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My sister has been in assisted living for 6 months. The facility where she is a resident has the reputation of being very good. We have not found it to meet that reputation. They have had administrative level changes and appear to be penny pinching. She complained about the meals, so I have gone there on several occasions at mealtime. Unfortunately, I agree with her. The food was unappealing at best. Not sure what the Activities Director does, but it is not projects/activities/entertainment for the residents. There is frequently litter in the elevators as well as in the eating area. (They call it the dining room, but it is far from my perception of a dining room.) Frequently, calls to the staff are not returned. Even weeding of the plantings outside is neglected. In addition, she fell and broke her hip and we question how good the supervision is. She is incontinent, has dementia and has always had emotional dysfunction. Her perception is that any other facility will be just as bad. Thoughts?

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With a diagnosis of dementia, of any type, Memory Care would be more appropriate for her.
There is more supervision.
They do try to engage the residents a bit more.
Now any place can offer an activity BUT a resident can refuse to participate. A good staff will try to encourage involvement but they can not force involvement.
Most meals are not that great, just as they were not that good when you had lunch in school or at camp. They have to provide "nutritious" meals that the majority of residents will find acceptable.
I suggest that if you visit often make it at meal time and bring a meal that you two can share in her room or if there is a smaller dining room or an outdoor area. Make it a treat for the both of you.
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Sounds like your sister needs Memory Care Assisted Living if she's incontinent and suffering from dementia. My mother lives in such a place and has fallen 36x in the past 25 months, even with all the extra precautions that the staff has put in place to help prevent her from falling. It's impossible to stop an elder from falling, even if you hire a companion to sit with them 24/7......they will still manage to fall! No ALF on earth can possibly provide enough "supervision" to prevent it.

As far as food goes, I think it's the law for elders to complain about it while living in managed care of any kind. I bring my mother restaurant food or home cooked food at least once a week and make sure she's stocked up with plenty of snacks, too. And she still complains because dementia has killed off her tastebuds for everything but sweets these days, it seems to me.

If you are dissatisfied with the quality of care and services at your sisters current ALF, I'd speak to the Executive Director before doing anything. Express your concerns and see if changes are made to your satisfaction. If not, look into other ALFs and memory care facilities in the area and avoid corporate owned franchises, that's my advice. Expect high turnover with staff because that's the norm throughout the industry. Don't expect perfection or gourmet food or top notch entertainment anywhere you go, and set realistic expectations for good care and reasonable services.

I think your main goal is to make sure she's in the proper section of the ALF though......and memory care residents get a higher level of care because they require it. Regular AL is for more independent residents in general who don't need too much help with ADLs and are quite functional on their own.

Good luck!
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Definitely move her to Memory Care, and try to find a place that provides care through end-of-life. They focus on mental stimulation, so the activities will be much better in Memory Care as well.
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