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Senior Housing Mar 13, 2022
3 Steps to resolve issues with your mom's assisted living
by Jenn Buman

You walk away from your parent’s assisted living heaving a big sigh of relief. Finally, they’re moved and settling in. You think to yourself, Things are going to be great! I can relax now.

And then…things aren’t fine. It’s not great. There. Are. Issues.

Sadly, even the best communities experience glitches in care and service occasionally. Some chronic complaints in assisted living include staffing, food, call bell response times, and quality of care.

Follow these steps for resolving problems in your senior living community.

Prepare for crucial conversations before moving in

Manage any false expectations upfront. Before moving in, meet with the community nurse, resident care coordinator, and/or administrator. This is your opportunity to begin building a foundation of good communication.

Ask the leadership staff how they prefer you communicate should an issue arise. Some communities want you to come directly to the administrator. Most ask that you start with the department head. So, for care issues, you’ll talk to the nurse or resident care coordinator. Regarding food issues, speak with the chef or dining room coordinator.

Carefully review the careplan, contracts, and rules. Make sure you understand exactly what services you’re paying for and how charges are assessed. Find out how services are delivered and what’s the norm. For example, ask about call bell response times. How they’re measured, tracked, and recorded.

Care Conferences

A care conference is a good first step in resolving your concerns. Senior care communities are required to meet with you 30 days after move-in. And every 90 days thereafter.

But don’t wait. Request a care conference earlier, whenever a problem arises.

In a care conference, all department heads should be present. This gives you a chance to hear from each one about how your loved one is doing. And you can ask questions and give feedback from your perspective.

If changes are made to the careplan as an outcome of the conference, make sure you carefully review it.  

Communication Tips

First, know what you want from a conversation. Be specific. A vague wish for “better meals” isn’t helpful. Do you want softer, easier to chew meats? Or more fresh vegetables or variety? Would you like to see bigger portions served or reassurance that your loved can ask for second helpings?

Next, stick to “Just the facts, ma’am.” [This is an idiom attributed to Sergeant Joe Friday from the 1950s TV show Dragnet.] Basically, stick to what you heard and/or saw. Hold the hot indignation, exaggeration, and embellishments.

It’s tempting to get emotional and make assumptions about another’s motives or character. Especially when it comes to your loved one.

Example 1:

Maybe you’re worried about nutrition. Perhaps the food quality or portions seem skimpy. Maybe your mom complains about meal variety or being hungry.

The next step is to visit during several different mealtimes.  Make notes about what’s served, the presentation, portions, etc. See if there’s a pattern of low quality or quantity.

Example 2:

You may notice that your mom’s apartment smells of urine. You notice the garbage can is full of dirty depends. Or your mom’s pants and chair are wet. You worry she’s not getting toileting help, or housekeeping isn’t showing up. It’s easy to conclude neglect.

Instead, make notes about what you saw and when. Perhaps take a picture of the full trash can. (Make sure you’re respectful of others when taking pictures).

Deal with the immediate issue by asking for assistance. However, don’t try resolving the issue with direct care staff. They rarely have power to fix underlying problems (like staffing or training issues). Not only that, the caregiver or housekeeper might take a comment as a personal criticism and become defensive.

Next, try visiting several days at different times. See if there’s a pattern regarding the issue.

After gathering your observation notes, ask to speak to the appropriate department head or resident care manager. Follow the chain of command. Share a copy of your written notes and discuss the facts.

Again, check your attitude and assumptions at the door. This is a problem-solving conversation. If the person you’re talking with feels attacked and becomes defensive, nothing will get resolved. Ask for their insights into the issue.

Then determine what actions will be taken to resolve the issue and when. Get an action plan in writing. Set a follow up appointment.

NOTE: if your loved one is in imminent danger or your concern is a safety issue, get help ASAP, don’t wait for a conference or meeting.

Taking it to the next level – get professional help

If you’ve followed the chain of command but nothing changes, consider getting outside help. An ombudsman is your ally.

  1. Notify your referral agent about problems you’re having and any suggestions they may have.
  2. Call the facility’s state-appointed Long-Term Care Ombudsman and enlist their help.

Ombudsman work to resolve problems related to the health, safety, welfare, and rights of people living in LTC facilities, such as nursing homes, assisted living facilities, and adult care homes.

Each community or facility has an assigned ombudsman. The name and number should be plainly posted. They’ll know if there’s a pattern of similar complaints in the community and act as your loved one’s advocate in resolving issues.

Ombudsmen identify, investigate, and resolve complaints made by or on behalf of residents. They make sure residents know their rights. And they help advocate by representing resident interests with governmental agencies.

The Ombudsman will help if you end up filing an Adult Protective Services report.

In addition, if the facility you’re having issues with is part of a larger corporation, you might consider contacting the regional administration. The higher up bosses. You can do this at the same time you’re enlisting the help of an ombudsman. 

If it were a perfect world…

Without a doubt, understaffing is a chronic issue these days. Covid, poor pay, inflation, and supply chain all contribute to shortages. They directly affect care and services in senior facilities.

However, in my experience, senior care communities focused on caregiver ratios, have fewer complaints. They refuse admitting new residents if they can’t meet their needs due to staffing shortages. They’d rather have fewer residents getting quality care. Even if it means empty rooms and lower revenue.

It’s insider knowledge like this that makes a difference when selecting a senior community for yourself or a loved one. That’s what you can count on when working with a local Certified Senior Referral Agent – like me ??

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