AL with a MC option.... hour away or 5 min away

Marianne*

After reading feedback from another post I feel like I'm starting over again.  I'm planning on moving my mom who at best is working in stage 4 and 5 somewhere depending on the day to an AL in my town 5 min. from me.  

Members have pointed out that moving her to AL that isn't a CCRC isn't wise and that's it's easier for PWD to be in one place.  That said, I've doing some research in towns that are 45 min and 55 min away.  It looks like there are some nice, newer CCRCs.

But.... this kind of squashes the plan for having mom 5 min away, being able to drop by and pick her up to run an errand, bring her over to garden, dinner, ect.  Life won't be like that.  I understand that the CCRC's are important, but doesn't quality of life matter, too?  Having her 45 min to an hour away means the times I've described won't happen for the most part.  

I'm so torn.  I'm going to spend some time today researching the best choices in the two areas but the clock is ticking.  I've given a deposit for the place in town, Park Merced, and we'll need to do contracts soon so I can start to remodel the apartment. (looks like 1970.)  

So what wins here?  Having me and my family 5 min away to be an integral part of her life, she's over a lot, sees my dogs she loves, etc.  Or, she's almost an hour away in a CCRC?

Thank you in advance!!!

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Marianne*

Thanks Victoria.  The best care is Park Merced but they don't have memory care.  I called and asked about the assessment they did.  It was the Mini Mental State Exam (MMES) and she scored 20 out of 30 which is the bottom of "mild" category.  

There is a "nicer looking" place in Merced where I live, Pacifica, but it's not so nice for care.  They have a memory center but people move into Pacifica and then move to Park Merced sometimes.  When we were there for a few hours a couple of months back I didn't like how they threw an activity together cause we were there and just a couple residents showed up.  They were like, oh we're gonna do something?  It was obvious they don't provide the program they say they do.  Food was terrible.  Reviews not that great.  So, if it's by me, it's Park Merced.  They do have  residents with dementia there also.

After those 2 options, I'm looking in Modesto and Fresno California.  Both pretty much and hour away give or take a few minutes for traffic. 

Deanna_M

Marianne, I know that this is a hard decision. When I first placed my mother, I had the idea that I would be bringing her to my house, out to lunch, and other outings. I lived about 35 minutes from her facility, so it was a real logistical challenge.

What I found, though, was that as she settled into her facility she did not enjoy the outings and found them stressful. She really thrived on the routines and familiarity of the MC facility. She was not even that far along with disease progression when this became the case. I decided, instead, to spend time with her in the facility: eating meals with her and doing the group activities with her. We enjoyed bingo, concerts, worship services, and crafts. I would often bring my kids to participate as well and got close to many of the residents at the facility.

Your mom may be different, and perhaps she would enjoy outings, as you have envisioned they would be. But, I did want to offer my experience: I had to let go of the idea that I needed to take her "out" all of the time. Spending time alongside her in the facility was fine and I treasured those times with her.

Good luck to you!

May flowers

Is this place closer? It is in Turlock and it has both AL and MC https://frontiermgmt.com/communities/paramount-court-senior-living/

zauberflote

Hi Marianne-- we were sort of in your position when we moved Mom 600 miles from AL in the village she'd spent 20 years in to MC in my city.  She was stage 4-5ish, 91 in a couple of weeks, frail yet strong from working out with a personal trainer. 

I had to replace her church group, who saw that she attended services etc with them twice or more per week, and continue to be the one to take her to movies, opera simulcasts, concerts, and extra church services every couple of months, at which I was a featured musician. Also out for coffee, snacks, a meal here and there, and one time to my "definitely not designed with the elderly in mind" house. My sons were occasional participants. 

All of these lovely enrichments lasted about 10 months, but the list of things she was physically capable of grew shorter more quickly than her tolerance for stress. Attending activities at her facility wasn't in the stars-- whenever I showed up, she wanted us to be just us, and she strongly hoped to go out somewhere (or, back to the peace and quiet of her room, for which I truly cannot blame her!)

I can't really advise, only tell you how it was for Mom. We chose the place primarily for its location only 20 minutes from me (our city sprawls into its many suburbs, this place was smack in the geographic center of town, and equidistant from all activities I might take her to. The price was another consideration. Here was a nearly-91-yr-old who could equally well up and die tomorrow, or, last to 95. She had good LTC insurance, but it wasn't going to get her much past 92. 

So there was one picture of one person's journey. Every one is different. Whichever option you choose, I know you'll cope with its results!

Cynbar

Marianne, this is so difficult, your desire to spend time with your mother is shining through. No one here actually knows your mother, or has had the chance to actually assess her and her dementia progression. We can only give you insight based on our experiences with our own loved ones. Yes, of course quality of life matters. Your mother sounds like she is pretty far along, based on your description of the trip to Eskaton. Also, dementia progresses at a different pace for everyone. Most PWD become less and less interested in the quick, spontaneous outings your describe -- they function best within the structure of their facility.  Many PWD have a very difficult transfer to a totally new facility for MC when their dementia is more advanced. You might also ask Park Merced if they would encourage the frequent outings you envision, some facilities would feel it disrupts the routine in the building. But in the end, only you know your mother. Consider all our input, then trust your gut instinct here. No one knows for sure what the future will hold.

Mom's Baby

Marianne, my mom was at about the same level as your mom when we placed her in an independent living facility with assisted living attached. Now, I can say right off that this was a mistake. I thought because I lived only a couple of miles away that I could help Mom get along there. The reality is that she was worse off than I thought. Couldn't find the dining room. Didn't really know where she was or why. Started not recognizing me soon after, but acted like she knew me. She may have thought I was family but couldn't put a name to the face. 

I ended up running over there every single day. It was horrible. I enjoyed seeing her, but I had a full time job and a new marriage to tend. I traveled a lot for work, and I'd have to beg a sibling to take my place and visit Mom while I was gone. 

I would try to take Mom to my house, just a mile or two down the road, and she would be at my house for 5 minutes and want to go home. Taking her for rides was no better. She'd grasp onto the door handle for dear life, and after 5 minutes, "We should probably go back." 

I appreciate your love for our mom and your desire to be with her and help her through this. But I echo the thoughts of others here that these folks with dementia start disliking change and disruption very, very early on in the process. You are thinking more about what YOU would want if you were in your mom's situation, but the reality is that she does not think that way anymore. 

Do what you need to do to make sure she has the best care for her WORST days, not her best. Those will get closer and closer together. 

towhee

Marianne, take a deep breath, the truth is that almost anywhere would be better than your mom staying at her home alone. As Cynbar says, none of us have personal experience with your mother and we cannot really say what would be best.

My suggestion is to consult those who do know your mom. How about her doctors? In my state the doctor has to fill out a form saying what level of care is appropriate for someone and we cannot place under the level of care specified. Often, unfortunately, the doctor ends up asking the caregiver for the answers to all the questions, but if the doctor has been seeing your mom for a while their input might be of benefit. You referred to an assessment by the assisted living facility, were you able to be there for part of that, or talk to the person doing the assessment before or after they talked to your mom? Persons with dementia can perform really well with strangers sometimes, and the person assessing your mom needs to have all the information to be able to judge whether your mom will fit into their facility. You mentioned someone coming by every day to give your mom her meds. Have you talked to this person? Any others who see your mom on a daily or weekly basis?

What about your own experiences? You took a trip recently. Did you mother have any problems finding the bathroom, or navigating physical spaces? How much assistance did she need? 

From what you have said, your mother likes to walk outside, in a place she is familiar with. Would the facility allow this? Do they have an exit delay and alarm system, a wanderguard system, what type of security? Are you comfortable with what they have?

Sorry, take another deep breath. Sometimes you just have to take a chance. If you have to move your mom later, than you have to move her later. I researched the heck out of 7 different ALs and MCs and still ended up moving my LO twice both as her capabilities changed and as I gained more info about the capabilities of the facility. It is impossible to know everything you need to know going into this. A lot of the advice you are getting is basically people saying "don't make the same mistakes I did".

Take care

Marianne*

Thank you everyone for all of the feedback.  I've decided to place her at Park Merced AL by me for now.  She is a Level 1 for care which means that they will give meds morning and night, remind and escort her to activities, remind her it's time to go the dining room and help her if needed.  I've also made sure that my caregiver that helps me now with meds is ready with their qualifications as a companion if the need arises (fingerprint scans, TB test, Covid vaccine).  

The building is a large rectangle with two pretty courtyards in the center.  Her room is in the back far away from the front door.  There is a door in the back but it goes to the gated perimeter around the building.  My mom is an avid gardener and likes to be moving and busy.  So, I chose the large studio they offer because it's the only size that has a sliding glass door to courtyard and personal patios.  There are lots of flower beds just waiting for her.  They incorporate walks and other physical activity daily.

I've researched MC that is in Modesto and Fresno (about an hour away).  As soon as I get her in the AL, sell the house, and move her stuff, I'll start visiting MCF.  I'm not sure if it will be 2 months or 2 years.  My mom has bounced back to her normal from the whole visit to Eskaton.  I'm hopeful that once the initial shock and adjustment period passes she'll bounce back.  I realize this may not happen and she may have to go to MC much sooner than later.  I just can't bring myself to do it though without giving this a chance. I need to know that I tried and did my best.  

Jane Smith

Marianne,

Hope you’re doing okay. This is so difficult, but I hope you have some relief that a decision is made and you can go forward with that plan. 

None of us have a crystal ball. We can’t know exactly how things will work out. But you do know this will be safer than the current situation, so it’s an improvement.  If you do have to move her later, then you move her.

We can only make a decision with the information we have available at that moment.  So, we do what we can. 

At the end of the day, you have to be able to look in the mirror and face yourself. Do what you need to do, to be able to live with yourself, your conscience, whatever you call it. 

The next part is one of those easier said than done sayings, but now that you have a decision, move forward, rather than spending time and energy (that you probably don’t have available) on second guessing yourself. As much as you can, anyway!

If you are inclined, please let us know how it goes. We will be thinking of you and your mother.  Best wishes.

King Boo

In your post Marianne you provide additional information that was missing in your other posts.

The fact that they can provide escort to meals and activities, mediation management and that egress is controlled by a gated perimeter indicates it has at least some 'stepped up' care.  

AL is, after all, just a label.  Some facilities labeled AL have almost nursing home ready patients in them.  Others have 1 aide per 100 residents, just enough for a daily 'touch base.'

Good plan, good luck.  And it's good you are planning to research for contingencies.