Wednesday, August 5, 2009

Mom doesn't like ALF alternative - now what to do?

I took Mom to visit a small assisted living facility and she didn't like it. I believe she could be persuaded to move to the small facility IF she could have her own room. This ALF is the second of two recommended by her doctor; I ruled out the first after meeting the owner/manager's dog.

At the smaller ALF the only room available now is a shared room with an odd bathroom setup and Mom feared that she might fall. It's a valid concern and I don't want to push it. We are on a waiting list for an individual room so we'll just wait. I don't want to tell Mom's doctor, I fear he will be angry and expect me to force Mom to move into a shared room. He forgets that Mom is still cognizant enough that she should have input into her living situation.

Before I go into details I must admit to feeling very foolish at this point. I researched ALFs in Mom's town. I visited, unannounced, on more than one occasion. I snooped around; I talked with residents. I talked with others who've parents were in the same ALF. I did not decide on this ALF without great thought and investigation. Now I am regretting my decision and fear for Mom's long term safety and condition at this ALF.

Mom says that she's finally feeling at home in the ALF; she's become acquainted with people and enjoys her table mates. Honestly, I am surprised she said no to the move. Mom complains about something everyday - the quality of the food, the room, the lack of a view, the slow response of the aides; the laundry, the long corridors, the lack of good "company"..... on and on.. So- I will meet with the administrator and discuss my concerns along with the doctors recommendation that she move to a smaller facility. I hope I will get some positive results.

Mom's complaints are valid but my concerns are broader. On Monday afternoon I visited and the fire alarm went off. I was in the hall outside Mom's room and asked two aides - the ONLY aides for her floor of 70+ residents - what I should do. They said "we don't know, we have not been trained on that yet..." I was dumb founded. That event is the last straw, I MUST discuss my concerns with the Administrator. Other things I will brings up include:
  • Relationship between the RN as medical coordinator with the LPNs who handle records and coordinate prescriptions. The RN is new to the job and the LPNs seem to want to make her look bad.
  • Failure to empty her commode before lunch time. This has happened on four occassions and I'm disgusted by it. It can smell and I don't want Mom's room to reak.
  • Failure to help other residents. More than one lady is incontinent and during long visits I see them ( and smell them) wandering around. They are pleasant enough but as they walk past I can see that they have wet spots; their depends are full and should be changed. The aides just stroll by; no one takes them to their room to clean them up. They let them wander around reaking - it's disgusting and makes me wonder how they might neglect my mom!
  • The attitude of the LPNs toward residents who are sick; they are very abrupt with residents and make everyone feel like they are a pain in the neck.
  • I believe that one of the day LPNs lied to me. Normally I get a call when Mom falls. She fell last week and they told me that they can't get through to my cell phone. However, the night aides manage to call me when Mom falls. The night aides have called me four times; the day time LPNs won't return my calls.
  • There is no way to leave messages for a nurse or LPN; they have no voice mail and no one takes messages. When I've called I've been told to call back and when I do, no one is available. This is the same problem Mom's doctor described.
  • The food REALLY concerns me. For supper one evening Mom got half a sandwich, three pieces of lettuce smeared with oil and about 1/4 cup of fruit cocktail. I feed my cats better than THAT! Supper is supposed to be "light" with their lunch or dinner being the biggest meal of the day. I'll be watching for those dinners to see how big they are.
  • Overall lack of common sense among the aids. Here's an example: I go to Mom's room and find her trying to spread a shirt across her torso; her room is freezing and the AC is going full blast. She is like an iceburg. The aid said she was cold and asked for an extra shirt. Obviously it didn't occur to him to turn down the AC (ah duh??!!) or get Mom a small afghan that is on a shelf immediately above the shirt he pulled from the closet. I had to take her outside in the warm evening air and put her bare feet on the warm concrete to warm her up.
So - these are the things I'll discuss with the administrator. She is a sweet lady but I just don't know if she can be hard nosed enough to get these people in line. Many are kind and I think their intent is good but at some point it becomes just a job and they put in as little effort as possible. She likes to believe they have one big happy family but my family is fearful that theirs will not be good for our Momma!