Hi Friends,

My mom is at an assisted living facility along with nine other people. There are two very old lady caregivers one over 70 years old the other over 65.

For the most part my mom needs very little care. But every now and then she gets dizzy or week and she will fall in the bathroom. Last time she laid on the floor for three hours calling for help and when the caregivers came of course they’re too old to help her or pick her up so they called 911 and off to the hospital she goes.

Tuesday of this week my mom who is very high anxiety felt sick started to panic and called 911 and told them she cannot breathe and off to the hospital she went and no one tells me. I don’t even know she’s at the hospital until the nurse calls me.

My question is what state agency regulates in-home assisted living care? I think her caregivers are too old to be caregivers they don’t tell me when my mom goes to the hospital and they don’t tell me if she’s having a problem with anything.

I have discussed my concerns with the owner via text but she never responds and when I try to discuss in person she just giggles and says she loves my mom. But truth, she loves the $3600 I give her every month.

I am looking for a new place to put my mother and in the meantime I want to report this facility to the state.

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I am a Certified Personal Care Aide PCA. I am age 65. I am fit, active, healthy and well trained by my agency in all aspects of client care including responding to falls. When following all appropriate protocols for care the risk of injury to caregivers and to clients is minimal. Residents should always be assisted by paramedics following a fall, not facility staff. Age in itself is not a determining factor in quality of care! Not all caregivers in their 20's or 30's are fit enough or well trained enough to safely and effectively perform caregiving tasks required of the job. To limit one's evaluation of a care provider's performance based on age alone can be inaccurate and therefore is discriminatory by definition.
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"Residents should always be assisted by paramedics following a fall, not facility staff." While I understand that a serious fall should be attended by paramedics, if a facility had to call 911 for every fall, the paramedics would likely be there all the time!

Mom's MC if at capacity is 20 people. If two fall (tumble, slip down to floor, etc) every day, and then several in the AL upstairs fall every day, there wouldn't be enough paramedics to cover other emergencies!

Each fall should be assessed. When mom first moved in (she was the first MC resident when the rebuild was done), yup, she was transported to ER for several simple tumbles. That has since stopped. They check her over, monitor vitals for a few days and that is that. If they were to call 911 every time mom fell, I would get no peace! They do call me to report it, but it doesn't require me having to go pick her up at the ER!
Very old at 65? We could run circles around these young people, who whine and complain about everything...
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Myownlife Feb 2020
And are on their cellphones constantly texting or playing games !!!!
I had to laugh at the "very old 70 and 65 yr old" I am 70 and don't feel very old.

I do agree, though, that 65 and 70 are a little up there to be Caregiving with dealing with the physical aspect. My GF and her sister retired at 60 because the work was getting too much.

These places are overseen by the state. I would start with the Ombudsman.
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For what it's worth, my mother has lived in Assisted Living for over 5 years now. She has fallen 41x and has been helped up EVERY SINGLE TIME by the care givers; 911 was never called. Of course you should expect the care givers to help your mother up when she falls; that goes without saying. They should be trained with gait belts, or ask for another person to come assist them, but it's their job to get her up on her feet again. It's also their job to call you each time there is a fall event so that you are aware of it. The nurse is to check her vitals and make sure she isn't hurt or didn't hit her head in the fall. If there was a head injury of any kind, she MUST be transported to the hospital for evaluation.

Grandma has given you some good advice here. Call the Ombudsman right away to inform him/her of the situation that exists in this ALF your mom is in. There needs to be a public notice inside the facility of the Ombudsman's name and phone number; if it isn't there, then that's an infraction as well.

You are wise to find your mother another ALF to live in. The smaller ones are not always the 'better' ones, either, as you are seeing. I suggest you look for privately owned ALFs and ask the residents AND the staff how they enjoy living/working there. That really tells you all you need to know right there.

Best of luck!!
Helpful Answer (7)

When you say the caregivers came, do you mean they arrived in morning because there is no staffing at night or that they were on duty over night but didn't respond to her? At the very least, your mom should be wearing a Lifeline type product that detects falls and there should be a call button in the bathroom that she can activate or she needs to live in a facility that has staffing overnight that can respond and well check through the night as assisted living facilities usually do well care checks in morning. Once they responded, calling the EMTs is correct. If they know that you are her health care proxy, they must call you. Not calling you is unacceptable.
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FIRST LINE in OP's question:

"...My mom is at an assisted living facility..."

"...there should be a call button in the bathroom..." Mom's MC facility has these, HOWEVER, if she falls in her room and can't crawl her way to the bathroom, she can't push the button.

Additionally, they have put a lanyard with a call button ON mom - she has NO clue what it is, periodically will notice it and then push the button, not having a clue that she is calling the aides!!!

These idiots "working" at a place with only 10 residents should be checking on the residents EVERY 1/2 hour! That place should be closed for business (reporting fine, but clearly the "owner" is an idiot.)
I'm not very old - only 56, does that make me quite old? - but I can tell you that even the rosy-cheeked 22 year olds we have on our team are not allowed to "pick up" fallen elders. It isn't safe for the elders or the caregivers. There are techniques you can use to prompt the person to get up unassisted and safely, if the person is uninjured; but if in any doubt we would call either the Falls Response Team or an ambulance.

But why doesn't your mother wear a falls alarm? Why isn't the facility equipped or the staff trained to deal with falls?

I think the owner might well respond with a straighter face if you put your concerns down in an email and tell her that it's going to the long-term care ombudsman next.
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LesleeCares Feb 2020
Thank you for this response CountryMouse. As a caregiver I agree with your response in its entirety. This question reminded me of a CEU course or recertification quiz question. In a different scenario, I am currently providing care to a client in his home who was abused by his spouse yesterday. I work for an agency. I reported the incident immediately to my agency who in turn is reporting it to Adult Protective Services immediately after I document the incident in writing this morning. If I was providing care to this client in a private duty arrangement I would have called APS immediately myself and submitted documentation in writing directly to them.
It's the protocol with many agencies that the caregivers should NOT attempt to pick up a fallen elderly person; it's not safe for the elder or the caregivers, and it can be a liability issue if one of them is injured in the process. The protocol is to phone 911.

Somebody else mentioned gait belts. Gait belts are passé and should never be used to yank somebody off the floor, as they have been associated with many abdominal injuries. (I'm an RN, by the way.)

I am curious as to why the woman lay on the floor for three hours. Does she live alone part of the time and the caregiver had not yet arrived? If this is the case, then it's fairly clear that it is no longer safe for the woman to live alone any longer, even for a few hours.
Helpful Answer (6)
Always phone 911, Dragonflower? I'm just comparing notes, not arguing, I'm interested.

I don't know how long we've had this service where I live but presumably because the emergency services got so sick of helping elders off the floor or out of their bathtubs we now have a dedicated Falls Response team who roam the county and try to get to any call within the half hour. If an injury is obvious or suspected, then it's still an ambulance, of course; but if the person is perfectly happy only not able to use any technique to raise themselves (with appropriate support) then the falls team people come along with special inflatable cushions and kind of lever them upright. I believe they do have relevant paramedic training, but I'm not sure if they are fully-qualified paramedics. Still - they do a brilliant job :)

Completely agree - gait belts are to aid gait, not for use as block-and-tackle!
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I don’t think you’ll be able to find this perfect situation for $3600 a month. Look before you leap. If you really want to pursue allegations, you can contact the ombudsman; the name and number should be posted in a clearly visible place in your Mom’s facility.
I think you’ll be less than enthralled with younger workers. They are attached to their phones and have poor attendance, constant family drama, and transportation issues. I hope you find what you seek, yet again I implore you to look before you leap.
Helpful Answer (6)
This is a perfect situation? 10 residents and the idiots working there can't do a resident check/head count every 1/2 hour??? Even if she has to spend more, I would get mom OUT and also report the place. They'll have their cover up for sure, but there are places for rating out there, at least post the truth on them!
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There is a requirement that the name and number of the ombudsman be posted. Find and use that. If it’s not there, that’s another huge red flag. Clearly, as you’ve seen your mother needs to be moved. Is your mother paying for her care or are you? I ask because when my mother required nursing home level care, she went from private pay with long term care insurance to needing Medicaid in short order. Her care was no different on Medicaid than with private pay. If this might be your mother’s need, don’t pay and delay that process. If you don’t see ombudsman number, call council on aging or adult protective services. I wish you the best as you advocate for your mother
Helpful Answer (5)

There is an Ombudsman that you can file a complaint with.
I would do this even if mom were not having a problem. 2 "caregivers" that can not help when necessary, can not either hear a call for help or ignore a call for help should not be working in this capacity.
I think you are wise to report the facility and I think you are wise to find another place for your mom.
Is there any way you can install cameras in your moms room so you can monitor what is going on and if there is a fall again (hopefully not) but you could call 911.
I might also contact the local fire department to see if they are aware that this facility is pretty much unsupervised.

by the way personal comment here but I am over 65 and would not consider myself as a very old lady caregiver but there is no way I would want to care for 10 people. I would not feel like I was doing a good job.

Good luck in your search for a new home for mom and I hope you find one soon it seems like a dangerous situation.
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