When do you know it's time to look at a facility?

TimRing

New here and my mother in law has Alzheimer's for the past four years.  I think she is in stage 5.  She still lives by herself and we do all we can to help and let her still have some life.  But we don't think she is eating and taking her meds timely if at all.  We can spend a few hours with her and she won't remember any of it a mere 30 minutes later.  It's disheartening.  Any suggestions?

jfkoc

Hi Tim...

The time is now when you have the time. You do not want to search in a crisis.

harshedbuzz

TBH, it's past that time.

She's neglecting herself; who knows what transpires when she's alone.  At this point, it's probably prudent to hire aides from an agency to provide care while you tour facilities this week.

M1

Hi Tim. My partner is stage 5, and there is No.Way. she would be safe living alone.  Period.  She couldn't feed herself or manage her medications, either taking them or managing the prescriptions.  She couldn't shop adequately or pay bills (better check her finances sooner rather than later, you may be surprised what you find).  Agree with the others that you better act pretty quick.  Good luck.

rzrbaxfan

Stage 5, the time is now to do something.  If there is any way to have her live with loved ones, explore that.  We moved my mom in with us at stage 5.  We are currently stage 6 hinting at 7, and we can still avoid facilities with the exception of occasional respite care.  But I understand that living with loved ones isn't for everyone.  It is hard work.

Emily 123

Hi Tim,

Sounds like you're there.

Please browse the threads--there's a ton of great advice here for what to do to get your MIL's medical and financial affairs in order, which will ease any transitions she will have to make, and ways to approach her about making a change. As noted, you should set up either aides or family assistance to make sure she's eating, taking her correct meds, etc. She should have a checkup with her physician to rule out any other causes of her confusion-it will help if you write a note for the physician to read beforehand about the changes you're seeing (to avoid discussing 'memory loss' as the reason for the doctor's visit in front of your MIL-which often seems to make things harder). We told my mom her visits were for a Medicare wellness check.

If moving into AL, it's usually it's easier for people to make the transition sooner rather than later, so that they can adapt to the new enviornment. Since she has no working memory be prepared for there having to be a months long settling in period while she gets into a routine.

MimiMinder

Welcome to our online support group! Glad you found us. One thing to keep in mind is that things can change rapidly. My mother recently went from searching for a word or subsituting a word to having entire sentences and conversations that are a jumbled mess. 

But, to answer the question you posed in your topic -- Now is the time. You want your MIL safe and cared for, and there are facilities with wonderful staff who can do just that. When food is provided, meds are being distributed, showers are happening, activities are offered - that brings a sense of peace to the family. I would encourage you to seek out a facility that 'speaks' dementia. My mother is at a place where all staff members, including the cooks and the maintenance people, have received training in dealing with individuals with dementia. It is a beautiful thing to walk in and see the care they are receiving.

This is a tough journey, but remember that you are not alone!

sandwichone123

When you think about wondering if you'll someday have to do it--that's the time to start looking at facilities. Don't wait to start the process when you need it right away. Start now and you'll learn a lot during the process. You may learn that there is a waiting list for the facility you want, and you'll be glad you looked before you were sure you needed to.

Diane

mommyandme (m&m)

If you want to keep her home longer, get cameras and hire help.  My mother lived alone and we hired in help starting with 3 hours in the a.m. and three in the evening.  Her meals and meds were prepared and supervised that way.  Well lunch was placed in the fridge for her.  Also in the evening they would help get her ready for bed so all she had to do was get in it, which she was capable of doing. We went to 4 hours twice a day along with the cameras which was a way to keep her supervised 24/7.  Eventually 24/7 with caregivers was necessary.  

Im hoping to keep her home for the rest of her life, that’s not carved in stone though.  I was already looking at facility options.  You should be looking too.

Sending positive vibes to you and yours on this journey. 

Amymv

It is good that you came here to inquire and the fact that you are asking hints that you might already know the answer.  You are a caring and thoughtful son in law. One poster recommended getting a camera and some outside help to come in.  That sounds like a good bridge until you figure it out and find a facility.

Looking for a facility is easier said than done, but there are agencies out there to help in your search.  Some do have waiting lists and some are short staffed. 

I commend you for reaching out.  It sounds like your family is actively involved in your mother in law's care and now you just need to adjust a bit. 

Please come back to let us know how you are doing!

mac9372

Hi Community! I’ve been the caregiver for my mom for the past two years while my father struggled with his own health issues. My mom rarely got angry with me and always said I brought her great comfort. My dad recently told me that I’ve been causing her great stress and agitation after my visits (she mentions me taking things, blames me for everything, etc) so he suggested I not come by for awhile. The problem is, this is going to happen with this disease and I don’t think it’s healthy or realistic to stay away, he needs the support too. Maybe someone knows a better approach…should we try all meeting  at another location other than their house (restaurant, etc)? Any suggestions are welcome, thank you!

ADH77

This is such a good question--and a challenging one to answer. It depends on a number of factors. I moved my mom from her home (where she lived alone in a big suburban house) to memory care (MC) when I concluded she was no longer able to stay there safely with in-home care. Here are some factors I wrestled with, regarding my decision with an LO who has dementia:

1. LO's ability to care for self. I think this is the most critical one. Can LO still make meals safely (i.e. they aren't leaving the stove on)? Does LO still grocery shop and eat a balanced diet without significant weight gain or loss? Does LO take their meds? (In my situation, my mom started telling me that she would leave the stove on, which was an immediate red flag, as she could damage her home and self if she started a fire. Also, my mom took several medications, and during a visit, I could tell she could no longer manage her meds, as she had reminder notes--lots of them all over the place--regarding when to take them. However, that requires one to remember that they have or have not already taken them for the day, which she could clearly not do.)
2. LO's ability to manage their home. This one only applies if LO lives alone, but if that's the situation, it's almost as critical as the first. Sure, you can get people to do things (including yourself, if you live nearby), but a person living alone will sometimes be alone--that's unavoidable unless you're able to afford around-the-clock care, and even then, there's always the chance they won't show up if they are ill or there is inclement weather). A home requires care and decisions. (In my situation, the red flag was when my mom's house suffered a major plumbing failure that required immediate repair and a water shutoff. My mom called services to the house to do these things and they started a multi-day repair. The next day, upon waking and discovering there was no water in her shower, she called another plumbing company for help--completely oblivious to the events of the prior day. The second company, unaware of what the first one did, actually made the problem worse when they tried to tackle it. This was a sign to me that my mom could no longer manage taking care of her home, even with assistance.)
3. Affordability. MC is expensive. It can cost around $100,000 a year (cost goes up usually each year as the LO needs more intensive care). And people with dementia can live years with the condition, even after it gets back enough that they can't take care of themselves. Does LO have long-term care insurance? If so, become familiar with its terms--how much will it pay and for how long? If there's no LTC insurance, does LO have enough income/assets to cover living there for what could be an extended period? This is a tricky one, as you tend to do best if you're on opposite ends of the wealth spectrum--you're wealthy enough that you can afford it, or you're poor enough that Medicaid will cover it. Those in the middle, especially without LTC insurance, could easily deplete their life savings quickly. (My mom was fortunate to have LTC insurance, which I estimate will pay for her care for about 4-5 years before the policy max is reached. However, if she lives past that time, I will have to figure out how to continue to pay.)
4. LO's susceptibility to deception and fraud. In today's age, there are a lot of criminals who try to take advantage of people--and they are more likely to succeed with someone they can fool, such as a person with AL. An LO with dementia who still has access to their bank and online accounts, is easy prey for criminals calling to "help" or those who might appear at the door needing "assistance." (My mom fell victim to an online fraud scheme that tricked her into turning over control of her computer. Although they managed to only install malicious software onto her computer, they could have easily gained access to her bank accounts by logging onto those institutions' websites and transferring funds--easy to do when passwords autofill.)

When I was looking for MC, I struggled with these questions. The MC facility I ultimately settled on gave me good advice: you can weigh factors, pros and cons, etc., but really it needs to be a decision based on when you know it is the right time. My mom was immediately better off after I moved her to MC. She was often very anxious being home alone--I learned later that she called 911 everyday for 3 months. She was properly fed, she had trained caregivers around, she got her meds on time in proper amounts, and her overall happiness increased as her life simplified and the things that caused her stress and anxiety--her home, loss of her car, etc.--were now gone.