10 things "I've" learned about MC's.

ghphotog

These are just a few of the things I've seen in the last 6mo. My DW is in a fairly decent facility but there is no perfect place.

1. When you place your LO in an MC facility and walk away, that will be one of the hardest days of your life.
   
2. The staff are generally well meaning, caring and perform an incredibly difficult job day in and day out but like all of us they have their days.
   
3. The staff are not nurses and not well paid persay but put in very long hours pulling many double shifts a week, basically babysitting, feeding, toileting, showering, cleaning “messes”. Washing clothes. Dealing with emotions, outbursts. . . 
   
4. During off hours, overnight and weekends there are rarely more than two staff members onsite for all of the residents in a particular section, at times only one. I have much respect for them. It’s a hard job and you have to be wired and cut out for a job like that for not much money.
   
5. Just as you get to know,  appreciate and trust some of the staff they are gone and replaced by others. Are they caring, compassionate or will they treat your LO rudely and disrespectful? You won’t know until you get to know them and watch them everyday.
   
6. You will lose most of the nice clothing, items, wheelchairs, etc you brought in with your LO. It's very difficult for the staff to keep track of it all.
   Other residents are constantly going into each others rooms and walking out with things. The staff try hard to prevent that but it happens a lot. Not because they are trying to steal something, that’s just how many with dementia operate.
   
7. Many times you will find your LO wearing someone else's clothing not because it’s getting stolen by staff members but it just gets mixed up in the wash, literally. Even though you try to label it all.
   That’s OK as long as they are clean. My DW doesn’t know the difference anyway.
   
8. There are romantic hookups between residents sometimes. Don’t get jealous or upset if you walk in one day and see your LO holding hands with another resident. If that brings them some level of comfort then that’s alright. . . as long as it’s just companionship.
   
9. The food is just industry food and can be prepared very well one day and possibly inedible the next. 
   
10. There can be tension between some residents. You can’t have people living together without some annoying others constantly. There can be name calling and threats between them. Mostly when staff are busy trying to shower or clean another resident so their backs are turned. Many residents are like children and they don’t understand their own condition much less everyone else's. Be patient with the staff.

I'm sure you could add to this list!

fmb

@ghphotog This is an excellent list. DH has been in an assisted living facility (ALF) with enhanced services since last November, and all of this applies to his residence, too. I would add the following:

1. MCFs and ALFs are bound by state regulations that sometimes get in the way of providing care. Management and staff don't like them any more than family members do. It is always better to try to work with staff and management instead of assuming an adversarial position from the start. Choose your battles wisely.

2. When the time is right, a good team from a good hospice provider can make a world of difference in helping you and the facility staff provide the best possible care for your loved one.

3. If you visit your loved one often enough, you may become friends with some of the other residents and their loved ones. These people can become almost like family and can be a great source of support. We share resources and information and help keep an eye on each other's resident. We celebrate the good days and commiserate about the bad days, and yes, we console each other when our resident dies.

Beachfan

A comprehensive list, ghphotog!
One of DH’s cottage mates appropriated DH’s Phillies baseball cap and wore it or carried around all day, every day. One day I said, “ I see you’re a Phillies fan.” He said, “I hate the Phillies. The “P”stands for Palmyra” (his hometown). My little granddaughter got mad and stole the hat back. (Neither DH nor the other resident ever noticed. Both are gone now.) We smile at some of the memories. 😍

Joe C.

ghphotog, A well composed list. My additions.

1.Pitch in when appropriate:

a. If staff is overwhelmed at meal time help serving the meal.
b. If taking you LO out to a courtyard on a nice day offer to bring another resident(s)
c. Help guide other residents to and from activities.
d. If staff is not around redirect other residents when necessary.

2. Let staff know how much you appreciate the care they provide your love one.

Chammer

@fmb I agree that the employees in these facilities are bound by state and/or company policies. My son recently started working in the culinary department of a local Senior Living Residence - they provide independent cottages, IL apartments, AL apartments and a memory care unit - 2 dining rooms and the MC unit folks eat in the unit.

He told me some of the "rules" they must follow as employees for all clients who live there. A couple I agreed with - no CPR if someone becomes unresponsive - call 911 (employee may not know DNR status - the resident assistants don't even have to be CPR trained to work there), if someone falls- call 911 - don't help them up (client may have broken something and moving or helping up may worsen the injury) but the last one I said I might have to balk at if I observed and I worked or visited there and that is if someone is choking -don't assist - call 911. I would be very inclined to do something about that cause I think the terror while choking must be incredible.

He was just told the "don't's" not the why for the don't! I explained some of it to him.

ghphotog

https://alzconnected.org/discussion/comment/224415#Comment_224415

My mom's MC wouldn't let the staff help someone up who had fallen but instructed to call 911. Even if they were not injured. I don't agree with that but I understand it. My mom fell, hit her head, cracked her neck and had a brain bleed. She was in bed afterwards and nobody knows if she somehow hoisted herself back in bed or a staff member helped her even though they weren't supposed to. Never know the answer to that but fall can create very serious injuries even if they aren't obvious. So much litigation and liability in that business.

fmb

@Chammer

At DH's ALF, all staff are trained to assist someone who is choking and have done so a number of times in the special needs dining room where my DH eats. Waiting for 911 could be fatal.

@Joe C.

You make a couple of good points, especially about showing appreciation. I have helped set/bus tables and put garment protectors on residents in DH's dining room.

One caveat I would add is that most facilities do not want anyone but trained staff pushing a resident's wheelchair due to liability if a resident gets injured.

psg712

These are such great suggestions. I am a daughter, not a spouse, of a PWD, but I think all family members can benefit from these ideas. I try to show appreciation to the staff who put in such hard work for little pay, but sometimes my frustration at "policy" shows. It's good to remind myself that the real tyrant here is dementia.

Dio

I haven't visited since the one time that traumatized me. But I am in constant contact with the staff, especially the med techs, client relations director and the owner. I drop off meds and anything that DH is short on or have asked for, like more DVDs. It's a thank-less difficult job. To show my appreciation, every 2-3 months I'd drop off some treats such as donuts, empanadas, Asian BBQ pork buns, cupcakes, etc., for the entire staff—including maintenance, kitchen and housekeeping. Their favorite is a delicious guava pastry from a Cuban flair bakery.

frankay

The big thing I learned is that many MCs don't use a Hoyer lift. A very important question to ask when touring. If residents get to a point when they can't stand to transfer or go to the bathroom ( and many do) what then?

lenbury

This is a very good thread. I would add one more. Don't underestimate the complexity of medications. I had provided a very comprehensive list of medications and frequencies for my wife. I was told they could only provide medications as directed by her primary care physician. For example she would take an ibuprofen for back pain but without a written authorization from the pcp they could not provide that. I understand the legal reasons for this but it was very frustrating and one of the reasons we brought her back home after 12 days.

GothicGremlin

That's a great list @ghphotog .

One other thing I did — after my sister passed away, I sent an email to the executive director, the director of resident services, the memory care director, and a couple of the other "higher ups", letting them know how impressed I was with certain memory care caregivers. I listed some of the extras that they did to make my sister's life better. I wanted all of this information to be in the files so that caregivers get yearly work evaluations, they hopefully get raises.