Tips to Evaluate Mom’s Memory Care on a Long Distant Visit

Tips to Evaluate Mom’s Memory Care on a Long Distant Visit

Amy cleaned her plate!

Amy cleaned her plate!

Can you ever trust a retirement or assisted living community to take care of your mom better than yourself or a family member? Long distance relationships are never easy. Add dementia and hearing loss to the story and long distance communication with a senior parent is impossible.  

The only way you really know if your mom or dad is okay is to have eyes on them for yourself. My husband just went 1000 miles by plane, two hours by car and a 20-minute ferry ride to visit his mom, Amy. One year ago, she was hospitalized after her husband had a heart attack. After the trauma of her husband (who was her caregiver for five years) being hospitalized, she eloped and the police had to bring her home. Amy is now in her third licensed assisted living community.

How do you evaluate the care of your senior parent? What should you be looking for or asking about on a one-day long-distant visit?

First, how does mom look? Is her hair washed? Are her clothes clean? Do the other residents look well cared for? The answer to all of these for my mother-in-law was good and yes!

Can she feed herself and how much can she consume? Always stay for at least one meal. My mother-in-law ate three plates of food over four hours by herself and asked for dessert. A year ago, she never wanted to eat, so this was a huge improvement.

Does she know your name? Can she hear? How does she communicate with the caregivers? My mother-in-law introduced my husband (her son) by his full name to a caregiver and said, “This is my number one son.” It was difficult for my husband to communicate with his mom in the dining room, it had too many distractions and was too loud. One-on-one, she could communicate and hear better. Plus, the caregivers actually bent down to talk to her – very nice! 

What is mobility like? Is it better or worse? Invite them for a walk to determine the current status quo. The memory care layout can be shaped like a square inside. So they can walk all the way around the square without going outside. Amy and my husband walked it 25 times. She always used her walker and this was a huge improvement.

Observe the activities or it’s even better to become engaged with your dementia parent. Unfortunately not one activity happened at the memory care community on Saturday. One activity was scheduled and it never took place.

Watch the caregivers’ treatment and management of the other residents. This better be good or you need to move your parent ASAP. Amy’s caregivers were super. They treated all the residents well and managed an entire room full of dementia residents simultaneously.

Here was the report card for Amy and the memory care community.

  • Cleanliness of all residents: B+
  • Taste of food: B+
  • Communication with mom: C  (The severity of her hearing loss is dictating this score.)
  • Caregivers interacting with residents: B+
  • Activities offered: D+  (They did offer to paint her nails or it would have been an F.)
  • Building layout and community spaces: A  

Some of you may want a care conference to meet the key staff like the administrator and the nurse. You can learn exactly what types of care they are providing and details about medication management. We had one of those a few weeks ago, so my husband wanted to spend all his limited time with his mom. 

You have to see mom or dad for yourself. Please have one local relative with eyes on your senior. We are so lucky that my sister-in-law does a super job with this. Her regular visits have improved Amy’s mind, attitude and appetite.

Good luck with your long distant visit and hopefully these tips will help you.

If you have a long distant parent, please share your experience in the comment section.

Diane Masson is a senior living expert who has authored two 5-star rated books. Her new book is an all-encompassing answer guide for seniors called, “Your Senior Housing Options,” designed to help seniors navigate choices quickly. The second book was written for senior living professionals called, “Senior Housing Marketing – How To Increase Your Occupancy and Stay Full.”   Learn more tips at: Tips2Seniors.com

Sexually Aggressive in Memory Care?!!?

Sexually Aggressive in Memory Care?!!?

Violence in Memory CareHow do you keep your mom or dad safe in a memory care community or assisted living? A retired cop moved into my mother-in-law’s memory care community and has been demonstrating sexual and violent aggression against her, other residents, and staff. This is what my family is facing now. Read about the incidents in, “Violence in Memory Care,” HERE.

This is a list of whom we have emphatically voiced our concerns:

  • Caregivers
  • The nurse
  • The Administrator
  • Two ombudsmen
  • The State of Washington (surveyors of licensed assisted living)
  • Adult Protective Services

Our family requested a care conference to discuss the safety of my mother-in-law, Amy. Two ombudsmen, the administrator, three adult children and myself attended it. It was the worst care conference that I have ever experienced in my 17 years working as a professional in senior living. On a personal level, I have attended numerous care conferences for nine years as an advocate for my own mother who had dementia. There is always a conclusion at the end of the care conference that provides some sense of hope for improving care or concerns.

Why was this care conference so bad?

The administrator would only talk about Amy. She refused to discuss Amy’s safety in regards to the aggressive cop, because of HIPPA. She refused to share any measures or policies that the staff was following for Amy’s safety. Are you kidding me? I specifically asked, “What are you doing to protect her?” She said that she could not answer that question and kept talking in circles.

The ombudsmen were no help either. They said they could only discuss Amy because we gave them permission to do so. They could not discuss any other residents or the aggressive retired cop because they had not been given permission to do so. Nobody would address the elephant in the room, which was an aggressive retired cop with dementia preying on vulnerable residents.

What about Amy’s safety? What about the other residents’ safety?

The state did a surprise visit to the memory care community last week and said there are no new violations. This community is in a rural part of Washington State. There is not another community in the local area.

Any advice from senior living professionals? What else can we do?

Tip: For adult children looking for memory care or assisted living. Interview the administrator, before you move your parent into the community. Find out how long they have worked there. We did this and the answer was two years. Life was good for Amy until this experienced administrator moved on.

Diane Masson is a senior living expert who has authored two 5-star rated books. Her new book is an all-encompassing answer guide for seniors called, “Your Senior Housing Options,” designed to help seniors navigate choices quickly. The second book was written for senior living professionals called, “Senior Housing Marketing – How To Increase Your Occupancy and Stay Full.” Reach out to her through her website: Tips2Seniors.com and read the weekly blog.

Violence in Memory Care

Violence in Memory Care

Fists and violence in memory careA former cop moved into my mother-in-law’s memory care community. He was doing simulated punches to people including the administrator. The administrator was worried the punches might become real, because seniors with dementia do not have good depth perception. Then my sister-in-law witnessed him doing it to my mother-in-law, Amy. She was horrified.

My sister-in-law was sitting across from her mom. The former cop came up from behind my sister-in-law and then she saw a fist heading for Amy’s face. The fist stopped six inches away. Here is the weird part. A caregiver witnessed the whole thing, but showed no concern, never said a word, or redirected him. He did walk away and the caregiver accompanied him down the hall. My sister-in-law shouted, “That was not cool,” after them.

So the staff started locking residents’ rooms because they caught the former cop standing over sleeping residents. The doors were locked at night so residents could still wander out, but he could not wander in.

Something combative must have happened between the former cop and a staff person. They would not say what but my sister-in-law observed that he was gone over a day and then came back drugged.   All these situations have transpired over two weeks.

My sister-in-law is very worried about Amy. What if she gets up in the night and leaves her room? What if the former cop is out too? Amy will have nowhere to go because every door is locked. A few days ago my sister-in-law discovered the doors to the residents rooms were locked during the day. She shared her disapproval with the administrator. The administrator said it was because both residents were asleep in the room (which they were doing at the time). My sister-in-law said to the administrator, “You said you would only lock the doors at night.”

Who is protecting the residents? The community says they cannot provide one-on-one care for the former cop. They say he has rights too and just can’t make him leave. If another violent incident happens he will be thrown in jail because there is a 49-day wait for a geripsych hospital.

One caregiver shared that the former cop pointed to himself and then her. Then he made gestures of sexual intercourse. He tried to grab her behind, but she wouldn’t let him. Other caregivers do let him grab their behinds and laugh. This is very concerning to our family, because how can someone with dementia distinguish who is a caregiver and who is a resident? He should always be redirected on proper behavior. He is not. There is no redirecting consistency with the caregiving staff.

When my sister-in-law shared the above examples with the administrator she said, “The caregivers are burned out and fearful of him. I am glad you told me and I will talk to staff about consistency.”

The family called the omsbudman and the state. The state triggered a call back to the family from adult protective services. They wanted to know if Amy was afraid. The answer was yes!

Recently, Amy was watching the fish swim in the 100-gallon tank. The former cop came up behind her and grabbed both of her arms. She screamed. My sister-in-law heard the story from a caregiver. Here was Amy’s interpretation to her daughter: Amy said, “A drunk guy grabbed me and tried to beat me up.” She pointed to the former cop and said, “There is that bad man, I don’t like him.”

Is the facility doing all that they can and should? Should this guy be gone? How much violence is okay in a licensed assisted living community in Washington State?

Any answers would be much appreciated.

Diane Masson is a senior living expert who has authored two 5-star rated books. Her new book is an all-encompassing answer guide for seniors called, “Your Senior Housing Options,” designed to help seniors navigate choices quickly. The second book was written for senior living professionals called, “Senior Housing Marketing – How To Increase Your Occupancy and Stay Full.” Reach out to her through her website: Tips2Seniors.com and read the weekly blog.

Tips for an Alzheimer’s or Dementia Care Conference

Tips for an Alzheimer’s or Dementia Care Conference

You know who they once were better than anyone! Be the best advocate you can be!

You know who they once were better than anyone! Be the best advocate you can be!

Here are some tough statements that family members can hear at an Alzheimer’s or dementia care conference for their loved one (who might be residing in assisted living, memory care or skilled nursing care):

  • She can’t direct her own care…
  • Is regularly disoriented…
  • Needs full help with bathing and dressing…
  • She can become frustrated…
  • Can be resistant to care…
  • Does not always remember to use her walker…

It can proceed into an in-depth conversation about the ability of your loved one’s communication:

  • She is not very verbal…
  • She has improved in the last four months from not speaking at all (because she was still coming off of the psychotropic medications) to being a little more verbal.
  • The staff has to use phrases or questions that are seven words or less to create less confusion for her.
  • The staffs’ goal is to elicit a “yes” or “no” response, so she can make choices.

Then a group discussion can proceed about who she can still recognize and if she can still call anyone by name (this is tough one):

  • Does she recognize you?
  • She thinks her daughter is her sister.

How much food is or is not consumed?

Our family has experienced witnessing continual weight loss of my mother-in-law for 10 months. She is eating 50% of her food, but can pop out of her chair and start wandering sporadically while dining. She walks almost continually. The staff have problem solved this by feeding her in the country kitchen instead of the dining room to increase her food intake.

What should you ask in a care conference? Don’t be intimidated; no one knows your loved one better than you. Be his or her advocate to the best of your ability.

  • Find out exactly what medication they take and why. Sometimes they were given a medication like a psychotropic in the hospital and no one is paying attention to the fact it is not necessary anymore.
  • How much exercise or movement do they experience? Staying mobile is important.
  • Inquire about live entertainment. Your loved one may be refusing to go to live entertainment and you know they love music. The only reason they may be refusing is because they can’t HEAR the caregiver asking them to go. Maybe the caregiver needs to speak up or…
  • Ask about music therapy. It can be very affective for dementia and Alzheimer’s. If they tried it once and it was refused, try again. Every day is a new day. Seniors with dementia (such as my mom) can be more receptive and oriented in the morning.
  • How much food do they eat? Maybe they are not eating because they have lost teeth (this happened to my mom)? Food adjustments can be made.

Is there anyone else out there dealing with a parent who has dementia? It is not easy. What tips can you share?

Diane Masson advocated for her mom who had dementia for nine years and her mother-in-law currently lives in a memory care community. Diane writes a Tips2Seniors blog every week and published a book to take the guess work out selecting senior housing before, during or after a health care crisis, “Your Senior Housing Options.” She has worked in senior housing for 17 years and her first book, “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” is helping senior housing professionals on a nationwide basis.

Proud to Walk For Alzheimer’s

Proud to Walk For Alzheimer’s

Residents and Staff from Freedom Village in Lake Forest , walking for Alzheimer's!

Residents and staff from Freedom Village in Lake Forest walking for Alzheimer’s!

If enough of us keep walking and raising funds for Alzheimer’s we will eventually find a cure for this detrimental disease that affects so many seniors including my mother-in-law.

Almost $110,000 was raised by 741 walkers at the Laguna Niguel Alzheimer’s Walk on October 24, 2015. It was my first time raising awareness for Alzheimer’s in California. I was part of team Freedom Village (a Continuing Care Retirement Community in Lake Forest) who came in seventh for fundraising.

My mom had dementia for nine years and died in April. I watched the disease rob her of the ability to communicate. Her last and final roommate in skilled nursing was a wonderful woman who is still battling Alzheimer’s. I rode the bus to and from the Alzheimer’s walk with her husband. He shared the struggle of trying to keep his wife independent as long as possible. He had alarms on the doors to wake him if she tried to wander off in the night. Eventually, those alarms where not enough to contain her at night. He had to find her a safer home.

IMG_7033This brilliant husband took his wife one day a week to Silverado memory care to participate in activities. After several months he increased it to two times a week. She was so comfortable there that she would walk in and immediately be engaged with a staff person and walk to an activity. Then the decision was finally made to make it a permanent move. This time the community recommended that he not return for one week, so that his wife could adjust. She did adapt. In her three years at the community, she never asked once to go home.

At the walk, I learned that Alzheimer’s affects more women than men. It was a beautiful experience to walk side-by-side with other people that have been touched by this mind-altering disease. People carried blue flowers if they had Alzheimer’s. I carried a purple flower because my mom died from dementia. Other colors of flowers that people carried signified being a caregiver or financial supporter of Alzheimer’s.

All the Freedom Village residents and staff had a blast. Imagine what we can do next year in group participation and fund raising. We will build on our momentum and team enthusiasm from our first annual walk for Alzheimer’s.

How have you raised awareness for Alzheimer’s? Let’s keep this conversation going on social media to find a cure soon. 

#Walk2EndALZ #freedomvillagelakeforest #silverado

Diane Masson is a sought after author, blogger, speaker and regional marketing director.  She is very passionate about advocating for seniors on a nationwide basis and educating them about their future choices.  She just published a book to help seniors take the guess work out of selecting senior housing options or staying home.  It is called, “Your Senior Housing Options.”  Her other book has been popular with senior housing professionals on a nationwide basis.  It is called, “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full.”  You can contact her through her website at tips2seniors.com.

Becoming Overly Dependent on a Caregiver

Becoming Overly Dependent on a Caregiver

IMG_6156A senior can easily become overly dependent on a caregiver. A helpless 92-year-old senior woman, who is recovering from a surgery, can suddenly become isolated in her own home and becomes reliant on her new around-the-clock caregiver.

In memory care communities, seniors with dementia rely on the loving support from their caregivers or fellow residents.   Joyful smiles, from a dementia resident, may only be reserved for those who see them daily. Sometimes a wife learns that her husband in memory care has decided to marry his “friend.” The “friend” might be a caregiver 50 years younger or another resident.

“Dear Abby,” recently published a letter from a man in his late 60’s. He wanted to marry a 28-year-old woman with three children. His question for “Dear Abby” was should he do it? She suggested a prenuptial agreement.

A frail senior man moved into a residential board and care home to recover from a hospitalization. His wife was optimistic about his ability to recover and return home. Her other wish was to have him improve enough to move into a Continuing Care Retirement Community with her. Unfortunately, the caregiver at the board and care home did everything for the husband. The wife begged for them to help her husband recuperate, by letting him dress himself, strengthen his legs by standing up, improve his endurance by walking around the home and etc. Instead the caregivers continued to make him 100% dependent on them, so he grew weaker and wheelchair bound. Now this couple (married for 60 years) will not be able to live together again.

Unlicensed home care workers (fly-by-night) can take over the finances of seniors while they sleep. This happened to one of my neighbors. She became a prisoner of her own home. The OC Register newspaper recently published an article about a senior who signed over her home to the caregiver who had lived with her for less than 90 days. She died with no children. The caregiver is still living in her home.

As humans we crave love and companionship. We need relationships in our lives. An isolated frail senior can easily become beholden to the one person who is sustaining their existence.

What have you seen or experienced?

Do you know a senior that is struggling?  Diane Masson’s new book can help walk you or them through, “Your Senior Housing Options.”  Diane has helped educate thousands of seniors in her career and shares weekly real life stories like this one.  Join her blog at Tips2Seniors.com or follow her on Facebook at Tips2Seniors.

Her first book “Senior Housing Marketing – How to Increase Your Occupancy and Stay Full,” has helped new and experienced senior housing professionals (assisted living, memory care, skilled nursing care and Continuing Care Retirement Communities) around the world.  Both her first book and second book, “Your Senior Housing Options,” have a 5-star rating on Amazon.com.