Assisted living facility cut off communication. How do I approach a sit down with the staff?

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Assisted living facility cut off communication. How do I approach a sit down with the staff?

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My parents were moved to an AF in July 2019. Dad has passed. Mom has had great care except for one aide. I have complained and so has Mom. She is bedridden and despite my complaints, she has missed baths.

She now has had back to back UTI’s and all of of sudden I am cut off from contact from staff. They avert their eyes, the lovely billing girl won’t file my moms insurance or respond to me asking why.

I'm not stupid, I will be making an appointment to talk with them and will record. We can do that in my state.

I am a a trained medical professional in many areas. I know what they are up to.

I have had a great relationship for over four years and I am devastated to see staff avert their eyes. I don’t know how to approach a sit down with the staff. Advice is much appreciated. I literally can’t sleep at night over this abandonment.

Assisted Living Bathing Poor Hygiene Urinary Tract Infection (UTI)

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When was the last Care Meeting?

Have you spoken/emailed the Social worker and DON?

Is it possible that they think that mom needs a higher level of care?

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If they do why aren't they suggesting that? It is all about the money they are getting?

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She is in a facility that allows all levels of care, she was on Hospice for two years and is back on Palliative.

i am very hands on and speak with the medical director and staff often. She is 1/2 mile from me. I am there several times a week. I believe this is because of the infections and one of which is antibiotic resistant.

i am going to go the the directors office tomorrow but this sudden behavior is concerning

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But she is in the assisted living portion of the facility, right? It sounds like it's time to move mom to the skilled nursing section of the facility, if there is one. If there isn't I would start looking into a more appropriate place for mom where she will get regular bathing and hygiene care that she needs. This place sounds like they were great while dad was around to maybe pick up some of the slack but now that it's just mom the reality that this place may not be good for her is clear.

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Request a care plan meeting. Can you contact ombudsman? I don’t know if that will help…or just deal directly. Evidently, they know something that they’re not telling you . Don’t let it go.

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OP, I can see why the staff have been told to cut communication with you. You “speak with the medical director and staff often”, you are “there several times a week”, and you are a “trained medical professional”. You “know what they are up to”.

My guess is that they appreciate families who care, but your level of involvement may come across as that you think you are in charge and can tell them what to do. If you disagree with them, you can become a very difficult “customer”. You are probably pointing out things that staff have said or not said, as part of your criticism, which is why lines of communication are part of the problem.

Perhaps your expectations of Assisted Living are higher than they are actually offering?

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This was my thought exactly. There's a reason the saying is "absence makes the heart grow fonder". I imagine the OP has made a thorough nuisance of herself by demanding time the staff is too busy to provide and opinions that may or may not be accurate. As for how to approach the care plan meeting - respectfully and ready to listen.

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You say you have had a great relationship for four years. Now it has gone wrong. Creating now an "adversarial relationship" will certainly not help. Were I you I would go in and ask "We had such a wonderful relationship here for four years; I hope I haven't done something to change that. Mom loves it here. I recognize she is getting worse, but I feel as though right now people are avoiding me. What can I do to make our communications better?"

Bedbound seniors require a lot of skin care, but bathing is overdone. If there is an indwelling catheter there may be more infections, but otherwise infection comes of incontinence often enough, or even just of aging problems and general debility. It is common both in in facility and out of facility care.

I think perhaps your Mom is progressing and becoming more ill and helpless and this is escalating your frustration, and I am so sorry for that, but I do think an adversarial relationship will leave them advising you that "if you are no longer happy with our care you may need to explore moving your mom". If you have a good place, try not to lose it. I am sorry things are going so poorly and hope it gets better for you and for your mom.

Your Mom is sounding now, like without extra help coming in, she is beyond assisted living care. She may require memory care. More staff there and of course higher costs.

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I have never felt the need to have a discussion so I would never be adversary which is why I posted the question.

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Why do so many assisted living facilities keep seniors in their places when they are clearly well past the assisted part of assisted living? It it because of the money? It seems to me that a bed bound senior is not a candidate for assisted living and should be in a skilled nursing facility at this point? Has the OP looked into moving mom into a more appropriate place for her mom's care?

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Good question. Maybe it's the money, but this is where a good advocate (next of kin, POA or whomever the patient has previously chosen) gets to make sure the patient is getting what he/she needs.

Often the family is in denial of the true condition of the patient. We see that a lot on here where a family member posts that their LO has "mild dementia" or "a touch of dementia" and then goes on to mention that she's wandering, no longer remembers where to poop, and started a fire in the kitchen. NONE of that is "mild." Those symptoms all together almost surely mean advanced dementia, yet the family wants to believe there's not much REALLY wrong with Aunt Betty, she just gets a little confused and must continue to live alone so she can keep her dog (who would burn up in the house with her if it comes to that).

Skilled nursing seems like the better place for this OP's mom. OP needs to go to the highest level of that facility and get serious with the people who run it. Not the aides, they're at the bottom of the ladder.

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I am with SP, an AL is not equipped to care for your mother. They are not equipped to care for a UTI if she now has had two. Mom probably needs to be placed on IV in a hospital. A culture taken to make sure correct antibiotic is given.

"I don’t know how to approach a sit down with the staff" You don't approach staff you sit down with the director/administrator and voice your concerns.

"billing girl won’t file my moms insurance or respond to me asking why" My Mom was in a small AL. She had her own doctor so no billing needed there. Prescriptions were billed by the pharmacy. So no billing done at the site. Do u use their doctor? I think that the billing girl is obligated to bill on the day the service is provided. Or at least in a timely manner. I would call Medicare and ask that question. I may also inform the providers that billing is not being done and that you are not going to be liable for the bills.

This is interesting so please update us. We learn from each other.

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It is her long term care insurance, she does see the facility Dr. That is not and issue. The facility has a person who sends me the bill to pay and they send in the information to LTC insurance

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Has there been a change in ownership or the upper level admins recently?

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Yes, about a year ago the director was fired and replaced

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OP, I read through your post again, and wonder exactly what you mean by “I am very hands on”. Are you doing things that would normally be done by staff – providing the ‘assist’ in Assisted Living, or sharing in it? This is added to your concerns about management, and your wish for some involvement there. Do you not see that it would be quite inappropriate for you to ‘sit down with the staff’ and talk to them about their performance – it’s the business of management, not of the customers. That you intend to record it is even more inappropriate.

Your involvement with the AL centre is certainly unusually high. It may have been welcome initially, but if has increased over the last four years it could have become a bit much. It seems to be a major part of your life. Would it be better to back off a bit?

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Your question just came up again on my computer, at the end when you say “I literally can’t sleep at night over this abandonment”. If you are losing sleep thinking that the staff and management are ABANDONING YOU, your involvement is too much. They are there for the residents, not for you.

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I will try to give more information. This particular facility accepts patients up to level five. My Mom became bedridden over two years ago. Both my parents needed extra care, trust me, my Dad could not help Mom.

I communicate in a positive way while checking in at the kiosk, I do not make demands of any staff, they actually appreciate me coming in. I am the private aide if you will that assists the staff. I go in not just to help my Mom. The Aides are often understaffed so I will go feed my Mother dinner, set out the supply station etc.

my Mother is on Palliative and refuses to go to a hospital. If she needs Hospice they will put her back on Hospice should she need it. That is her choice and it will be honored. She is comfortable, alert and ok.

I am not pestering staff, I was concerned that there was a lack of communication. I am not needy and do not make demands of the staff at all, quite the opposite.

I simply asked how to approach a sit down meaning the director as I have never had an issue.

today I went in and it was fine, they also have a Covid outbreak so that may have been an issue for a shut down of communication.

for those who labeled me as to hand on, let the staff take care of her etc. I have a bedridden Mother, the staff can’t give her the time I can. They love her and yes, they appreciate a family member who didn’t dump her at the door and leave. That actually happens.

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I wanted to respond to Krista, in my Mothers situation I make no demands of the staff. They appreciate me going in doing what they would have to do if I want there. They know me and have told me they appreciate me taking care of my Mom as often as I do.

There is not on facility in my area that is not understaffed. If you think the Aides think I am a nuisance coming by to feed my Mother when I can they will tell you you are wrong.

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Thank you for the clarification. Your original post did not make that clear.

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OP, it’s clear that you think you are a help, not a hindrance. You need to read your post again to remind yourself of what you actually said, which doesn’t seem to be what you now remember.

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Your response is why I will leave this group. I am a good person who has stepped up to the plate, I may not be articulate but I just wanted advice.

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So why won't the "billing girl" but through your mom's claims?

I'm really confused by what you think might be going on. Please let us know when you resolve this!

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You don't leave a forum because of one person. We have all been Caregivers. Some members are RNs and a few CNAs, some running their own businesses hiring CNAs.

We can only go by what you have written. Yes, we assume. You ended up making your situation clearer. The only way you approach the director is to go to his/her office and ask if he has time to talk with you about some concerns you have. Be ready for what he/she has to say. Don't take offence. I think the billing girl not billing the LTC insurance is a big thing. Maybe new Owners don't believe that is their responsibility to send LTC paperwork. Maybe since you pay upfront, its felt that you should send in the info to get reimbursed. The billing girl may have been told to stop. If so, she should have told you when asked u why she was not billing the LTC to seevthe director.

New management, new rules. Maybe its felt Mom is now too much care and she needs to be placed in a SNF. Because she is grandfathered in, they have to honor the contract she came in on. But this new management may not have a #5 tier. My Moms AL only went to #4. From your post, I think u know what is going on here. They want ur Mom out of the AL. Her care is now more than they feel they can handle especially with the aide shortage.

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I am having the same problem with momma's assisted living with not filing her LTC papers for her to get reimbursed. I have to call the billing lady almost every month. She gives me the same excuse and blah blah. Blames it on the LTC people. So last time I called the LTC people first and asked them if they had received momma's LTC papers. They said no and that they sent a reminder on such and such day to the facility. I called the assisted living place and spoke with billing lady and listened to her give me the same excuse and blah blah. Blaming it on the LTC people and I then proceeded to tell her that I just spoke with LTC and they have not received the papers and furthermore they sent you a reminder on such and such date. Caught her in her excuses and blah blah. That was the month where momma had already paid out of pocket but had not received reimbursement and then assisted living was about to take out another months of $5,374.71. If they had taken out next months that would have been over $10,000.00. I told the billing lady that momma could not afford that without being reimbursed. I would move momma but don't know if it would be any better at another facility or not. I live out of state which means all of the work would be on me. Momma is 89.

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I would talk to the Administrator/Director and tell them the billing girl is not sending paperwork in a timely manner.

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Assisted living facility cut off communication. How do I approach a sit down with the staff?

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