Who do I talk to at Mom's nursing home about concerns regarding her care?

Jan52 asked...

My mom does not understand that my dad passed away almost a month ago, and her dementia is getting a lot worse. She will not keep her dentures in her mouth at all, and when she eats, she chews and spits it out. She is losing weight. She removes her diaper, whether it's plastic or cloth and has already peed on a chair and floor. She really has no idea what she is doing and is so fidgity in the day room in her nursing home and only wants to be in her room, and has been seen sneaking out of the day room and wheeling her wheelchair into her room and has climbed into her bed, which is VERY dangerous. I am getting worried that she will get even worse. Do I talk to her case manager at the nursing home, her doctor or the nurse manager? The nurses try their best but she can't continue barely eating anything and peeing on a chair is unacceptable. Please give me ideas of what I should do and who I can speak to? I am so worried she'll get even worse very soon.

Expert Answer

Maria Basso Lipani writes a popular website on geriatric care topics, where she puts her expertise as a Licensed Clinical Social Worker to good use answering care planning questions. Maria is a graduate of Columbia University School of Social Work and is licensed in California and New York.

The middle stages of dementia, where it sounds to me your mother may be, are among the most challenging. Behaviors like the ones you are describing are the norm and can be very concerning and upsetting to family who see such a stark contrast to the person they knew before the disease. That said, there are a few things I would suggest:

1) It seems to me that a meeting with her care team at the nursing home is in order - this would include the nursing home doctor and the nurse manager. You can request this meeting by contacting the head administrator at the facility. The purpose would be to discuss the same concerns you've posted here and to talk with the facility about how they might better manage them. Specifically, I would want to ensure that your mother is not allowed to return to her room unassisted, as attempting to transfer herself into her bed from a wheelchair is just as you say - dangerous.

2) If you haven't already, this would be a good time to call your local chapter of the Alzheimer's Association and find out about upcoming workshops where the disease - and what to expect - is explained. These meetings, which are free to the public, have been immensely helpful to many families I've met. If nothing more, they provide an opportunity to meet others who are facing the same challenges.