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My dad was stepping out of the shower when someone was opening his bathroom door. He yelled at them to stop and they did. He wrapped a towel around himself and opened the door. There was a care provider who wanted to speak to him. She says she knocked but he wasn’t wearing his hearing aid so he did not hear her. Care givers come in 3 times a day to give him his pills. They knock then walk in. They all know he’s deaf. My question - he is entitled to his privacy. If he wanted to walk around in his underwear, he should be able to do that. How do we bring this up with management? That caregivers, other than those who he expects daily, need to have a better system to contact these residents? Is it to much to ask them to call before coming? I don’t know what to tell Dad or how to approach this with management. Dad doesn’t want me to mention it, but it just doesn’t seem “right” to me.

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This is a stickler. Yes, he definitely deserves privacy. But he also has to be safe.

I can't blame the staff member totally. There may be regulations in place that the staff have to see the residents with their own eyes, to make sure they're okay.

Let's say this incident was a different outcome... your father fell in the shower, or had a medical emergency, and couldn't call for help. If that had been the situation (thank God it wasn't), you'd be glad someone walked in when there was no response. Better to risk a "whoops" than someone not get help.

If your father has some sort of schedule, like say he showers around 9:00AM, this can be made known to the staff so they won't knock at the time and wait until he's out and ready.
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These places are marketed as "homes" and a lot of people like to believe than but at their very core they are institutions, and the staff who work there have an institutional mindset. A lot of lip service is given to privacy and respect for the people who live there but staff that have to check and/or assist a few dozen people are not going to stand around outside the door waiting to be granted entry or come back multiple times if they aren't granted it, it's not practical. That said it never hurts to remind them of their manners - I can remember visiting my aunt when an aide barged in, announced it was time to remove her patch and the proceeded to root around under her blouse until she found it, that should never have happened! Talk with the admin about this and ask for their take on it and suggestions, a little give and take can often result in a compromise that satisfies.
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Dosmo13 Dec 2020
Understood that staff or caregivers need to enter if there is no response to their knock. But they should be reminded that residents may not hear well or move quickly. There should be a knocker or bell.
A simple tap with knuckles is often not heard. I have IL and still have staff open the door before I can reach it. I have a sign on the door that says "PLEASE use KNOCKER" but it is often ignored.

It is a matter of staff training. Employees are busy, often rushed. I understand. Hard for them to stand and wait, but management needs to be told...not in form of a complaint but rather a suggestion for training. Compliance of employees will not be 100% but nothing changes if management is not informed.
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My had this exact problem. I had to finally read him the riot act on this one. He became quite paranoid about the entry of staff in his ALF. He was level one on care, meaning basically self care. But yes, in ALF if there is no answer, they WILL walk in and check if they suspect there is a reason the person is unable to answer. As you can imagine, there are falls. Frequently. The staff at Dee's facility were kind, and they had it all over the care plan please not to enter without permission unless there was GOOD reason to suspect injury. All cleaning personnel knew not to dust his place as he feared loss of his last "pretties". They didn't enter or clean unless he was there.
But there was a limit and I had to tell him that. THEY ARE RESPONSIBLE if they suspect it is too long with no answer, or time for medications that are being missed, or someone who isn't at meal without notice and without sign out. I had to tell him that this is the way it is now for him.
The system cannot be perfect for each person's needs. That just isn't how it works. So meet with administrator by phone or zoom, be certain care plan protects his privacy as much as they are able, but ALSO let him know that it will not be perfect, and there will be times they do not get an answer and they check on him.
Wishing you best of luck. Dee was always so cooperative, but he LOATHED that people could enter his premises without his permission.
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My Aunt in her 90s went to an AL after the death of her husband. She had an apt. Bath and bedroom separate from the living area and kitchenette. One reason she didn't like it there was because...they came in during the night to ck on her and woke her up. Was a little scary too. Personally I wouldn't like it either.

My Uncle was in an AL. My Aunt said an aide came in and told him bath time. He walked into the bathroom, turned around and locked the door. The aide stood outside hollering she needed to be let in. My Aunt told her not going to happen, Uncle liked his privacy.

I would read his contract with the AL and see what it says about privacy. I agree with everyone that the AL has responsibility to make sure people are safe.
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Moving into Assisted Living means precisely that: the person is in need of assistance. That said, the caregivers knock on the door, then they enter.....to administer medication, to check to make sure the resident is okay, any number of reasons. It goes with the territory of agreeing to reside in Assisted Living. As long as the staff knock before they enter, and stopped when they were told to, they're respecting your dad's privacy and shouldn't be expected to do more, especially considering he's deaf. And, being deaf, how would he hear the phone even if they DID call before they came in? Since your father doesn't want you to mention it to the management, I'd let it go if it were me and save it for something truly important which is likely to come up eventually.

AL living is not perfect; there are issues that WILL come up from time to time, that's for sure. My folks have been in AL since 2014 and I wound up moving them from Brookdale corporate to a private AL after 10 months. To say the chronic BS in Brookdale was insufferable would be an understatement. Not once in 10 months did I receive a correct bill, the food there was literally inedible, the list goes on and on. So finally I gave up and toured some other local ALs and found the privately owned one which I moved them into. It's not perfect either, but it's HEADS above Brookdale in every way imaginable.

As long as you feel your father is getting a good level of basic care, decent food, good accommodations, etc., that is the main thing to focus on in my opinion. If the staff brings him the wrong meds, THAT is a problem! Pick your battles, you know?

Wishing you the best of luck with the new lifestyle in AL~!
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NeedHelpWithMom Dec 2020
I agree that privately owned facilities are better.

I toured several ASL for my mom and the one I like best was a privately owned one.
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Your options are limited due to your dad hearing issues and that he is living in a community that provides services he needs. My sister lived in a community for 6 months last year-a horrible place for many reasons one of which was privacy. My sister could not manage a door key or mail box key at the last place-she kept loosing it and did not remember which way to turn the key to lock unlock-she could not manage turning the lock button either-even when i put red tape to indicate the locked position. Next community-NO locks anywhere. Lady who was moved down the hall had my sisters room at some point. Lady had dementia and kept coming into sis room opening the closet-also unlocked to take things. Bath door did not lock-same lady comes out after using my sister's bathroom. Closet door eventually got a lock as the wandering lady and others took stuff from sis room all the time. Eventually about $1000 dollars of clothes were missing. Social worker says he will look for stuff-mind you all her stuff had her name on it-never got anything back. Some one defecated in her room-getting her cloth sofa filthy. There is a reason for no locks but no way to keep belongings secure-keep wandering people out of the room-no way to stop someone from invading much needed privacy. there are all kinds of guidelines for communities and nursing homes to protect residents safety and privacy but impossible to maintain or enforce due to the way the community is managed and staff unwilling to try other solutions to the problems you are having.
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Invisible Dec 2020
Disagree. My father's memory care had locks on the individual residents' apartments that could be locked from inside and all the staff had a keys to access all the rooms. My father felt safer that way and only once did someone wander into his room when he left the door open. Granted they would sometimes leave the door open when they took him to dinner.
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I am training myself so rigidly to knock and peep round any door before entering that I find I'm doing it in my own bathroom, in my little house where I live alone.

Calling your father on the phone would just mean that your father (assuming he hears the phone any better than he hears a knock at the door) would have the hassle of going to pick up the phone. I think on balance it would cause him more daily nuisance and intrusion than it would save.

The routine should go:
Knock and wait.
Knock and wait.
Knock, gently open the door part way, and look round it. If there is a naked gentleman in the room, back out and call to announce yourself through the partially open door.

Your father certainly does have a right to privacy and dignity. Perhaps the practical compromise is that if a caregiver known to him glimpses him in his shorts there's no great harm done?

It worries me more that your father is unhappy about something but doesn't like to tell the management. I would URGE him to tell them. They cannot solve a problem they're not aware of. Maybe you could draft a nice memo for him asking the caregivers not to come fully into the apartment until they are sure he knows they're there.

Two other possible ideas:

1. A notice on his door reminding callers that he may not hear a knock, so please be patient and look in to check before entering.
2. A large, loud, old-fashioned bell hung behind the door which will ring whenever anyone opens it.

Attitudes to privacy vary so much! I went to a new client recently, and while I was still washing my hands his wife came steaming out of her bathroom absolutely in the altogether, with her own HCA trailing in her wake with a towel, because the wife had wanted to catch me to update me on her husband before I began his routine. I hope I did manage to look as if it was perfectly normal to have this kind of conversation with a stark naked and dripping wet 90 year old lady I'd never met in my life before - the HCA kept her eyes closed, trying not to laugh I think.
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NeedHelpWithMom Dec 2020
I like the bell idea!
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Talk to the administration to see what they can do to modify their routine when entering his unit. The AL facility that my mom and dad were in were very good about trying to accommodate resident wishes and preferences. They don't want to fight with their residents or families!

But AL is also a care facility that operates under a lot of regulations. They have to count every fall and when the number exceeds the regs, the resident has to find a higher care level facility. They have to keep everyone safe: if a resident burns their toast, as my dad did once, the smoke alarms go off and the entire residence is subject to evacuation for a potential "fire." That is a MAJOR problem. So the toaster goes away.

If the staff cannot contact the resident, if the resident does not answer the door to the unit, they will come in to do a well being check. They won't wait until the resident finds it convenient. That is the trade off for 24/7 help being available.
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Talk to administration. Also look up administrations rules of operation. Your father is entitled to some privacy, but the facility is also responsible for the safety and health of their residents. "Walking around scantily clothed" is probably against their rules.
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Ask about a door bell that could be on entrance door and bath door. They don't require any wriring, just battery. You might buy just one to see if loud enough for him to hear w/out hearing aid.

Or, just talk to management and put a note on the door to remind staff they shouldn't just knock and walk. Give him a little time to answer the door like he would do at home. A cute little sign - I enjoy my privacy. If you knock, please count to 10. I might need to get dressed before letting you in. Thanks.
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There are doorbells for people with difficulty hearing. The doorbell will cause a light to flash.
A sign on his door might work. If he remembers to place it so that people know he is not available.
If he consistently takes a shower sometime between 6 and 8 am is it possible to tell staff not to enter his room until after that time, or after he has breakfast. That way if he has not come for breakfast by 8 they know there might be a problem.
The problem with any of these is if he does not respond the staff does have a duty to check to make sure everything is alright.
Frankly I would chalk this up to one of the disadvantages to living in Assisted Living. Now if he were in Independent Living I am sure the staff would follow other rules.
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Put a big note on his door to knock loud before entering.

Or, have your Dad hang a sign out that says Do Not Enter whenever he is taking a Shower.

Inform the Caregivers and Management your Dad's feelings of privacy and that he will have a sign when he doesn't want anyone coming in.
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If your father is fully capable of doing this (and remembering to undo it afterwards), one solution would be to have a "do not disturb" sign to hang outside the door, just as is done in a hotel. He would need to be consistent in removing it when he is out of the shower and dressed. This (sometimes!) works in a hotel.
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I am writing this article because recently my wife who was infected with covid 19 within a assisted living facility in Babylon because of poor care she received.
The AARP special Edition Bulletin December edition has written a very important article in this edition which is called An American tragedy It list why so many thousands died, How to change the system to protect our love one's by changing the rules that are 40 years old, who is to blame for their deaths and How the AARP is doing now to make these facilities accountable for proper care Please for you and your loved one's read it. Right now I would not not send my loved one's their until they have more Aids give better care and could go there to see how she or he is being treated. Remember during the beginning pandemic no one including health inspector and nursing home ombudsman were allowed in these homes. You should demand that you see your family members or take the out.
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Invisible Dec 2020
I'm glad someone has brought this topic up on the forum. Someone said the pandemic has shone a spotlight on several areas that were already problems. Lack of adequate aids for caregiving institutions is one of those problems, especially with the boomers now entering that stage of their lives which will require more caregivers. There aren't enough because salaries suck and the work is difficult. Many places try to get by with as few as they can, which means there is no one to fill their spots when they are sick or have family emergencies or make a career change. The data show some of these aids have multiple jobs and have actually brought covid into the facilities. With the high ratio of residents to aids, things get done on a best effort basis and not always on the same schedule.

That being said, there isn't a good reason they can't try to walk a fine line between privacy and need. Since her father is already living with the expectation that aids will come in with his medications at certain times during the day, to have a caregiver come in spontaneously with a for a different reason with just a brief knock is a violation of privacy and I would ask management to have aids make more of an effort to alert him before they do that. And I can't think why they should have to open the bathroom door once they are in his apartment and realize he's in the bathroom. They could have called from the desk alerting him that they needed to talk to him and suggested a time. Once they were in his apartment, they could call out again once they realized he was in the bathroom. Common courtesy.
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Imho, that is an invasion of privacy and you shouldn't have to tell the staff members this, but apparently it is a problem. So knock three times and wait for a response, which may not come if a patient - in this case, your father - is hard of hearing. Prayers sent.
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If they knock and there is no answer, they sort of have to come in, don't they? They would need to make sure the resident wasn't in need of help. How would you feel if they went away and came back later and he was laying on the floor?
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In my mother's senior residence they had a white board and the aides wrote her schedule on the board each day. Perhaps the extra caregivers can schedule their visits with him and have the aides remind him each day of scheduled visits.
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Is your dad in a ALF for a particular reason ? I’m sure it’s hard , but some privacy issues will be hard to negotiate. If he can’t hear , and forgets to put in his hearing aid , the staff will be alarmed , and feel the need to check on him . An apartment might suit his needs , if he has no issues, health wise , or mental. It’s really a no win situation for anyone .The staff is paid to watch out for him .
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