Assisted Living to Memory Care?

Worried about mom

How do you know when it’s time to move your loved one from assisted-living to memory care? My mom’s doctor is suggesting it and I am petrified. How on earth will I convince her to go after being in the same place for five years? I am so afraid the trauma will cause severe progression

John2.0.1

I take it the AL she is in doesn't have a MC wing? My mom just moved downstairs the lure being no elevator to deal with. She is in a wheelchair. Easy and she still thinks she lives upstairs.

Worried about mom

No, they have a memory care center but it is a few miles away. It won’t be anything like where she is now unfortunately.

harshedbuzz

As they say at Nike- Just do it.

If it's time for MC, then it is past time for a reasoned discussion about why the move is necessary. You do the move behind her back and the day of create a fiblet that puts "blame" for the move on something else. Perhaps residents of her old AL are being moved out for redecorating or because there's a water main break so she's going to stay here while the work is done. In your shoes, I might take her out for lunch and a little shopping while someone else sets up her room in the new place.

I know it can be hard to see your mom move from a community where most adults are functioning fairly well with assistance to one where you might find the full range of the disease process including those who are nearing the ends of their lives. And I get that the decor and amenities in AL are probably "nicer" than what she'll be moving in to. But, if the doc thinks the AL ship has sailed, there are a lot of positives to the move. 

I had 2 aunts with dementia. The sweet one never had kids and was found living in a cold dark house after she stopped paying bills. Her sister obtained guardianship and placed her in a well regarded MCF where she actually improved a bit with a routine and staffing that were dementia-appropriate.

Her scrappy sister had lived at home with her adult daughter until daughter cried "uncle". This was never an ideal arrangement, but the daughter did provide a great deal of support and scaffolding which meant that other people thought she was functioning much better than she was. They moved her into a beautiful AL which was an unmitigated disaster. She wasn't able to get herself down to meals when she was supposed to and ended up not eating. Once we got that ironed out, she struggled with the activities which weren't intended for someone with a cognitive shift. And the other residents who didn't have dementia did not include her so she was eating meals alone. About 2 months into AL, she had a fall sometime in the night and was not discovered until the medication cart came to her room. In MC, she still could have fallen, but hourly checks (every 2 hours overnight) would have kept her from being on the floor all night.

I know this is hard. Good luck.

HB

Sjodry

Worriedaboutmom,

It can be very challenging for some to know when the right time for MC is. Because my mom still had/has days of higher cognitive functioning, I tended to keep thinking..that we were “close” to the time for that decision, when in reality it was past time for that decision.

It actually took a midnight visit to the Pysch hospital for her behaviors for me to recognize that it was time for memory care. The visit with the psychiatrist ended up being more for me than my mom. The psychiatrist straight-forwardly told me that the mom I had always known was gone and that she needed memory care as soon as possible. This conversation forced me to understand that just because I see glimpses of my higher functioning mom does not mean that she can sustain that functioning in all areas of her life at all times anymore.

As for how to convince her that a move is necessary..some here choose fiblets, others like me rely on the doctor to help have that conversation. My mom had been with her doctor for so many years that she trusted him explicitly. When I needed to move her to my state, her doctor was helpful in convincing her. When moving her to memory care, as mentioned above, the psychiatrist helped me to make the decision. The actual move was made straight from her stay in the hospital to the memory care unit. When she was cognitively coherent enough to notice her surroundings in the new MC unit were different and asked about it..I just told her that she had some medication issues the doc wanted to adjust and this is the best place for it. She never even questioned it.

Good luck to you. It is always a tough decision. Please don’t feel guilty about making the decision as you are making the best choices for her safety and care.

Take care.

Sandy

zauberflote

Hi Worried-- this is such a hard time to think about...

My mom went from a lovely 2-bed apartment where my sis was doing all the work to a non-profit AL which had strong support. Sis had burned out running two households and simply living in the same town as Mom for the 20 years of Mom's widowhood. Not to mention the trips to the ER for falls, and several small but necessary surgeries. Sis got Mom to AL, and bro and I took over her care management from 1000 and 600 miles away respectively. The next move wasn't dictated by decline (although it would have been soon enough, in hindsight), but rather by a hospitalization of Mom that nearly killed bro and me. 

We moved Mom to my city, to a small 60-bed all-in-one, one-fee-for-all-care-levels AL/MC, where she could stay in her room until she died unless she needed skilled nursing. She did have a sudden decline, but she smelled a WHOLE lot cleaner! It had taken her a year to acclimate to the AL. It only took a few months to get used to being in MC. The only two main differences were that she couldn't go out for a walk whenever she wanted (and couldn't remember where the door to the courtyard was even though she passed it at least 6 times a day on the way to and from the dining room), and the immense culture shock. The last time she'd lived in Virginia segregation was still in effect. Being an elderly white New Englander didn't prepare her to be able even to understand what her caregivers were saying half the time. But-- love is a universal language, and the caregivers all loved on all their charges in ways that Mom may have been craving-- hugs, sweet words, hand holding-- it was the loving that helped her acclimate. The not being able to walk outside twice daily was what caused the decline, we felt. We had to agree with her feeling of being locked up- for the first time in90 years, the outdoors girl couldn't get out. 

That's our story, hope it can be helpful!