another memory care question

tucson anne · November 9

I've been looking at memory care facilities, most of which are owned by corporations, but a few are privately owned. (I'm not looking at the ten person homes yet—he needs more stimulation than they offer). I check my state health department website for complaints and citations for each one I visit. What I have found is that all the corporate ones have not infrequent citations for failing to update care plans (required every 3 months in AZ). This is not the case with the privately owned facilities. On the other hand, the corporate ones offer many more activities and mostly better space. I asked one salesperson and her explanation, not unbelievable,was that they did the updates but had to contact the caregiver for approval and often there was a lag in response. Have any of you looked at your memory care facilities for issues and are there similar problems? I assume it's because there's more staff turnover at the corporate places that have worse pay. I wish I didn't have the personality to study this to death!

Dio · November 9

I went with private owned, but looked into the reasons owners chose this business and philosophy to care. Corporate places are in for the money, IMHO. Whether private or corporate, large/mid-size/small, I don't think there's a perfect memory care facility. I also looked at the nature of the complaint(s) such as trends or if it was just a one-off. When you tour facilities, try to do some unannounced/pop-in visits and talk to other residents' family members. You'll get a better picture.

Nowhere · November 9

Hello-

My husband has been in four corporate run homes and on our case the care plans have been updated routinely at two of the homes. I suggest you visit and talk to the other families to seek their opinion regarding care, and observe the interactions and activities going on at different times of the week and day. Also important, ask how long the director has worked there. Director and activity workers are revolving door in some places. I’ve seen beautiful large calendars posted complete with hourly activities offered, only to not see the activities happening. The care plans can look good on paper, but are they revisited and followed? Yes, the workers are oft spread too thin, and work over time when another worker is ill or has quit. A big problem (to me) is to watch the aides who are sitting engaged on their phones or taking to each other instead of interacting with the residents. It’s the rare memory care facility where aides will do activities, house keeping talks with the residents, and LPNs help with feeding. The director sets the tone. At long last,, my husband is in a decent memory care where the director can be seen cutting up fruit for snacks, washing floors, checking rooms, and/or doing activities right along with the staff. She has her doctorate in social work and clearly loves the residents. There is laughter and joy and this feeling tone permeates throughout the twenty-two resident wing.

Dunno · November 10

Tucson anne, I have to tip my hat to hospice. They were so helpful transitioning my wife from the hospital to the memory care facility. I wonder if you were to call around and ask the directors of the different hospice providers in your area if they would recommend an MCF. After all, they visit and care for patients and get a firsthand look at the performance of each facility.

sandwichone123 · November 10

I have worked in long-term care and I looked specifically for a locally owned facility. I know there will be profit in any case, but an owner who is on-site will necessarily care more than a faceless corporation. Another thing to ask about is staff training, but I will say that corporations are really good at giving the right answers, and not necessarily as good at staffing adequately to make those promises reality.

SDianeL · November 10

I found that the stimulation was no longer important after a few months as the disease progressed he could no longer participate. I would be more concerned about the quality of care.

Joe C. · November 10

My DW has been in a corporate MC for 3 years and they do the 3 month care plan updates but honestly I do not see much value in these plans other than meeting a regulatory requirement. I have excellent communications with the nursing staff and I am consulted regularly on any small changes in care and immediately any more significant changes. I am at the MC almost daily so this helps with my communication. I can say that the residents that do not get regular visitors also receive the same quality care as DW but I obviously cannot know how communications work with their families. As for activities, DW is in stage 7 and cannot participate in many of the activities but still loves any activity that has music. Her MC has live music entertainment 4 or 5 and although she cannot speak more than 1 or 2 words she can still sing along with familiar songs and wants to dance. There is live music this afternoon and I will be there dancing with my bride.

harshedbuzz · November 10

@tucson anne

IME, the single best resource for quality of a MCF is a local support group. With boots on the ground, they generally have information about the best options for your PWD based on their presentation, assets and stage of dementia. My dad ended up in my second choice— a 40-bed dementia-informed standalone corporate facility. We were very pleased with his care. Another member here placed her husband in a different facility under the same brand and was similarly impressed. My top choice was a state operated veterans' home. My auntie was placed a large religiously affiliated CCRC's smaller MCF. Care was excellent and they were very fluid about integrating her with their AL population where appropriate in the middle stages.

I am fortunate to live in an area with a lot of options; I drove past 10 potential facilities on the way to the one we picked for dad and two more have been built on that route since his passing. I toured at least a dozen when looking and found things like ownership type, size, decor and religious affiliation didn't seem to factor into quality of care.

Care plans are not a hill upon which I would die if care and communication were happening IRL. I could drop in (or call) the DON or an aide if I had a question or concern— it went both ways. We often met informally to come up with strategies to improve his quality of life— the DON (who dad assumed was "the doctor") would give him handwritten invitations to the daily music activity to try to get him out of the room. His aide asked me not to bring him the hot coffee that gave him GI issues.

DS's facility didn't have the fanciest decor, but it was clean and easy for a PWD to navigate. Scheduling was done so that his main aides were scheduled Tue-Sat and Sun-Thu, so that he almost always had a caregiver who knew him and vice versa. His daytime aides had over 40 years experiences between them mostly in this facility. I was told this company pays a bit better than most and is quite accommodating of staff. On school holidays a few staff brought kids in to hang out in the activities area and on snow days, the DON picks up the caregivers in his big Suburban, so they don't have to drive in snow. One thing I checked when touring was the employee's parking lot; the newer and nicer the cars generally meant less turnover of staff and a better level of care.

HB

tucson anne · November 10

Thank you all for your thoughtful comments. Much to consider.

jfkoc · November 10

HB took the words out of my mouth. Your local support group is your best resource.

tucson anne · November 10

Thanks again but our local groups are mostly full of caregivers who haven't placed anyone in MC.

harshedbuzz · November 11

https://alzconnected.org/discussion/comment/228077#Comment_228077

True. Our was mostly spousal caregivers with their PWD still at home. That said, a few were actively looking for care themselves and had word-of-mouth suggestions from friends. One or two had done respite placements. The moderator ran several groups and had years of experience, so she was a great resource.

HB

tucson anne · November 11

I think I'll try a few new groups. They conflict with the one activity my husband does, a twice a week gym thing for 45 minutes. He won't notice if I miss it!

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