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Pardon the blunt post, but I feel the background is necessary to explain my questions:


We removed my mom from her AL community after only four months because she was having sex with another tenant. Before moving into this community, we met with the director and intake nurse regarding the level of care, reiterating her advanced dementia diagnosis. In this meeting, and because she was high functioning, they assured me that the add-on services would be more than sufficient to keep her safe and well: What I didn’t know then was that she could make decisions such as getting physical with another without informing me. This physical relationship went on for a few months before I was informed. When they did tell me, they labeled it as being cute. I explained to them that in my mother’s right mind, she would NOT behave that way and asked them to discourage it. It was then that I learned that they could not and would not intervene.


Long story short, I removed her that week and moved her in with me, which was a year ago. We are now hunting for a suitable Memory Care community. As a side note, on the day I removed my mom, one of the caregivers pulled me aside to tell me that she refused to shower the entire time she was there.


My Questions:


Once we find a Memory Care community, is it a legal obligation for them to force her to bathe? Further, is it an obligation of theirs to ensure that she is not engaging in questionable behavior?

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Call your State Ombudsman and see what they say about the legality.

My daughter is an RN and has worked in NHs for 20 yrs. The thing I found that was frustrating was my Mom was asked if she wanted to go to therapy. Of course my Mom said No. I said to the Therapist don't ask her, tell her "Mrs E, time to go to therapy". I never asked my Mom, I told her. Time to shower, time for the bathroom. They become like toddlers you ask, they say No.

My daughter says you make them think they made the decision. "Mrs E time,p to shower" Mrs E, "no". "Mrs E don't you want to feel nice and clean and have fresh clothes on." Mrs E "yes" My daughter "so lets go" and Mrs E goes. Its really how much time does an aide have to encourage a resident to bathe when she has others who need bathing to and care for.

The sex, this has been discussed before. ALs are residences. Just like living in an apartment but with assistance with ADLs. I don't think there is any law that says the facility is allowed to keep residents of different sexs separated. My daughter says it happens in her NHs. One couple thought they were married. If you tried to separate them they would scream and holler. They had spouses too who visited. I agree if this stuff goes on then residents need to be separated women with women and men with men.
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deedee2524 May 2023
Absolutely agree. You don't ask, you tell them with as much diplomacy as possible.. I learned that as soon as my mother moved in with me. I'm hoping memory care takes physical relationships much more serious than AL but if I can find an all female care home, we'll be going there. Thank you for your reply.
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There’s been a court ruling that a wife with dementia could consent to sex with their spouse who didn’t. Given this, especially, most facilities are increasingly not policing sex when both parties seem to be enjoying it.
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deedee2524 May 2023
Completely irrelevant ruling to my situation!! A spouse is worlds apart from a stranger.
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Deedee, let me tell you a story.

My mom was in a NH with very caring folks. Once, after she returned from a stint in the hospital due to her CHF, I sat with her as the intake nurse went over her preferences for a variety of things.

'Do you prefer showers or baths, Mrs. A?" she asked.

"Oh, I can't have showers any more" my mom said, adamantly.

The nurse paused. I asked, mom, why is that?

Mom said, I would have to stand in the shower. I can't stand any more

The nurse said, "but Mrs, A, we have a chair you can sit in while you shower".

My mom looked shocked. "Really?"

Sometimes you need to ask really basic questions. And not assume anything.
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deedee2524 May 2023
I have no clue what your point is. Who's asking questions? Who's assuming?
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"Once we find a Memory Care community, is it a legal obligation for them to force her to bathe her? Further, is it an obligation of theirs to ensure that she is not engaging in questionable behavior?"

are you asking, so that if they fail in doing that, you have a just cause to sue? the thing is, these facilities have hundreds of lawyers. they know exactly what to say, to get out of any legal or non-legal obligation.

regarding your 1st question, i don't believe it's a legal obligation, and even if it were, the facility will say, "she didn't want to bathe, and we couldn't force her because she resisted and it would have ended in violence. we had to let her be. unbathed." ...in fact, even if she didn't resist at all, sometimes they'll say that just as an excuse for why they couldn't be bothered to bathe her; it's less work for them if they bathe her less frequently.

OP, no matter what, the facility will ALWAYS try to say they weren't responsible for whatever happened. they know every legal excuse in the book.

regarding the 2nd question, they'll probably try to be careful that she doesn't do questionable behavior, but if she does, they'll say, "it was unpreventable. we don't and can't have eyes on her 24 hours a day."

regardless of legal or non-legal obligations, what you need is a facility that seems to genuinely care for the elderly people. look at the staff. speak with other family members if possible. do customers, family, look satisfied?
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deedee2524 May 2023
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DeeDee, I'm so sorry for your dilemma. We were also at a loss when first trying to find a good facility fit for our mom.

I think perhaps you need to consult an Elder Law attorney. Unless you have guardianship of your mom, you most likely won't be able to restrict her choices.
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deedee2524 May 2023
I was hoping that with the higher level of care, the legalities would be well defined & in place. I do have sole legal guardianship, POA, Medical POA, etc, but I'm not looking for conflict, only peace in choosing a home for her. Thank you for the kind reply!
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If anyone can answer my original question regarding the legalities that would be awesome and appreciated!
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oclovee May 2023
I would like to know that too. With the cost of MC there should be legal responsibility! In sorry about your mom :(
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There is a senior living place near me that has memory care. Residents can choose a plan where they’re in the company of men and women or only women. There must be more places like that.
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deedee2524 May 2023
That was my first choice but I haven't had any luck with that. Thank you for the input!
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My post was edited and some if the details are missing?? As I mentioned, my mother bathes and does whatever I ask of her, but I'm sure she was not compliant with the caregivers..Everyone has differing opinions but knowing my mother's beliefs and behaviors prior to her dementia is what I must base my decisions on.
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In my opinion allowing demented residents to have sex is akin to facilitating rape. A demented, broken brain cannot consent to sex. Same as a passed out drunk person cannot consent to sex.

I wish the facilities that allow this would be prosecuted and the administrators and any aides who responsible be put in jail.
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oclovee May 2023
Agree!
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Welcome to the Forum, DeeDee.
I would ask these questions of the facility, not of us. They vary a good deal. You say your mother was "having sex" with another patient. What evidence, I am wondering, do you have of this?IMHO the facility was wrong to accept into ALF someone in need of memory care. That is not fair to you, to your Mom, or to the other residents in that facility.I sure wish you the very best. The level of staffing is generally better in MC than in ALF, but as you can imagine, lest you hire a one on one aid (very costly, indeed) you can never be completely reassured that your Mom will be under scrutiny of staff at all times.Good luck.
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deedee2524 May 2023
Yes, it was all new to me when we began our search for a home for her, and I have educated myself a lot since those days. She was definitely having sex, as I caught her, which is why they decided to tell me. I appreciate your reply.
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Even people with dementia have rights to decide what they want to do within reason.
Issue 1: my mom was always searching for a companion in 3 places where she lived. In the earlier stages they shared living quarters until he passed away. I am sorry you felt that late companionship caused your reaction. The only time I spoke on her behalf was when there was an aggressive resident scared her.
For bathing, MCs have different ways of encouraging a shower up to a point. If the resident becomes combative, then she or the caregivers can get hurt. You might want to speak to a gerantologist if this becomes the case.
You can ask those questions when you do your search. Are you having problems with her now? If she is compliant with you, then fill the MC staff in. Just remember as she ages these issues can get worse
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sp19690 May 2023
No sorry people with dementia should not be having sex. This is basically rape. Same as someone having sex with a person passed out drunk. It is no different.
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