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I'll make my story and questions as short as possible. In February my mom had a stroke, hospital for a week, then went to rehab for 10 days and then she was home with me caring for her and my brother (Down Syndrome). I am lucky in many ways my mom has long term health insurance so getting caregivers to come in and care for her while I went back to work was covered but after about 3 weeks at home something changed. (Now I know it was Sundowner's & a UTI) Mom began to fight the caregivers. It didn't matter who it was. When we finally got an appointment with a neurologist she attacked her and was placed in Geri Psych hospital (worst experience). Now she is in Memory Care unit at a assisted living facility about 5 mins from me. I go to visit her everyday if not twice a day. I go in the morning before work and on my lunch break. My brother goes to a day program so evenings are spent with him. Yes I know I am crazy but my mom's stroke took her ability to speak, she had no psychical limits she was walking just fine until she entered the facility and now she can no longer walk. She is in a wheelchair or in bed. Well this week I have noticed that they are having difficulty transferring her to the toilet and bed so now they just seem to be putting her in the bed. Only a few girls have said they have problems with her transferring , the others say she does just fine. So I took a day off and hung out there all day. Well mom did just fine while I was there. The very next day when I went to visit mom was back in bed.
What do I do? I asked the caregivers about it and they got very defensive and then I was given two different excuses. Went to the director and was given another excuse that the girl I had questioned gave her..... So I am getting 3 different stories.
My thought is if you are unable or do not want to care for my mom then please tell me and I'll find another facility. I don't want to move her, she has been there since May and I feel has just gotten settled in.
Do I back off and let them keep her in the bed all the time? I feel like if I say anything my mom will be the one to suffer. And my mom is practically non verbal so if they do anything she wouldn't be able to tell me.
And now I feel like the CNAs are mad at me cause I questioned them. One is avoiding me and she use to be so friendly. What do I do? I don't feel like I should apologize for questioning why they are always putting her in the bed. Or should I Just to smooth things over?

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UPDATE: Thank you to everyone who replied just knowing others that are going or have gone down this road has given me a little piece of mind. We couldn’t get her pain under control and the Dr feels her dementia has progressed so we made the decision to put her on hospice care. In doing that I was given the option to place her in their Comfort Care Center/nursing home. It is a little further from my home but only 25 min drive so not terrible. She seems to have done well with the move. But I fear the Dr was right. When they try to get her out of bed now she refuses screams and fights. She does wake for a while during my visits sometimes she is “with me” sometimes she isn’t. I did follow much of y’all’s advise and visited many nursing homes in my area. None of which I felt were right for mom. I again looked into getting in home care for her but with my brother I just feel that is too much for him to handle and watch. I have to be very mindful of the impact of this on him as well. I don’t wish anyone be in the position but I know many are in balancing their family with the care of a loved one. The old facility administration was actually very helpful with her move. CNAs weren’t vey helpful but that’s ok. The facility even gave me a refund for the days we didn’t use after I paid. I will never know for sure that I have made all the right decisions but I have to trust that I am doing what I fell is right for my moms care during all of this. I was with my father when he was placed on hospice but he had cancer (my step mother made all the decisions for him) and his time in hospice was more clear. Although I had hoped my mom would bounce back, I’m afraid that she has started down the road to leaving us. She made her advanced directives very clear in her trust so I know I am doing what she wanted. And in the new place they have made her comfortable without sedating her which is a very fine line to walk when you have a new pt. I am at ease in the new place and have been with mom everyday at different times to make sure she is getting the care she needs. As we all do, I wish my moms road was easier.
Again thank you to all who gave their advise and wisdom to a newbie who is just trying to navigate a path that is so difficult to go down.
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Momheal1 Aug 2021
You are an Amazing Daughter. Surrounding you in Peace - strength and comfort. 🦋
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Put a camera in her room if you are able. I would not feel bad about moving her if you get the same unacceptable answer from the administrator. She will get better care if they know you have no compunction in removing her. Make Contact with an ombudsman for sure, if nothing else for future reference.
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Nayners24 Aug 2021
Yes, yes, yes to the camera!! In my personal experience with my aunt and horrible caregivers, the camera was my witness. I didn't hesitate to send video to the caregiver company. Many caregivers are in it simply for the money. They do not care about the client. Just the thought brings tears to my eyes.
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My experience tells me that you need to be her advocate and make sure that they deliver quality care, not just what their supervisors will tolerate. I see it frequently: call lights on all up and down the hall and the staff laughing it up in the office.
There were simply no nursing homes where I would place my wife with dementia. I undertook the task of caring for her at home with caregivers whom I supervised and worked with. We became like a family and provided 24/7 care for her for 2 years. It was expensive, yes! But, she was happy, clean and knew that she was loved.
Anything less is simply neglect.
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Move her because you won’t have peace of mind worrying.
If the aides are avoiding you, that’s huge red flag.
I did not like a placement she had (years ago) so I called her doctor, told him I wanted her to move to an assisted living with private room and bathroom.
He sent the order to the supervisor, I gathered her belongings and wheeled her to my car, with her oxygen tank, and she was much better off.
Long term care insurance enabled her to have more options.
Long before that circumstance, my cousin was an absent POA. She never visited places, she decided from afar which was inadequate.
During a visit, I found her scratching her shingles, hands all bloody, soiled herself, the whole hallway stunk, so I called the state omnibus.
He was there within an hour.
They had tons of violations and understaffing. Closed for a few months to address it all.
No regrets making that call.

Your instincts are talking to you.
Listen to them.
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My mother was in a rehab facility and they were horrible to my mother until I hooked a camera up in her room, when they noticed it, they put a huge note outside mothers door saying “your under video surveillance” everything was peaches and cream after that!
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Move her! You shouldn't feel bullied because you question your mother's care. She needs to be able to be as active as possible for as long as possible. Sounds like they are "restraining" her just to make it easier on themselves, and that is detrimental to your mother. Trust your gut and find a better place for her.

In my situation, my mother in law was in hospice, and and we disagreed with their care (they were making it easy for them to handle her). So we fired the hospice and got another one. It was a horrible experience as the hospice was totally unprofessional and violated the law while we were going through this. That told me I was doing the right thing in moving her to a different hospice service, and I fought them until we got her transferred without ANY cooperation from them. My gosh. My only regret is that we didn't do it sooner.
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My mom had long term aphasia from a stroke when she was 70 and wound up at 93 in the hospital after a UTI. She was not moved and her dementia took off from the hospital experience. I was told as much by a doctor at the rehab I placed her in when she couldn't hold up her own weight. I was hoping the extra pt at the rehab would help her make one of her miraculous recoveries. But things were not great at the rehab either and I couldn't visit due to covid. Looking back I realize she was declining even before the UTI.

There is the stress of moving your mom vs continuing as it is. I wouldn't expect things to get better there. What you see when you are there is probably even better than when you are not. I don't see a reference to your mom's age. Wondering if she can express her wishes and feelings even with her aphasia.
I would talk to an outside neurologist if she has one asking considering where she is now, what would be the best way to go. Maybe even talk to her primary as she/he may know your mom well.
There are places that prioritize walking with the patients, moving them and assisting with their independence but it's not easy to know which ones actually do these activities from outside reviews. Maybe talk to some people who know first - hand the experience with another facility.

Hoping you will take care of yourself as well.
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Unfortunately, many facilities do not force them to do anything - easier for them. Especially, if she is nonverbal, the longer she is left in bed, not bathed there will be more deterioration in both her physical and mental decline.
I had a similar situation with my Dad and we made the call to move him.
Don’t forget, they get money for each client.
If I were you, I would get her out fast. Once done, put in a formal comply with the state.
Been there & Done that.
Good Luck & Hugs
Nanakw
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I am so sorry you and your mom and brother are going through this.
My sense is your mom needs a higher level of care than this memory care facility can provide. They do not have the medical resources a nursing home has. My mom recently went from ALF to hospital after delirium we thought was triggered by a uti. It wasn’t. She was dehydrated. Anyway, after a terrifying few days when we thought she was mentally gone, (hospital security called; sedating her with Haldol), she spent 2 1/2 weeks in rehab and returned to herself. She is now back at the ALF. I say all this bc during that time I was looking into memory care and learned they don’t have the medical team like a rehab or nursing home does to deal with the delirium (should it return).
I do not think the ALF is enough for my mom and in looking for her next placement, I will be looking at nursing homes, not memory care, bc I don’t think they are equipped to handle my mother’s needs. It sounds like your mom’s needs aren’t able to be reliably met where she is. I would visit some nursing homes, check their medicare ratings and talk to the staff and residents there.
Wishing you some good support in caring for your mom.

Oh! And if it’s less than 30 days since she left rehab, you can ask for her to be returned bc she was prematurely discharged—which is what it sounds like with her not walking.
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Dragonfly39: Imho, you have every right to question why they are keeping your mother in bed all day, e.g. it's easy for them, but your mother is the individual whom they are supposed to be caring for.
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You should go with your gut. I also highly recommend having a camera in the room if you have a loved one with dementia. They do not have a voice and rely on you to advocate for them. Based on the things I saw in my moms high end memory care facility on camera, I would never have blind faith in the caregivers in these facilities.
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I live in assisted living because I can't walk - but I am l00% functioning, still working two jobs at 87 l/2 years old (51 years and 15 years as a Power of Attorney) and do 99.9% of what normal people do against impossible odds - but I force myself to succeed. On two occasions I nearly lost my life because no one stepped up to the plate (emergency heart surgery after I was unconscious for 25 hours saved my life because I dialed 911). The other situation was critical too - but I made it. And there were two more times. I do it all myself because I cannot depend on anyone to do anything. They are understaffed, underpaid, and do what they must. I would consider another facility and see how it works out.
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Dragonfly39 Aug 2021
Thank you so much for your reply. God bless you for giving me a 1st hand account of living in a ALF. What a strong lady you are. I will be you one day as I don’t have any children and out of cousins and such I’m one of the youngest so don’t think I’ll have anyone looking out for me either. I pray for good health for you for many years to come. You sound like an amazing lady. I’ll update on mom soon.
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We had an Aunt with Sundowners and knew that she wouldn't adjust to the Caregivers. A demanding woman she wanted to stay in her home: but Re luck ently, we agreed to and chose to let her sleep at our home, every night, then would transport her back to her home daily. It seemed awkward but we both quickly adjusted. Obviously, her own home and our help made life livable, even enjoyable. She lived on taking care of her personal essentials, and we enjoyed the experience of living with a person who was living in her past - often repeating stories of her life in the 1920' and 1930s. JCD
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Jimmy35 Aug 2021
I think you qualified for your Saint's wings! Find out what works and do it!
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You have a very tricky situation there. The problem is what happens when you're not there. If she's pretty nonverbal it will be hard to know anything. Can you have a camera recording? They did allow that where my dad stayed but I didn't put one in, didn't know if I should or not or how to go about it. What to do. It helps to try to be friendly with the staff though I know that can be hard to do usually if you can they are more helpful. You are in a really tough situation with your brother as well. You may need to look at other places to see if that is the problem, sometimes the staff really don't do their job or they do but they are understaffed and can't work with all the residents. The same problem could come at a new facility also. Has the irritability gotten any better? Staff will usually avoid the more irritable patients though they do the job they get out fast and move on, maybe she is still being fiesty with them. She may even act different when you aren't there. Also I think you should start writing about what happens each time like when you visit and what you observe and what you ask then what the staff or manager say. If you have it written down it is your account in case something happens. It can show the discrepancy in what stories they each tell you. I'm sure the facility doesn't really want to lose the pay from having her as resident. Tough decision but you have to make one. When you visit, though you're probably exhausted, maybe can you be the one who helps her get up and get around a little. That may be the only therapy she gets if they aren't providing it.
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Don’t back off. Keep at it. There’s no reason for her to stay in bed all the time unless she has MS and even then people still get up. They’re being lazy. I worked in facilities for six years. My mother died from nursing home neglect. Is there any other facilities or is home health an option? You can anonymously report them to the state department as well. One thing I learned the hard way was to NEVER tell them when you are coming. Pop up at all hours unannounced. Send in people they’ve never seen before to visit. Make nice with the people who aren’t having a hard time and see if you can get information. Unfortunately you have a long road ahead but don’t back down! Get a lawyer if you have money and keep on retainer. Whatever you do keep the facility in the dark about any plans you have! It keeps them honest! I will pray for you.
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jimlindac Aug 2021
You are right on target with your perceptions about these facilities. I had a camera in my moms memory care unit for 2 years and it was unbelievable how short staffed and neglectful they were. This was a high end facility and touted themselves as a boutique facility highly trained in Alzheimer's care. I ended up filing multiple cases with LARA in Michigan and also the State Attorney General. Anyone with a loved on in these memory care facilities should have a camera that records 24/7.
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The physical road downhill starts with limiting mobility. By all means, they should be getting her out of bed and encouraging her to move. Does she get PT? Do they have a lift in case it gets to the point where she cannot transfer herself with assistance, because if they don't, you will have to move her to a different facility anyway. Look around.
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First of all, your Mom has raised one great daughter. Your devotion to her and her needs is truly wonderful.
My own mother’s ability to communicate is very limited. (96 years old with late stage Alzheimer’s), can’t’ walk and is in a wheelchair. What helped me and may be helpful to you is to ask for evaluations by OT and/or PT to assess your Mom’s abilities and come up with a plan. The social worker on her floor may be very helpful too. You can ask for a Care Plan meeting to make sure your mother is getting correct level of care and decide if her facility is able to meet those needs.
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Dont EVER stop questioning. Even If there is a small issue you notice. Bring it up. You are your mom's advocate! Having her in bed all the time is easier for them and not good for her. I can guarantee your mom on some level knows. If she doesn't talk...watch her eyes. Amazing what you will pick up on. My mom had vascular dementia...the doctor stressed different levels of simulation on a daily basis.
If they can't comply to the care you expect....you need to find somewhere else.
As a caregiver this is my #1 petpeve.
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We also had issues when my mother-in-law was in Memory care, when my husband would question things, when his mom's needs were being neglected. We found another Memory care facility, and she did better there, at least for a while. Staff makes a huge difference, and with Covid, there's more of a turn-over I think. You're caught between a rock and a hard place. I agree with the other posters: you shouldn't feel guilty about asking questions. Best of luck.
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You have a difficult situation that most of us who have LOs in Nursing Home have had. I am guessing that your mother is depressed. Being depressed and having other medical problems make matters worse. She might be going through a period of adjustment with all the things that she has experienced recently. It is difficult to say because she does not talk. If she was combative with at home she probably is doing the same in the NH (when you are not there.) You are going to need more time to figure things out. If you jump the gun and move her to another facility it might be better or worse. Talk to the on-site doctor, What are their observations? Maybe geriatric psychiatrist should be considered for your mom. Keep in mind, you are on a difficult road ahead and this is only the beginning.
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All I know is as her advocate, you have to follow your instincts. If you don’t feel it’s in her best interests to keep her there, then visit & talk to other facilities & move her. If it made her present facility uncomfortable & defensive then they probably aren’t willing to adapt & may harbor resentment to you for asking them to. To me, that means they are thinking more about themselves & their weight load more than kindness & care to their patients. If my mother had to be in a facility, I would want it to be a place where the residents care always came first.
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It is our job as healthcare workers and yes, we did choose it because we want to be able to help people. However we are being so overburdened, short staffed, so one nurse is doing the job of three or four yet being paid for one. We are being picked on, spit on, peed on, and pushed around. Yes we chose it because we want to help people but the healthcare industry has made it impossible for us to actually feel like we are doing any good. Instead we're being micromanaged, nitpicked, and so overburdened that we can't keep up with even the med passes. So please next time you have to deal with any health care workers please thank them. Who will care for the aging population if not the healthcare workers?
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Invisible Aug 2021
I totally agree you are the soldiers in the field, and despite the limitations you are facing in healthcare, you make a huge difference in the lives of your clients, the residents. I'm all for giving you what you need to help them live their lives in satisfaction and joy. How do we do that?
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It’s important to stand up for your mom as she is voiceless. Yes, it truly is uncomfortable to do it, but necessary! I also brought the poor response of a caretaker (she was very rude to me when I was talking to her about dad on the phone) to the attention of administration in my dad’s facility (dad also has vascular dementia). She was not happy about it either. Unfortunately caregivers are poorly paid, and you “get what you pay for” so to speak. In my town they are paid 11-12 dollars an hour. My dad’s place has the reputation of being a very nice, even pricey home, and they have lost many of their regular caregivers, there’s been tons of turnover since the pandemic started. I even suggested that we put in a camera. We didn’t end up doing so, but if they had resisted the idea I might have been even more suspicious regarding what was going on. My dad (age90)has also lost all mobility after getting COVID last January so has to be hoyered to and from bed, to chair, to wheelchair. Certain caregivers are less efficient about getting him out of bed in the am, and I often call ahead before visiting to let them know I’m coming and want him up. In fairness to the caregivers, there are often only 2 or 3 on the floor, and it’s a workout for them to help everyone AND do all of their other duties as well. You’ll probably never get the same kind of care your mom received when she was home. It’s just not available at most of these places. I guess that’s why home care is so much more costly. Even so, My dad has become part of a community there. He has connections with the administrators, the social coordinator, Some of the residents, and the caretakers. It’s something that I can’t provide for him as his family. I’m finding that it’s beneficial for me to not be there every day. You might need that as well, and might want to consider giving yourself a break by not going all the time. It gives them a chance to develop friendships and relationships with the people that work with them when you’re not there. Of course I’m thinking that this would only apply if you’re feeling comfortable with the place she’s at. It seems horrible to have to move her, but, when they know that there’s a possibility that it might happen, it’s amazing how they change their tune and their attitude! And if they don’t, then maybe you are on the right track to find a different place that’s better for her. Good luck!. Your mom is blessed to have you caring for her as you do!
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These are not easy situations -
FIRST . . . . YOU ABSOLUTELY need to take care of YOURSELF. Do not go at your every free moment - as you WILL burnout and not be available for you or her, or your family.
* If you can, research other locations for placement. Observe, talk to other patients or families of other patients.
* Will the long. term health care pay for caregiver in the facility?
(or is that doubling up?)
* Certainly, with dementia - each day or some days, care needs could be different. It is not a steady or even decline. Medical needs are up and down.
---- And, abilities to move /walk/function change based on medications given. Absolutely check on what meds are given and ask for a print out of the meds and what each med is for - this happened to my client. She is stabilized now although it took awhile. And, the process of figuring out what meds are needed presents different behavior due to how it affects the brain / body. Ask the physician there.
* And, do talk to the MD in charge, not just the administrator.
- I would recommend you cease focusing your frustration on the caregivers / aides as they 'may' react accordingly with your mom. You want to encourage them to do what is in your mom's best interest by either talking calmly (if you can) and if you can't - talk to their supervisor. In essence, you want the best care for your mom and the aides will provide their best when they feel good about you/your mother. Of course, they should respond to each patient the same no matter what the family says ... This is reality.
* If you could / can, apologize to the caregivers - and say you are concerned and upset and that you don't mean to take it out on them. You don't want them on the defensive, which certainly is very easy to do in this situation. (Don't blame yourself, just adjust your thinking and behavior towards them. This is a learning process for you, too).
* Yes, it is a lot for aides in any setting to manage handle / with case load and emotionally managing dementia communications/acting out.
- Some are outstanding - amazing. Others want a paycheck. And income is low and generally so it their education level. This is very hard work. (I manage care for elders and offer direct service).
* Did you check on this particular facility to see if any reporting has been done - due to wrongful / inadequate care? Call an Ombudsman and check and/or ask them to assist you / advise you.
Gena / Touch Matters
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I would start looking at different facilities so you have options. You may want to consider a NH over assisted living since she appears to be at least starting to have mobility issues. NHs generally cost more than AL facilities, but AL facilities generally do not want to keep patients who become bedridden. If she can still ambulate and her fall risk is low then it is well worth it to keep her mobility. From what you described, it really seems that walking without a great deal of assistance is becoming more of a thing of the past. Sad - but likely true. My mother became bedridden last August. We manage to get her up in a chair every day with. Hoyer lift. If the AL you are in would be willing to move her to a chair and sometimes a wheel chair to take her for a walk that would be great. She just can’t stay in the chair all day - probably 3 hours max. Then back to bed where she will need a change of position every 2 to 3 hours. If they can’t or won’t do that you need to find a place that will. She will be at risk for bedsores if she can’t shift positions several times a day. This is all very tough - I wish you the best in solving thus problem. Seems we are constant problem solvers - that is the life of a care giver.
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I agree with being present with mom and installing the wii fii camera as mentioned below.

Have you met with the social worker on campus? Maybe its time for mom to be accessed and speak with the physician there. Can mom start PT and OT there? Something more stimulating for her day.

Not sure how old your brother is but to help could you find someone to spend a couple of evenings with your brother?

At the pace you are going exhaustion is around the corner. Get as much help as you can for yourself.

It may be time to find another memory care.

Prayers and best wished
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If you can have a wifi camera installed - do so. Go with your gut. Your Mom's well being is way more important than someone's miffed feelings. I get so angry when people say health care workers get paid so little and are overworked - that's their job-they chose it! . You are your Mom's only advocate - do it with conviction and be relentless. The squeaky wheel gets the oil. In my experience, most of the elderly are confined to a wheelchair or bed, not just because it's way easier, but also due to fall risks & liability issues. That said, if things really aren't to your liking, then find another place that will adhere to your needs or at least be more transparent. Your Mom will eventually adjust just fine anywhere if she being treated well.
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Please remember that assisted living facilities and memory care facilities are just types of businesses. You are the customer, and have every right to get the services for which you are paying. If a clear plan cannot be decided upon and executed by the facility where your mother is currently housed, you have every reason to look for another. I hope you are in a large enough urban area that you have some better options. If your mother is already in memory care, she will not remember how often you are able to visit. A better facility may be found farther away from you that does not require your constant intervention, appeals, and oversight,
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Does she qualify for hospice? It might be worthwhile checking out. They can go to the nursing home to help care for her, and can be extra hands for you. Keep in mind they can't be there all the time.
Some facilities just suck, and I would suggest moving her in the long run. I know it is stressful, but consider the long term stress on you & her by staying there.
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get a nanny cam to see what is really happening...i have heard of families doing this due to issues...just check your local laws first...
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