So Much Confusion over Assisted Living

I placed my wife in an assisted living facility in early 2025. She had a fall and needed back surgery. Her Parkinson’s seemed to be getting worse, and she was at extreme risk of falls with osteoporosis. My feeling was that assisted living would be a great step for safety and care, so I transferred her into AL after 3 weeks in rehab.

My mom (93) in Assisted Living keeps getting UTIs. I feel like the PA who serves as the facility “doctor” isn’t doing enough to ream them out. For one thing, when my mom starts showing symptoms and the nursing staff takes a sample, the PA doesn’t call in a prophylactic antibiotic to cover the days while they’re waiting for results. Mom has clear symptoms, and I find this frustrating. Any time I’ve ever had a UTI, my docs through the years have called in a covering antibiotic until the test results come in and they can better target them. So, Mom suffers for days until the results are in. And yes, she might still suffer if it’s the wrong antibiotic, but she’s had enough of these; they should be able to look at her chart, see if there’s a pattern, and, if so, choose the prophylactic based on that. I also don’t feel like Mom is on a long enough course to fully ream out the infections in the first place. They keep coming back.

I generally don’t feel like this PA is worth her salt, for other reasons (my dad had a TIA a few months ago and she wrote off his symptoms as “probably neuralgia” because he has a history of that; he also had a TIA in 2024, so he has THAT history, too. He just happened to have an MRI scheduled the following week after this latest one for follow-up on something else, and the neuro caught that second one.

I have some other issues with how the nursing staff handles things, but they’re based on hearsay from my folks, and I can’t be sure I’m getting the straight story.

I’ve talked to their Director of Wellness on two occasions -- nice guy, knows how to talk the talk, and I did get some movement on a couple of things, but this UTI thing is still a problem. I’ve talked to the charge nurse, who promised things she never delivered.

Should I ask to speak to the PA directly? Go through the director again? Stop meddling and let my parents handle it. I’ve got chronic illnesses myself, and I know if I don’t advocate for myself, I don’t get good care. But because I have chronic illnesses, it’s exhausting to have to take this stuff on. I thought having them in AL would take the burden off me, and to a large extent it has. But I still get the occasional 7 am call with my mom crying and in pain because she has a UTI and no antibiotics while she’s waiting for the culture to come back. I shouldn’t be getting those calls.

CaringWifeAZMay 19, 2026

Assisted Living is not a medical clinic. If you don’t like the In-house PA, then take your mom to another doctor of your choice.
As for your dad, a physician’s assistant is not qualified to diagnose any neurologic condition or stroke (TIA). Take Dad to see a neurologist for a proper diagnosis and treatment.
To answer your question, yes, you should advocate for your parents.
However, the care provided in Assisted Living is limited. It is not a substitute for seeking medical care from a doctor. They can listen to your complaints, maybe say something to reassure you, but they probably can’t or won’t do any more than they have been.

ShirleyDotMay 19, 2026

Why isn’t your mom following up with her PCP and relying on the PA where she lives? ALs give assistance but do not provide the medical care you would receive in a skilled nursing facility. Maybe you are expecting too much from what they can deliver? AL residents are still expected to manage their own healthcare usually, and AL staff are not substitutes…(more)

FawnbyMay 18, 2026

Consider a hospice evaluation. If mom qualifies, she benefits from having extra pairs of eyes on her: hospice doctor, nurses, equipment, etc. All free under Medicare. They’ll visit her regularly in AL. They’ll advocate for her. They’ll even interact with the AL staff on her behalf, and you perhaps won’t have to be so involved.
Hospice doesn’t mean that mom is going to die within six months, as some people assume. My mom, who died at 95, was in hospice care for 2.5 years. My husband has been in hospice care for 1.5 years.