question for those who have used AL and MC

M1

We're not there yet, but the time is nigh when I will need companion care here, and I have learned so much about thinking about MC from you guys.  If something happened to me it would be a necessity, as my partner has no family who could step in.

Here's my question:  did you have a sense ahead of time of whether your LO would adapt to MC/AL, and was your sense borne out in the long run?  My partner is truly charismatic and can get along with people from all walks of life; everybody tends to love her.  But she has always been a loner, relatively unique in her interests (not many women builders then as now, after all), is a classic introvert, and I do not think would easily participate in the kinds of social activities that I think most MC facilities--or day programs for that matter-- offer.  Games, movies, group meals, group art projects, music or singalongs, exercise groups:  none of that would be her thing.  Gardening might appeal seasonally, and watercolor/painting might, but in short stretches.   Animal care would appeal, and she would want to help the maintenance workers and cleaning staff!  Back pain and joint pain from scoliosis/rheumatoid arthritis is also limiting, and she needs to be able to pace her own activities/lie down when she needs to (that's certainly the deterring factor for any day program I think).  So my overall sense has been that she would not be an easy adapter, at least not until it was so late in the disease course that none of that mattered.  On the other hand, she is bored without company here, and her loss of executive function has shrunk her activities to a precious few:  cleaning (constantly), feeding the animals, puttering through old papers (nearly constantly).  She rarely ventures outside any more, rarely watches TV except in the evenings.

Just interested in your thoughts and input, thanks.

Ed1937

M1, I'm sure you know we haven't been down that road yet. But I feel much like you do concerning how well she would adapt to a new way of life. I can't see my wife taking part in the things you described. Although I wouldn't call her an introvert, I doubt she would make "friends" with other residents. But the good news is that I really believe many people are surprised at how well their LO adapts. I expect sometime this year I will have done what I can for her, and there will be no choice but placement.

M1

Yes Ed I kind of sensed that you felt that way too.  Maybe I'd be pleasantly surprised, but those basic personality traits haven't changed, and I just have the sense she would be miserable in any group setting and just quit eating as slow suicide--if she were still aware of her surroundings at all.  I'd love to be wrong, but she's never been a joiner/group participant and usually went out of her way to disrupt (school, for instance, and once got kicked out of a dog training class for being too distracting/not serious enough.  Her home ec teacher in HS gave her a D, saying she should have failed her but did not want to have to have her back in the class a second time.  She wanted to join FFA, but they wouldn't let girls be in it in the '50's.  And yet was voted most popular in her graduating class).  I could see her deliberately being oppositional/defiant in anything that required group participation.  I really dread what's coming in the next little bit when I have to have some help.  Getting her to cooperate is not going to be easy.

Quilting brings calm

M1-   There are probably facilities that might be able to guide her to activities that suit her.  Outside activities that are more suited to her.  

My parents’ AL seems more geared toward single females because that’s the majority of their residents.  They seem to only offer one or two scheduled activities a day, while allowing for informal card and board games, coffee clubs, old movies, puzzles, etc.  they do have a pool table and a shuffleboard, but I do not think they are used.  

They don’t force anyone to participate in activities, 

The problem with an AL is that residents that want to spend the majority of their time alone in their apartments are allowed to do so.  Sure, staff will notice if they don’t come up for meals and go check.  If the resident uses the facility’s medication management, staff will come to the apartment to give the scheduled meds.  My parent’s  facility told me staff comes into each apartment  overnight at 1 and 5, but they will cut that down  if the resident desires.  So your partner needs to either be able to press the help pendant for help as needed, or be able to be self functioning in the apartment between meals, etc.  

There are residents in my parent’s AL that are in wheelchairs.  At least one that only has use of one side of her body, so I know she gets appropriate assistance such as her meat cut up, etc.  

harshedbuzz

M1 wrote:

We're not there yet, but the time is nigh when I will need companion care here, and I have learned so much about thinking about MC from you guys.  If something happened to me it would be a necessity, as my partner has no family who could step in.

In that case, the secondary agent on her DPOA needs to have a plan B they can implement on the fly even if you aren't planning placement in the foreseeable future. 

My mom refused to contemplate a time when dad might need a care facility because she was unable to do it due to death or disability, so I made my own Plan B. 

Here's my question:  did you have a sense ahead of time of whether your LO would adapt to MC/AL, and was your sense borne out in the long run? 

I did have sense of how placement would play out for my dad, but the actual experience was a complete 180 of what I anticipated. Where I fully expected exit-seeking, threats and anger for months, dad calmed down in about 2 weeks and settled in within a month. 

My partner is truly charismatic and can get along with people from all walks of life; everybody tends to love her.  But she has always been a loner, relatively unique in her interests (not many women builders then as now, after all), is a classic introvert, and I do not think would easily participate in the kinds of social activities that I think most MC facilities--or day programs for that matter-- offer. 

We avoided day programs because we didn't think dad would cooperate in getting ready or participate in organized activities. And forget tricking him into volunteering at the senior center- he was not altruistic by nature.

While dad and I seldom saw eye to eye, he was the life of the party with other people and liked attention. It turns out, he became a favorite of the staff in the MCF because of his charm and nice manners. He saw the aides as professionals and treated them with respect and gratitude and they went out of their way to accommodate and interact with him. 

Games, movies, group meals, group art projects, music or singalongs, exercise groups:  none of that would be her thing.  Gardening might appeal seasonally, and watercolor/painting might, but in short stretches.   Animal care would appeal, and she would want to help the maintenance workers and cleaning staff! 

Dad wasn't much into MC activities either. I thought he might go for the morning coffee/news discussion group but it was a bust. He did enjoy music activities like live performances by local church and school groups as well as when thy brought in a DJ for an in-house event. Sometimes he's watch a sporting event or movie in a group but not often. The DON used to write him notes inviting him to certain activities he thought dad would like and that often got him out of his room. 

At dad's MCF, there were a couple gentlemen who helped out with simple maintenance stuff like light bulbs and emptying trash cans. Many residents helped with their own laundry. One gentleman had owned a restaurant and for a time set and bussed the tables and even supervised staff during meals.

Back pain and joint pain from scoliosis/rheumatoid arthritis is also limiting, and she needs to be able to pace her own activities/lie down when she needs to (that's certainly the deterring factor for any day program I think). 

This also factored into our decision on MCFs. My first choice was understanding of dad's preference to sleep late and allowed him to nap in his own room if tired. Other places I toured that seemed to cheery pick for perky PWD in traditional casualwear tended to enforce participation more. 

So my overall sense has been that she would not be an easy adapter, at least not until it was so late in the disease course that none of that mattered.  On the other hand, she is bored without company here, and her loss of executive function has shrunk her activities to a precious few:  cleaning (constantly), feeding the animals, puttering through old papers (nearly constantly).  She rarely ventures outside any more, rarely watches TV except in the evenings.

Like I said, I expected a disaster, but I was hearing murder/suicide ideation and he needed to be out of the house to keep my mom safe. Whether he adapted or not, he couldn't live at home at this point. He had a sense he wasn't long for the world and believed she should die when he did because "they did eveything together".

There were a rough couple of days- he was very angry with my mom. We managed this by not letting her visit alone and making sure visits happened in the public areas of the facility rather than his suite. About a month in I took him to his urologist for a ADT shot and offered him lunch after- he said he just wanted to "go home" meaning the MCF. Around this time he developed a delusion that his beloved brother and my mom lived at the facility, too which really changed his attitude around it. 

Just interested in your thoughts and input, thanks.

M1

Thanks HB, that's helpful. We do have a plan B, thanks to the input I learned here. It remains an Operation Hope Not-for now.

Vitruvius

DW is not yet in an MCF, but I did get her into a daycare program. What happened is what I hope happen when it’s time for the MCF. 

I was going nuts with DW at home and checked a local daycare. I convinced DW to investigate a local “social group” because I needed to work and I didn’t want her home being lonely. (Actually I had to retire to care for her. I just needed a break.). We went and sat in for an hour or so. The activities seemed juvenile to me and I was embarrassed that I took her and was sure she felt the same and would be mad at me for it. The director then brought us into her office and asked DW if she liked what she saw and did she want to join them. I was dumbfounded when she cheerfully said yes.

She often gives me a bit of a hard time to get her there, but I came to understand her problem was with leaving me, not the program.  The staff have assured me that she enjoys herself and participates in everything willingly. I had figured she would never go for it but I was wrong. 

Beachfan

M1 wrote:

…… So my overall sense has been that she would not be an easy adapter, at least not until it was so late in the disease course that none of that mattered.  

Sadly, this is the state of affairs in which I find myself with DH.  In his MCF, he does not participate in activities; at best, he sits with the group and watches.  He doesn’t have “friends” per se, although several of the female residents stop by and tell me how “nice” he is.  The staff seem to love him; they chat with (to) him and reply to his gibberish.  He is well cared for and content.  His progression has been slow but steady and there’s only one outcome, I know, but it hurts to see him fading away before my very eyes.  

M1

I'm encouraged by those of you whose LO's adapted better than you anticipated.  But I find myself perversely hoping that it won't come to that, and that some other health event will intervene before I truly have to face placement.  Sad but true.

billS

I moved my wife into MC just about one month ago. Because she often complained of being lonely and bored at home I was hopeful she would accept the change, and as it has turned out she has adapted very well. In her prior life she was always very sociable but at the same time self sufficient and capable of being independent. Now in her MCF she participates in the activities in which she is able, and just seems content to watch other activities. Even if she just sits at a table with another person or two she is at least no longer lonely. To me that is a huge win, loneliness is a terrible thing for someone to suffer.

Jeff86

M1, I have wondered similarly how my DW would adapt to MCF.  She’s always been sociable and makes friends easily but she also is not joiner, not likely to jump into a group activity.  

The one time she trialed memory care for a shortened session, she refused to stay for lunch and would not go back again. 

Of course, that was then…

aod326

I was very concerned at how my DH would adapt. He was a very physically fit 59 year old and all of the places I looked at had mostly much older, predominantly female, residents. He loved to talk (one of the reasons I was looking at places, because he needed more socialization than he was getting at home), but made almost no sense and I thought none of the other residents would be able to understand him and he'd get frustrated. As social as he'd always been, he was definitely not a "joiner", plus the activities were mostly geared to much older residents. He had always hated daytime TV. Even with one of his biggest loves, music, he was into classic rock, 70s and beyond (really he was too young for that, but hey), not 40s and 50s music. I'm not saying any of those things to be disrespectful to others, nor to be complaining about the facilities - they cater to the majority of their residents.

Aside from a couple of weeks of aggressive behavior (another of the reasons I'd decided to place him), he adapted perfectly well. Apparently he liked to help the "old ladies", and as he didn't want to scrapbook or paint or whatever activity they had, the nursing director had him "help" her in her office. She knew he'd been an attorney so would tell him his legal advice was helpful.

He had very particular likes and dislikes regarding food and drink, which I also thought would be a problem, but apparently not.

I honestly believe in the majority of cases placing in MC is far more of a worry for us, the caregivers, than it is for PWD. Good luck.

M1

Thanks aod--I've been glad to see your recent posts.  Most of the replies here are reassuring.  We're fortunate to have a state of the art Alzheimer's facility relatively near us (probably best in the state), and I'm getting ready to make initial inquiries.  We'll see.  Today has been one of her clearer days--we talked about home care and need for planning (I didn't specifically mention MC though).  She's ready to die, which is sad, and on her clearer days she has much more insight into her limitations, which is also heartbreaking.

Joe C.

M1, I had concerns about DW acclimating to MC but for different reasons. At home she always wanted to “go home” and get out of the house so I assumed this would continue in the MC. Although she was always talkative & outgoing, her social interaction with family & friends had declined significantly in the year leading up to placement. I assumed the desire to “go home” and her social withdrawal would continue in the MC. To my surprise, once she was around people at her level her social personality reappeared and the request to “go home” ceased. It was like she fit right into the MC community.

billS

Joe C. wrote:

M1, I had concerns about DW acclimating to MC but for different reasons. At home she always wanted to “go home” and get out of the house so I assumed this would continue in the MC. Although she was always talkative & outgoing, her social interaction with family & friends had declined significantly in the year leading up to placement. I assumed the desire to “go home” and her social withdrawal would continue in the MC. To my surprise, once she was around people at her level her social personality reappeared and the request to “go home” ceased. It was like she fit right into the MC community.

My experience is pretty much the same. My wife settled into memory care immediately and has never mentioned wanting to "go home" since.

Stuck in the middle

My mother said she wanted to go home after an outing, such as a medical appointment. She meant back to the NH.

Quilting brings calm

Joe- reading your comments makes me think.  Part of my mom’s anxiety and distress is because she knows she’s confused. She knows she has more issues than others in her assisted living  center. There are 4  women that will play informal evening games of Rummikub. She will come back to the room after a single game some nights because she can’t follow the conversation or the game and it upsets her.  She is not ready for MC( stage 4).  I think that when she is ready, going to an MC will relieve her anxiety and distress shout comparisons to others.  She will be on an even playing field with the other residents.