<p>The last time I visited my 92 and 1/2 year old mom , I noticed a sign on the wall " blank may not hit or kick her caregivers " Really ? Sounds like pre-school all over again . I wonder if they get time -outs ? Mind you , this is a top of the line facility . What else goes on that you are aware of ?</p>
<p>fauxmaven, Does your mom have a history of being combative with her caregivers or is this sign in everybody’s room? My 91 year old MIL has been in assisted living and now has been in a memory unit for the last couple of years. Most assisted living places are not really equipped to deal with residents who hit and kick staff. I believe that could be cause to be asked to leave so hopefully, your mom is doing okay with that. Assisted living/dealing with these issues with elderly parents is very tough. I know in my MIL’s memory unit they do puzzles,crafts, with the residents,so yes, sometimes it can remind you of preschool. My mom died in July at 87 and was able to remain at home with my sister. Had she lived much longer though, she probably would have had to go to assisted living or a nursing home as she had really declined in the last year of her life. There are no easy answers to any of this,especially with people living much longer than in the past.</p>
<p>fauxmom:</p>
<p>Did you ask the staff why that sign is on the wall? Is it really some sort of punshment or do they actually think a written reminder would prevent the hitting? There’s no way I’d let this pass without finding out the details behind it. And of course, you need to be open minded enough to realize that some elderly do sometimes resort to strange behavior but even so, what good is that sign going to do in the minds of the staff?</p>
<p>I agree with ucsd<em>ucla</em>dad, The first thing I would do in this situation would be to ask why the sign is on the wall. With all the years of assisted living and memory unit with MIL and hospital and physical rehab stays in the last few years of my mom’s life, I’ve gotten pretty good at just asking the staff what’s up with something. That is the first place to start with this so you do not let it continue to bother you. Maybe there is a simple explanation or perhaps they would take the sign down if they knew it was bothering you. Good luck.</p>
<p>I agree, you need to ask about the sign. They do not always notify you when there is an incident. I had something happen with my father when he was in rehab. An aid claimed that he did something that he had no memory of and he was put on a very expensive prescription drug for Alzheimer’s by the resident Doctor. He has never been diagnosed with Alzheimer’s and when I went to pick up his prescriptions I was shocked that they had added this drug without consulting his Cardiologist or Nephrologist. The Dr. that prescribed it never saw him or consulted his regular Drs, just ordered the meds over the phone! Now I make sure that it is written in his chart that any med change must be ok’s by his Nephrologist and I review his med list at least once a week when he is in rehab.</p>
<p>Ask them about the sign, and ask them to call you when there are incidents like the one that must have led to the sign. My mother’s assisted living and later her nursing home always called me when there was any kind of an issue. I believe they were required to notify family for a whole list of things, from minor to major. It may have been the facilities’ policy. I always made a point of asking questions when I visited and developing a good relationship with the staff. In my experience, that made the quality of her care much better. My mother was the kindest, sweetest, most mild-mannered person you could imagine. But as her dementia progressed she did start hitting staff members. It was dangerous to her (she could have fallen or had a seizure) and to them. I was always impressed with how well they handled these situations.</p>
<p>I have heard of dementia patients that hit staff, too. It is a difficult disease. Ask questions. If your mother has dementia, who is her medical poa? If it is you, then you should have no problem getting the info.</p>
<p>Sorry that you are dealing with this.</p>
<p>When my M-i-L was in a dementia assisted living, we were lucky that she never became combative. But her roommate did, and hit her. The facility immediately removed the roommate. I would ask about the sign as well. It may simply be a reminder to the staff to stay calm. I am so sorry that your mom’s dementia may be causing her to behave in an aggressive fashion. They should definitely be calling you to report even the slightest incident. I know MiL’s facility did just that. They were wonderful. I wish you well.</p>
<p>I am not the contact person . I live on the east coast , and my mom is in Calif . She has hit and kicked people . No one else has the sign . My sister and I are not on good terms and I have been told by her not to speak to the staff , but to let her know . My mom has a Geriatric Case Manager who send my sister and I emails every week or two . She keeps in tighter contact with my sister . I call my mom every few days .</p>
<p>I have seen many “memory” signs in the rehab/assisted living facility that my mom used and have an aunt with dementia who has been booted from such a facility due to her attacks on staff. In my mom’s case, she didn’t need the memory signs but we had to post several large signs over her bed and near the door to remind the staff not to leave her without O2. There were several times when we found her gasping for air after they left her hooked up to a small portable tank instead of putting her back on the concentrator. The staff wasn’t too happy when we put up the signs…too bad.</p>
<p>fauxmaven, I can understand that your sister is the primary contact with the facility if she is local but it seems very oppressive to feel that you cannot even ask staff a simple question about your mother’s care (like what’s up with the sign) when you are visiting California. Since the geriatric case manager emails you updates as well, I assume there is no problem with release of information re: your mother’s care. I would think a discussion with your sister about your role in your mother’s care may be in order. My older sister (who my mother lived with until her recent death-I was out of town but visited often,sometimes for days or weeks at a time when there were problems ) had power of attorney re: my mother but I was still involved in her care and would not have stood for one minute with my sister telling me not to speak with the staff directly about any of my concerns. There would have been a major discussion if she had ever said anything like that to me. Luckily though, my sister and I were pretty cooperative so I of course, can’t really know what is going on between you and your sister. My sister in law is the primary contact re: my 91 year old MIL but there has never been a problem with any of the rest of us talking to the staff. As long as those that are not the primary caretakers are not doing anything to undermine the primary person, I don’t see any downside to having other family members have a relationship with the staff,especially with the staff that are providing day to day care. It’s great that you are calling and visiting.</p>
<p>I love my parents. They are still in an independent living apartment, but really should be moved to assisted living. </p>
<p>Today, my dad was discharged from skilled nursing. I will not go into details, but for one week it was necessary to resort to our old pill tender rather than the one prepared for them by the pharmacy. Dad absolutely must take his antibiotic. </p>
<p>My background is former LD/ED teacher, school psychologist for 30 + years. I made a chart to accompany the four time per day pill tender. I sat with my folks and explained in very simple terms. I repeated, practice, repeated, quizzed and reviewed. I made an additional poster. At some point I almost cried not out of frustration, but of sorrow because I was treating my parents like children with severe learning abilities. It was so insulting, but totally necessary. </p>
<p>Unfortunately, if one of my parents were hitting caretakers (so far no problems there) it would be necessary to post reminders and use techniques that are effective with much younger learners. It is sad, but unfortunately instructions must be simple, repetitive, and reinforced frequently. </p>
<p>I know it can be upsetting, but we it is so hard to find strategies that are age respectful AND effective. </p>
<p>It is not easy.</p>
<p>Sometimes facilities do have rules about who can have what level of discussion with the staff. I resolved that problem by putting the names of several people in her chart. In the OP’s case, maybe staying in close touch with the care manager is the best thing if you can’t communicate with your sister.</p>
<p>And OP, I just remembered this about signs: When a friend’s father was in the first stages of Alzheimer’s and knew it, he had his wife label things with Post-it notes (refrigerator, keyboard, television. . .) so he would remember what they were. Using labels is fairly common, and maybe that’s what the sign is about.</p>
<p>worknprogress2, it sure is not easy. Some days I really want to be able to share all that I learned in the six years my mom was in long-term care, and other days I want to erase it from my memory and never talk about it again.</p>
<p>worknprogress and geezermom, We were starting to have to do things like post reminders in the last year or so of my mom’s life as well. That is pretty typical I believe and has been going on with MIL as well. I know what you mean,geezermom. This is all very painful to see our parents deteriorate. Mom died in July at 87 after 5 1/2 years in and out of hospitals,physical rehab and finally hospice. MIL at 91 is currently in hospice because of Alzheimer’s but has been in assisted living/memory unit since age 85. I have felt emotionally worn out at times but it’s just what alot of us at this time of life are facing with our elderly parents. It definitely is not easy but I was glad I could be there for my mom at the end.</p>
<p>Thnx, geezer & servmom. As I re-read my post this morning I felt bad that I went on and on about my situation. My purpose was really to just say to fauxmom not to be too offended by the sign, whoever put it up may not have been as condescending as it would appear. There is certainly no harm in asking, by all means ask what’s up; but it may be that the sign is actually helpful. As I said, if you had watched me yesterday you would have thought I was being patronizing. Actually, at one point I said something and my mom said in a slightly irritated voice, “Well THAT’S simple.” I am pretty sure by this morning she will have forgotten the instructions.</p>
<p>
A co-resident at my Dad’s Assisted Living slammed a metal door on his hand because she found him irritating. They had to amputate 2 of his fingers. Impulsive anger can cause someone else serious injury. Perhaps the staff is trying to avoid such an accident. </p>
<p>That said, I understand first-hand how hard it is to be the out-of-towner and not know what’s going on as fully as your in-town sibling. </p>
<p>Facilities often ask family to communicate primarily through one child so they don’t get caught in a cross-fire among siblings, or confused by too many family instructions. They assume the siblings will “talk amongst themselves” and winnow down the essential information. That goes both ways, however. </p>
<p>Can you engage your sibling to fill you in more often about small changes in your Mom’s behavior? It sounds as though you were taken by surprise, not so much by the sign but that there was a need for such a sign.</p>
<p>For awhile it was common to prescribe atypical antipsychotics for dementia patients because it calmed them down. My grandmother who finally died at 99 was prescribed such a medication. It allowed us to visit with her and the staff at her assisted living to have pleasant relations with her. I believe the FDA issued warnings that it can lead to stroke. In all honesty, I think it was worth the risk in her case. She was a delight until she passed peacefully in her sleep.</p>
<p>I get messages from the Case Manager every 2 weeks or so . My role is to shop for any clothing my mom needs , and then mail it . I get reimbursed from my sister , who is a co-signer on mom’s account .</p>
<p>
Sorry if this comes across wrong but it sounds as if you’re taking a very passive role in this. It seems that your role would be as the child of your mom who as such should be pro-actively performing whatever tasks you want to perform and that are needed. There’s no way I’d allow my sibling to stand in my way on taking care of my mom and I know she wouldn’t accept such behavior from me either. </p>
<p>Being a co-signer of an account is just a technicality and doesn’t prevent you from inquiring on the conditions at the home, discussing it with the staff whenever you want, and generally making sure your mom is well taken care of and that you truly understand what’s behind things like the sign. This sign that you understandably find irritating is likely just a telltale of something else, something more concerning, like perhaps an increase in dementia and untoward behavior, than the sign itself.</p>
<p>Make sure you’re communicating well with the facility - don’t just wait for someone to give you info every couple of weeks or so. Ask questions and make sure you feel comfortable that you’re getting info. Just the fact that they know relatives are actively involved can make a difference in how they treat the particular patient.</p>
<p>It seems that those aging sometimes follow a path that reverses the maturation and learning process that occurs when you’re a child. The “filters” that are established in childhood about how to behave and what to say seem to erode and sometimes disappear.</p>
<p>Maybe the sign is there to help the caregivers with a response when they are met with physical resistance. Perhaps having them point to the sign would be helpful. </p>
<p>In any case, the people who work in these facilities do not have an easy time. My experience is that the management positions and sometimes the caregiver positions have a lot of turnover.</p>