MC Falling Short of Care Plan

MrsAnnabelLee

A large portion of mom's rent is her "care" portion, as it should be. However, up until the past couple months, she really hasn't needed much direct care. By MC standards, she's been very independent. That's no longer the case. It became apparent that she was dealing with some incontinence and cleaning issues, and was no longer showering. I met with her MC staff to create an updated care plan that included washing her sheets 2x a week (they become soiled quickly), and giving her either stand-by or assisted showers.

I noticed the sheets weren't being changed, so I emailed her supervisor who said she'd address it. Another week goes by, and her sheets are still unchanged. I change them myself and send another email. Another week goes by and she's sleeping on a bed with no sheets.

On 9/9 she's given her first assisted shower. This does not go well, as we expected it wouldn't. She was very upset. I was assured by staff they would try different approaches to help her feel more comfortable. To my knowledge she has not had another aided shower since.

I sent an email over a week ago about these two concerns and copied the care mgr and exec director. No response. Followed up on Thursday of last week, again, no response.

I just sent another email requesting an in-person meeting. 

Is this normal??? How should I approach this meeting?

loveskitties

It is not  just that they are not following the care plan, it sounds like they are not following good health practices which is reportable to the state health agency.

Sheets which are soiled should be changed immediately not on a scheduled basis.

If you are not getting any positive responses from the management, then you should let them know you will be reporting the issues to the state.  

You will also need to be prepared to move your mom to another facility, as they may come back with being understaffed and cannot care for her.

harshedbuzz

Ugh.

This is a challenge. Your mother should not be sleeping on a bed that's not been made-up with sheets. And showers should be happening twice weekly with "spot cleaning" as needed with incontinence. Is your mother a difficult individual who might be especially difficult to coerce into accepting care? Might she be stripping the bed after it's made or refusing/hiding when it's shower time? It can be difficult for new routines to be introduced with a non-cooperative resident and medication might be needed if agitation is preventing care. 

Sitting down to craft a plan to correct this is a good first step. How do the other residents look and smell? Are they well cared for and it's just your mom? If that's the case, working with them to get mom more accepting or care makes sense. If the other residents look uncared for, it might be worth escalating to the ombudsman or corporate. 

Dad was very resistant to care. The staff kind of played it by ear that first month allowing him to opt out of showers and trying again later or changing his linens/collecting dirty clothes while we engaged him elsewhere. One thing that got him acclimated to showers in the MC, was my mom doing them the first couple times while introducing a caregiver slowly. 

HB

jfkoc

Please start by carefully reading your contract and looking up their license which will list all services they will provide.

If you are needing other than what it is written you may be asked to pay more.

Dave Cahail

Sorry you are dealing with this. This is not normal. 

Hold the facility responsible. Don't just rely on email. Document and take pictures of the lack of performance to plan. Hold regular meetings (monthly or quarterly" with key staff members, present your documentation and photos, have them lay out a plan to address your concerns as well as how you will hold them accountable. 

They need to recognize you together with them are the team to take care of your LO. And that you expect regular communication and confirmation of their adherance to the plan. 

If they don't meet your expectation, you may need to find another place that you can count on for the level of care you expect and want to see. 

BassetHoundAnn

I'm seeing the same problem at the memory care where I recently placed my mom. According to the written care plan she is supposed to have her laundry done every Friday. Has yet to happen. I've spoken with aids, complained to the director, talked to the head nurse. Everyone apologizes, promises that her bed and bathroom linens will be changed promptly in the future and her laundry done on schedule. The laundry never gets done. I keep getting different and conflicting answers as to why. I've been the one stripping her bed, gathering up soiled clothing from the bathroom, dragging the overflowing hamper to the laundry room. Ugh. I thought I would finally get a respite from laundry duties once mom got to memory care. 

A friend who went through this with her parents remarked "For some reason laundry is a problem for memory cares. Why can't they ever get it done?"

There is a meeting scheduled for next week with the nursing staff to review mom's care plan and laundry is obviously on the agenda. If this and other issues aren't resolved, well, I do have her on the waiting list for another memory care which is supposedly better about these things.

I just wanted to let you know AnnabelLee that you are not alone in this frustration. I wish you luck! Please tell us if and how the problem resolves. Best... 

harshedbuzz

BassetHoundAnn wrote:

 The laundry never gets done. I keep getting different and conflicting answers as to why. I've been the one stripping her bed, gathering up soiled clothing from the bathroom, dragging the overflowing hamper to the laundry room. Ugh. I thought I would finally get a respite from laundry duties once mom got to memory care. 

A friend who went through this with her parents remarked "For some reason laundry is a problem for memory cares. Why can't they ever get it done?"

One of the things I liked about dad's MCF (of course this was pre-COVID staffing issues) was that they incorporated laundry into an activity for those residents who had an interest- many of the ladies in the midstages did their own laundry as something to do with assistance and prompting from their aide. The laundry room was right off the kitchen and living room in each wing of the MCF. You'd often see residents folding their own towels and clothing while watching TV together in the communal living room. 

BassetHoundAnn

harshedbuzz wrote:

BassetHoundAnn wrote:

 The laundry never gets done. I keep getting different and conflicting answers as to why. I've been the one stripping her bed, gathering up soiled clothing from the bathroom, dragging the overflowing hamper to the laundry room. Ugh. I thought I would finally get a respite from laundry duties once mom got to memory care. 

A friend who went through this with her parents remarked "For some reason laundry is a problem for memory cares. Why can't they ever get it done?"

One of the things I liked about dad's MCF (of course this was pre-COVID staffing issues) was that they incorporated laundry into an activity for those residents who had an interest- many of the ladies in the midstages did their own laundry as something to do with assistance and prompting from their aide. The laundry room was right off the kitchen and living room in each wing of the MCF. You'd often see residents folding their own towels and clothing while watching TV together in the communal living room. 

Oh gosh, I wish my mom's MC would do this! During her last hospital stay the staff had her folding towels all day. To keep her from leaving the room and wandering. She seemed to enjoy it. Every day when I visited I'd find her amid heaps and stacks of neatly folded towels all over the room, busy, busy, folding away. She will NOT fold towels when her daughter does her laundry. Heavens no. <g> 

MN Chickadee

No, this is not normal in my experience. Things I might let go of: my LO's nails longer than they should be for a week or two, unkempt hair when I visit, wearing a sweater I don't recognize, a stain in the carpet that doesn't get addressed quickly, one or two showers skipped,  and yes, laundry taking a while. As long as she has bedding and clothes to wear the laundry not getting done on a set schedule is not the end of the world. Wet sheets, no sheets, and no shower for months is not ok. A difficult first attempt at an assisted shower should be followed by a second attempt within days with a different staff person, different approach. I know long term care is suffering extreme (dire) staffing shortages and other challenges due to the pandemic, but they still have a duty to keep your LO clean and safe. I would definitely ask for an in person meeting.  Not getting any response from managers or directors is a big red flag. I would approach a meeting as calmly as possible and be reasonable but firm. You aren't here to be a pain in the butt about things that could be viewed as inconsequential, but you are the advocate for this person who is a vulnerable adult who cannot advocate for themselves and you have to be able to expect basic hygiene is being looked after. If you don't get anywhere you may need to engage the ombudsman (if you look around the facility you will probably find posters of how to contact them.) You might also try buying a couple extra sets of sheets so they have plenty to work with. If they are still getting to know her in terms of incontinence they may be going through many sets in a week and the workers are so strapped for time right now.

Space within

  I agree with JFKOC- check your contract first and then go from there.

 Laundry was an issure when my mom was in MC.  I eventually came to the view of it being an issue from how the whole system of MC and assisted living facilities operate.

Before COVID we were doing my mom's laundry.  COVID came about and we'd skype with my mom and she'd be dressed in an outift that was not hers!  I had to just let go. and laugh and be grateful she was in a clean outfit!  But I went through some tears of sadness, no doubt.   

As for the bedding, we would have them put chucks on the bed. But the sheets would still need to be cleaned .  

wish you the best with getting this taken care of.