I knew the assisted living facility was wrong for her. I would often find her doing nothing, sitting on the edge of the bed in a darkened apartment. She had no visitors. She claimed that the place was too far out (and it was, because her friends don't drive anymore). She complained that no one socialized at lunch. (They didn't. I sat at the table with them.)
"Where are they going? What do they have to do? They're not going anywhere," she would say when they got up and left immediately after eating.
She perked up when we took her to her house, where she had lived practically forever. There were Things She Had to Do.
It might have been different if she'd had home care, if she had been in her own home with her own things
I intervened last month at the assisted living facility when I learned that her primary doctor had recommended hospitalization and this request had been ignored by her caregiver. The assisted living facility nurses claimed they hadn't known about it.
"She has failure to thrive," they said. "We see a lot of this."
She was covered with bruises from falling. She had become too frail to get up by herself or go to the bathroom alone. She had lost 15 pounds in two weeks. Her weight loss was the result of a serious health problem, not "failure to thrive."
It was a case of severe neglect. And she ended up in the hospital.
After much coaxing and detailed documenting of problems via email, I persuaded her caregiver to consider a nursing home--thank God, we thought--but it proved to be too much trouble for him. Like someone out of Middlemarch, he thought our offers to help were some kind of power gambit.
After the hospitalization, he returned her to the assisted living facility.
She fell at night. No RNs after 6:00. This facility was designed for people who are much more mobile. Was she able to push her emergency button?
And so she had surgery.
But it is horrifying to see what goes on in the system of eldercare. The problems are common; many families have the same frightening experiences; and unfortunately there is no regulation for assisted living facilities. They may be fine for people who don't need too much assistance, but unfortunately many are owned by development and real estate companies, and care varies.
Two books that have really helped me: The Good Caregiver by Robert L. Kane, M.D., and A Bittersweet Season by Jane Gross.
It is very important to do the research, no one knows this world until they're in it, and these books are superb.