Dad has dementia that is getting worse so I don’t know that he would remember to use a call button pendant or wrist BUT his memory care facility doesn’t use them or anything similar. Dad used a wrist button frequently when he was in assisted living a few months ago. Anyway dad still is continent and hates to use the diaper but has no way to call for help. His voice is very soft and low so I doubt he can yell loud enough to get them in there. When I’m visiting he will always tell me he needs to go and I’ll track down help. I can imagine that most in memory care are not concerned about diapers or call buttons and it might not be long before dad is the same way. But for now I feel like they aren’t offering a good solution. What do other memory cares do? I could buy something I suppose like a personal keychain alarm. Even a big school bell might work.
Suggest whatever time interval you think will be manageable/comfortable for him.
This worked quite well for my LO before Covid ruined everything.
Huge red flag.
If the answers aren't satisfactory, argue!
(How does he mobilise, by the way? - what does he need help with?)
I’m still not sure hospice was the right thing because he is still healing from that TBI. But I guess we’ll see.
I appreciate knowing what other places do while the patient still feels the urge
If your father is that wobbly while walking and unable to stand up by himself, he should be using a wheelchair for safety reasons. Staff should be toileting him regularly, and installing either pull cords that are accessible or call buttons for the residents. It's ludicrous not to!
My mother also has a bed cane near the top of her bed. While it's not a bedrail or a restraint of any kind, it's designed to help her pull herself up out of bed.....but also acts like a bit of a guard to stop her from falling out of bed. Go to Amazon and search "bed cane " to see what I'm talking about. If your dad's MC would allow 2 of them, that could help a lot with fall issues.
They had a lanyard with a button on it as well as pull cords in the bathrooms, but those only work for someone who can 1) get to them and 2) still know what they are for!
My mother wasn't totally incontinent. We had her in briefs just in case, but when she was still mobile, she'd go herself, and with the rollator she would go herself. Once she ended up in a wheelchair, she was more reliant on them. I had been there several times when a staff member came up and asked her if she needed to go. She would know and respond. Other times she would ask. She wasn't left alone in her room, so chances are some staff person might be passing through between tasks.
They gave her that button several times, but she had NO idea what it was. Typically when I was there, she might happen to notice it, inspect it a bit and then push the button, having no clue what it was for! The poor staff person had to respond and reset it to turn it off.
Actually it is hopeful to hear that they wanted the name of the person suggesting he go in his briefs. It could mean they do care. It is one of the benefits of having a good facility, because they will typically get rid of those who don't meet standards. With home care, unless you live there, how does one know what that aide is doing all day every day?
It also sounds like they are willing to work out the situation. If he still knows what the button is for, that might help. In time, that won't work, so having a standard toileting time for those who aren't mobile is the way to go.
The day before yesterday a client took one look at me and called out to her husband to come and help her mobilise. "Problem?" I asked. "Look at you. You'll never get me off this bed." I sighed inwardly and got her off the bed.
The point is that if mobilising requires "a strong guy or two strong women" you are doing it wrong (and potentially putting your client at risk, never mind yourself). As a matter of fact I am a lot stronger than I look, but that really isn't the point: moving and handling are all about technique, and nothing at all to do with physical strength.
Supporting a client with standing and walking progresses thus:
verbal prompting
minimal physical support with assistance of one person (AO1)
minimal physical support (AO2)
plus use of mobility equipment such as profiling beds, riser-recliners, bed sticks, stand aids, turntables and so on
So that until your father loses the ability even to maintain a standing position with his bottom resting on paddles, it will be possible to transfer him to a wheeled commode. He can then either use the commode, or the commode minus its bucket can be pushed to the bathroom and positioned over the toilet.
And in fact, I myself used a hoist to transfer my mother to a commode. So that, in fact again, as long as your father is continent and able to ask for support with toileting in time, there is no reason for him to be forced to "go" in his pad.
These places do put continent residents on a "toileting schedule." But as others have noted, they are chronically understaffed and cannot always adhere to it.
Can you, or another family member, stop by twice a day to assist him to the bathroom? That would at least help.
They also have no call buttons, as I assume half the resident would be pushing them all the time, and the other half (my mother) wouldn't have the slightest idea what they're for.