laying in her bed; she wants to get up and move around and they are afraid she'll fall. Whenever we go out there after one of these calls, we find that she is agitated and wanting to walk around and talking about wanting to go home. My husband usually gets her walker and walks her around the halls for 30-40 minutes and that seems to calm her down.

I realize that nursing homes aren't staffed to give one on one attention to each individual, but we can't keep going like this. With working full time, we aren't able to take care of her ourselves, which is why we had to go with a nursing home to start with. (We've had to use sick time and vacation days to cover time off from work with the nursing home has called us to come in.) Shouldn't the staff be prepared to handle this, or are we just expecting too much?

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That is the responsibility of the nurse on duty~ I would have NEVER called a family member for that at odd hours! I would rarely call during the day. That is what they were in the nursing home for~ (I am a nurse and used to work in nursing homes.) You need to call and talk to the administrator or the DON. I would probably try the DON (Director of Nursing) first, and tell them that it defeats the purpose of having her their if you are still required to do the work. They SHOULD call in an emergency, or perhaps set up a certain time frame that is exceptable to have her be allowed to call if needed. Like if she is feeling lonely, she can call in the afternoons, or what ever. ?? They need to be responsible. That is what THEY (staff) are there for! We often had people up all hours of the night at times. We dealt with it. One lady loved to help fold bed packs and towels. Some would get a snack and go back to bed... some would watch some TV in the common area. Some would need to be followed around. Yes it was a pain sometimes and put us behind in our other work... but we dealt with it. That is just part of the job. If they can't do it, perhaps they need to think about cutting the work load at night for their staff... or putting an additional person on duty at night. Either way, not your problem. If the DON can't or won't do anything, call the administrator. If that doesn't work, start looking for another placement.
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Ok here's my thoughts on this, both my parents are in te nursing home both ave dementia. I have NEVER received a call in the middle f the night or day telling me they can't handle one of them. If I dd receive that call I would be looking for other placement for them. As far as her walking around and not staying in bed that is not your problem. My dad did the same thing when he first went in but I never was called tat they couldn't handle him to come out there. They would redirect his attention, it may last 10 minutes or 2 hours it didn't matter they took care of him. it's all about patience and understanding. If they can't handle that then I would be researching other facilities. Talk with the DON or the administrator,you might be pleasantly surprised. Hope this helps.
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For $8000. a month they should be able to handle this.
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It may be that your MIL needs the extra attention and understanding of a Memory Care Unit. Is such an option available to you on a short-term basis?
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I don't understand why they don't call her doctor and get her some meds to keep her calm. After all NH are very expensive and why should your life be disruptive when they are getting paid.
My mom was admitted to hospital doe UTI and diahrreah. They called me in the evening late and wanted me to sit with her for the night because she was upset
I had to be home cleaning the white carpet of crap all over the place. It took hours. I refused to go. I asked them if I stayed there were they still going to charge her and they said yes. They said they would have to get some "sitter" for her. I told them I was up to my neck in poop and had to get it cleaned up before she could come home. I called 15 minutes later and she was sound asleep. But they called dirst thing in the morning and told me to come and get her thankfully her carpet was clean although still wet. It must be on her record because they will not admit her anymore. She has fallen, UTIs (which they admitted, but never treated her), severe back pain, etc. Doc keeps saying she is old and will keep getting "chinks" in her armor.
These places charge an arm and a leg, but don't hire the staff to take care of these patients. Someone is pocketing the money.
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I realize that people are mostly expressing frustration that they either cannot afford or just don't want to pay for nursing care, but the fact is it is extremely expensive to provide and that is why it costs so much.
I used to work in sales at a senior community and was often amazed by some of the adult children's reactions to the cost of care. For some, you could tell that they considered every penny spent on care to be a bite out of their inheritance. Others have a "spare no expense", "it's mom's money" sort of attitude. For most, it's somewhere in between. The ones who always befuddled me though, were those who just think it should be "free". The parent has the money; a house, a retirement account or pension, Social Security, etc. They just think that high-quality, 24 hour care personal care is something that one shouldn't have to pay for. I would often hear statements like "I can't believe we have to spend her money on THIS." I remember one daughter actually saying that it was a disgrace, in a country like ours, that families have to pay for nursing care. I don't know what she meant by that, but it sure made me curious about how she votes : )
Having said that (or ranted that, I should say), I agree that for whatever a facility charges per month, they should provide high quality care.
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I agree with Darcy. I used to get calls like that too but I told them that just because I live ten minutes away, does not mean I can drop everything and come running. What would they do if I lived 100 miles away? I realized they wanted me to do their job for them and called the Director of Nursing to tell them to stop calling unless it was an emergency. They did and learned to deal with it. With the amount of money my dad spends to care for her there, I was not going to fall into that trap.
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I took me about a year before the NH understood my Mothers behaviors. Some behaviors are personality some Dementia and some medication. My Mother went directly from my care to a behavioral health hospital, she became a harm to herself after a year in my care, due to worsened conditions . There was no way I could handle it alone. Mom's Dr., recommended stabilization with meds at BH hospital, as he was well aware of her decline and I kept him up to date on the behavior change involved.
Then she had stayed for 3 months in a locked in unit (wandering issues) with all sorts of seniors with different mental health issues. A strict routine and diet and schedule and carefully watching her meds and effects of meds and behavior monitored closely. Mom became so stable that when she was finally admitted to reside in a NH she fooled the NH into thinking she was perfectly fine. The social worker called me and said why is your Mom here??? I said "What?" "Really?" Then she said I know your the contact but who are you to her? I said "I am her daughter?!" She then says "she said she doesn't have any children." I Laughed, and said, "now you understand why she's there?"

I am telling you all this for many reasons:
I had to figure this out myself....
No one knows a parent better than a child, you know what makes them sad, you know what makes them mad, happy, likes, dislikes, comforts them, etc.
.There is an epidemic of dementia and I don't think that everyone that works in a NH is not educated to deal with this as in a single position (according to their job).
(Another words, Would you o to foot Dr to treat an Eye problem?)

There are LPN's they administer meds (by Dr's request according to LPN's daily log) There should be a RN "Head Nurse" if there are issues with meds or Dr's or problems medically.

There are aids who dress, bathe, clean room, basic daily needs. They really know what the resident's personality is even how they feel and act on a regular basis. The aids spend the most quality time. Nurturing and caring, they know what comforts the resident. I feel they should get paid the most.

There should be Activities Professionals and Director of Activities. They also spend quality happy time with the residence. Music, singing games, exercise, etc.

Social Workers do paperwork, complaints, request from family address problems, or direct you to the issues and what to do about them.

Administration.... handles issues that you really trouble you with the staff, billing etc.

What I am trying to say is if you were in the hospital and said I am cold can I need a blanket to a nurse she would understand your request and see that you got what you need. Someone with dementia needs a person to translate their needs, and the responsible party needs to see that these request are dealt with because they are not understood and don't know how to ask or who to ask, in a way that is can't comprehend. They can't speak for themselves, in a sense.
When a person with dementia has change of location, scenery, routine, it's like living in a place completely unfamiliar. Just Imagine If you fell asleep and woke up in a place where you knew nobody's face and nothing around you looks familiar. Then you see a face that you recognize, wouldn't you ask to go to a place you feel comfortable.? It's like Dorthy in OZ ...NO PLACE LIKE HOME!
You have to talk about happy memories, bring things that they recall and that are familiar. Talk to them as if they are right no matter what...no anger or sadness.. just happy, they relate to emotions and expressions.
I hope this all helps.
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I agree that a dementia unit would be better able to handle your MIL's care, but I'm shocked that the SNF she's in is insisting that you come provide care because of a situation that's VERY common. Lots of nursing home residents have this sort of 'restlessness'. While it's not reasonable to expect them to provide a one-on-one caregiver 24/7 (at least not without a significant increase in the monthly fee), it is reasonable to expect that your MIL will be provided with support for taking regular walks throughout the day. That's part of standard care for someone who has limited mobility.
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I have to concur with Jeannegibbs. I don't believe that standard units are prepared for the challenges that come with some cases of dementia. Wandering, behavioral outbursts, and so forth are often presented in the extreme when Alzheimer's is prevalent.
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