Community Based Residential Facility Visitation

Annettefaye

My neighbor, Wally, had to move his wife of 65 years to an assisted living facility 12 days ago due to her severe dementia. The facility will not allow anyone to visit her. They are saying it will help her to adjust better to the change. Does anyone know if this is standard procedure? I tried to go check on her and they wouldn't allow me to see her. We are very worried if she is receiving the care she requires. If I take her Ensure, I don't even know if she is actually receiving it. Has anyone heard of this for residents that have difficult behaviors? We don't know if she is actually eating or bathing etc. Is it rational to be concerned?

Quilting brings calm

It’s standard practice in memory care. Memory care would be a more suitable location than assisted living for someone with severe dementia and behavior disorders. I would have thought Wally would have told you about the rule when you discussed visiting his wife with him. It’s also possible that Wally requested the staff to turn away visitors if they weren’t on a list he provided.

harshedbuzz

@Annettefaye

Hi and welcome. How kind a friend you are to visit us here and ask. You're going to be concerned, of course. But we have to trust that Wally has done his research on the matter and chosen well.

Are you using the term "assisted living" generically or euphemistically to describe a secure facility for people with dementia or do you mean an actual hospitality-model AL where residents get meals, medication management and a daily well-check?

Yes. This is very standard practice. It's not universal; dad's MCF encouraged it but didn't insist. We went to see dad during that time, and, in retrospect, it was hard for all of us. We were visual triggers he wasn't home which agitated him. In retrospect it might not have been a good idea.

The thought is that a 2–4-week period will allow the PWD to bond with their new care team. Once dad came to know and trust these people, he was much more settled in his new environment and mom could visit as a wife instead of the person nagging him to shower, eat, and take his pills.

It's also possible that the facility or Wally are restricting access to other visitors at this time. Many care facilities are still partially restricted because of the rates of respiratory illnesses and Noro virus in their communities. Or they may be gauging her reaction to a handful of close family to make sure visits don't overly upset her.

If you disagreed with Wally that it was time to place his wife, he may be restricting you in fear that you'd go in and share that opinion with her which would only serve to upset her. I had issues with an uncle who was not 100% supportive of the decisions mom and I made for dad because he was in denial about how bad things were at home. I was fortunate he only shared that opinion with me; otherwise I would have shut his visits down.

If you want to help in this situation, perhaps you could have Wally over for a meal or cake & coffee. My mom really struggled with being alone as she adjusted to dad being in MC. Placing a spouse in care is such a difficult thing to do. My small family made it our mission to take care of mom because she was objectively suffering more than dad was given the differences in their ability to parse the situation.

HB

Annettefaye

https://alzconnected.org/discussion/comment/200083#Comment_200083

I guess I wasn't very clear. I am helping Wally find out if restricting family visits for several weeks is normal or acceptable. He does not use a computer so has no access to these discussions. This isn't about me. He is obviously concerned not being able to check on her care. With all the stories of elder abuse it is very understandable. I live next door to them and see him every day. They are my parent's age, and I am very empathetic to his concerns. He called the care facility this morning and told them he is visiting tomorrow. Hopefully she has adjusted well. I didn't share with him that was not the facility in town I would have chosen. Unfortunately, there are waiting lists for open rooms in all the CBRF in town. Appreciate your response.

harshedbuzz

@Annettefaye

Ah, that makes sense. At least I was right about you being kind.

Yes, it is not uncommon for facilities to disallow visitation for the first 2 weeks or so. Sometimes, these facilities have a way of allowing the family to observe their LO without being seen through a window or one-way mirror and he should be able to call and speak with her team to get feedback any time he wants. In his shoes, I might want to speak with someone on each shift to get a fuller picture.

Dad didn't get into my first choice nor mom's first choice MCF. Mine had a waitlist longer than he lived once we placed him and the other rejected him. Our second choice wasn't as nicely decorated and looked a bit lived-in, but the care was exceptional. Many of the rubrics factored into the CMS ratings are self-reported, so I tried to rely on what I was seeing rather than weigh those numbers too heavily.

You're a good friend.

HB

MN Chickadee

Some places discourage visits in the first couple weeks to allow the person to adjust, but I have never heard of them actually banning a spouse or POA from visiting. In my experience they may say it works best to wait to visit but leave it up to the family to decide what is best for their loved one. I did stay away from the MC facility for a couple weeks for my mom to adjust, however this was totally my call and I still went a couple times a week to talk with staff about how she was, observe her from far, check the stock of toiletries in her room etc. She took a few months to adjust to memory care so after a couple weeks I started doing short visits. If she had not been receiving the care she needed I would have had no idea for months and a lot could happen in that time. I guess at minimum I would request daily updates on whether she ate, bathed, what she did etc. Even in really good places there are sometimes mistakes or oversights and the family needs to say please do xyz daily etc. If they are operating with zero concern for a husband wanting to know his wife is ok in a facility I would be very wary of that place to be honest.

Annettefaye

It has now been three weeks. I went to visit her yesterday and she still has not had a shower! If she says "no I don't want to" or yells at the employees, they just leave the room. It really appears to me that this facility is not equipped to handle a dementia patient who is not cooperative. She isn't eating and they told me they try to get her to drink an Ensure. I sat with her for an hour and a half and showed her videos of my dog playing and photos of the flowers I grew last summer. She seemed to remember them. She just wants to lie in bed and cry.

When they brought her soup in for dinner they just sat it on the counter and walked back out. I told her I would try it first. I got a spoon and took a mouthful and it was awful. Tasted like burnt potatoes. I choked it down and she actually laughed at my expression. Then she said "They are not nice to me. I am not eating that." I told her I would return in the morning with my dog for a visit.

I stopped next door to see Wally when I got home, and he is so very frustrated with it all. He checks with staff every day and always the same response. She won't let us bathe or feed her. This is very upsetting in that Wally is not healthy himself and their four children don't seem to think there is anything wrong with this and that it will improve per Wally. Only one of the son's lives in the area. If this was my mother, I would pull her out immediately and move her.

When I got there today her room door was locked. I found an employee and they said she tested positive for COVID. They told me they could unlock it so I could visit, but of course I wasn't going to do so. I have never heard of facilities locking the resident's doors.

I have done some research on other facilities in the area, and they sound more equipped to handle her care. Yes, Wally too has Covid and once he is better he said he will be visiting them.