Memory Care is not Skilled Nursing

David J

In this state (CT), and maybe everywhere (?) memory care facilities are considered assisted living.  This was driven home to me in the last few days at the MCF. My wife has been very restless and walked herself to exhaustion. The staff  worried she would fall, but could not devote a caregiver 100%.  At the LPN’s request I spent the afternoon and early evening being a dedicated caregiver to my wife at the MCF. They took a urine sample and sent it for culture, but results weren’t expected until Monday. They wouldn’t/couldn’t do quick Azo stick to see if a UTI was probable. Even if it had been positive, they can’t prescribe antibiotics.

Yesterday, I got another call from the LPN telling me my wife’s restlessness was worse, and she was displaying some attention seeking behavior, going up to people and grabbing their arms and squeezing hard. The LPN was pretty sure that she had a UTI. But they are not a skilled nursing facility and couldn’t deal with this medically.

The problem was that I was in Massachusetts for the weekend and couldn’t get back to CT to take my wife to her PCP. In cases like this, the MCF calls an ambulance for transport to the branch ER in town. So that’s where my wife went. I spent a he afternoon, evening, and night calling the MCF and ER getting updates. Last might at 10:45, they told me that she was going to be admitted to one of two hospitals in the system, as soon as a bed became available. They couldn’t tell me which hospital or when she would be transported. 

So I got up early this morning and came home. I found out where she went and talked to the aid who was feeding her breakfast. I will be able to visit her this afternoon.

So a person to an MCF doesn’t relieve the caregiver of all responsibility and medical issues still meed to be managed  

DrinaJGB

It sounds as if your LO is suffering from Akathesia. It can be a side effect of drugs such as anti- psychotics, anti- emetics and certain antibiotics. It is very distressful.

  I would mention this to her doctor who should in turn re evaluate her meds.

My DH was in a facility when I noticed he could not stop rocking and moving his hands. The next morning he was worse and could not walk. I had him transferred to the ER where he was placed in ICU and washed out---the medications had caused his reaction. He remained there for 9 days then was transferred to a rehab floor where he had to learn to walk all over again.

The neuro team at that hospital told me a patient who has had brain damage never should have been given those certain meds---that were prescribed by the rehab doctor. It was a hard lesson learned indeed.

It is a red flag that the nurse has not considered this drug side effect as a possible cause for your DW's distress.

Jeff86

Sorry to hear, David, about your DW’s challenging behavior, and especially how the need to address it has substantially limited how much respite you’re getting while she is in a MCF.  

(Hopefully, it proves to be a UTI easily treated with the right antibiotic.)  

It’s a tough way to learn important lessons about the boundaries of MCF’s—what we all can and can’t expect if or when the time comes.  As you note, each state regulates facilities within its jurisdiction.  

Here’s a link to a site that (if you skip down a little) describes the various types of facilities and capabilities as NY defines and regulates them:  https://www.memorycare.com/memory-care-in-new-york/   Perhaps useful to frame the issue, whatever state you may reside in.

Your experience is a good reminder to all us that we need to thoroughly interview prospective MCF’s to know, in advance, what care they can provide and what they cannot handle.