How can I approach assisted living about an issue my dad is having. According to the physical therapist, his last two meals were untouched and he is getting noticably weaker. He says the food doesn't taste good but actually it makes my mouth water so I know it's fine! He didn't even like his favorite dish last night at my house so it's something else causing him to not want to eat.
Anyway, it's ASSISTED living. I'm sure they don't track food consumption, right? If I do say something, what can they even do? If I don't say anything I doubt they'll know.
He had an episode I caught on camera which he doesn't know I know about. I'm sure he's very embarrassed but he didn't make it to the bathroom and had a big mess on his hands with poop everywhere. They helped him and it all got straightened out... but I'm wondering if he is withholding food for fear that might happen again?
I have been nothing but a pain in the butt for the past two weeks with assisted living managers about his continued decline. He hasn't lost any weight (yet) so I don't want to appear to be a "Chicken Little" always calling them.
But don't you think they would notice this not eating themselves?
If your dad is not losing weight, he's not in immediate danger from lack of calories.
Let the doctor come in and give you an evaluation. The nurse on staff at the ALF should call you if something is awry, or if she feels your dad is ill or needs to go to the ER.
Every time there's an 'incident', such as your dad having a diarrhea blow out and the staff needing to clean it up, it's written down in a book for the next shift to see and so it's charted for reference purposes. The nurse will look at that book to see if she thinks a pattern is developing; if he needs urgent care, etc.
Not eating much, in and of itself, is not really cause for a huge amount of concern, especially when there's no accompanying weight loss. That's not to say there cannot be a medical issue going on; there certainly CAN be, especially at 93. Things can change on a dime at that age. So it's important his doctor comes in to see him and do an evaluation asap.
That said, is your dad taking any new meds, especially pain killers? When my father was taking Tramadol for pain after hip surgery, everything he ate tasted foul. It turned out to be the MEDS causing the foul taste in his mouth, we came to learn. If there are any new meds in his life, that would be the first culprit to be suspicious of.
Good luck!
I don't work in a facility - I belong to a community-based team providing short-term services aimed at helping people live safely and sustainably at home. Quite often they've been discharged from hospital, sometimes they have longstanding mental health issues; but in any case if there's any question that poor nutrition is a factor or a concern that's something we monitor.
Has your father only been in this ALF for two weeks, then?
As far as being a "chicken little", if your Dad is new to ALF then they may expect to hear from you more. But if you recognize that you are being too bothersome then it is a good time to take some control over yourself. They do have care levels that can be bumped up. If you want his meals monitored that can likely be done for a fee.
I doubt if your father is starving himself for fear of another explosion - I'd be more worried about the nasty taste he's experiencing, and what's causing that. Meanwhile, though, I know that we use two different charts for clients we have concerns about, one for Fluids and one for Nutrition - everything the person is given to eat or drink is documented, along with whether or not it was consumed and how much. It isn't difficult to do, and I'd expect the facility to use something similar when necessary. Have you asked?
Did these episodes of weakness and not eating start AFTER the falls? How closely was he examined after the falls?
This doesn't sound like an adjustment problem; it sounds like a medical issue.
My mother was briefly in a nice AL. It was completely the wrong level of care for her; she was having a medical issue (episodes of VERY high blood pressure--in the 200s) and it was badly mishandled, in part because they didn't know my mother and WE didnt realize the level of her cognitive loss. (Ex., she took her bp, saw the number and went to the nurse and said "I think my bp machine is broken". Nurse labelled her a chronic complainer(!) Dr. who called in several times a week was unavailable that week, so it wasn't until my SIL found mom unresponsive in her room that she got care (as in ER).
Get dad the medical attention he needs and make yourself as big an annoyance as you need to until he gets seen.
Then re-evaluate if he's in the right place. We moved my mom to an Independent Living facility with better on-site medical care and she was much off.
A good memory care will have those who are still high-functioning doing things together and the lower-functioning ones doing their activities with caregivers.
My mother's memory care has more people who are still pretty with it than those who aren't. Before Covid, I regularly talked books with one resident who's a retired neuroscientist and visited with another who was a retired city manager. Another one was an RN who knew exactly what memory care is and was mighty bent about being put there, but she was part of the girl's clique within a week. They even havea guy in there who's only 49 and has two elementary-age kids. Nice guy and I have no idea why he's there, but he either has early-onset Alzheimer's or had a head injury. Either way, he assists the caregivers with getting out the silverware for meals and watches a lot of sports with the neuroscientist.
It's harder on someone to be in an AL with people who avoid you than it is to be in a memory care where there are folks who are more like you. Don't worry about the socializing, because that's what memory cares emphasize.
He is in a NH facility b/c he can no longer care for himself alone, right? I think that perhaps you thought this place was going to restore him to his 40 years ago stage, and that doesn't happen.
IMHO--placing someone in a NH usually results in a downward spiral, to a degree, as they acclimate (or not) to the new living situation.
He probably does need a checkup and baseline workup. He may simply be growing older (well, of course he is) and you don't see him everyday as perhaps you did before, so the deterioration is more apparent.
When mother had to put Gma into a NH, it was shocking how quickly she went from 'needing a little help' to dying. Actually, she'd be living at mom's for a week and it wasn't working, so mom put her in the NH that grandma chose. She went downhill so fast--and at age 95, that was fine. Gma wouldn't eat and barely drank. It's been almost 28 years and mother STILL feels horrific guilt about it, even tho gma was where she chose to be.
As for meals, some seniors won't eat more than a few mouthfuls at one time. Try giving him snacks of supplemental drinks and bars to have near him at all times. Sometimes the snacks are a way around this problem.
If he is still not eating, consider talking with his doctor about the experience you witnessed and his lack of eating. The doctor will check to make sure there isn't a physical problem. If everything checks out fine, then a referral to a geriatric psychiatrist may be needed.