MC logistics issue

M1

My partner is withdrawing in MC because she's reacting negatively to some new residents.  Has anyone else had this kind of issue?  I went in to check on my partner yesterday because twice in a week, she hasn't wanted to get up, get dressed, or leave her room.  They had called me concerned that she was ill, but when I got there she was fine.  But she had told me Friday that one new resident had been chasing her relentlessly, and another (who sat by us during music) was clearly driving my partner crazy because she was clapping out of rhythm to every song.  And a third--a sweet guy, but very big at 6'5" and well over 250 pounds--made a concerted effort to enter my parter's room--and this concerned me for multiple reasons, including because she nearly slammed the door on his fingers.

Her room is unfortunately a target for wanderers because it's right by the dining area.  I've emailed the staff this morning when it dawned on me that her withdrawal is probably a reaction to some of this.  But I don't know whether to ask for a room change too?   I can imagine that changing rooms now might present other problems, because she's now used to that space and might get confused by a change.  But I'm wondering if any of you have encountered similar issues and found solutions, or have negotiated a room change within a facility.

I think I'm also going to ask about room or hallway cameras.  I don't think they have them, and I can see how cameras in the rooms might be problematic, but maybe cameras in the halls that could be monitored from the nurse's station might help with some of this.  Just trying to think out loud here.

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dayn2nite2

Get a room change - too much activity by the dining room.  She would do much better at the end of a hallway.

harshedbuzz

M1-

I am so sorry for this situation. 

I agree with the others that it makes sense to ask for a different room when one becomes available. My dad's room was the first door in his hallway off the central activities hub. This left him vulnerable to both "space invaders" and "shoppers" from his and the other halls. His door was fitted with an automatic locking mechanism, but he preferred having it open. Given his dementia, there was no ability on his part to parse the cause and effect in the situation nor ability to understand his role in it. 

Dad was also aware of the limitations of the other residents and could be quite harsh in his opinions of them. Given the nature of a MCF that allows residents to age in place, turn-over and decline can change the feel of the community in a surprisingly short time. 

That said, I wonder if she hasn't had a further decline in the time since she needed to be placed. Dad became less engaged as the disease progressed despite his care team pulling out all the stops. Staff tried seating him with a group of guys, then a nice lady who was so well groomed I assumed she was staff and a woman who looked to be in her early 40s to find a good fit-- he found faults with all of them. His DON even sent dad a note daily inviting him personally to music activities he thought dad might enjoy. That worked for about a week and then it was back to the inertia of lying in bed between meals. 

HB

M1

Yes HB, she has definitely declined since admission last April, but she is still very reactive to the other residents and like your dad, mostly harsh in her assessments.  Despite her decline she remains one of the more interactive people there--and she has not found anyone to make friends with other than the staff.  There have been two unexpected deaths in the last two weeks and therefore significant turnover, and currently she is very unhappy.  I take what she tells me with a big grain of salt, but I have witnessed some of the negative behaviors of the others--and my partner is apparently not the only one who is upset.  I'm sure this kind of turnover is always a challenge for the staff.

Unfortunately given the layout of this particular facility, I don't know that a change in room will help, though I will keep it in mind.  The downside of her location is that hers is the only room with easy access to the dining area, so it's a target.  But--it's in a corner, and away from the main activity room, which is a good thing.  I'm not sure that moving would help.  Like everything else, there is just not a way to make her happy at this point.  But I am going to try to remember to keep my antennae up for this kind of withdrawal when there are turnovers like this in the future.

Fortunately the very large man who was trying to get into her room is being moved (out of the country in fact) in March.  That will help, he is intimidating for most of the staff.  Usually he has a full-time sitter, but she wasn't with him last week for some reason (staffing shortages, again). 

dayn2nite2

I also don't understand the timeline here or the fact that one wouldn't be aware of an inheritance affecting eligibility.

Medicaid is for those who have run through their resources.  When my mother went on Medicaid, we had run through all of her resources AND even my own retirement account trying to keep her out of a facility.

In hindsight, not a wise thing for me to do but oh well...I guess I'll qualify sooner, won't I?

So she was destitute, with only her Social Security check coming in.  Being destitute, she was a shoe-in.  And every month, I wrote a check to the NH for all but $60 of her Social Security benefit (allowed for personal expenses per the state)- that was her contribution toward her care and the state picked up the rest.

There is also the issue of hospice.  Hospice is not covered by MediCAID - that is MediCARE and those services are covered by them.  The Medicaid (if he qualified) would pay room and board.

ImMaggieMae

M1, maybe it was the two deaths that are affecting her. Even if she wasn’t interactive with them, if they were around at meals or activities she may be aware that they’re missing. That may feel like a loss for her even if she didn’t like them.

MN Chickadee

New residents were always disruptive at my mother's MC. The staff don't know them well enough yet to have the right tricks up their sleeves and each new resident comes with their own set of challenges and behaviors to be worked out. It's hard when it's multiple new people at once or back to back turn over.  If it were me I would give it a few weeks and see if things settle down a bit before deciding whether a big change is needed. Or it could also be that your partner is just having an off week and wants to lay low. My mother had inexplicably bad days and weeks sometimes. Maybe something going on we can't see. Perhaps fighting off a germ or sleep disturbances at night causing daytime fatigue or something. Has she been checked for UTI? Any chance her meds need to be tweaked?