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We recently placed my father in a memory care facility. The facility we found is small and provides all the care we feel he needs.
My issue is we never get any sort of update on my father unless we stop by to see him or email questions on how he is doing.
I realize now I should have asked this question during our process of finding the right facility.
Am I wrong to have expected the facility would provide more updates on how my father is doing?

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My mom has a private room and she has little recall on her day or activities. I put a blink camera in the room. She thinks it is a speaker and it is that too. I also got an Alexa show so I can drop in to see and talk to her. This has helped me so much in seeing how often she gets up during the night and the way the staff interact with her as well as when she may need help. One time, when she tripped, she called out for help because she doesn’t remember how to push the pendant and Alexa texted me. I was able to see what happened because of the blink recording and drop in on the Alexa and talk her through pushing the pendent. I did not ask permission from the facility, I just put them in there. The facility eventually put up a surveillance sign on the door. It has helped me when mom has had inaccurate recall. For example, she thinks she ate or didn’t eat and it bothers her. Or, she cannot remember what the doctor said and wants me to find out. One thing I don’t appreciate is that the doctor sees her without letting me know and Mom cannot talk to him about facts because she doesn’t remember. Having the camera allows me the ability to drop in on Alexa and be part of the conversation.
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suzieQw Feb 2022
What a great idea
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I don’t know where you are from, but I can barely get answers when I visit daily. They are so short staffed I do most of his care as I pay $9,200. A month! This is the best skilled nursing facility in Charlotte NC! Things are awful.
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Butlerna71 Feb 2022
Dear God. I feel for you both and I feel the same way. I feel lucky if they don’t mess up my Dads medications.
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I never got updates. The only time I was ever called is when there was an incident.

I think asking to be kept updated is asking them to take away from the actual care required or hire another staffer, both have negative consequences.

Go visit as often as possible and don't worry about them calling you. If you are curious, pick up the phone and call.
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GAinPA Feb 2022
Problem I noticed with calling is that the unit was so short staffed they barely picked up the phone. If someone did pick the phone up, the chance that they were the one that had daily contact with my mother was slim. If they were not familiar with my mom, they might check the daily log. Often, they could not locate the daily log if they were new, had a limited or weekend only shift.

The only way I could monitor my mom’s was to live 1/2 block from the facility and go there every day. When I started her on 5day a week M-F hospice, I went in on Saturday and Sunday.
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I know this will sound terribly blunt, but yes you were wrong to expect it as a routine part of the service.

There are two things that matter: #1 is the facility keeping complete and accurate records? (probably, yes) #2 are they happy to answer any questions and give updates when requested, and when they do this do they also sound as if they know which resident they're talking about?

And why isn't it done routinely? Well, some (one) of the reasons are (is) really obvious, and that's lack of time. To provide routine updates to all persons on each client's list of nominated contacts would occupy many staff hours AND would either mean giving an administrator access to confidential information which s/he would not normally have, or would present a task for caregivers or nursing staff which (with all respect and love to my coworkers) is likely to be beyond their communication skills (especially if you're expecting anything in writing).

Even more sadly, and it still makes me well up to think of it, not all families want to know. I will not forget sitting with my sister during a respite care assessment and being asked by the (best I have ever, ever met) manager if we wished to be contacted with updates about our mother. "Of course!" we chimed, "who wouldn't?" "You'd be surprised," she said quietly.

And then there are of course those residents who have no one to inform.

So. All in all, no it isn't routine. But you can always ask for the name of a nominated contact, and call in for updates at agreed intervals, no?
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ces2695 Feb 2022
Thank you for your insight on my question. Wouldn't have thought that there are some families who don't want know, or the residents who have no one to inform. That's a bit heartbreaking.
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My mom is in a small memory care. I do not get updates. Communication, yes if there is an issue, or question. I don’t have an expectation to hear from staff if everything is status quo.
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I get zero communication from my mother's memory care staff unless I ask. Even then, they act like I'm a nuisance. They don't write anything down. If I ask if she had a bath, they always say, "Oh, you'll have to ask the aide that was on duty." That's their favorite excuse. They are not used to family members being around and they like it that way. I visit my mother every day and have to fight for every little thing. I am so sick of everyone using the "short staff" excuse too! The Care Plan meetings are a waste of time. They are just a paperwork formality. They don't really try to solve any issues. The doctor who supposedly makes rounds doesn't communicate with me at all. They won't let me put a camera in her room because she has a roommate.
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texasrdr22 Feb 2022
Wow! That is the exact response that I get when I ask about the cuts, bumps and bruises all over my Mom's legs and arms! "That did not happen on my shift" seems to be the standard answer. Mom does not walk so it's not like she could bump into the coffee table! No caregiver ever seems to have been there during the time about when you have a question! Amazing. Mom has been there a year and I have had only ONE care plan meeting. Doesn't matter. They are not doing the care they agreed to in that one meeting. I never met nor heard from the faciity doctor, so I fired her and found another PCP that would see Mom at the facility. We do have a camera and it has come in handy, for sure. Wonder if our Mom's are in the same facility?!
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I call daily to check on my husband… sometimes morning and evening besides visiting him at LEAST 3 times a week( usually more). I worry about him constantly and see his rapid decline due to Hes Alzheimer’s/ vascular dementia. They call ME with any med changes, or issues but not just to say “ he had a good day”. He’s getting wonderful care at a Veterans Health Center and the staff love him. I miss him so much but feel happy that he’s now safe.
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If the facility is Medicare/Medicaid approved and your loved one is there with either paying or making some payment towards the care, then YES there is a legal duty of the facility to provide updates "no less than every 90 days" or if there is a "change in status." State laws/rules may require other things too above and beyond the federal law/rules.

The "no less than every 90 days" contact is called a "care plan meeting" and with COVID these generally are conference calls now of about 15 minutes. The unit nurse will review all meds Rx and OTC meds, labs and any care plan changes upcoming. They generally try to have your loved one on this call too (depending on their capacity to understand). And as your loved one's representative, you can ask questions and suggest new medical things that may be considered and/or warranted. Then the social worker usually takes over and reviews things such as activities and social adjustment or not. Sometimes others may be on the call too -- the dietician, a PT or OT provider -- if there is something specific any of them need to raise. But any of the previously noted folks on the health care team will take a call (not like one should call every day and waste their time) and they will answer questions.

I have had several one-on-one calls with the dietician, as my mom was not eating well and we had to work on several ideas to try to resolve that and now my mom gets to pick her food options a week in advance rather than having something delivered to her room that she does not like. Yes, previously she would get to pick from two options for lunch and dinner daily, but that was too many decisions every day and she'd forget to do it by the 11 am deadline. So the solution was for an aide to help her on Saturday, to pick all choices for the upcoming week all at one time. And we also worked on more "finger food/bite sized" options as she only has the use of one arm, so if food needs to be cut she cannot realistically eat it.

I think they are more open to more regular calls at the beginning of a placement as obviously this is all new for you and for your loved one. Over time, and as things settle down, I have found the communication wanes (frankly is not necessary) unless there is a "change in status." ANYTIME there is a "change in status" I get a call from the floor nurse if something simple: "we are doing labs this week," "your mom is getting her flu vaccine this week," "we added a new Rx as your mom has a UTI, it is Y Rx and Z dosage and she will take it for 2 weeks."

If there is any major medical "change in status" her assigned physician at the facility calls me, like when my mom tested positive for COVID the first week of Jan. I have also found that my mom's assigned physician (a board certified geriatrician and internist) as well as the other MDs on her team (geriatric psychiatrist, the psychologist, and the neurologist) all will call me back if I have questions (not many now) but there was a lot of communication early when my mom was first placed AND following the workup an diagnosis for dementia.

And now with the Omicron outbreak at my mom's nursing home that started the first week of Jan., I get a robo call any day there is a new positive case be that among the residents, the staff OR vendors. Somewhat anyone, but I have gotten used to it now as there has been a daily call almost every day since 1/3/22. And they post the actual number of confirmed cases and cases recovered on their website so you can see just how bad it is. They went from 5 in early Jan to over 50 within 3 week, but now it is 1 or 2 so thankfully dropping. The website also posts the % of fully vaccinated and boosted among residents, staff and vendors too which is about 98% for all of them. The post their COVID-death number too if any and thankfully just one since Jan.

All to say, the amount of communication depends on the facility, your loved one and what is going on with him/her and there.
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The memory care facility where we have mom will call me if mom tells them she needs to speak with me or they will call if she has a medication change or if someone she was friends with dies and they think she needs consoling. Other than that...there really isn't much to say. She is existing and they are taking care of her day to day needs. I feel like it is up to me to visit to make sure something isn't getting missed in her care and to just spend time with her.

What do you want them to report on exactly? Are you visiting on a regular basis to check on him? I strongly suggest that you do....even the best of places are short staffed right now and you don't want your dad slipping thru the cracks.
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My mother was placed in December 2021 for PD and dementia. I visit 2-3 times a week and my father visits (meh I wish I could say every day but he doesn't). Every 3 months the facility has what is called a "care meeting" where we sit down and connect and discuss mom over all. We are very communicative with the staff and head nurse. We visit every week and make sure we are known as the very caring observant family and the days we dont' go we call to see how her day was. They do call every time she has a fall which I believe is a state requirement. Facilities are short staffed and don't have the time to make nightly calls to all of the family members. It is your right to call as often as you'd like and go visit. A squeaky wheel eventually gets oiled- so showing up and expressing, asking and showing love and concern I think helps the staff take better care of your loved one. They are less likely to forget about your loved one b/c they also remember how kind and warm the family is as a whole. Thats my thoughts and approach.
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ces2695 Feb 2022
Thank you for your response and experience with your mother.

I am one of 6 children (my mother has passed away) so at a minimum we are visiting my father 2-3x a week. He doesn't ask to call us as he doesn't remember he has any children.

My issue is our calls to the facility (he is one of 8 residents in a memory care home) go unanswered, or the mailbox for the person who manages the house isn't set up, another staff members mailbox is full, appointments are set up online to visit then when we arrive we are told - we should have called first (yet the phone isn't answered). Extensive forms we submitted with all of my father's health and personal information seem to have never been delivered to the staff. It's these types of things I find worrisome, but not much more we can do than keep visiting and making sure he's OK.

Also please know we fully understand the care of the staff at this facility is paramount to us. It's a learning curve now for us on how to navigate this new stage of care for our father.

I am going to call and ask if we can schedule some sort of follow up "care meeting". I like that idea.
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