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My 99-year-old father has been in assisted living and nursing care for the past 2-3 yrs. after a series of medical screw-ups. In nursing care because of a pressure wound, PT/OT would say they are visiting him 3x per week, but months would go by w/ him saying no one was working with him. When questioned, PT/OT said, "Oh, he just doesn't remember, beginnings of dementia, you know." He now has moved to assisted living where PT/OT have been great and are working him 3+ times per week saying he is motivated and should be out of his wheelchair soon. However, now he still needs assistance getting dressed and showering. The physical assistants at his current establishment have ranged from abusive and unwilling to help him to caring and helpful. When I mentioned my concern to the wellness director her first response was, "Well, the PAs are trying to work with him, but he must have been unwilling that morning" or "he's gotten a shower everyday scheduled, he must be forgetting." We are paying for level-4 assist. As an aside, my father has passed all the "mental capacity" tests taken. He doesn't have dementia. I am EXHAUSTED trying to make the system work. The year-long lack of PT/OT work in the nursing home has cost him, and I was unable to get anyone to address even after offering to direct pay for the service. The abusive/negligent PAs at his current assisted living facility had him demanding that I get him out of the place. The "blame the resident" approach of administrators+ is puzzling and maddening. Any suggestions as to how to get administrators to recognize there is a "staffing problem" and not a "resident problem" that needs addressing?

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Because it's easier than taking responsibility themselves. Sad but true.
I remember back in 1996 after my now late husband had his massive stroke at the age of 48 and once he was well enough to go into our major hospitals rehab facility to learn how to walk, talk and learn how to do everything one handed as his dominant right arm/hand was now paralyzed, I made sure to be present with him to watch and see exactly what I would eventually be dealing with.
And I clearly remember aides bringing the older folks in, mostly in wheelchairs and them just sitting there ignored for the entire hour until someone came to bring them back to their rooms. It was appalling to say the least, because I'm sure that the patients insurance was being charged dearly for something that wasn't actually happening.
I couldn't help but wonder if I had not been there all those days and weeks with my husband just exactly how much therapy he would have actually gotten either.
And again this was back in 1996. I can only imagine how much worse it is now especially with most if not all facilities running short handed.
I'm sorry you're having to deal with this as I'm sure your father deserves so much better. There's not an easy answer here as to what you should do, as you certainly don't want to make it worse for your father while he's there. No one should have to worry about that, but sadly these days you do.
I wish you and your father the very best. Sorry I don't have a better answer for you.
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anonymous1732518 Aug 2023
It is much worse. If you look at the help wanted ads you'll probably see many openings for nurses and probably even aids.
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At my Moms AL there was a book kept at the Nurses station showing when everything was done. See if this facility has one and ask to see it. His medication records are kept by the RN or medtech you have a right to see them. He is paying for the highest level of care then he should be given a shower and helped with dressing. If you have proof he is competent, then show them. I would sit down with the Administrator and bring this all to their attn. Tell them you would hate to move Dad because he has done well there but he is paying for services he is not receiving. Tell them the excuse is that he declines and forgets. Tell the Administrator that he does not have Dementia. Tell him that if Dad does refuse help in anyway, to please have the aide call you. You will then talk to Dad to see what the problem is.

Could it be when the aide is ready to bathe Dad he says he is not ready then. Same with dressing. If so, he needs to understand that aides are on a schedule. They have other residents to care for besides Dad. If he refuses, they move on to the next person. In Moms AL, aides were required to help with serving meals and cleaning up. Shifts usually 7 to 3, 3 to 11 and 11-7. Each shift has certain responsibilities that must be done in 8 hrs. I would say there are less aides on the 3 to 7 shifts.

Just go into it as you see a problem how can we resolve it. Your father is 99 and just because of his age there is some decline. Maybe he thinks aides will do things when he wants them done. It does not work like that. Don't accuse the aides until u have heard their side of the story.
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You’ve done an incredible job keeping you dad healthy and happy. 99! Amazing!
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As you knew before entering a facility (for your dad), facilities are famous for sometimes being negligent/abusive. That’s one big reason people try to avoid them. But as we all know, sometimes a facility is necessary, even tough we know the quality sometimes is bad.

“how to get administrators to recognize there is a "staffing problem" and not a "resident problem" that needs addressing?”

They already know that. But how many facilities will admit THEY’RE making a mistake? Legally for them, much better to blame your dad.

You’re in a weak position OP, and they know it. You can complain to them, go up the chain to the highest level. You can report them. Sometimes all that, will backfire and your dad will be treated worse.

Some health“care” workers retaliate.

I hope you find a good way for your dad, so the facility gives your dad the services they promised you.
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anonymous1732518 Aug 2023
Exactly VentingIsback. The more the more the resident can't do for him/her self, the better chance they'll get substandard care.

From seeing with my own eyes. many nurses and even the aids are overworked and overwhelmed. They should probably expect this taking the job, though they may be unprepared for what they encounter.
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