another MC policy question--your experience?

M1

Curious about other people's experiences.  In my partner's current facility, we have had recurrent problems not only with not having toilet paper out in the bathroom, but also no towels and soap.  They insist that all toiletry supplies remain in a locked closet all the time, but --despite multiple requests, after nearly a year--have yet to supply me with a key to that closet that works.  So when our friends were there this week, she went to use my partner's bathroom and didn't have access to anything to wash her hands.  They say that they always supply these things when needed---but my partner is still independent with her ADL's and does not require bathroom assistance yet.  So it doesn't appear that she has access to these things either, unless there happens to be a care associate in her room.

Have others of you with LO's in MC run across this?  Is it in fact a widely accepted policy?  Seems to me like there could be some middle ground here.  Yet another reason why I'm considering a change, the communication on personal care issues has been far less than ideal.  I know my partner triggers off of me, but some of her complaints may have a factual basis.  Very hard to know.

Keep your fingers crossed for me, communication with my preferred facility is still pending.  And if that doesn't work out, I think I am still likely going to pursue a change.  They've ticked me off now one too many times I think.

harshedbuzz

M1-

Fingers crossed for you.

Dad's facility required family to provide incontinence care and grooming type products but not TP.  I don't recall him ever running out; there was usually a new roll on the back of the toilet. The latter were secured in the vanity under the sink and staff would open it if you wanted to access it. Dad had his own cloth hand towels in his bathroom which the staff washed.

HB

ImMaggieMae

No experience with MC’s , but from everything you’ve written about the the place over the past year, I wouldn’t hesitate to find her a better facility. Towels and soap and toilet paper are basic sanitation issues. Having a music entertainment program and a few aids that she likes doesn’t make up for all of this. It seems like there is just one issue after another. I know you care deeply about her and this is very stressful for you. I hope the place you like can take her.

GothicGremlin

Hi M1 - my sister's facility is similar to your partner's. They always have TP in the bathrooms, and as a backup they have hand soap in a dispenser. Everything else - shampoo, conditioner, lotions, towels, incontinence care (underwear, wipes, etc.), shirts & pants, are kept in the locked closet in Peggy's room. I don't have a key.  If I need help with something, I need to go get one of the caregivers to unlock the door for me.

I don't know if this is how all memory care facilities work, but this is what I've experienced. We're in California.

Jo C.

Gosh M1; the more I hear, the more I understand the depth and breadth of the concerns you have regarding the present facility which does not seem to be meeting the needs as they are for your partner.  It is interesting that the couple who are close friends and visit her also feel that there is a need for change; have they detailed why they too feel that way?

With my mother, step-father, MIL and GMIL; all who had dementia, there were seven care facilities that were used for long term care over time between all of them.  In these facilities, toilet paper was provided by the facility as was hand soap in a dispenser in the bathrooms. Towels were provided with the bathing/washing. The facilities had shampoo and body wash soap for bathing, but we brought shampoo and body wash for two of the ladies as  they had delicate skin and it was milder.  Three facililties provided incontinence supplies, but we ended up purchasing our own as they were of much higher quality for fit, comfort and effectiveness.

The only things not openly provided were personal care items such as toothbrushes, deodorant, hand lotion, hair brushes; shaving soap and razors.  Had our LOs not had their own, the facility could provide, but the request was to bring in those personal care items as well as clothing.  Also; lipstick was not provided, we brought in our LOs.  Beauty shop was on site and we had ongoing appointments for shampoo with cuts as needed.  Fingernail care was done at all facilities at no additional charge.  Did have to ask that nail polish not be used as our female LOs did not like nail polish.  Toenails were routinely cared for by in facility routinely scheduled visits with a podiatrist.  By the way, these were not posh up-scale facilities; they were middle class all the way and all but two accepted Medi-Cal if private pay ran out.

In your situation, from your writing, it appears there has been difficulty with communications coming to you from the staff.  There also have been a few strange requirements for accommodating your LO, such as the toilet paper fiasco; as well as so much having been missed or lapsed.  Also an issue appears to be not being able to meet the higher functioning capabilities of your LO as well as what appears to be difficulty in one way or another to meet her psychological needs as well as missing physical care issues, that I can almost feel your discomfort as you have shared those times with us. Especially being that you are a physician, this undoubtedly resonates even more strongly for you.  Simply holding her in place without working with the needs or missing them as they evolved, may (or may not) possibly be part of the problem.

From "knowing" you here on this Forum, and being aware that you have a good relationship with the care facility staff despite the challenges, I get the feeling that you are not a nit picker and that you do not fuss the tiny stuff, but are concerned regarding significant issues that have been going on over pretty much the entire length of stay despite the management and staff meetings and follow through has not been forthcoming.  Question is; will this be able to be redeemable for the important things on a consistent basis?

So hope that you are able to get positive feedback from your preferred facility.  The present facility need not know what you are doing and where the dynamics lie unless or until you are ready to make a change if that is to be your decision. As has been mentioned by some of us here, you are an intelligent, experienced, well-versed medical person and you know your LO very well in all ways; it is probably best to assess all of the bits, pro and con re making a move if the other facility can accept your LO, and then trust your instinct after that and see where it leads you.

Sending best warmest wishes for all to work out for the very best whatever is decided and will wait to hear from you; we are of course, thinking of you.

J.

Joydean

Definitely have my fingers crossed for you and your partner!  I have no experience with MC personally, but my SIL is in mc. My niece and I talk quite often about this, the mc SIL makes sure soap, hand towel and tissue paper is always in bathroom rooms. Niece does have to buy the tissue paper and hand towels. Basically provides all personal care products, and she has a key to the locked cabinet. She goes every other day to visit her mom, so she can see what is getting low and restock it as needed. A few times my niece noticed that the supplies were disappearing way too fast, so she started taking a picture of cabinet right after she restocked it. The next time she was there the director mentioned that her mom’s supplies were getting low, my niece showed her the picture of all the supplies and asked director where the supplies went. She’s never had a problem with supplies disappearing again. 

Really hope and pray things work out for the best for both of you.  

Nowhere

My husband is continent and at his facility it is expected that families supply personal care products, including toilet paper and hand soap. I buy 8-12 rolls at a time and store them in plain sight in the bathroom so he can find what he needs when he needs it. Every time I visit I make certain he has a second (open) replacement hand soap if his first dispenser is not at least half full. I switch out his hand towels and change his sheets frequently. It’s been my experience that residents who are continent, conversational, and ambulatory fall thru the cracks of memory care. I live too far away to visit him everyday and am considering moving closer. He sleeps in his clothing at night and doesn’t brush his teeth. We had a big win today! He allowed the aide to remain in the bathroom while he showered and she was able to remind him to wash his hair and help him get into clean clothes instead of putting back on his dirty ones. It only took him 2 1/2 years to get to this point! It was such a relief to me, but Ying/Yang as it’s only because the disease is marching past his sense of independence and control.

Joe C.

M1, The MC That my wife is in provides toilet paper and only one time in 15 months have a found the toilet paper roll empty. I do provide all other personal care items. They can not leave soap out in Her room as DW will try to eat or drink it. Hand towels are sometimes not out but I know where they are kept. The facility also has a visitors restroom off the common area which is fully stocked.

M1

Thanks, these perspectives help a lot.  Supposedly there is now a key waiting for me (I've had two attempts previously, neither of which worked).  So...we'll see.  And I'm going to let our friends ask about soap dispensers--I think any suggestions from me are probably kryptonite right now.  

Nowhere, I think you're spot on, continent, conversational, ambulatory-AND a true claustrophobic and a lifelong loner/individualist describes my partner to a T.  There are some situations were it's a disadvantage to be unusual and this is one of them (you also never want a doctor to tell you you're unusual).  There is some validity to her discontent and thought I am sanguine about making everything better, I have to at least try.

DJnAZ

My wife's MC facility limits toilet paper to one roll due to several instances of residents stopping up toilets by putting in too much paper (full rolls in one case) and flooding their room. Now there is only one roll available on a dispenser. There is only a small hand towel and washcloth in her room.

Personal grooming items are not provided by the facility, although my wife's insurance includes a personal needs allowance that provides shampoo and other needed products. The facility only allows liquid hand soap in a dispenser on the sink over concerns of residents ingesting soap/shampoo. Her shampoo is kept in a locked cabinet.

All showers in my wife's facility are disabled due to...you guessed it...covid. While they blame the pandemic I believe it has more to do with being very short staffed and a corporate concern about liability should a resident slip and fall. Taking a bath and/or shower now must be in a separate room with one or more staff present depending on the residents mobility and ability. My wife does not like this arrangement and must be sedated before she can be bathed.

I have come to expect as little as possible from the facility and I'm surprised when something they do seems normal. There is a serious shortage of trained and competent staff and turnover is constant. The facility has not had an executive director in 6 months. They get around regulations by bringing an "interim" manager from another facility as they look for the "right person".

Good luck with either improving your partner's current situation or finding a suitable facility. I am also considering moving my wife to a more accommodating facility should such a place actually exist.

Jo C.

I have been slow on the uptake!   After reading all of the Posts, it dawns on me that we may actually be speaking of two different types of care settings.

While my LOs were in Memory Care and SNFs after that, they were not licensed and dedicated as Assisted Living. 

In an ALF licensed model for memory care, in all probability that is why one must bring in one's own toilet paper, soap, towels, etc.   In any Assisted Living setting, one bring's in one's own supplies same as if it was an independent apartment setting even though it is Assisted Living.

May be varying models, but that is my guess.

J.

M1

One hour of decent time together today when an old friend/former customer of hers went with me to see her.  Immediately resentful and hostile toward me when he left though.   Despite the renewed promises, still no key waiting at the desk as I was told--so no way for me to check her closet.  Art activity (making valentines) going on when I got there with 8-10 residents in a back room no more than 15 x 20 feet--too claustrophobic for me and I'm not sensitive.   But I think I'm looking for things to criticize at this point.  I have clearly crossed a barrier in my own mind, I don't want her to stay where she is.  Not working well enough for either one of us.  

One  piece of good news--the place I want her to go IS willing to reassess, have asked for updated medical information.  No timeline yet and it's not a definitive answer, but at least it wasn't a denial.

Joydean

That is good news!!

jfkoc

agree...good news

Ed1937

M1, I'm happy for you. Happy that you had one good hour with her, and happy she is being reconsidered. I'll keep you both in my prayers.

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M1

Indeed he was. Agree on all fronts Victoria, my buttons have been overly pushed. I had hoped not to burn bridges but where there's smoke there's fire.

MaryG123

That’s just what I was thinking Victoria2020.  Yuck!

Rescue mom

I’ve been “touring” MCs for my DH, the last couple weeks. M1s earlier experiences were always on my mind…all the places I went (five) included/provided TP, towels, sheets and linens, and some/most toiletries. If you wanted to bring your own, that was fine. (Most people prefer their own toiletries, especially).

  We didn’t get into any restrictions on soap etc. being on-hand. I do know they all had hand soap available in bathrooms I saw, including residents’ rooms.  Never even thought about that, although now it’s mentioned, I can see how some might try to eat or use inappropriately. That was only an issue for us with DH using bad stuff on dog.

I had it hit home again, though, how vastly different facilities can be in using the terms MC and ALF, and what gray areas exist. There are legal requirements for ALFs, but how they “blend” or differ or merge with MC, can be a whole different thing—at least IME, in FL.

jfkoc

Just an FYI shared on another post;

facilities must provide all services noted on their license!

M1

Rescue mom I just posted on your thread too. After yet another email today, I’m told again that there’s a key waiting for me now, and they are going to get her some nontoxic hand soap that can be left out.  After a rather short email from me on Friday, the young activities director finally sent me an inventory of her supplies. Ten months later, it’s a step.

MN Chickadee

My mother was in two memory care facilities. The first one the family had to provide everything except toilet paper. They did inventory monthly and called me with what was low. The second one provided absolutely everything like shampoo, depends, lotion, everything.  In the first one she was mobile and could really make a mess when left unattended. For this reason they removed almost everything from the bathroom like toothpaste and shampoo and kept it locked up, but there was always a roll of toilet paper and a hand soap dispenser that was bolted onto the wall. To not provide access to those two items seems insane! They did encourage guests to use the public bathroom instead of the one in the room for a variety of reasons but still. There should be soap and TP in a bathroom for anyone who goes in there. I hope your other facility works out. It sounds like you know in your heart you have to try something new.