My mom is a home health aide who had had stints working in memory care facilities. The facilities do not have enough staff and the residents are in individual rooms so hard for 1 person to look after 10 or more patients overnight. She would work an entire floor herself overnight (11 patients).

Anonymous wrote:What happens if you don’t take their calls?

This is exactly my question. Also, whose name is on the billing, OP? You or your parent?

Anonymous wrote:It sounds to me like memory care, if they can compel you to get a sitter, is almost redundant. That it’s better to get the sitter and other support staff, and have the patient home as long as possible. What is the next step after memory care, aside from hospice? Is there anything “all inclusive” for fall-prone dementia patients?

No. Memory care plus sitters plus medication to make them malleable/easier to care for despite the side effects it caused her: in our case still not enough.

I posted upthread about how we’re going through this with MIL. We have already done meds. Unfortunately they make her even more confused and upset and fall-prone. In our case after the last fall the memory care refused to take her back (she had lived in the community for years AND had a private sitter additionally) so she had to go to the only rehab place that would take her. Conditions there were horrible, she declined rapidly, lost significant weight (she was thin before), and finally the memory care said they would take her back as a hospice patient (ie, heavily medicated and dying). It has been a very rough last chapter of her life and sad.

It sounds to me like memory care, if they can compel you to get a sitter, is almost redundant. That it’s better to get the sitter and other support staff, and have the patient home as long as possible. What is the next step after memory care, aside from hospice? Is there anything “all inclusive” for fall-prone dementia patients?

My cousins were in this situation with my aunt. I think this is not uncommon. Could you find someone to work evenings off care.com?

Is the doctor involved at all? They can be ordering blood work, urinalysis and tweaking his meds. Also, some doctors refer patients to “good” facilities and may have some suggestions. The facility should try to not get a bad reputation with community doctors, who often refer patients and can be their main source of income.

Anonymous wrote:Memory care is the sitter. If they aren't doing their job, fire them.

This person has not been there. I assure you, you need them more than they need you. As mentioned by another poster I would opt finding the right meds to manage the challenging behavior. Unfortunately, that may increase fall risk, but you can come up with a plan for how to manage that. You may want to look into hiring an advocate who can help you negotiate with them. This isn't forever and I repeat, you need them more than they need you.

Anonymous wrote:

Anonymous wrote:$400/day is actually very cheap for memory care from what I’ve researched. I think your only other option if you can’t be there and you can’t afford private nurses is to medicate him until he’s catatonic.

Sounds like this is on top of whatever they are paying for memory care

Sounds to me like this is what OP is paying for the memory care (the base), not that it matters if OP can’t afford more.

Anonymous wrote:$400/day is actually very cheap for memory care from what I’ve researched. I think your only other option if you can’t be there and you can’t afford private nurses is to medicate him until he’s catatonic.

Sounds like this is on top of whatever they are paying for memory care

Have they tried Abilify? Worked wonders for my mom. She stopped wondering off, but is not remotely cataconic. I understand there are health risks, but at this point, what is the point?

Whoever dreamed up “memory care” was an evil genius. Because they’re not caring for memory, they’re (ostensibly) caring for the lack of it.

The bottom line is that the contracts at these places tend to be very one sided and take it or leave it. They have a certain type and quantity of resources they’re willing to expend for any given patient. If somebody needs more, the facility “can no longer meet their needs,” and out the door they go.

At least in my experience, sitters don’t have to be nurses, nurse’s aides or even specially trained. They are, as the title indicates, hired to stay with the patient, discourage/distract from risky behaviors and so forth. The facility may know some people or you might find something on a local whatever passes for a grocery store bulletin board these days.

Agree with PP about checking for a UTI, which can definitely cause/worsen mental status changes.

Has he been tested for UTI? It is incredibly common in older men and can mimic or worsen dementia. Where my dad was, their standard practice is to always test for UTIs with behavioral issues, but the social worker said a lot of places don't. She said people will be diagnosed with dementia or that their dementia is worsening, even put in psych wards, and it's really a UTI.

Won't solve all your problems but may help with the more erratic behavior.

They can't push you to give him enough drugs to basically make him comatose so this is their way.

Anonymous wrote:

Anonymous wrote:It is memory care only and one of the best places in Northern Virginia (supposedly). They only accept memory care patients and before I put him there I specifically asked if they would require private duty nurses and they said no. But here we are.

Those places are like timeshare sales pitches. They'll tell you whatever to get you in the door. Now that centers know they can put the expense of staff directly on the patient, they don't want to spend it themselves. Is there a social worker there? Even though they still work for the center, they would have more legal obligation to let you know your options

^100% correct. Make sure you have everything in writing before you sign a contract. Typically memory care provides 24/7 assistance and it takes up the majority of the CNAs. I would imagine the facility is short staffed in general due to Covid. It is their responsibility though to maintain the standard of care you are paying for so they should be out hiring more resources to be able to meet the needs of the patients. If they can't, they should slow roll taking in new residents until they have a staff big enough to handle everyone.

$400/day is actually very cheap for memory care from what I’ve researched. I think your only other option if you can’t be there and you can’t afford private nurses is to medicate him until he’s catatonic.

What happens if you don’t take their calls?