Please help -having issue with Assisted Living facility LO is in

ryleepompa

My LO is currently living in an assisted living facility. Her Alzheimers has progressed throughout the last year of living here and we have had many issues with this facility adapting to her changing needs. The biggest issue we are facing right now is she is having a lot of bowel issues which is causing clothes and sheets to be ruined. We introduced her to the idea of wearing depends because she tends to have a lot of accidents and does not make it to the bathroom especially if she is out with friends/family or in a hurry. She is hiding her messy underwear in all different places. I want to reach out to the facility she is in and ask for assistance and any extra care they can offer her because I think she needs to get put on a bathroom schedule and also needs help with her daily hygiene. They have not been very good about adding new plans of care to her routine, sometimes they don't even watch her take her meds so she will store them throughout her room. My mom has been going over there and throwing away her ruined sheets and underwear a few times a week and she feels helpless at this point. Any suggestions would be very helpful, we are desparate!!!

H1235

Welcome. In my experience assisted living is very much just a bit of assistance. If they are not watching her take her medication then expecting them to help with difficult toileting seems like wishful thinking. Even if they come up with a reasonable care plan with you, will they be able to follow through with it? I found moms Al staff untrained and inexperienced (unfortunately I didn’t figure this out before moving her there). From the problems you are describing it sounds like it may be time for memory care or a nursing home. Even if your lo still seems pretty “with it” and not ready, I think the toileting issues mean it’s time. They will have a staff that are familiar with these kinds of difficult situation and will know how to handle things.

Quilting brings calm

when my parents moved into AL, the AL told me they provide some assistance, medication management, laundry, housekeeping and some hands on such as dressing and shower assistance. However they did not ( and do not) change diapers. Unless the resident goes on hospice.
I think your loved one needs more care than the AL provides.

SDianeL

memory care facilities are more familiar with dementia caregiving including incontinence issues. I would recommend moving her. If the AL facility has a memory care wing I would discuss with the social worker or director.

harshedbuzz

@ryleepompa

Hi and welcome. I am sorry for your reason to be here but pleased you found this place.

To my ear it doesn't sound like this facility is a good fit for your mom. Is this a hospitality-model AL or a secure (locked so residents can't leave on their own) enhanced AL for Memory Care. Traditional ALs generally provide meals, medication management and some routine assistance and prompting around hygiene and dressing. It's more for folks who are frail or have mobility issues.

Hospitality-model AL isn't designed to deliver the kind of care your mom needs in this stage of dementia. Bowel incontinence is generally a symptom of stage 6 dementia. I'd look at moving her to an actual MCF where the staff ratios are better and care is dementia-informed.

Until you are able to move her, it might work to hire extra private pay aides to help with this issue.

The other piece is your description of her incontinence. If she's soiling herself multiple times in a day and the stool has a diarrhea-like consistency, she may have encopresis which is a stool blockage around which softer stool escapes. If this is what you're seeing, a visit to the doctor is in order to rule this out.

HB

Anonymousjpl123

@ryleepompa I’m so sorry you and your mom are going through this. It’s the worst. Also, it especially sucks in my mind that AL is often framed as a place with “support” for dementia but as others have said, the support is really minimal.

MC is way more expensive but will provide support for incontinence and med management. A good one should know exactly how to deal with this and more - everything that comes with dementia. That’s why they are so expensive.

That said, it’s often more affordable than at home care or AL + aide.

And by the way you’re not alone: incontinence and medication are two of the hardest things to manage.