Touring Assisted Living/Memory Care Tomorrow

John1965

After over six years of full-time companionship/caregiving for my DW, I'm feeling burned out and have started researching care. It seems that assisted living morphing later into memory care is the best option. I'm visiting the first place on my list tomorrow. 

- How do I broach the subject with DW?  A big fear is that she'll be resistant and perseverate on the negative until placement happens.

- Am I considering this too early? She's only 57 and is currently at stage 6(c). The director of the facility I'm visiting tomorrow said that her age will be a bit of an outlier, but not to worry about it. She also said that it is best to start her in the facility while still able to speak and somewhat independent. It gives the staff a chance to get to know her before she becomes non-verbal. Good advice or part of a sales pitch?

Big decisions and potential big changes coming. 

jfkoc

Please do not broach the subject. Please do not take your wife. There is simply no need to involve her until your home work is complete. Actually you may find that it is in your wife's best interest to say nothing until the moment of placement arrives.

When you  leave tomorrow please have a copies  of  the contract, the last incpection and the license as well as clear information about initial and ongoing staff training.

Unfortunately there are those who will say anything. I question  the logic behind the director's statement since the AL living staff will not be the same as found in MC.

Finding the "best placement" is not an easy task but tomorrow is a start...hopefully it will be a good start.

JoseyWales

I agree with everything jfkoc said. Staff is probably different between the two placements. Don't say anything to your DW, just visit and get a feel for what could be. 

I didn't tell DH anything ahead of time. To be honest, he wouldn't have understood. I just packed him up and drove him there. When we arrived, I said we were on vacation, let's find our hotel room. He never questioned it and never asked to go home. But I think DH was much further along than many of those who are placed.

DH is an outlier, too. He's 58, surrounded by those in their 80s and 90s. He never noticed. Again, I think he was just that far along, but I'm not sure if he would have really noticed had I placed him earlier. Here's what I've noticed lately. There are several newer residents in DH's unit, who are a little bit more "with it" than the ones who have been there a while. Many of the newer ones gravitate toward DH and treat him with sweet care. Little pats on the back, sweet smiles, and offers to share whatever they have with him. I don't know if they can tell he's younger or not, but it's almost like they're looking out for him.

A. Marie

John, if your wife is really in stage 6c, I think she is already too far along for assisted living--even if she is only 57. Aim for memory care, and try to find MC that can bump her down to skilled nursing when the time comes. My own experience is that we may think we're aiming too low, but we're not. The less you have to move your DW from one facility to another, the better. My DH is 73 and is 11 years into the process--and I have never regretted getting him into SNF when I needed to place him. His condition has declined sharply since placement.

And jfkoc is absolutely right: DO NOT discuss this with your wife in advance. Make up the most convincing cover story you can, and just take your wife over there when the time comes. That's what I did, and it worked out for the best for everyone concerned.

John1965

Thanks for the responses. 

Follow-up question. How do I not tell her in advance if the facility insists on doing their own evaluation before placement?

M1

John, just tell her a visiting nurse is coming to do a health assessment for Medicare.  You can tell her that you did one too.  My partner was assessed by two different facilities while she was in the hospital and she had no memory of either one.

Jo C.

That is what we did too; it was simply an RN coming to do a health check and the RNs went along with it just wonderfully.

I also agree that an ALF may not be the best setting due to the extent of the dementia; to make a decision for MC is a good call on your part and will do best for your dear wife as it will be sustainable.

You can ask for a copy of the admissions contract to take home, while some honor that, not all facilities will do that if the patient is not being admitted.

You can ask to see the report of the last facility inspection, that is not an insult, it is expected and it is required by law that any family requesting to do so are to be granted access.

NOTE:  Every single hospital setting, whether an acute med center or a long term care facility will get "recommendations," for lapses found during inspection.  ALL of them, it is a matter of degree. You can see on the Report what the facility is doing to correct said issues. However; that Report is not to be copied to take home.   I have never known a facility to permit a copy of said report to give to a family, etc.  (I am an RN who spent years as Administrator of Patient Care Management in acute med centers and also had a lot of in person contact with the many long term care facilities that our families used.)

It is unusual to ask to see a copy of a facility license and whether or not that would be readily available on the spot would be iffy.   They would not be in business without a license.  Some MCs are licensed as a sort of ALF model; others are licensed under a SNF license.  You will want to ask IF the facility can care for your LO once she becomes bed bound and to the end of her life and if they permit Hospice at life's end.  Ask if they accept and assist with incontinent patients and whether she must take all meals in the main dining room.   Some MCs that are pure ALFs will not permit any incontinence assistance, nor a portable commode near the bedside and the resident MUST be able to go to the dining room to eat . . . this is the purest form of an ALF model which for dementia is not sustainable; the patient ends up needing to be transferred to a NH as the disease advances into end stage.  

You will find a good fit and then will be on your way.  It is of course, as others have mentioned, not a good idea to bring up this topic to your wife early on; that can only cause upset and avoidable difficulties.

You will know what to do and how to broach the topic when the time comes.

Take good care and let us know how it is going, we will be thinking of you.

J.

Ed1937

We had a nurse come for an evaluation before my wife went into MC. I handled it exactly the way M1 suggested. It went over with flying colors.

toolbeltexpert

John Hoping it goes well for you today.

jfkoc

The purpose of seeing the license is to know in advance exactly  what services are provided. It is not to verify that they are licensed. 

I would not place a loved one in a facility that hedges on showing me the training program, contract, inspection or license no matter how pretty it was or how good the food.