Tips for Move to AL

NDW322

Hi all,

Mom is in stage 5 approaching stage 6 and after a couple of years of taking care of her - along with working full time and raising small kids - our family has identified a facility for her and we are moving her within the next couple of weeks. 

My questions are - what tips do you have for this transition? My biggest concerns are mom is used to seeing myself or my brother every day. One facility we toured told us it's best to give her a little space to get used to her new home and staff, and NOT have her create the expectation that one of us is coming again every day. How often did you visit in the first 30 days? I know my brother will want to see her a lot.

I'm also torn on how much we talk to her or don't about the move. For the most part she just goes along with whatever we say. We selected a 1 bedroom unit so we can set it up like her current apartment and hopefully it will feel familiar. She has few moments of clarity but I know trying to reasoning with her is... unreasonable. She seems to be aware something is going on but  then later forgets. 

Also, her dog. Her dog has been her companion for several years and I hate to separate them. I do worry that she can adequately care for him and the facility charges a hefty fee to help with care of pets. He seems to be more "out of sight out of mind" for her right now, but then she'll randomly ask where he is in a clearer moment. Do we bring him or not?

Any other tips? I'm worried about her remembering where her room is and being able to identify it. I'm thinking of having a sign made for her door to hopefully make it easier. 

Thanks!

PickledCondiment

While I agree the facility has 'expertise' in the area of transition, you and your brother know Mom better than they do at this point in time. At the risk of being contrary, see her as much as you feel is necessary to smooth the transition for all involved.  While it is important to seek facility guidance, you're ultimately making the decisions for your mother. 

Regarding the dog, my LO would be lost without our dog.  While she does scold him, etc she is still attached to him.  While your having the dog at the facility probably isn't feasible, consider him as the reason for frequent (possibly daily) visits until a routine is established.  In my situation, the dog is a great source of comfort (and aggravation) depending on the day.

NDW322

Helpful advice. Thank you so much!

Marta

Hello. Will your Mom be going to a facility with Memory Care?

NDW322

Yes they also have memory care and will do an assessment prior to her move in.

towhee

Sign- good idea. Check with the facility first though. Some have rules about how big, how attached, type of material you can use. Does she have a long time hobby or activity she likes? One place I saw put a shadow box on residents doors with pictures of their favorite activity, so they would be drawn to it even before they saw their name and they usually used just the first name if the person was further along in the disease.

Dog-Might not want to bring the dog at first. If she is upset for a while it might not be great for the dog. Can you keep it at your house? Bringing it to visit is a great idea.

Talk about Moving-Usually here, if someone has been resistant to the idea of moving the advice is not to talk about it at all. Even if not resistant, still don't mention it a lot. Most here sell the move as temporary "The doctor said you needed to get a little stronger, or You need a little work done on the house etc."

Not visiting--It has become a common practice of facilities to ask all families not to visit for a week or even two. But I agree with the previous poster, not all new residents have the same reaction. I suspect that what the facility is concerned about is not your mom expecting to see you every day, but that she might expect you to take her home and become agitated and harder for the facility to deal with. You might try a phone call that first day and see how things go. There was one poster on the boards a few years ago that actually moved in to the AL with their mom for a couple weeks and then gradually shortened the amount of time she was there down to short visits a couple times a week. For her mom, that worked really well.

Emily 123

Familiar things in familiar places.  They will be using a lot of their brain power to make sense of the new landscape--nothing will look familiar for a while, so things that they can still cue off of will help.  I tried to keep my mom's bedroom and living room pictures in the same rooms, thinking that might help.

Two examples:

Mom couldn't recognize the (newer) nightcream she had been using, but when replaced with the one she had used for years (that yellow stuff from Clinique) she started applying it daily.

Wouldn't put clothes in a hamper I had bought her, started to cue once I replaced it with a white plastic laundry basket like she had always used--I put it to the left of the closet like she used to do at her home, as well. Sometimes she thinks she can get another day's wear out of things and festoons the closet with tees, so a once a week laundry check occurs during visits.

Less choices means less challenges!  There will probably be a go-to set of clothing she selects after a while. Make that stuff the most accessible. For my Mom it's tees, cardigans and then skort or khaki's/dockers.  Even if they do separate loads of laundry for the residents some things will show up or disappear on laundry day. Amazon has some labels from Avery that work well if you need to label clothes. 

My mom's not a sharer or a joiner, so...I think it took her about 6 weeks for things to seem familiar to her and about another 6 to kind of let go of worrying about outside things and to start to let the routine structure her day.  Once she did that she seemed more relaxed.  A you-tuber described a person with dementia as trying to juggle all these balls in the air as they tried to recall the steps in tasks and interact during the day--the facility removes a lot of the need for the juggling act. 

Vickivicki

These are great suggestions. I'd like to add that because we had to move our mom against her will, I was advised to stay away because she would rage at me and my presence just caused her to be very upset and in turn, caused stress for the staff. I was the target. We were blessed that the AL was owned and operated by a loving family member who was on site and took special care of Mom and all the residents. I was in constant touch and visited Mom later the first week. My normal routine was to spend one day a week with her, more when she was sick or had dr appointments, etc...But she had a manic episode about a year and a half later and began raging again at us. I asked what I could do and they said, "do not come here"as it will further upset her. Having complete trust in the staff of facility, I could accept the directive. We worked with neurologist to adjust and add medication and she settled down. I'm so sorry for all the caregivers who are working to help their LO's and may be experiencing anger or aggressive behavior. Mom's been gone 2 years now. Her AL was a godsend who cared for me as well during the 12 day bedside vigil after she had a stroke and passed away. 

Sleepless in Sleep

I am approaching a similar situation soon. I believe my parent is staged close to where yours is too.

My impression, after speaking with a couple of places,  was that ‘in stage 5, approaching stage 6,’ was late for AL. With that said, I also feel my parent is not ‘ready’ for MC. Did the facility advise you on this?

Thanks.

King Boo

Leave the dog home 'for now'.  See how it goes.   It will be much easier to re-introduce the dog in case of need, than to remove him.    Plus, doggie deserves proper care.  Over feeding, inadequate supervision, etc places the dog at risk.   Doggie can also be 'staying with you for medical care like the vet says.' if a reason is needed.

I will observe that at Stage 5-6, their AL should be a very, very high acuity AL, not just supportive AL.  Also known as a Memory Care in disguise.   Dementia specific care found in a Memory Care level facility is needed by this stage.  But a rose by any other name.  Our wing was called "High acuity AL" but functioned as a MC.