Assisted-living, memory care: How did you find a good facility?

@methel
That is so interesting. My father, who is a smoker (so that can have an effect for sure), and who also has sinus issues, is much the same. No dementia diagnosis, but he is always complaining about the food I make having no taste—like hospital food. And honestly, although I do not make spicy food for him due to digestive effects, I put a lot of seasonings in everything! He, too, loves Hostess Cupcakes and always has a supply in his room!

Alot of people lost their sense of smell which directly effects taste with COVID19

He can chalk those symptoms up to smoking. If he quits that he'll find that the sinus and taste issues will clear up. He's doing it to himself!

Getting back to original post about finding good assisted care facility I want to be very honest here. I have worked as a nurses aide and also have experience with my mother at these facilities. Until nurses aides are paid fairly for the job that they do there will be no good facilities. They do 90 per cent if the day in/day out work. Nurses and doctors prescribe and administer meds. That's it for them. I am telling you this not as a disgruntled employee but as someone who sees the steady decline in the attitude of these people. They wash feed dress etc etc every patient there and get paid very little. Most are recent immigrants that barely speak English. This job is considered poorly by all of us and until that changes assisted living facilities will never be a place that either you or a loved one wants to go to. It is like every else. The wealthy can afford to have private duty help and pay them nicely for their work. Our pay attitude needs a big adjustment in the USA in order to attract dedicated people

@scain
I can see this being true. I hope that there are exceptions out there! I have not researched the financials of these places. They, on the whole, are quite costly for the consumer. I don’t know if big corporations want to pocket too much profit, or if insurance costs are just so exorbitant in our litigious society, or what. But the front line carers who do the most diligent, and let’s face it, most unpleasant jobs (cleaning up messes, bathing, etc), need to be compensated for sure!

And we as a society must take stock and see the value both in our elderly and those who take care of their needs!

My one experience aligns with your reply.

First, thank you to you-for speaking up and to all CNAs-certified nursing assistants who provide good care.

After a hip replacement post-fall, I spent 3 weeks in-a facility.

One CNA was awesome-on her shift. She whispered what to watch out for from experience. Still, two separate times i was “offered” the wrong meds—both times I asked to check, the facility records - or I’d be glad to show my personal list of meds and or call my doctor. They each check d my records there and the problem was resolved.

Nutrition not considered-I verified that heart healthy, low salt not used! I had family bring me “that kind” of food.

One experience is not statistically significant of course.

One more thing that I neglected to mention that is key is to have as many "advocates" as you can. The facility where I worked nights and my mother was the charge nurse during the day shift was a Catholic facility that is run by the Carmelite nuns. These nuns dedicate their lives to the care of the elderly. Sadly, no matter how many good intentioned people run these facilities, it still comes down to the nurses aides doing the work. My mother had to be admitted to a facility that we five children checked out and felt confident that it was a caring, clean place for our mother. She had a stroke in her late 80's that left her without feeling from the waist down. So she was 100% incontinent. I remember her being very vocal when a male nurses aide had to change her and her bedding. This was accomplished using a harness type contraption. She was absolutely lucid until the end. She was a strong, proud woman who had to have some aides that she was embarrassed to have the need for.
My two sisters are both R.N.'s and I asked them what about having Hospice and they both told me that unless a doctor said that the patient had 6 months or less to live, our mother was ineligible. One day while visiting, I asked the R.N. and she told me that a patient on that ward had hospice for 2 years now. So I quickly asked for my mother to have hospice too. It is another set of eyes to visit the patient and advocate for them as needed.
One of my sisters did not want my mother to have pain meds as she would not be lucid. While visiting with a minister from hospice we stood at my mother's bed while she slept and he told me that seeing my mother "wince" while sleeping, that she had pain. So I went again to the nurses desk and asked for my mother to have pain meds. Listen, none of us will ever know now what it is like to be admitted as a patient and live out your days there. The 5 of us siblings kept a vigil for my mother during the last weeks of her life. She simply stopped eating and didn't want to live any longer in her condition. I am a huge proponent of assisted death. At any rate, she did die shortly after hospice began. She told me that she didn't want to live any longer. She was almost 90 years old and we as a family did nothing to intervene. No feeding tubes, etc. etc. We have no regrets. I once told her on a visit that I wished that I could take her home (with a hospital bed) and she said to me "Susan, that will never work". If only we could all die with dignity. We can only try. I guess my only advice to the person wanting to know about care facilities. It is like any other place (ie. daycare, dog care). Visiting unannounced at odd hours is helpful. Is it clean? Does it have enough personnel to care for residents? Will you have enough advocates who understand your wishes now that can be carried out. I am not sure about a restricted diet. My experience tells me that your advocates should be the ones making and bringing the food. It doesn't sound practical. I am not trying to scare anyone. I simply want to help people understand the challenges of administering care to the elderly. Yes, a lot of these facilities are run like corporate America that is bottom line conscience. As baby boomers, we currently make up a large portion of Americans over the age of 65 yrs. old. Can we change this system. I don't know. It seems unlikely. Please, have your advocates ready and willing to go the distance for you. That alone can be a challenge.

I think practically one of the things that can be done is to check the staff to licensed beds ratio for any facility under immediate consideration. Longer term, one could lobby the state to set and enforce workable standards for the staff to beds ratio. This wouldn’t mean that the aides would be caring and competent but at least there would be enough of them to do the work.

Has anyone had any experience with building a relationship with the ombudsman for the facility? Or with facilities that use cameras in the building to monitor staff performance?

Good idea get to know state ombudsman. I did it for 10 years. Written requests. Make a difference. Biggest case was call lights were totally inadequate. They had to update and install code quality lights. So speak up. That is how improvement happens. Also volunteer to be an ombudsman. Be a difference