First in- person tour of MCF

David J

Today I had a tour and interviewed the Executive Director of a local AL/MCF. It is a high end facility and more expensive than others I have looked at. I had a virtual tour last year, but this was the first in-person tour I have had of any facility. I came away sad and frustrated that this the best(?) I can do for my wife. DW is EOAD, and I knew the MCFs are populated by older folks, but I was struck by how much older they were and how sedentary they appeared to be. The thought of putting my Dear Wife into this environment fills me with dread and anticipated guilt. There wasn’t one resident as young and active as my wife, and it seemed so many were completely out of it.  They say they don’t medicate their residents, but how could so many PWDs all be so calm? I am more confused than ever.

Don’t get me wrong; it is a very nice place.  It is apparently well cared for, didn’t smell like a nursing home or hospital, and seemed to have a well trained and dedicated staff.  My best friend from high school had his mother and mother-in-law in a sister facility in another town and they were very pleased with the care. I saw nothing to contradict this evaluation. I am just sad and scared about putting my DW into a place filled with old people. She has so much more energy than I saw in the residents.  

I met administrators, nursing staff, direct care CNAs, food service employees, housekeeping, program assistants, etc. I know I just  do all that for my wife now and I can’t do it forever, but when is the right time? They have all the staff that I don’t, but how do I hand over my wife, my partner, my life, to these people?

Stuck in the middle

My mother spent the last six years of her life in a NH, but I didn't just "turn her over."  I visited frequently to see her and to assure she was cared for.  I took her places with me as long as she was able to get out.   Restaurants, my house, walks in the park, etc.

Your wife is still the woman you love, but you are getting help with her care.

When is the right time?  I don't know.  I'm pretty sure the wrong time is during a crisis, when you have to place her right now and have to take whatever placement is available that day.

M1

David your heartache is very real and very touching. But I agree with stuck that placement is not abandonment.  You'll probably be there a lot. And like on Joes recent thread: remember it's not irrevocable. Have you thought about a respite stay, to see how it feels for both of you?

French

Oh David, how I understand your feeling. We visited 2 MCF. My partner was 51 years old. He is now 52. 

For respite, I let him 19 days in a memory care. All other people were almost 25 years older. Most of them had great difficulties to move. When we arrived they were sleeping in armchairs, some of them were pacing. More than the age, what was difficult for him was that some were very advanced and he realized he will become old like them (his words). Also, one was violent and he was shocked.

In the second we visited, the younger is 69 years old, in a good shape. But he doesn’t speak anymore (AD for 12 years now, it began at 57). Our feeling was better because the space was larger and there is less residents (14).

What is important is to feel the ambiance. In the first one (which I chose because it was a high level one, with light therapy and lot of other services... and very expensive too), the mood wasn’t good to my partner. In the second that we visited after his stay in the first one, we felt better, less oppressed. 

But still, how the others were old compared to my partner... in France there are 3 facilities for EOAD, only 90 places. None in our region. I applied to one in November. It is 700 km far from here, but I applied because it is an innovative village for Alzheimer’s where people are not  locked up. Accepted in February... on the waiting list since then. They only have 12 places for EOAD. I have no hope.

Cynbar

I am struggling with this also. My DH is 70, so not as young as some of you, but also not very elderly. He has physical issues too in addition to late stage 6 dementia. He is currently in a local facility for short term rehab. The other patients/ residents there just look so debilitated, either very confused and pacing or lethargic in a chair. One man paces constantly and at mealtime tries to grab food off other residents' plates (staff redirects when they can but are especially bust at mealtimes.) The place is clean and air conditioned, the staff is warm and friendly but cannot give DH constant 1 to 1 service. Most of the other residents are not conversational (neither is he, come to think of it.) Activities are ongoing but no one seems too interested. Of course, this is a nursing facility and not memory care, where things might be different. But I see posts that talk about how enriching the socialization and activities are in a facility, and I'm not seeing it. DH is declining and not bouncing back as well as he has in the past. The plan is to bring him home, but I don't know how much longer I can care for him as his care needs increase. The thought of leaving him in a place like that sends me into a panic.

David J

Maybe I was a little dramatic saying “turn her over”, but they would be her primary caregivers. Right now I am with my wife 24/7. If she is in an MCF, I would be a visitor only. It’s different. 

I am looking at two facilities, one of which is 5 miles away and one is 10 miles away. I will be visiting often if not daily. One facility is memory care only, the other is assisted living with a memory care unit. Under Connecticut law, they are both considered housing facilities and the contract is actually a lease agreement, with 30 or 60 day automatic renewal. Respite stays are a minimum of 30 days at a daily rate that is about 1/30 the monthly rate. I need a minor operation I’ve been putting off, and may need to place my wife in respite care, so we’ll get a trial run.

I appreciate everyone’s input. It is a scary decision. Not irrevocable, but another step in the journey. 

French

Respite stay is a good idea. 1 month is quite long but it has the advantage of being long enough to see how your wife adapts there.

Joe C.

David, I totally get your concern with the age difference between your wife & the other resident, it is something that also concerns me when I tour facilities. I am in MA, so relatively the same geographic area so we may be looking at facilities with the same corporate group. One thing I have notice is there are facilities in my area with higher functioning (not necessarily younger) residents but the down side is they require residents to move on as the disease progresses. If you are just looking for a respite stay maybe a facility with high functioning residents may work best.