What can I realistically expect from private board and care home?

Hi CleanUpBatter,

I had to place my loving and amazing grandmother in a nursing home. She begged me to see that she wasn’t taken to a home. My mom tried finding a group home (not a nursing home) and when I visited (this was in AZ, I live in IL) I saw horrible things. Despite my mom’s best intentions, it was an awful situation. My grandma lost 40 lbs in the shortest of time. It was not clean and no stimulation except the TV. It killed me seeing her this way. So I arranged to be the POA and swiftly moved my grandma to a nursing facility about 20 minutes from me.

I visited five days a week and hired someone to spend time with her on Sundays.

There’s a lot you won’t like to see. Residents who are ambulatory get the best care, as there’s more risk for falling. The awful truth is there is always staff shortages. But most staff want the best for patients but simply don’t have the resources.

I recommend stopping by unannounced and seeing what is wrong or right and swiftly take your organised list to the head of nursing. You really must be vigilant.

Be friendly with the staff and memorize their names. Let them know you’re there and sadly but true, your mom will get more attention. The squeaky wheel gets the oil — this could never be more true than in a nursing home.

Also, I decorated my grandma’s room with her own things. (Her side of a shared room) Curtains, photos, comfy chair, stuffed kitty (which she thought was real and it kept her company. She would pet it all the time.) And I asked the staff to call it her “apartment.” Some complied others didn’t. I even left soothing music playing for her (with the permission of her room buddy’s family).

People will thieve, not knowing they’re doing so, so things will get lost but typically you’ll find them again, in someone else’s room. (Put your mom’s name on everything!!)

To finish my story, six months into my grandmas new residence, she gained all the weight back and more! She was designated hospice when I first moved her here. My goal was no matter how much longer she has, she must know she’s loved and have visitors.

She live four more years!!! And her last words to me were: “Thank you for bringing me here.” Which was the biggest gift she could’ve ever given me.

I hope this is helpful to you! It’s difficult but please don’t let the guilt get to you. I wish you all the very best and I’m happy to help anytime if you have follow-up questions/comments.

Blessings!

No matter how good a facility is it can never replace the personal one on one attention that can be given in the home, staff needs to divide their time and attend to the diverse wishes and needs of all the people living there.

I think one of the pros of these types of home is that there is limited staff so they get to know the residents personally, and there is a less "institutional" mindset.
On the other hand the intimacy and small number of staff can also be the greatest deficit because everything depends on the care and reliability of those few people. Even if there are excellent people working there there is no guarantee that they will still be there 6 months down the road, and if there are slackers there is less oversight.

Thanks to both @isthisrealyreal and @cwillie for your responses. Each adds to my bank of knowledge and expectations! I didn’t expect mom would still be treated like she was before but Isthisrealyreal states exactly what we are experiencing and it sounds kind of like it’s normal. I don’t care for 2 of the caregivers that came in as a couple right after mom moved in but you’re right, the place is only as good as it’s caregivers and they can change on any given day. Maybe the good outweighs the “bad” rather than being in a memory care facility. As of today I have asked one of her old caregivers to start visiting two days a week starting next week. Thanks again!

Is "less stimulating environment " the only issue?

Exactly what does that mean?

You will never find any place that will treat her like a queen.

You can expect that her needs will be met ie, fed 3 times a day with snacks, getting her up and dressed with basic hygiene daily, 2x a week showers, her room cleaned, bedding kept cleaned, bed made daily, medications managed, that type of care.

If she needs activities all the time and more one on one care, a board and care is not the place for her. You will need to step in or hire someone to be with her.

One of the reasons they are cheaper then a big facility is because they don't have the overhead of activities and the space and employees to run them.

In addition to a clean environment, you should expect nutritious and delicious food, a "homey" atmosphere, individualized care, and of course, stimulating environment with a range of activities, music, art, gardening, cooking, and conversations. No restrictions on visits from you, family, and her friends.

Your state will have regulations that apply to care homes. Talk to your local Ombudsman's office or your state's health department. Also, be aware of "Residents' Rights" http://www.nursinghomealert.com/residents-bill-of-rights.

I also encourage you to stay involved with your mom, not just standard visits, but group gatherings to help her connect with other residents. Maybe you could offer a weekly group activity, like a sing-along.

CleanupBatter: Imho, perhaps your mother's "late to mid stage dementia" warrants a higher standard than what a board and care offers. In addition, no place is going to treat her akin to a gueen.

Thanks to both @isthisrealyreal and @cwillie for your responses. Each adds to my bank of knowledge and expectations! I didn’t expect mom would still be treated like she was before but Cwillie states exactly what we are experiencing and it sounds kind of like it’s normal. I don’t care for 2 of the caregivers that came as a couple right after mom moved in but you’re right, the place is only as good as it’s caregivers and they can change on any given day.

Sorry to have to say this but all Nursing type Homes are an awful place to live.
They are all understaffed and your loved one can lay in their own urine and feeces for up to an hour before being changed.

You can't keep anything nice as it seems to walk away.

Thints go to the Laundry and never come back.

It's the last place you would want to put a loved one or even an enemy for that matter.

You should re think it and If there is any way possible to let her move back,, DO IT!
Seniors in Nursing Homes only live, more like survive for approximately 6 months.

When you go to tour the place, they show and tell you everything you want to see and hear as they are wanting your business and trying to make a Sale but the truth of it living there is Pure He'll.
She would be better off moving back, installing a Camera, I used Nest Cameras so I could check in by my smart phone or lap top at any time and then since you mentioned money reasons, just hire someone to be there to check on her a couple hrs in the morning, afternoon and evening instead of 24 7.

Believe me, you will see your Loved One go down hill fast!

Prayers

Your post suggests that you were paying for 24/7 carers (very expensive!) before the move and that the move was less expensive (hence the financial reasons). You had four ‘fantastic’ carers, and at least one of them might even be missing her. Perhaps it might be financially possible to hire one of them to visit her, perhaps twice a week for a couple of hours, to provide her with a bit more one-on-one and make it a bit less of a change. Worth checking?

I am slightly surprised that board and care will take someone with mid-late stage dementia as I would not have thought they were equipped for someone needing that level of care. Perhaps a memory care facility would provide more of what you expect and avoid having to move her as the dementia progresses. Good luck in finding the best for her - which may require a modification to what you expect knowing what she has had being able to be close to you, but may be closer to her needs as her dementia progresses.