My great aunt and great uncle live in an assisted living facility. My great uncle requires someone to help him get in and out of bed, use the bathroom, wheel him to the dining room, wound care, etc. My great aunt requires no assistance. She does help him do small things around their apartment, like adjust the wheelchair if he would like to watch TV, get him drinks and snacks, etc. This place does confuse me...assisted living, to me, is more like what my great aunt requires. But there are multiple residents in this facility that primarily use wheelchairs. There are aides, med techs, and nurses to care for the residents. So to the question of "are you confused about what assisted living is" the answer is that this place seems to do both, but on the same floor, so it's rather confusing. Often, the med techs and aides get upset with my great aunt. Recently, I witnessed an aide get angry that my great aunt wouldn't fetch the smaller oxygen tank my great uncle uses when he goes to the dining hall (it was hooked up to a larger machine and we didn't know how to get it off.) The situation escalated to an uncomfortable place. Last night, I was on the phone with my great aunt, and I heard an aide yell at her because she was "on the phone" when the aide wanted to speak to her (I'm guessing to tell her to fetch something) and to "get off the phone." A med tech has told my great aunt that she's supposed to be cleaning the area around my great uncle's catheter and that she doesn't "do ointments." My question is: what is a spouse's role when they live with someone who requires assistance? I have looked over the contract and spoken with the executive director about this, and there is nothing anywhere that my great aunt should be assisting the aides, cleaning wounds, or applying medications. But time and time again, employees seem to expect my great aunt to assist them with direct care. Is this an understood practice? Or are the employees overstepping?
I also agree that she should go up a level with her documented concerns,
A couple of other ideas - 1) have family get involved with these meetings and following up on actions taken by management. Get everything in writing.
2) Bring along a pastor to be a support, or anyone in some official capacity, like a representative from a local politically active seniors' association. They usually want to follow up on these kinds of concerns
3) ask her doctor or some other professional to express their support for her in writing.
Good luck, She deserves better treatment than that.
Log all incidents - date, time, people, what happened. Keep plugging away at it. And praise good practice every time you see it, too.
The director and the management team are responsible for the behaviour of those reporting to them. If their staff are failing, their leadership is to blame. Banned from the room isn't really good enough, is it? That aide isn't banned from treating residents disrespectfully, spreading discontent or setting a bad example. If she can't be made to understand what was wrong with what she did and given training to improve, she shouldn't be on the premises at all.
Can you go any higher in the organisation?
She shook her head and said that the aide involved with the oxygen tank incident is now banned from their room. This specific aide also made fun of my great aunt and laughed at her when their toilet overflowed because she didn't know that you couldn't flush Clorox wipes, stopping it up. The Executive Director also stated that it is not my great aunt's responsibility to bathe, clean, or otherwise do the job of an aide/med tech/what have you. But the staff that cares for my great uncle seems to not have gotten this memo and this happens, if not on a daily basis, then at least a few times a week.
But even back then, I was not expected to bathe him - I was allowed if it made DH more comfortable but it was not my responsibility.
What has the Executive Director said? At the very least, NO ONE has the right to scream at your Aunt. NO ONE. I would report that and then make them tell you what responsibilities the spouse has. My guess would be to call for help when needed.
It is not for the aides - scratch that. It is not for *anyone* to be giving your great aunt orders, let alone for them to be yelling at her to get off the phone, or indeed yelling at her at all (unless she is very hard of hearing and they're more speaking up than yelling, as such).
The good feature of this ALF is that it allows your great aunt and great uncle to live together as a married couple. That is best practice; very good.
They have very different care needs, and it is important to check that the ALF is staffed and equipped to meet them all. But unless their admission to the facility was based on the condition that your great aunt would be your great uncle's primary caregiver with assistance as needed, they should be looked on as separate units and provided with the assistance they need individually.
Are you *quite* sure that your great aunt doesn't routinely insist that she "can manage" and the staff are having to work round her?
It is important that she is involved in her husband's care as long as it's nothing she can't cope with and that has always been her habit. If she takes on certain tasks, and the aides then think she isn't carrying them out properly, you can see how that would get frustrating for them.
What does your great aunt say about the situation?
An aide should never show anger towards a resident. Never. Doesn't even need discussion.
An aide should never yell at a resident (but see above).
If a resident is struggling with a routine, whether it's dressing herself or checking her husband's catheter, an aide should assist her and encourage her. Not criticise, let alone scold.
What was the director's response when you approached him/her?