I'm wondering how to find out what's reasonable and understandable versus carelessness or neglect in memory care units. It has been a real education since we got my 95 y.o. dad into one in January. I've spent my life trying to be understanding, and yet I find myself privately angry at this fancy place we are paying 13k a month for. I understand that working as a caregiver on a memory care unit can be like herding cats. I understand times are hard with staffing and there is turnover. I understand I understand I understand. But how much should you excuse? What's important and what do you let go?
I stopped by on my way home from work tonight and saw my dad sitting alone waiting for supper. Everyone else had eaten and had gone off to watch TV in the group area. Dad often orders something other than what is served everyone else, because he doesn't like the food there. I was told he had ordered fish and chips or a cheeseburger. They kept saying it's coming, it's coming... and 40 minutes later it still wasn't there. I went down to the kitchen to check and they were harried and didn't know what I was asking. I came back upstairs to let my dad know they were still working on it, and he looks so pathetic sitting there off in the dining room by himself with his elderly head hanging down still waiting for supper so long after everyone else had eaten. It broke my heart. I went down to the front desk in tears asking the concierge the best way to schedule a family meeting in the next week with the manager, and he encouraged me to do so.
I went back upstairs to tell Dad it should be here any minute and they finally came around the corner with a very cold plate of fish and chips. Another caregiver told me that staffing had been erratic that day and a person who is telling me food was coming had gone on her break.
What do you make of something this? I know plenty goes on when we're not there, but I can only work with what I witness. I know things happen. I know there is a possibility of displacing my feelings about his decline onto the care facility. I don't want to rant and have them mistreat my dad either.
What would you do?
(I added a bit on about a lost wheelchair, which dropped off my first edit )
He could well be annoying the staff, just as he could be an annoying demanding parent in home care.
My stepmother is now in MC (stepfather died), she doesn't even know what she is eating all the complaining has ended.
He always wants special service/attention? These places are institutions serving the masses not designed to serve each person's special order for food, can you imagine if all patients wanted to order special meals? No one would get fed.
Perhaps you father needs to be told the facts, he won't die if he eats what is prepared for him, it is not a restaurant. Most menus include salads and more than one choice of food, why don't you go over the menu with him?
*If you show up and he is sitting in wet clothing ..that needs to be corrected.
*If you show up and ask where he is and no one knows and you find him wandering in the courtyard...that is a problem
The example you give with your dad's meal. What I would ask is this. Even though dad orders another meal could you bring him the meal that is being served to everyone, or at least a few items like some fruit or one of the sides. This way dad can eat while others are being served and then the meal that he wants even if it comes a bit later he will not be so hungry. This is sort of like what I did when the kids were little and we went to a restaurant. I would ask the server to bring some crackers to sort of tide the kids over until the meal came.
It is very possible that if they bring him the regular meal he may actually eat it and not "need" the one he ordered.
The wheelchair. Was his name on it? Where I worked I was responsible for a durable equipment loan closet. Our stickers were on every piece of equipment we had. Our wheelchairs had our info stenciled on the back if every wheel chair. I took pictures of everything Mom took into LTC, even her glasses. Goid thing I did, clothing lost was returned. Glasses lost were found, on another resident. Hairdresser mixed them up.
How do people get to where they think their "likes" must be catered to? Did their moms cook especially for each one in the family? Did their wives go, "Oh, honey, I've worked so hard all day and I can't wait to sit down, but if you don't like the stew, I'll stand here at the hot stove another hour and a half and make your favorite cheesy pasta with escargot on the side and your favorite chocolate cake? Would you like another helping, dear one?"
The food in the assisted livings I was acquainted with through my relatives was really good. Even if it wasn't, they would have eaten it.
I'm very sorry your dad is in such shape, it's distressing, but fish and chips or a cheeseburger don't sound particularly appealing, and I can't help but wonder what they were better than.
Part of the problem is these facilities ( at least by me ) advertise " Restaurant style dining" My FIL is in a very nice AL . most of the meals are pretty good , we have eaten some and my friend ( now retired) used to work there and could buy a meal for $2.00 on her shift, which she frequently did , since the food was good and very cheap. FIL has 3 entree choices for dinner and there are multiple alternates available at all times, sandwiches, salads, soups, chicken breast, hamburger , etc. Yet FIL was disappointed because he expected an actual large printed menu with dozens of options like a diner handed to him for each meal. He does not like that he gets a paper menu the day before where he has to check off what he wants for the next day. But then again , my FIL is a very spoiled , entitled person. He thinks this is beneath him. I told him he is lucky he can afford this place.
That said, if this is the "norm" at your Dad's facility, go ahead and speak to whomever in admin they suggest. I will say that at some point, this being a private business, often residents are told that they "may be happier somewhere else" when their needs cannot be met at the residence.
Only you can really decide, and I hope you approach honestly, asking the ADMIN (rather than us) the question above you wrote to us. Ask the admin if your requests seem to them at all "unreasonable". Ask that they be honest with you; tell them it's a learning curve for you, and you understand they are trying to keep many families and residents happy in an unhappy situation. If they are worth their weight in salt they will lean forward, grasp their two hands together, say "You know....................." and then level with you about whether or not your expectations are likely to be met. It would be a relief for you all, I hope, to approach this honestly and openly.
I sure do wish you the best. We sure do suffer for the elders we love when they needs must be in care. Well do I remember.
It seems to be a case of the facility over promising , but I don’t think I’d ever have the expectation that a care facility would operate like a restaurant. I think that when you find a person who thinks the food is good in one of these places, you have found a person who isn’t picky about food.
Yes he's a narcissist but with pretty bad dementia, I don't see how we could hold his eating preferences against him. There's not a lot you could hold against him at this stage. He's not consciously starving himself.... he's got dementia! No amount of reasoning is going to change that, or telling him to straighten up and fly right. The food is not good. Really surprised at that for how much we pay.
There is no menu in this memory care. You get what you get, one choice only. But in order to entice us to move him in, they promised he could order something else if he didn't care for what was being served. That is always either a cheeseburger with fries or fish and chips with fries. He does eat what they serve quite often (but always ignores the green vegetables). :-)
I don't know enough about adult family homes, good ones, but maybe he would have been better off there... There's just something about this corporate warehousing of the elderly that is really hard to take. But there are very few choices when you can't do the caregiving yourself. At least he's in a nice place and staff seems careful and caring for the most part.
In my case, it was a poorly managed facility and the fact that it is hard to customize with so many residences. I ended up going every afternoon and preparing a meal that I knew she would eat and yes, second guessing the caregiving decision.
As the dementia became more severe, she lost her appetite and her taste changed. So, that made it even more difficult for the facility and for me. But I agree, for $13,000 it should be served on a gold plate.
That said, if he doesn’t like the main meal, they typically have offerings that are always ready ie: salads, tuna or egg salad sandwiches, pb&j sandwiches.
The facility may have an in house nutritionist and perhaps you can request a meeting to brainstorm how to optimize his eating.
I would be careful about entitlement— you don’t want to develop a reputation of being difficult. You want to make sure that you are operating under the right expectations.
I do think it might be a good time to have a general meeting with the staff to review how everything is going and the meal plans can be part of this.
Bur remember, it’s not a hotel or restaurant (despite the outrageous fees). Hang in there!
My BIL has been in the NH memory care place for a year now. His cost of the memory care is $260 a day. Ranges from $7,800 to $8,060 a month where they give him everything that he needs.
Also he has a little fridge in his room where they put his Diet Pepsi he likes and water. Also he has a snack drawer where we put snacks in there for him if he remembers they are there if he gets hungry.
My BIL is on Medicaid which I had to jump thru hoops(all the paperwork) to get him on it last December. His soc sec and pension only pays for a portion.
We have his room set up like his apartment he was in. Got his recliner with foot stool, his tv, his pictures on the walls, and his hats on the closet doors. Also has his own pillows and blankets. Easy for him to adjust to the room. He swore he wouldn't be there but when an accident happened he landed there.
I would talk to whoever and get it arranged that on certain days he gets what he loves to eat then it won't be a fight. If they have a special menu maybe they can stick to it.
Hope you get some results. Prayers
I am experiencing much of the same issues with my mother who moved to MC when dad fell and can no longer take care of her. He is now in AL in the same facility. It has been a 6 week constant battle and visits almost every day to try and get moms care to a level I’m comfortable with - haven’t gotten there yet. Mom, too, is narcissistic and controlling. Her deal is she wants to be left alone to sleep until 11, not take her meds, or shower. She continually orders the staff out of her room in the morning.
I realize she is on a whole different schedule than what they are used to but this is MC. I’ve met 3 times with the head of the unit and discussed strategies to deal with mom. I get a lot of lip service that she’ll instruct and work with the staff but other than when we are lucky enough to get the 1 or 2 staff members that are just exceptional at their job get assigned to her area mom is unshowered, doesn’t wash her hands or face or brush her teeth for days, wears the same dirty clothes each day. I have signs all over her room to instruct her and the staff - “brush teeth each morning” “put all clothes in the hamper at night” etc.
it’s been suggested to me several times to hire a home health caregiver for mom but I’m sorry that seems crazy to me when you’re spending so much for MC.
Any other ideas friends - I’m all ears and desperate.
MDs must write ALL prescriptions to "drug up" residents and "keep them immobile". Funny but I always had trouble getting moms M.D. to write her ANY prescriptions for zombie meds.
The issue our op is talking about relates to a meal served late and cold one time. Not a safety issue or a horror story so many people loooove to post about.
I assume you took your mother home to properly look after her after the abysmal ordeal w cameras in the MC ? I had my mom in one MC for 3 years and saw none of the horrors you mention, nor did I see them in the MC I worked at.
Narcisistic behavior often involves making other people jump in order to prove how important they are themselves. There are many many posts on this site about how to get out of the habit of ‘jumping’. That’s why there’s not a lot of sympathy for Dad. The staff have almost certainly run out of sympathy. OP is still jumping.
Some people hire a person to visit their loved ones every day (at a different time) to gather information about what goes on. If the person has an apartment with a kitchen, then a helper can be hired who likes to cook and spend a little time doing a joint activity (e.g., Visiting Angel or Care.com companion). A fancy place doesn't make up for loneliness or personal preferences. Most memory care patients aren't even aware of the frills, those places are really catering to families who are willing to foot the bill (i.e., those who appreciate the finer accommodations and can pay for them).
I am sorry for the predicament your dad’s appetite has placed you both in.
This is a long shot, but maybe you could get management to agree that you can bring and have the kitchen store in their freezer a couple of delicious restaurant-purchased fish and chips meals that you have frozen in secure packaging…and in huge letters marked and dated that it is fish and chips meal for (your dad’s name)…so that no-one steals or dumps the couple of meals.
Then, when your dad vehemently refuses whatever dinner is on offer that day, the kitchen staff can pull out and heat your dad’s special meal?
Additionally, I have never tried them, but one can purchase boxes of eight individually wrapped cheeseburgers on buns*. Maybe you can buy a set and see if your dad will accept the flavor? You could then stock a couple at a time at the memory care place’s freezer if management agrees.
Here is taste test article about frozen hamburgers (& cheeseburgers) on buns: tinyurl:
https://tinyurl.com/4t7vzerj
I hope my ideas can help you, and your dad. At that advanced age, I hope he can enjoy most of his meals. Love, and good thoughts to you and your dad.
————-
*do search term online for “Pierre Signatures Angus Cheeseburger, 6.2 oz, 8 ct $19.89” or see this link - please note again I am not recommending this brand, I’ve never tested or tasted such a thing but maybe your dad will go for it. I am hungry right now, so this looks tasty to me: tinyurl:
https://tinyurl.com/4vecajst
Edited to add: this brand of frozen Angus cheeseburger gets 4.5 stars out of five, and has hundreds of reviews. Looks good: tinyurl:
https://tinyurl.com/d3juth8t
That said, they can’t be expected to make an individual meal for everyone so your dad needs to eat what is given or else move to a place where he likes the food better. When my mom was in a nursing home they said the residents were more than welcome to have Door Dash or whatever service they wanted deliver food - at their own expense of course. Is that an option?
First, I would figure out what you want to do about what is going on. Then I would call LTCOP and get a case worker on your case.
Lack of staffing is no excuse for cold food and leaving a person by themself in an otherwise empty dining room.
On the other hand, food is a very important part of the social activity of a senior at one of these places. If your Dad doesn't like the food nearly all the time, I think you might want to look at another place for him to go that has food more to his liking. Does he choose his food the night or week before? If so, there is no excuse for the kitchen to have provided his unique meal on time.
I would suggest you talk to LTCOP.
Once when my mother had broken her leg, her elderly, outspoken sister had raised a ruckus upon locating my mother's cold tray of supper.
I've found for things like this, the eating issue, I would speak to the aids. They are the ones that spend the most time with your loved one. They probably know more than anyone there about your dad. I would just let them know, I don't like seeing my dad sitting there by himself, waiting for his food while everyone else is gone. Then his food is cold. Ask them if there is something they can do to help.
Maybe you can keep some snacks in his room and ask the aid, if his food isn't ready when others are eating, could they bring him a snack until his comes so he can eat with them while waiting. Or, could they place him with the other folks in the main room until his food does come. If you start this conversation with them, they may also come up with some ideas to help.
I found that as obvious it may look to you, people in these places are sort of numb to it and need a reminder. Also, speaking to the people who do not spend a lot of time with your dad may not get you what you need. If you discuss your sadness at seeing your dad like this to the aids, they'll be more aware of it and hopefully will help.
I still think you do need to talk to the higher ups though, just to make sure everyone is aware. We paid almost 11K per month until mom got approved for Medicaid and this place is not even close to the really nice places I looked at and couldn't afford. I could not believe this cost when I first started this journey.
I visit as often as I can and at different times to make sure my mom is being cared for properly. There are still always issues but I'm feeling somewhat better about it.
I hope you find some peace with time and can visit your dad without worrying about his care all the time.