Questions about memory care

Mitsu2 · September 20

My husband has been in a secure memory care unit for 3 weeks. It's noisy and the shared areas are crowded. About a third of the residents are non-verbal. There are 18 patients with a nurse and two CNA's. After lunch, everyone is told to go to the TV room where they seem to stay until dinner, unless they decide to take a nap.

There doesn't seem to be much help for those who are able to dress themselves, in terms of choosing appropriate clothing or hygiene. When I visited yesterday, DH had his boxers layered over his pants. His dresser drawers are broken, and I find his room mate's urine soaked clothing around the room. I let the staff know about these problems, but they don't seem to be corrected.

There are very few activities, and the ones I've observed are just handing people coloring pages or worksheets without much interaction. His medication was changed without informing me, but I think I got that corrected. The best treatment so far is OT twice a week.

He's losing ground quickly. I know I would if I were in that setting. He has Medicaid pending and there is only one other program in this area that will consider pending cases and it has a one star medicare rating and some serious safety issues. He is so sad and anxious there, and visits are stressful for both of us. Medication is 25 mg of Sertraline and .5 mg of Risperidone.

I could bring him home and apply for case management and home based services but there would be a gap of a month or two. I'm not sure what to do. When I ask the staff about the rapid decline, they just tell me "Well, it's a progressive disease." Any thoughts or suggestions?

Gator1976 · September 20

Sorry you’re having to go thru all this. If both you and he are unhappy with this MC facility. It might be best to start the process of hosing one that meets your expectations for care and atmosphere. Caring is so important on everyone’s part when taking care of MC patients. If one does not meet your expectations, you may need to look a bit farther away. Maybe use social media like Facebook to search for a memory care group in your area. You can also talk to a minister at a local church. They visit most all these kinds of places for members families. Reach out to your local social services department or Alzheimer’s Association nearest you.
Best to you, we are here for you. Your not alone no matter what.

ronda b · September 20

18 resident to 2 aids and 1 nurse sounds about right. Talk to the administrator, see what activities is doing with them or what they should be doing. They will ask a resident to change clothing but if they say no they will not make them. Take all your complaints to administrator or Don. It will really will not do that much good to complain to nursing staff.

cdgbdr · September 20

My DH has been in MC 17 days. The conditions sound a bit better than what you describe there. It is difficult to see the residents that are non-verbal/non-ambulatory. I agree with taking everything up the chain of command to the administrator. This is so difficult. I can't advise you on what your decision should be. You may want to check out the other facility and see if other would be better for you and him.

Michele P · September 21

I had similar issues with a loved one in memory care. The Medicaid facilities do not offer what other non Medicaid facilities offer as far as activities and overall care. Talk to an administrator about your concerns. They do not like to be reported to state agencies! I would come to visit my loved one with a clip board with a legal pad that I took notes on while visiting. The care drastically improved when I arrived.

H1235 · September 21

My mom was in Al and could no longer able to pay for it. She qualifies for Medicaid, but the facility she was in would not accept it. The Al places that did accept Medicaid were horrible! In a desperate attempt to consider all options I toured a certified nursing facility. In my state they are covered by Medicaid in full. It’s an hour drive for me, but was clean and well staffed. While I dreaded the thought of a nursing home it has turned out to be a good choice. She shares a room which isn’t great and she is in better shape than most there, but they have lots of activities she enjoys and medication is being managed better now. Maybe this is an option worth looking into.

BPS · September 21

I was having some issues at the MC my wife is in. I started taking pictures of my concerns (being careful not to get staff or other residents in the picture) then when I talked to the administer I would politely ask what the procedure was for dealing with the situation and show the picture of the issue. It helped but they are busy at times and it takes a while to get all the caregivers to change habits. I also stopped fixing the issues myself and started getting the staff to come in while I was there to do what needed to be done. I realized that I was there to visit not to do the staffs job, but I always (almost always) stayed polite and said thank you when they did what needed to be done. I wanted the hands on people to be my friends and hopefully by extension her friend. Things are better but not great.

M5M · September 21

https://alzconnected.org/discussion/comment/254103#Comment_254103

H1235, is this a "Skilled" level nursing home? There is a fairly good nursing home near us and I have wondered if that might be a good choice if/when… DH is not agitated or a flight risk, so I may think some more about this.

H1235 · September 21

https://alzconnected.org/discussion/comment/254144#Comment_254144

Yes. Where mom is at the doors are locked to prevent someone from wandering off. I believe there are medical requirements to qualify under Medicaid, but I think with dementia that probably wouldn’t be an issue. Unlike her Al the staff is so much more qualified. I think you would just really have to look around well to make sure it’s a nice place. I have seen some horrible nursing homes too.

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