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My mom tends to yell and flip the finger when frustrated. This behavior agitates my step dad who may be reactive. I just learned that they two were walking together in their hallway near their AL apartment when my mom let out a yelp and my dad was seen hitting her leg with his cane. (There was no mark or bruise left and my mom gets blood spots very easily).



I received a call an hour or so later, telling me about this incident and was told the Adult and Family Services would be contacted and it will now cost an extra $650 for each of them per month. $1300 more!!! They already hate being there so I can't share the increase of cost with them.



I did ask what they will be receiving for this extra fee. I was told they will be watched and looked after more. I have not seen this happening. I do call a couple of times a week and ask the help to tell me how they are doing. I want their perspective. Still, it is rare that anyone really knows how they are. I am frustrated and wondering if anyone else has dealt with a similar situation.



Nothing has come of the Adult and Family Service report either.
Any suggestions? Should I ask to see the report etc. ?

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Ask to see the report. Ask for weekly reports when the increased supervision occurs. If mom and dad can not get along, it might be easier if each has their own place.
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Reply to Taarna
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You will need to personally observe what extra care they are getting...or not.

Then report back to NH if you don't see extra care. At the end of your own observation (at least a week period of time spending all day with them) period, ask for notes for past month that document any extra care.
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Reply to my2cents
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Shellann: Peruse the four contracts, e.g. before and after x2 persons.
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Reply to Llamalover47
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The issue is that AL facilities are always a private business, and they can set any rules and prices they like. You choose whether to sign the contract. Look at your contract to check when, why and how they can up the prices – but chances are that in fact it’s whenever they want to.
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Reply to MargaretMcKen
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Look over the contract. There may be hidden fees. Visit your parents often to observe their behavior.
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Reply to Onlychild2024
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A Resident to Resident Abuse in NJ is a mandatory reportable event, that must be investigated and reported to the Department of Health, Ombudsman, and even the police. Not that Mom has to press charges but still reported. As for charging more AL will charge across-the-board rent increases annually and as the residents' level of care needs increase or they become more dependent on staff for ADLs and care. What state are your parents in?
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Reply to NJCALA
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Shellann Jun 23, 2024
Thank you for sharing. We are in Washington state.
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Why not, the family, POA, whoever, put cameras in their rooms? I have done this and been able to watch them from my phone. And you can get alerts when there is movement and you can watch if and when somebody does come into the apartment. Of course, they're going to charge you more, but that doesn't mean they're gonna do anymore then what they're already doing. I would be checking on that with cameras in there. And yes, look at the reports!!! Do not ask if you're allowed to look at them. If you put it that way, they're gonna say no most likely. Tell them you need to see the reports.
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Reply to DonnaF777
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Shellann Jun 23, 2024
Thank you DonnaF777. Great idea to ask for the reports.
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Shellann,
If you are still visiting this Forum it would be nice if you updated us on how this case is progressing?
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Reply to AlvaDeer
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Ask to see the report. Also phone calls are great but daily random visits are best.
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Reply to Deb4Mom
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I would ask to see the Adult and Family Service Report, if that information can be shared with you.
From the tone of your post, it sounds like you are not terribly concerned that they are abusive toward one another. I could see almost any long-married couple engaging in similar behavior, almost playfully. Although, their behavior and attitudes can change with the onset of disease, so definitely worth monitoring their behavior to ensure they are not causing harm to themselves or others.

I say ask for a copy of the report, because the ALF is using this as justification to get more money. For me personally, I would want some tangible evidence and explanation before just blindly handing over more money, because they say so.
I'm a little skeptical by nature, and would want some assurance that the ALF is not taking advantage and making up extra charges that are unjustified.

But, if in fact, your mother and stepfather's actions warrant extra vigilance by the ALF staff, then they should be able to charge extra for it. Not to mention the disturbance they may cause to other residents, who might be very upset by this.

And don't be afraid to TELL THEM their actions and behavior is going to cost them extra! If you had a teenager causing havoc in the school hallway, you no doubt would make them accept responsibility and pay the consequence!
Actions have consequences, and I'm certain your parents have lived long enough to understand that!
Perhaps they would be better off living separately, as some others have suggested. But not if they would continue to harrass others with the same behavior.
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Reply to CaringWifeAZ
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Hope you’re not paying this out of your money. I’d consider separating them into two smaller rooms on opposite sides of the building. It’s unfair to mom to be hit and unfair to staff to be expected to watch out for abuse. Consider if either or both of them might benefit from a medication to calm the aggression
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Reply to Daughterof1930
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Yes, if AL stated the increase in cost is due to incident you should absolutely see the report their staff should have done and the report to APS. I also think you should keep a log of each time you call with the date & time, who you spoke with(including their job title), and what they say. That way you can go back about the cost and ask specifically how they are being watched more closely. With proof you are or are not seeing that happening. Good luck 👍
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Reply to missspink918
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CaringWifeAZ Jun 18, 2024
Yes, agreed! Good Advice.
Logging communication or any reported incidents is always a good idea!
It will help you see if any patterns develop, and give you something to refer back to later if something major happens, and your recall of past incidents is unclear.
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Had something similar in the facility, though it was the nurse who took the ire of the wife. Hubby has been discharged from shared room with wife, wife was upset.

When nurse went to give wife meds, wife threw water on nurse.. Nurse couldn't catch herself, called wife a b''''
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BlueEyedGirl94 Jun 17, 2024
LOL - it happens. One of the only happy days I think we ever had with FIL (it wasn't happy for him) was him recounting the Charge Nurse telling him that he wasn't SPECIAL. And that he needed to learn really quickly that they were there to help EVERYONE not just him.

Frankly - with all of the lies and confabulations my FIL came up with - we weren't sure we believed him - he was SO PUT OUT!! Then we actually talked to her and she admitted/ said that she had told him that. We told her she was our hero!
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You might need to separate them. At one of my mom's places, the husband and wife needed to be in separate rooms on opposite sides of the unit
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Reply to MACinCT
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BlueEyedGirl94 Jun 17, 2024
My FIL's roommate for his last few months before he passed - his wife was in the same facility - down a couple of halls actually - but in the same building. I was told by one of the CNAs that when they were both in the same room - say the social room with the shared tv (all rooms had their own but there were several larger community rooms with bigger tvs, couches and chairs as well) or sitting at the nurse's station - they basically either ignored each other or possibly didn't even recognize each other any longer.

He probably had no business having a roommate - the behaviors we saw from him were exactly like my FIL with NPD, and it made it twice as hard on the nurses and CNAs to have them in the same room because they fed off of each other. But from what we could gather - he had roomed with his wife at one point and it was VERY ugly - so they had no choice but to separate them. (he and my FIL just fed off of each other and overstimulated and angered each other - but my FIL was a piece of work, gave as good as he got and was just as accountable for the problems they had - so I would imagine that the powers that be decided that they couldn't be any worse together than apart (they were wrong LOL).

But he had a reputation for not getting along with anyone - his wife included. BUT she was in a single room - so maybe she wasn't able to get along with people either - who knows?
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This is a simple fact of care in a facility.
When entering care there was/should have been a care contract that stipulates levels of care, and what constitutes these levels.
For instance Care Level I is someone who is self caring, requires no help with showering, walking, incontinence, eating, diets, etc--someone who is a resident able to get about the facility, come to dining for meals, who has no medications or is mentally capable of taking by themselves. Such a person can usually leave the facility for walks at will and etc.
The levels rise usually to level IV or V. and they all have a posted price that is added to the basic residency of room and meals. The jumps are steep!

Because this is an instance of an elder reporting abuse by her husband LEGALLY the facility must report this. They are "mandated reporters" meaning mandated to report a resident who claims a theft also (to the police) or a fall or other injury. That is neither here nor there. The report will be carried through and likely nothing whatsoever will come of it. Their findings will likely not be shared with you. The Adult Family Services would have RECOMMENDED this bump up in level of care had it not been done automatically, to provide better staffing, safer care.

You should not take on costs of care.
You will need every single penny you can save for your own aging care, as you are now clearly aware. At the point your parents cannot afford care they will be in medicaid funded nursing home care; if a danger, separated from one another.

Sorry, but this is all part of the norm.
For questions like this you will get EVER SO MUCH BETTER and more thorough answers by going to the administration of your own facility, but your question here provides information to others, so surely am glad you asked, and am wishing you the very best of luck.
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Reply to AlvaDeer
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AL is not where they should be. They need memory care. Is one able to stay in AL a little longer and the other go to MC? Your parents should not be responsible to care for each other when both have Dementia. Maybe separate ALs.
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Reply to JoAnn29
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Assisted Living doesn't generally handle combative elders with dementia. Did Dad hit her leg with his cane before Mom yelped? Or was he trying to shut her up?
Maybe they should be separated if they can't behave themselves.
Do you ever go visit them?

I would call your county's Adult Protective Services (APS) and tell them what "allegedly" happened. You should be honest and concerned about the extra money. The facility could be scamming for that extra $1,300 a month. I would insist I get a copy of that "report" if they want their extra $1,300. I would also want to know how long this "extra supervision" (aka punishment) is supposed to last exactly.

I'd call their Doctors about some Antivan or similar meds to calm down, because they might be separated, or are headed to Memory Care, where there is more supervision. You may want to visit and tell them to behave themselves, or they will get separated for good.

Call their own Doctors for their advice about calming them down. They probably set each other off, which will get them separated. Or find another place that tolerates elder couples bickering and getting combative or physical in Assisted Living.

Beatty has great advice. Hound them weekly for results for that extra money.
And yes....DO NOT PAY THAT EXTRA $1,300 YOURSELF.
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Reply to Dawn88
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DrBenshir Jun 18, 2024
You are right - the actual abuse may be the $1300.month scam!
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Adult Family Services called - Good. Abuse is never OK.

Yes I would want to see the report.

Yes they may need extra supervision to diffuse & prevent any further abuse. Cameras may see but not diffuse - extra staff may be needed, therefore the extra cost.

If I was the POA I would authorise the extra care/extra cost in the shorter term - until a longer term plan is made.

Assesmsment by their Doctor may help.. meds for anxiety? It may be this couple will need single rooms. That happens.

This is a serious matter. I would be asking for feedback from the AL Manager once a week.

PS If the couple require extra care, they pay for this - not you.

"They already hate being there so I can't share the increase of cost with them." Then stop antagonising & hitting each other folks! Tell them how it is. Aggression = pay up to be supervised.
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