I came to the conclusion that the older, smaller rural facilities in all three states gave better care. Staff worked in these locations sometimes for many, many years. Rooms are small. Hallways are narrow but clients seemed happy and workers seemed happy.

I have had this experience as well. It is not a bad idea to seek out a lower cost of living area. An area where the patient feels a connection. There are good/conscientious workers out there. We've had 4 elders pass and believe they received good care.

Has Mom liked where she has been the last several years? She hasn't been calling you to complain etc?
Has she been eating in the dining halls the last several years? Has she made friends there that she eats with?

Is it a continuing care facility? Understand these can be tough to find.

Mom has alzheimers and I've toured assisted living, memory care, and nursing homes in 3 states: Maryland, Delaware and Florida.

I've learned a lot just by talking to workers in the parking lots when they are going into shifts or going home. It is amazing what you can learn. I ask how they like working there? How long they have worked there etc? Some are positive. Some tell you they are very burned out and are looking for other jobs due to lack of staff.

Also make sure you drill down to learn glove change policy. I've had 2 private duty CNA's that work for Mom in Maryland tell me that when they worked for independently owned nursing homes in Maryland they had to wear 1 set of gloves for all of their patients each morning. NASTY. One facility was on the western shore and one was on the eastern shore.

In general from touring facilities in the three states I came to the conclusion that the older, smaller rural facilities in all three states gave better care. Staff worked in these locations sometimes for many, many years. Rooms are small. Hallways are narrow but clients seemed happy and workers seemed happy.

I also toured what is supposed to be the best Continuing Care facility in Florida on multiple visits. It was new. Rooms were large. Hallways were wide. The problem was you could never find staff.

I also found it helpful to go to the facility website and search the help wanted/jobs area to see how many openings there were.

There are no easy answers on this journey. If her current location allows you to hire an outside aid I'd look into that.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Move her near you. That drive will be a nightmare. My MIL was a 25-50 drive depending on traffic and it was hard to do more than 1-2 times a week. And, move her while she still has her mind (even a little bit and will be ok in a car)

She is adamant that she does not want to move.

That’s fine but you need to tell her the consequences of her decision. You will not be there as often as she would like. You will not be able to make your presence known to the staff. If there is an issue, you will get there when you can but it might be a few days.

One thing I’m finding challenging is dr appts. Perhaps the facility your parent is in takes them but the one my dad is in does not. I kid you not, a drs appt is a 4-5 hr endeavor. It takes 30-45 min to get him ready to get out the door even if he’s dressed already. It’s stuff like getting paperwork from the facility to give to the dr, switching his oxygen to portable, finding a wheelchair. Doesn’t matter if I tell the staff what time I will be there, no one seems to find the things he needs to go on an outing until I get there.

Then getting in the car takes 10 min. He just doesn’t move fast. He can’t buckle the seatbelt. I have to put the wheelchair in the car. Then we drive to the appt and have to unload him. Then we wait because the drs office never run on time. Now he has to pee. Then while we’re out he’d like lunch. It just seems it’s one additional step after another.

My dad is 5 min from me. I can’t imagine adding a 1.5hr commute on either end of this excursion.

Yep, totally my experience with my mom.

Anonymous wrote:I would hire an aide or service to visit her a few times a week. Different company than the CCRC. That way you have some coverage, and eyes on her.

Some facilities allow this. Some do not. Make sure to check the contracts.

Anonymous wrote:You go once a month, your sibling goes once a month, and that’s pretty decent coverage. You can be there in 90 minutes in an emergency! I had a family member with Alzheimer’s in memory care a 10 hour drive away and that was brutal. You do the best you can.

Two visits a month for someone who is cognitively fragile is not pretty decent coverage.
One sibling needs to step up and move mom closer.
Someone should be there at least once a week.

Good morning. I would definitely recommend an in home care agency, if you can afford it. Synergy in Rockville MD is an amazing company who has helped a lot of my friends' parents. Robbie or Ross are so nice, and you can reach them at 301, 300, 9292. Good luck with everything.