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My mom now needs help going to and using the toilet- getting up and down-sometimes the wait for an attendant can be up to 45 min. I have spoken to the director how to make it under 10-15 Minutes. I don’t know if I would get quicker results at a different facility or if she needs another level of care.

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Most of these facilities are very understaffed. At my husband’s rehab, he was once left sitting on the toilet for almost 2 hours. He passed out when they got him up and fell. It took that for his wait time to lessen. However, in the facilities defense, there were two aides for 25 people. I never saw the staff just standing around. The facility was a “no pass” zone which meant that any staff personnel who encountered a room with a call light on was charged with stopping and helping the patient, whether they were therapists, secretaries or any other staff member.

Any facility I've ever been in hasn’t had an instantaneous response, whether it’s a high-end facility or a Medicaid facility. It’s simply the “nature of the beast”. So, moving her to another facility would most likely be a lateral move. A higher level of care isn’t a guarantee of quicker help either. It depends on the staff:patient ratio, the size of the facility, and the neediness of the patient population at that particular time. Staff does more than care for patients. In hubby’s Rehab, they served and collected meal trays. Getting help from 11AM to 12:30 each day was impossible, the same from 4:30 to 6:00.

What your mother is experiencing, unfortunately is not uncommon. It’s more work for the staff because then she has to be changed. It’s a sad but true fact and makes the case that we don’t appreciate enough the people who work in these facilities.
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freqflyer Jul 2018
I agree with Ahmijoy, that any type of facility you will run into similar issues with call-bell timing.

There is also a triage system in place, too. It is not unusual for the staff to be helping two residents that are having an emergency situation.
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Thank you so much for this feedback. It’s really helpful. I was thinking that as well that there may not be enough staff to run from room to room. I’m realizing some of the problems may be with weekend/night staff. I am going to speak to the director just to get more feedback and see if they can change the weekend/night Staff ratio. I believe we can work it out with them but I realize like you said it may not be different anywhere else. This is a really nice facility so in some ways I may have better response with the director....
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45 minutes to me is way too long. after about 5 minutes a person with some dementia is probably going to try and get up on their own. my dad was(once) in the hospital er room bed, would fight to get up on his own no matter what. Even when he COULD NOT walk. maybe suggest also that having such a long wait time not only soils themselves, but a risk of a nasty fall. (?)
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45 minutes is way too long to wait. What if the need wasn’t just to go to the bathroom, (bad enough) but something more medical in nature? Moms NH usually has 4 aides for 38 people. 5 is better, 3 is chaos. When the call light has been on more more then 10 minutes the aides pager goes off. More than 20 minutes the bell rings at the nurses station. But I have still seen it take almost 30 minutes, at that point I have gone to find help.

Wow i I love the concept of a “no pass zone”. I wonder if all the people are trained as CNAs?
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Ahmijoy Jul 2018
I don’t think they are trained as CNA, but at least your call is being acknowledged. If one of the staff physically goes up to an aide and says, “hey the guy in 123 needs help now”, you’re more likely to get help faster.
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Thank you all for responding. I am going to speak with the ALF director tomorrow and discuss the call response times and staffing. But I’m wondering if we need to find a higher level of care? My understanding is that skilled nursing is short term. She needs help going to the bathroom and any other daily routine. If we transition her to a wheelchair she’s going to lose all strength to even get up to go to the bathroom.
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Ahmijoy Jul 2018
Kit, don’t expect too much cooperation as far as hiring more staff to shorten response time. You may get promises, but probably not results. All you need to do is read the health care want ads. Just about every health care facility anywhere is screaming for help. STNA and CNA are overworked and underpaid. Their jobs have little reward for no money. They are the front lines with the patients and those patients can absolutely treat them like dirt. In your meeting, it may be suggested that you hire a private aide for mom if you’re concerned about staff response time.

My mother was in Skilled Nursing for 4 years. I never heard it was “short term”.

Some decisions will need to be made. If Mom is safer in a wheelchair, and as you previously posted, she tends to fall with her walker, she should be in a wheelchair. Muscle strength is secondary to possible broken bones. You may want to ask about physical therapy.
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I hate to say this. as much as I love my moms assisted living facility and I think all the aids are very good.

I do think sometimes. if an aid knows WHO is asking for help. and they know WHAT the person needs. they may avoid going first. I mean... they may think, if I just wait a minute, someone else will respond cause I don't want to 'clean' that resident.
that's is just my opinion tho
I think sometimes the aids get frustrated with helping just like everyone/anyone would. NOT saying that's right. im sure it wouldn't take long for those aids to get called out by other aids.
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KitNew1 asked another question about the difference between assisted living and nursing homes:

https://www.agingcare.com/questions/my-mom-is-in-an-assisted-living-facility-and-has-daily-falls-uses-a-walker-may-change-to-wheelchair--441262.htm "The call response at the facility is sometimes 45 minutes. She may need more nursing care or would another facility have shorter call response times?"


The response time should be shorter as there is more staff.  However, there are certain times that it takes longer such as before and after meals because the nursing staff are trying to get everyone up, toileted and to the table or away from the table, toileted and to bed or back into their recliners or wheelchairs.  Bedtime is another time that it may longer for a call light to be answered as the nursing staff is trying to put several people to bed at the same time.
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I have had similar issues with one of the top rated skilled nursing facilities in our area, so as someone already mentioned it may not be any different by changing facilities. It seems that these places are short staffed together with the fact that there are people who should not be working in these positions since they become angry having to deal with the constant needs of seniors who may require a higher level tbose who need more care and they probably don’t respond when they should. After a month at the skilled nursing facility, we placed my mom in an AL facility but she is very unhappy with the response time she receives there even after speaking with the Executive Director about the situation. At first it seemed to be resolved but now my mother is still unhappy with even a six minute wait . I think that my mom is just being unreasonable about that as 6 mins should be more than acceptable. She also needs help getting to the toilet together with other things but she is angry that she is not getting undivided attention which she expects because she is paying so much money each month. These facilities have a limited amount of staff that service a lot of different needs and although there are many aides that are very good, they cannot give the kind of response time that probably should be given for the fees the facilities charge, but when you compare the costs and what you receive compared to in home care, which is cost probitive, I don’t know of an alternative that makes sense. I am having a hard time convincing my mom that even with some of the things she feels are not up to par, she will not receive better care elsewhere and she needs to be thankful for all the good care, meals, socialization, activities, and transportation to doctors, etc. she receives.
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Thanks all. This is really helpful. And caregiverx10 I totally can relate to
what you are saying. I personally think 10-15 min is within the realm of normal but I get what everyone is saying. I want to believe the workers at this facility are well treated because the director is such a great, with it guy. But I fear they may not be making much $ and it is sad. They should have good benefits at the very least. The talk with the director went well and let’s see what changes. There
was a problem with the call light and clearing messages... he was honest about it and said they are getting a new system.
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