Mom is getting bored in Memory Supported AL

Kristenlc1

Hello to everyone here, I am appreciative of this board and those who participate in it! I am out of town but I talk to my mom and hear her complaints that there is nothing to do in MSAL. My sister has talked to the Activities Coordinator who allegedly has tried to do some actitivities one on one with my mom. I think the staff overall does not have a great manner with her- they can be a little pushy versus adept at building rapport and my mom reacts strongly to being overseen, if that makes sense. The Social Worker and director of MSAL are…not great. The social worker will only respond if you copy her boss and then not even always. For those of you who have struggled with communications with staff at a facility, I would love any shared experiences or advice in the following areas:

1. How reasonable is it for staff to track your loved ones activity levels? My mom's was being monitored when she first got there…but ongoing, are there monthly meetings where residents are discussed? What sort of regular feedback on whatever a loved one is being monitored for should a caregiver reasonably expect?
2. My sister and I have hired an outside geriatric social worker/care manager to assist with my parents' decline and my father's being on hospice while my parents were in independent living. Now that my mom has moved to independent living and has lost her private caregiver who was helpful in providing the social worker with insights and acting on her advice —I don't know what an effective role for the geriatric social worker would be. for anyone who has used a geriatric social worker- do you have recommendations or shared experiences for how they have helped communications with facility staff or improved a loved one's day to day experience?

3. My mom's preferred activities don't involve organized craft times or classes or social events with other residents for the most part. Prior to her illness she liked window shopping and coffee with friends. She just likes to be out and about. Her best interactions within her AL community seem to involve bumping into people in the cafeteria or hallways and chatting. I am considering suggesting we hire an outside caregiver to come in a few hours a week to facilitate these types of activities. Any tips or experiences regarding bringing a private caregiver into a facility? I am sensitive to how my mom might feel about this, since again she is sensitive to "needing to be looked after." But I have seen that the benefits can outweigh these temporary feelings if my mom enjoys the activity and the caregiver is skilled in interacting with her and a good match.

Thanks so much, I know this was a lot, but if any of these situations strike a chord I would love to hear your thoughts.

​fesk

Hello - I know nothing about how to interact with facilities. I'm sure many will offer advice. I came to say the immediate idea that popped into my head was to hire a private caregiver to provide the social interaction your mom needs. You already thought of that. I think that's your best bet at keeping your mom social and engaged. If she is still able to go out and do window shopping, etc., let her with the caregiver. As for geriatric care managers, she should be able to hire/oversee the caregiver for you as you are not local.

harshedbuzz

@Kristenlc1

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

A couple of thoughts—

The staff at a MCF can be unreliable at getting a PWD to activities. The caregivers may be distracted by the needs of another resident in the moment. Exit seeking, a bathroom accident, tears, other families checking in after a visit can waylay the best intentions.

Your mom may refuse to go, and they really can't force the issue. Dad's DON and AD really put themselves out trying to engage dad in activities and socialization. They moved another gentleman into the neighborhood at about the same stage, the DON sent him written invitations to attend music events (this typically worked) and the AD even brought out a putting cup and clubs. The latter might have been successful if someone from staff (he recognized the impairment of others and avoided them) were to engage with him but that's just not possible with 44 other residents.

We aimed for getting dad out for meals and at least one activity a day. Staff would make sure his door was locked (he did have a key but never used it) to encourage him to be out of the room.

A number of families hired private companion care for their LOs. Most visited a couple times a week. There was one family who had an aide come help mom dress and style her hair daily. There was another very elderly woman whose DD and SIL spent winters in FL who had a companion come daily to do puzzles and color with her. She would not do this as part of a group.

HB

H1235

My moms facility has a coffee club. It really doesn’t amount to much other than residents sitting around, drinking coffee and chatting. There is usually a staff member that attends and poses questions and keeps the conversation going. Many with dementia just don’t want to socialize. Even though they complain there is nothing to do. They are restless and uncomfortable with their limitations. Could depression be an issue? Does the facility offer a calendar of activities for each month. If you had access to this could you call an encourage her to attend activities you think she would be most interested in. If she doesn’t enjoy the organized activities (crafts, music, bingo) Im not sure what you expect staff to do. It took me a while to accept that mom can not be forced to do things she doesn’t want to, even if it’s in her best interest. It’s a hard reality to accept. As far as meetings go, mom’s facility does a quarterly care conference that they insist mom has a right to attend. It’s pointless since I can’t really express any of my concerns in front of mom. They usually report that mom generally attends 2 meals in the dining room a day and occasional activities she is interested in. Sort of vague.

dcare45

I don't know anything about the other issues however I like this suggestion'"

I am considering suggesting we hire an outside caregiver to come in a few hours a week to facilitate these types of activities.

if you don't tell your DM the person is an outside caregiver she will probably assume they are friendly staff she happens to bump into now and then, not someone that is taking care of her.

[Deleted User]

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Kristenlc1

https://alzconnected.org/discussion/comment/278215#Comment_278215

Hi HB, I appreciate your very thoughtful and helpful reply. I definitely think it is time to hire the companion. And your experience with staff and care meetings is helping me to adjust my expectations as well. As for cooperative v more aggressive - cooperative has always been my default. I have kids with special needs and a ton of experience working collaboratively with their case managers. But I sense this situation is a bit different…if I had a crystal ball I would love to know if people generally get further with a squeakier-wheel approach. Thank you again and take care!

Kristenlc1

https://alzconnected.org/discussion/comment/278232#Comment_278232

thank you for your reply. Agree she would just think a friendlier staffer with a car was on hand and it was her lucky day!

Kristenlc1

https://alzconnected.org/discussion/comment/278224#Comment_278224

thank you so much for sharing your experience. Point taken that often people with dementia don't want to socialize even though they say they do. I do like that at least staff is attempting to facilitate interaction - not sure that is even happening at my mom's facility. I can understand your frustration about her having to attend the quarterly care conference, too. Best wishes to you and thanks again.

Kristenlc1

https://alzconnected.org/discussion/comment/278215#Comment_278215

https://alzconnected.org/discussion/comment/278215#Comment_278215

@harshedbuzz. Thank you for the very thoughtful reply. Going to move ahead with trying out a caregiver—even having someone to chat with would really break up her day. I would love if the community encouraged more interactions with neighbors the way staff at your dad's did. I really think there is a lack of attention to these kinds of attempts at my mom's AL - even if they aren't successful, it's good the staff at your dad's MC was trying . thank you again and all best to you.

harshedbuzz

@Kristenlc1

It's frustrating. My aunt who had been something of a hermit living 16 miles out on a peninsula in an area of summer homes blossomed in MC. She was so socially appropriate and crafty they included her with the AL folks her first couple years. She also formed deep bonds with 2 other residents in the 8 years she was in MCF even after neither spoke; she and the second man died within hours of each other. Dad perceived the cognitive changes in the others and dismissed them as "coo-coo for cocoa puffs"— even one woman (the one with the visiting dresser) who presented so well I thought she worked there for weeks.

I did really appreciate that dad's MCF tried to make it easier for residents to form relationships. MCFs tend to be estrogen-soaked environments. The majority of both staff and residents are women which can mean activities that are more familiar with and appealing to women. It can be hard to find engaging activities for men though I know it can be hard to engage some PWD. The man who was moved to dad's wing for male companionship for them both had owned a restaurant. He treated the dining room as his fiefdom— seating people, setting tables, bussing them after and generally puttering around the space between meals.

If your mom had a career, may you could find something along that line for her to do. My aunt (former executive secretary) loved stapling things together for a time, one woman at dad's placed graded papers (she'd been a teacher/her daughter collected her 2nd grader's tossed work). MIL didn't have dementia but could get fretful, having her mate socks or unstring beans for dinner made her feel useful.

Interesting. I, too, spent my son's K-12 years collaborating as part of a series of IEP teams. I was pretty good at creating goals and benchmarks. Some of those skills have stood me in good stead— collaborating and keeping my cool when utterly exasperated for instance. But I prevailed— my son is a college graduate about to start a nursing program. But this is different. For one thing, your parent's status as an adult makes them entitled to a certain amount of autonomy a child hasn't earned yet. Also, dementia progresses in one direction only; the outcome is predetermined no matter how diligent you are.

HB

terei

https://alzconnected.org/discussion/76644/mom-is-getting-bored-in-memory-supported-al

I hired a wonderful person who saw my mom once or twice a week who visited with her, took her to lunch, Dairy Queen, drove around to garage sales, parks, bookstore, walks, etc. My mom loved her and it helped me feel better about not being able to be with her as much as I liked. The woman had worked in ALs in the past and was very familiar with PWD