Paying for MC but having to spend night with Mom

tramey50

My Mother is in MC, but has become a falling risk. Because of Covid, finding caregivers has been almost impossible so they have 7:1 resident to caregiver ratio, and say they will likely go 8:1. They are requiring that we spend the nights with Mom as they don’t have staff to watch/help her when she gets up and she’s had a couple bad falls. We took her off Lorazepam this week which may have been the reason for the increase in falls.

Any thoughts on our paying over $5000 a month and still having to stay the night to make sure Mom’s safe? We’re in a smaller community with few options. Any suggestions? 

Thank you.

Deanna_M

My mother's MC facility does 2-hour bed checks at night. Her facility was more like assisted living, so they provide some support with ADL, managed medicines, but the residents have their own apartments and are physically quite independent (no wheelchairs and can eat independently with prompts).

Towards the end of my mother's stay there, she started falling more often. She had an unwitnessed fall at night: she fell in the bathroom and hit her head. Thankfully the staff was nearby and heard her fall. She was hospitalized and then taken to a skilled nursing facility for rehab. The SNF and the MC facility decided that the SNF was a better fit for her because she was classified as a fall risk.

I honestly am glad that she is in SNF now. They have a monitor on her wheelchair and her bed, so they can be alerted if she tries to walk unassisted. The staffing ratio is much higher there too, so there are more eyes on her and more frequent nighttime checks. She has only had one fall since being there: that is quite different than the fairly regular falls at the MC facility towards the end of her stay there.

Do you think that your mom is at the appropriate level of care. Some memory care facilities provide more nursing-type services, allowing for aging in place. Other MCs are more like the place that my mother was (that could not fully accommodate a fall risk resident). Given my other family responsibilities, it would not even be an option for me to spend the night with my mother to ensure her safety, so if that were proposed to me I would have looked for other accommodations. If I had a choice, I may have looked into another type of MC facility. But the choice was made for me after she fell and was hospitalized.

I hate to suggest a move for your mom, but I wonder if you spending each night there PLUS spending $5000/month is sustainable?

PickledCondiment

You probably signed an agreement with the MC organization when you placed your mother.  Please review that document to determine what their responsibilities truly are, what are they providing, etc.  There certainly should be some room to negotiate what you are paying when you're actually doing the overnight shift (which is their challenge).   We all realize these places have staffing issues.  That said, expecting family to cover the shift, their staffing shortages  is truly unacceptable.

M1

I'm afraid we're going to see a lot, lot more of this for at least the next year.  It ties to all the vaccine and pay issues that are still out there and not anywhere near resolved.  We can't get home care and can't get institutional care either......If you were really brave, I'd think about asking whether they'll decrease their rates (!) since they are requiring you to be there.  Or:  short of that (which I freely admit has its downsides), would be interesting if there is a state oversight board or something like that you could take your concerns to.  Althugh again I freely admit, who has the energy?  But maybe worth thinking about.  So, so difficult....

Cynbar

Absolutely read your contract, but it has been discussed on these boards that MCs do sometimes require extra care to be brought in, either family or private aides. In fact, that's one of the questions suggested when interviewing a MC --- "Under what circumstances would you ask me to bring in extra help?" I don't think this plan is sustainable for you for long. It's probably time to look around for a good SNF to move her to.

King Boo

1:8 is a good ratio for patient care in Memory Care.  Night time ratios are often higher.  Our facility had 2 aides on at night, it was probably more a 1:15 ration 11-7 am.

They did hourly room checks so that if a resident did fall, they were not harmed by excessive time lying on the floor.

No facility can guarantee no falls.  Falls happen - a lot.  Sometimes multiple times a day during certain stages.

Our MC had a notification protocol for family and an assessment protocol after a resident fell.

It's curious that they are asking for family.   Do they not have medical services like a nurse and physician on site at least part of the week?   Some of the MC out there are what I call 'lightweight'.  They are fine with absent minded, light care levels of early to mid stage dementia - but when the heavy lifting in care begins; the increased monitering, charting of food intake, stepped up medical care - they fall short, sometimes shifting their responsibility onto unsuspecting family members in a cover themselves sort of way.

A good MC facility would be talking abou tthe few things they could do to minimize fall risks (environmental changes, rugs, grab bars,, physical therapy to increase muscle strength if feasible) along with stepped up monitering like hourly room checks at night, frequent during the day, possibly a walker if rx by PT.

If they are saying no falls should happen - look elsewhere at other facilities.  Preferably one that has a nursing home too to absorb the decline that is near if falling is happening a lot.