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My mother is in a NH and basically immobile. She is generally not a major complainer. When she tells me about an issue that aides dispute I feel lost as to who to believe. Some aides are warm and caring and others have somewhat curt attitudes. One issue was about sleeping through the night. She says she hasn't been while a certain aide says she does. I had an issue with the resident next door who is very gone mentally. Her TV was on loudly during the night. I complained and that stopped but my mother told me an aide said she could have it on as loud as she wanted. At least I got that to stop. I just don't know who to believe as issues arise. I do my best to be polite and brought cookies on Easter for the staff. I feel bad that she could be at the mercy of an aide who has a bad attitude. I have found in the past such as when she was in the AL section a director defends the behavior of their staff even when they have attitude issues I observed. I just don't know how to proceed going forward when difficult situations occur.

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From your mother's perspective she could be sleeping less deeply and partially awakening several time through the night, from the aide's perspective she may appear asleep whenever she is checked on or if she isn't calling for help or obviously agitated then there is no problem. You have to choose your battles and IMO in the example you gave it doesn't really matter. Giving up control was one of the hardest lessons I had to learn about placing my mom in the NH, but my life was ultimately better when I accepted that my ability to micromanage her care there was zero.
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ZippyZee Apr 2021
This was my first thought as well. If Mom is waking up for awhile, then going back to sleep without getting out of bed, the aides will likely think she's slept all night.
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I have NEVER understood why NHs will allow a resident to BLARE a TV all night, especially in a shared room, but they sure do! How can anyone rest? Headsets should be required. My FIL has Bluetooth hearing aide and blares the TV. He is the only one who hears it! MIL sits in the same room and reads in peace.
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Riverdale Apr 2021
What was so annoying was an aide telling my mother the neighbor had a right to have the TV on at any volume during the night. The neighbor is very far gone mentally so someone else had to be making that decision.
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Will the nursing home allow you to put a camera in her room? That way you could check in on her on your phone anytime you want to. I know that some do, and some don't, but it's certainly worth looking into. Best wishes.
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Riverdale Apr 2021
Thank you but I don't feel that will go over well at least now. She has several years of available private pay and then if she is still alive I am hoping that she can be on their benevolence plan which I have discussed with a director. She was in the AL section from late 2016 until the septic infection diminished her and had her in the NH section.
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I have experience with three family members in the care complex where my LO currently lives.

While my mom was living there for 5 1/2 years, I got to know almost all of her hands on caregivers. I always gave off positive signals if I was pleased/satisfied with their care for her, and tolerated what I considered careless or non-helpful attention as long as it didn’t directly harm her.

As time went by, I learned that some of the caregivers I hadn’t liked or had confidence in turned out to be the best caregivers she had. The rare useless/problematic caregivers didn’t last long.

In Covid? MUCH MUCH HARDER. But I DID LEARN that even those caregivers who remembered my mom told the new people caring for my LO that I’d do my best to help with whatever I could.

I have been separated from LO for 6+ months, and had my first visit, outside, last Wednesday. She was clean, plump, and obviously well attended to.

Suggestion- try to “inform” instead of “complain”.

“Could you check on Mrs. Loud Neighbor’s TV before mom goes to bed for the night? Mom says it’s loud enough to wake her up sometimes”.

“Somewhat curt...” may be pretty understandable in current circumstances, and not aimed at your mom but coming from overworked and overwhelmed, and of course, it’s hard on everyone.

Maybe you’re also a little overtaxed and under appreciated too. I know darn well I am. Give yourself as much slack as you can, as long as concerns about caregivers aren’t resulting in damaging consequences.

Hope things will be smoothing out for you and your mother very soon!
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My brother told me I was my own worst enemy when it came to Mom. So, yes, pick ur battles.

Does Mom have Dementia? If so, I may lean towards the aide. And, I think a TV on after bedtime is a no no. That is not fair to the other residents who are also paying to live in the facility.

We went into an Aunts room that she shared. Her roommate first complained that Aunts TV was too loud so we got her earphones she could use with the TV. Back then the TVs were put on top of the chest of drawers on a wall at the foot of the beds. Meaning, both TVs were on the same wall. So then the woman complained that she could see Aunts TV screen and it was interfering with her enjoying her TV. So dear Aunt turned off her TV. I told Aunt that she was paying to live there too and she had a right to watch her TV. If they had had where the curtain between the beds went across to the wall, there would have been no problem.
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Riverdale Apr 2021
She doesn't really have dementia. Alot of short term memory loss but very good regarding past events. The TV situation seems to be solved at least for the present. It just feels so difficult to feel as though I am being treated without respect. She is on private pay at over $8,000.00 a month. I requested that she might be given Tylenol PM. Have to follow through with that on Monday. I wonder if she is having a form of Sundowners. I really try to be polite and to be given attitude back just feels wrong but I put the issues in my post. I just don't know what else to do. I don't feel the camera route will go over well. She never smells bad and is incontinent so that is important. One aide mentions she is changed during the night. Is that a good sign? Fruitless to say but it is so hard to be at mercy of staff who aren't pleasant and I don't know what other avenues to take. The OT staff are very good and warm and my mother has also stated that. Compared to many stories here she is not truly a difficult patient.
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My mother regularly tells me she 'never sleeps at ALL during the night' that she's up 'all night' for various reasons. When I call the MC to fact check, they tell me she DOES sleep, but wakes up once in a while during the night. I have to believe the MC b/c if she really WAS 'up all night', she'd be non-functional during the day and she's not.

We can't fight all these battles for our mother's and win them. Pick the ones you think are serious, and leave the rest alone.

You say your mom 'doesn't have dementia' but has 'a lot of short term memory loss' which sounds like dementia to me. Long term memory loss, with dementia, is not affected until the advanced stages. Similarly, Sundowners goes hand in hand with dementia oftentimes, and presents itself with many of the same symptoms.

That said, a lot of what your mom is saying nowadays should be fact checked. And then, you'll have to decide who's telling the truth, her or the NH. So again, pick your battles and let the small stuff go, that's my suggestion. If her overall care is good, that's the main thing, imo.
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Beleven your mom.
Set up a Camera in your mom's room and you'll at least be able to see what's going on while she's in her room. I set up a Nest Camera fir my Dad and now I can see what really goes on.
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TouchMatters Apr 2021
What's a Nest camera? Good ideas here that I've never heard of - thanks everyone.
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So when my mom was in a NH, I NEVER adressed mom's situation with her aides. My stance was that I was not their supervisor and had NO idea what the parameters of their jobs entailed.

I likened this to a school situation in which you wouldn't address an educational concern to the classroom aide; you'd talk to the teacher.

Find out who supervises the aides. Address the concerns mom has expressed to that person in a care meeting.

"I'm hearing from my mom that she isn't sleeping through the night and is disturbed by her neighbor's TV. What can be done about these concerns?"

Re: Tylenol PM- the physician or APRN is going to need to order that and it will need to be charted.
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Riverdale Apr 2021
I know that about the medication. I already asked the nursing director. The conversation regarding sleep evolved as an aide overheard us talking. They aren't planning any care meetings such as they did in AL. The only people to get an sense of what transpires is those working during the one hour I am allowed there. I really do try to maintain a sense of polite curiosity. I just found out 2 days ago the TV was on loudly during the night again. When I call about this it does get quickly addressed at least for a few days. I understand your clear message. I just feel I need to have some communication if there happens to be an issue. I also am able to speak directly with OT people if and when they come by. They are all great which is also what my mother agrees to.
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Get a ring camera
once we put that in we were able to support parents and aides better.
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TouchMatters Apr 2021
What's a ring camera? On the elder's finger?
How does that work if in a shower or getting hands dirty - and cleaned by aides?
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When there is a problem, ask to speak to an administrator. Aides generally do most of the work and do not always have the same assignment each day. LPNs are in charge of the aides during their shifts and do not always have the same group of clients every day as well. The only constant is the administrator. If you are with your mom and a problem arises while you are there, talk to the LPN who is in charge at the time. Make sure to document specifics - as best you can - since it is easier to identify patterns and identify which caregivers may need retraining or reprimand.
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Riverdale, I completely understand your frustration and can only imagine how much more complicated COVID is making your job of supporting your mom!!

I so totally understand your frustration; because of the distance I had to travel to get to mom, I could only go on Sunday and spent an hour with her. SW or administrator were never there on Sunday, so I was able to get everone's email address and would send my "concerns" to the DON and SW on Monday mornings.

Can I tell you how exhausted I was at the end of 4 1/2 years? 4 years later, I still startle when the phone rings.

Care meetings should be scheduled every 90 days, I believe, and ask for one if they are not forthcoming.

I would take my brother with me to care meetings, as he is large, quiet and calm. I would raise my voice, threaten ombudsman and joint commission--sort of good cop/bad cop. But only to the senior staff. And because mom was private pay and the facility had a low census, they seemed eager to keep mom.

I brought cookies and cake every week, paid for by mom and with a note that said "From Mrs. A in room 108A".

((((((Hugs)))))))
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Riverdale,
Is your mom mentally competent? If so could she manage having and using a cellphone?
If she can then when she's up all night have her text you with messages. Texts have the time and date with them and this is one way to prove who's lying and who isn't.
Never trust the word of any nursing home or homecare agency staff. They're number one priority is their job and making sure they please their supervisors and bosses.
Here's the thing about CNA's and other care staff. Everyone doesn't have the same kind of personality. Some caregivers like myself don't have a warm and fuzzy personality. I'll do right by your loved one and your family though because I'm trustworthy and competent with a good work ethic.
I've known many aides and nurses over the years who were the most warm and caring people. They'd always have a smile and hug for someone. That's all they had though. I've seen these wonderful, warm people leave someone sitting in their own mess waiting for the shift change. Ones who don't know the difference between plain old complaining orneriness and something actually being wrong. They'll blow a kiss and smile then walk away.
Those aides who aren't the warmest or nicest people are usually the ones doing right by your loved ones.
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Sounds as if you need a ñanny cam one that activated when detects movement. I don't know if they have one that is activated And records voice. But if not body language should tell aot. Hide it in a vent in her room.
Abuse doors happen in NH and most of the time the patient doesn't complain ,unable to speak or afraid to speak. Always check for brusiez on the body not just arms and face check back, torso, legs these are generally covered.
Good luck.
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I am disabled because I can't walk and live in assisted living. I hate to say it but there are many staff (medical) who should not be aides or in a position to help residents. They have NO personality, never speak to a resident, just bring meds and walk out - nothing. Definitely NOT suitable for the job they have but it is probably the only one they can get. Nothing will change their personalities or way they treat others. The higher ups are well aware of this but finding good aides is next to impossible although there are some really great ones but they are far and few between. The rest collect a paycheck and really don't give a dam. You know your mother and I would tend to believe her over the aides. I don't know what to say except keep the higher ups informed (and document it all if it ever comes push to shove) and ask for their help. They usually can't or won't go after the aides because places are so shorthanded.
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Riley2166 Apr 2021
And I hate to say this but all the cookies and other goodies in the world will be eaten by the staff but it won't make a darn bit of difference in their ways and personalities. Sad but true.
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Since I live in assisted living, I am all too familiar with what goes on. Fortunately I can take care of myself 99.9% and no one messes with me. But others can't. To my knowledge, every state in the country has what is called an Office on Aging in the county - and all residents in care facilities can contact them and they will be put in touch with an Ombudsman who will investigate and hopefully fix problems between these homes and residents. I assure you they have the power and will do so. Seek out that office and ask for help.
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TouchMatters Apr 2021
Great suggestion. From what I hear, Ombudsman are the best in protecting the welfare / rights of the elderly. Thanks for responding w this idea. Glad you're able to stick up for yourself. I applaud you. And hope to be like you when I'm older and in need to more support. Here's a hug. You are not alone. How did you get to be so strong and love yourself? That's what it takes - self love.
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Put a security camera in her room so you can monitor whats going on. There are always problems in nursing homes. They hire anybody with a pulse.Period.
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Your best bet is to try to go in when the aide is there. If you can’t put a security camera in the room. By the way make sure you put the camera in when nobody knows. Not even your mom. I wish I could have done it when my mom was in the nursing home. She said the more I complained about things the worse it was on her
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Riverdale Apr 2021
We are in the south and I feel a camera won't go over well. If I was hearing about alot of troublesome issues I would consider this more seriously. I can't put a camera in the resident room next door to understand the TV issue. Today my mother said it has been quiet the past few nights so I am presently relieved about that. I will never let this issue go without complaining because it is terrible for someone to have to try to sleep next door to a loud TV all night. The resident there has no idea of what is going on. I wonder if an aide puts it on to go in and watch it. Today my mother said she didn't want to get out of bed so that is not ideal but I plan to visit Thursday so will be updated then. I appreciate all the replies and the different perspectives.

This is a not for profit facility. As I have mentioned they have a benevolence plan. If my mother who is 90 now makes it to around 95 I will hope they will make that available for her. She will have been private pay since 2017 taking into account the years in the AL section. She had a LTC policy but that has run out. She was in a AL facility in NY for 3 years before we moved to SC. The cost there was much higher. I just hope for better days even though they are far from perfect given her condition.
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Riverdale,

My mom is receiving excellent care in her hospice house.

Her Parkinson’s disease has progressed.
Her dementia is very mild.

She is 95, so confusion is bound to happen occasionally, right?

I don’t know what to believe at times either. I question certain situations.

She told me that her hairbrush was missing. Then she said that the aide may be cleaning it for her.

So, when the aide came into the room I asked if anyone took mom’s brush to clean.

I went into the bathroom and her hairbrush was there where it always is.

I think it is getting to mom being bed bound. She can’t check up on things. She loves knowing what is going on around her.

I know that she is exhausted but she’s bored too.

When she was in the NH for rehab I could wheel her around to the lounge area or the chapel.

She feels utterly helpless. I understand that.

She has always been an extreme perfectionist.

Her hair, nails and makeup had to be just so.

The house had to always be in order and so on.

It’s hard for my mom not to have any control.

Even being bed bound she likes to be very neat.

The aide places a bib on her but mom will pick every single crumb that falls so the aide won’t have to clean it.

The aide told me that mom gets embarrassed if she spills something.

No matter how much they tell her that it’s okay if she spills, she gets upset. I wish that she wasn’t so bothered by it.

All we can do is look into the situation.

Even if something seems silly to me, at this point in time, if something is within reason and it makes her happy and satisfied, I will do it.

She had me write her name on her hairbrush with a sharpie! 😂 LOL

Guess what? I may have giggled to myself but it kept her happy so I did it. Not a big deal to me.

I truly have tried to not only maintain a sense of humor but also I have been able to relax, let my guard down and I think mom realizes that I am not as defensive as I once was due to being overly stressed out when I was the primary caregiver.

Plus, if it’s legal for you to do so, install a camera in her room.

No one should be put off or upset by camera use today.

There are cameras everywhere now.

Shouldn’t we be accepting and used to cameras by now?

If a person has nothing to hide, who cares about a camera? I am glad it’s legal here.

Wishing you all the best.
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Believe your mother. How, pray, would the aide know how much of the night your mother spent in restful sleep? The aide would know if your mother rang her call bell, she would know if your mother left her room; but know if your mother is lying there staring at the ceiling and thinking "for eff's sake turn that effing racket down!"? - is the aide a mind-reader through a closed door?

But in more general terms, I can see both sides. Do you yourself know the aide in question by name, or even to speak to?
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Who is the supervisor of the aides? This is the only person you should refer problems to (period.)
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Imho, speak to the head of this facility.
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Ricky6 Apr 2021
This may be a good idea in a small facility, but in a large facility the manager or head is not going to know what going-on without an investigation. I would start with the floor or section supervisor and then go further up the management level if necessary.
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Riverdale,

The first thing that came to me as well was a camera.

I believe that you can get a "Nanny Cam " that is wireless and is hidden in something like a Teddy bear or a plant.

Depending on the laws of your state, it may be inadmissible or even illegal, however, you could see for yourself what is actually going on!

It's impossible to know what the truth is without being there!

God bless!!
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If mom doesn't have a lot of delusional conversations, I would lean toward what she is telling you. As you say, one aide is sweet as pie and another can be curt. In my experience, mom could very well be at the mercy of an employee who should never have gotten a job working in that field. There are plenty of them out there.

If your mom has an issue with sleeping during the night, unless she rings the bell, how would anyone know. Trust me, they aren't popping in and out of her room all night long to monitor that. If mom has trouble sleeping during the night, what was it she wanted that she didn't get? Is she trying to say that sleeping has become a problem (and perhaps she needs a sleeping pill?). Perhaps the tv has become an issue in the next room again?

Does mom have her own room? If so, install a camera that would not be easily found by staff so you can look in on her. (The contract I read says if you install a covert camera and they find it, they can turn it off. If there is another person in the room, you are invading that person's privacy).
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NeedHelpWithMom Apr 2021
In our state, it is only legal for us to have cameras pointing at the patient, never the roommate. That would be an invasion of their privacy.

A person cannot have a camera pointing towards their roommate.

So, here’s the thing about cameras. They are everywhere these days but some people know how to dodge them.

Kids know that they have cameras on the school bus.

Do you think that it stops fighting on the bus? Nope!

Kids have figured out that all they have to do is to have a few kids stand in front of the cameras to block the view.

Meanwhile, a fight is happening outside of the cameras view.
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I think it would depend on the issue. As we get older we complain about somethings that are common amongst the elderly and wouldn't be an issue to staff, but as individuals they matter to us. I don't think approaching it as one particular aide is likely to achieve much unless the complaint is about mistreatment or some form of acceptable behaviour. Sitting down with the Director and discussing how your mother is doing and things she has raised as a general complaint may be more effective. We have to remember that just about every elderly person in care has days when they are in complaining mode if only born of frustration so a conversation with a more distant person may be more helpful.
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I know my mom just likes to complain and she will sometimes embellish facts to make a point. Also, when shes complaining, she's talking about her perception whether it matches what anybody else sees or not.

She will say she hasn't been able to sleep when I've been listening to her snore on the baby monitor that sits right near me. It aggravates her to no end if I dispute what she says.

It may be that she's had to toss and turn to get comfortable but she is by no means sleep deprived.

She has complained for years about her skin itching particularly at bedtime but the dr. has no remedy. So she complains that she hasn't been able to sleep when in fact she means her itching is driving her crazy. In order to make her point about the itching, she exaggerates and says she hasn't been able to sleep all night long.

Why does the staff feel the need to contradict your mother? And why does the staff defend the loud tv for a person who is not cognizant? Are they not aware defending one person's rights effectively abuses the rights of another? What is the policy? There should be rules in effect that make this a nonissue.

I feel the aide is behaving very unprofessional in this instance and you should be on your mother's side.

Charlotte
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Countrymouse Apr 2021
Have you tried substituting Dermol cream (or similar) for soap on her itchy bits? Probably! - but just an idea :)
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