what is expected in memory care?

eoverton

I am trying to understand what is expected in a memory care facility regarding personal hygiene, dietary needs and housekeeping. We just moved my dad (just turned 86) from on memory care place to a new one, mostly to get him closer to mom so she can see him every day. THe old place had a TERRIBLE menu. Supposed to have fruits and vegetables, but everything was canned an mush. They said it was because people have bad teeth, which my dad does not. Others might, but his teeth are all his own and very strong. Unfortunately, he gained 10 pounds during the 5 months he lived there, and has ban knees and mobility issues, so the extra weight makes it worse. He uses a walker, but moved very slowly and is very stiff. Also receives PT and now OT as well.

The new place is a combination of assisted living and memory care. They told us when we signed on that he would be able to choose from the same menu as the assisted living menu, which has salad and fresh fruit offered at every meal. This was apparently not accurate. Now, I have request that he just automatically receive the "entree salad" from the menu every day for lunch and then just get fresh fruit with his dinner to prevent more weight gain. I have had asked this now twice, so perhaps it may now actually happen.

Also - other questions:

fingernails - they said they are not "allowed" to cut his nails. they can only file them, but they are so long now they said they are too long to file down. Therefore it is my responsibility?

ears - shouldn't they be cleaning his ears? he has horrible wax build-up. I do it when I can, but I also like to spend my time with him walking, talking or taking him out.

housekeeping - he is sharing a room with another man - separate bedrooms, but shared living room and bathroom. There is ALWAYS pee all over the floor around the toilet and the bathroom is disgusting. Dad sits to pee, but I think his roommate makes a mess. THere is also another man who used to live in that room who wanders in sometimes and maybe uses the bathroom? I was told we could not keep cleaning products in his bathroom, even though there is a locked cabinet under his sink. THey said housekeeping comes twice a week, but I said that they would need to come more. Meanwhile, I bought a swiffer mop yesterday and hid it in his closet. I sprayed down the toilet and the floor around it and wiped everything with a rag and bleach spray first. Then, I went over the floor three times with a new swiffer head, untill it finally came out clean. It was BLACK from dirt and grime.

I am going to send photo to the Executive Director about this. I have a full-time job and I feel like none of this should be my responsibility. Of course, I will do whatever I have to to ensure he is well cared-for, but I'm they will hear about it, for sure. We are paying about $3000 a month MORE that we were at the last facility. Mom can not see him every day, but still having so many issues with his care.

Is this what happens everywhere?

psg712

Services and the diligence of staff vary from one facility to another. I for sure agree with sending photos to the director and pushing for better housekeeping services. I would make the point that urine on the floor is a fall risk as much as if kitchen staff spilled water in the dining room and left it there.

Fingernails, ear wax ... in my mom's MC that is definitely not included in routine hygiene assistance. There is a podiatrist who comes every 3 months for foot care, but fingernails fall to me.

Dietary plans also vary from one facility to another. Keep your dad's needs in front of the staff. Show up randomly at mealtimes and politely remind them of what was promised and what you expect for him. I'm uncomfortable being the squeaky wheel, but it's been necessary at times to get the care I feel is needed.

ARIL

Agree with the previous commenter. What you describe is neither sanitary nor safe and should not be routine. With two—perhaps three—male residents using the bathroom, it needs daily cleaning.

Nail care: My dad is seen by a podiatrist quarterly for his feet; I trim his fingernails.

Meals vary. My dad has been in one AL and two MCs. The place he is now is by far the best for healthy food. It’s also the most expensive of the three.

All that said, I do a lot of my dad’s laundry and some cleaning. And I too work full time and want to spend my visits actually interacting with him. After many discussions with management, cleaning and laundry care have improved. Some.

harshedbuzz

@eoverton

Your concerns are valid, but not all of your expectations are appropriate to a MCF.

Regarding his diet, I would continue to encourage the staff to offer fresh options like salads and whole fruits; your dad has free choice at mealtimes and may be opting for sweets as most PWD do prefer sweeter foods. Understand, too, that in many states, there are mandates for the number of calories offered daily in residential care. Dad's MCF was excellent in most respects but the food didn't appeal to him. I typically brought a portion from my previous night's dinner or food from a local restaurant or fast food joint when I visited.

Regarding his nail care, most states have very strict regulations around who can do this. My state doesn't allow an aide to do this and most facilities would not allow even an RN to cut nails because of liability. Most MCFs near me have a weekly visit from a manicurist and a monthly podiatrist for nail care if family isn't managing this. I would imagine ear cleaning would be left to family or his physician. FWIW, mom's PCP won't even do this.

Dad's suite included a private bath, and it was cleaned if there was a soiling incident but otherwise it was attended to a couple times/week. Because he was on a corner near the common area, he had quite a number of visitors because he didn't keep his self-locking door closed. The rules regarding toiletries and cleaning products are pretty universal. I would speak to them about the grimy floors.

HB

April23

I had several of the same complaints at my dad’s MC AL. Instead of visiting my dad, I was sweeping, cleaning, changing linens, cleaning urine off the floor and begging them to do his laundry. MC also did not get the same menu as AL but we were allowed to take them to the AL dining room or bring in food which we would do occasionally. I hired a stylist for his nails and haircut and he was seen by mobile podiatrist. I feel your pain but the reality is that “assisted living” means they provide assistance with ADLs, weekly laundry and housekeeping and the rest family must provide.

My dad needed a higher level of care than MC ALs provide. My dad is now in a MC RCF and it is wonderful.

cat911

to ApriL 23,what is memory care ref? Please

cat911

sorry,meant RCF

April23

https://alzconnected.org/discussion/comment/263563#Comment_263563

Residential Care Facility or Residential Care Home. Some people call them group homes, Only 8 residents in a home setting and a very high level of care. A step above MC AL but not the skilled nursing level of a nursing home.