Nancy has been in MC for 6 weeks and is not adapting well. She will go to breakfast and lunch, not dinner. They do have alternative meals but give her the meal of the day and never ask if she wants something else. She frequently just doesn’t eat and is losing weight. She has been getting paranoid, saying the staff is out to get her and has an anxiety attack at least once a day. They give her Ativan but she needs comforting talk to calm her.
I am concerned that she spends too much time alone in her room with no one checking on her. Once she told me on the phone that she was on the floor. I could hear her yelling for help with no response. I called the facility and they got her up. Another time she told me she was wet; bed, pajamas, everything, and could not find anyone to help her. Again I called.
This is supposedly a good facility but I’m concerned that she is deteriorating
I think your concerns warrant a formal sit-down with the SW, head nurse and activities director.
Has she been seen by a psychiatrist to evaluate the needs for scheduled meds late in the afternoon? These need to be given BEFORE she starts getting agitated. As explained to me by my mom's geriatric psychiatrist, you need a lower scheduled dose to prevent the anxiety from ramping up; giving meds in response to an episode means a higher dose.
Also, an antipsychotic like Seroquel may be much more effective in addressing the paranoia than an anti-anxiety med like Ativan.
If you are her PoA or legal guardian, then you can request a meeting with the admins. A good facility will be happy to meet with you and have solutions. The meeting should include her nurse and maybe her doctor to discuss exploring different meds and involving the staff to try other ways to coax her out of her room.
Right now there is a pretty severe labor shortage. My MIL is in a stellar LTC facility but even she has had longer wait times to be attended to. This is not to say something about the facility isn't a problem. Give them a little benefit of the doubt first.
Good luck to you.