When placing in memory care is a nightmare

Nowhere

I’m curious how many with spouses/partners in small town facilities are still facing nightmares of Covid staffing shortage? My husband’s director often works the floor instead of directing, the RCC is pulled to do other jobs, the med tech position is substituted by a “trained” aide. The aides in my state do not have to be CNAs. And today? I asked to speak with the director and learned he was out for a few weeks and that the maintenance man is going to take his place!! I see residents who look to have not had showers, as was my husband’s case while I was away for two and half weeks.  I cannot get help for my husband to successfully brush his teeth or change his clothes into pjs at night even though working with staff  and new goals are in place. No one is following thru on the written goals. He is on state aide. I live a 100 miles away from his facility, and see him two times per week. It’s I who showers and changes his sheets because he refuses other’s help even if/when asked. This facility was not my choice, it’s was the only one who would accept him after he broke out the screen and crawled out of his first facility. 

I think I have to move to his town and be there every day to keep him safe and clean. I have so much guilt leaving him there and trying to live what’s left of my so called life. I’m an empty nester, relatives are out of state, my dear friends live on the other side of the country. It feels wrong to come back to a nice home when he’s living in a mental, and physical hell. Although physically he is fine! I mean his facility is horrible. I’ve been ten years care giving for my elderly folks who both passed this past year and living with the fallout of my husband’s Alzheimer’s since 2007.  His disease being insidiously entangled within me, always. 

I’ve reached out to a state ombudsman.

M1

Nowhere, that all sounds so painful.  I think it's true everywhere:  we're private pay, but even there the assistant director of nursing is working the floor most days because she can't find/hire help that will stay.  I think they've completely given up on keeping up with any required paperwork such as quarterly care plans, etc.  And I see the same thing in my work for state Medicaid program---huge numbers of home health needs for the elderly and disabled not being met because no agency can staff.  

I think you are doing what most families are doing, which is just trying to do the work because there's no one else to do it.  My heart goes out to you.

Beachfan

My DH is in a small facility (a 16-person cottage) which is part of a nationally recognized chain of NH's, rehab's, ALF's and stand-alone MCF's.  Since his placement in November 2021, I have seen a dramatic increase in staffing shortages.  His care remains constant and acceptable, but staff have shared how they are working overtime and double shifts to cover shortages.  The facility is private pay and although the cost has increased to cover "expenses", it seems the company still cannot attract and keep workers.  I think M1 is correct; it is a national health care dilemma (and probably will not improve in the near future.)

Like you, I try to help out when I'm visiting, and staff is always greatly appreciative.  I don't know how I would react if DH were not well cared for.  I hope you are able to figure out a solution for your DH and for yourself.  

harshedbuzz

Nowhere-

I am so sorry you are dealing with this situation.

I feel like the staff shortages are not just a small town/rural thing. FWIW, I have a friend in a more rural part of my state who isn't having the shortages of HHAs at her mom's place that I hear of in the suburbs. Maybe it's a crapshoot.

I know my dad's former MCF shut down a quarter of their facility because they can't fully staff the place. And my niece's stepmother had to move her kindship foster son to a pediatric medical care facility because she can't find competent people to fill the 50 hours of care provided by his waiver that allow her to work and keep a roof over her other boys' heads. So far the pediatric SNF seems to be appropriately staffed but I know it was almost 2 months to get a bed. 

HB

Nowhere

Thank you for sharing your thoughts. I think many of you know that I disguise myself when I go there so that his behavior doesn’t escalate as I’m considered a “trigger”. So, each visit I wig up and have established I’m his barber/housekeeper/shower aide. He knows he is my favorite person there. If I have any sanity left, it’s because I’ve devised a plan to be able to see/help him, I shudder to think of his first year in placement because I had no access due to Covid. True to my role, I do shave, cut his hair, shower, clean his room, and change his sheets because this is not done for him. Trouble is when I travel to visit family out of state (and the facility knows I’m going) he is hygienically neglected to the point he’s wearing same underwear two and half weeks later. 

It is upsetting that our estate owes at this point in time $200,000 for 2 1/2 years.  I think it’s sometimes assumed that Medicaid means free care once the spend down is met, but that’s not the case. The community spouse (care taker) can keep all the equity in one home and drive a new car, earn money and invest own money/ thank goodness.  But, once the care taker passes, the state (rightly so) will recover the monies subsidized for his care before any heirs receive a dime, but he’s not receiving our monies worth in hygienic care. 

Cherjer

Beachfan...what is the name of the facility? You mentioned it is a national chain. Not sure if you are allowed to mention on this site.

Beachfan

DH is at Linden Village in Lebanon, PA.  The parent company is Promedica (formerly Manor Care). Most of Promedica’s MCF’s go by the name of Arden Courts.  They have locations across the country.  I’m not sure why Linden Village goes by a different name; but all of their MCF’s are stand alone, serving only Alz/dementia residents, cost is all inclusive and private pay.

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ImMaggieMae

Nowhere, you aren’t alone with your concerns about staffing shortages in nursing homes and MC facilities. There is an article in the Jan/Feb issue of the AARP magazine talking about a large scale exodus of workers over the past three years and talks about the unprecedented level of under qualified staff that work in these places.  Some of this is due to many states adopting a temporary nurse aid (TNA) program allowing workers to be hired with as little as 8 hours of online training. 

According to them only 45% of nursing home residents and 22% of staff were up to date on Covid vaccines. This explains why so many people here have seen Covid in their LO’s facilities. It seems like requiring Covid vaccines for staff should be a given in a population with the highest death rates from Covid. 

sandwichone123

MaggieMae, they did try requiring covid vaccines, but that made the staffing shortages worse, because people refusing to be vaccinated had to be laid off.

Cherjer

Thank you Beachfan for the information.