Moving Mom to Memory Care this week

Caring62

I could really use some advice on what and when to tell move we are moving her to MC.  Some experts have told me to transfer Mom without telling.  The closer we get to the date I continue to have concerns that this may unduly hurt her and cause long term damage to our relationship.

Mom's Alzherimer's is a bit uneven...short term memory "shot" for several years now but somewhat capable in other areas.  Living in AL for over 4 years Mom has been steadily declining with more confusion, agitation and longer-term memory disappearing also.  Mom's PCP, her current AL director and several MC facility assessments believe she needs MC.  

So, with all that, Mom can still have conversations and is aware of what is going on.  I just can't see picking her up to go shopping and then delivering her to her new MC Apartment will go without a lot of anger and upset.

Any ideas on how to make this work better, if possible.  

Much thanks

MN Chickadee

We did not give mom any warning. It wouldn't have done any good, she would have totally forgotten by the time the day came around and would only serve to make her mad at us. We kind of took it one minute at a time. First was the outing while someone else finished the last parts of moving stuff and getting her room set up. Then was the arrival at the facility, which we said we were "going for lunch at this senior center." Ate lunch together, said we would stay for an activity. By this point mom had forgotten lunch or how we got there because her loop was so short. Then we showed her the room. "The doctor wants you to stay here a couple days." Maybe there is a plausible reason you can float, like high blood pressure, diabetes, a bad hip. Pretend it's like rehab. Or go with a fib about the last apartment, there was a problem with the plumbing and they want you to stay here while the fix it. Calling it temporary seems essential with most people. Mom was skeptical and we moved away from that, went back to an activity and my dad and sister quietly disappeared during that transition. I got mom settled with a staff member doing an activity and then I excused myself to "use the bathroom" and slipped out to cry my eyes out in the parking lot. The moments before I left were awful, I had that adrenaline feeling and didn't think I could do it, even thought I might keel over at one point. The staff took over and I left.  It was days and weeks of sadness and anger, difficult phone calls etc. There will be a transition period that will be very hard on both of you. But then my mom finally settled in and really thrived on the routine and structure of MC. She actually improved mentally and physically some, and had a really good quality of life once she was getting the care she needed. Hang in there. Try to see through her negative emotions and remember you are doing your responsibility as a POA and child. You are getting her the care she needs and keeping her safe.

GothicGremlin

We didn't give my sister notice either. I had one of her friends sit outside with her and go through a scrapbook, and me, my s.o., and one of Peggy's other friends set up her room. Then we moved her in.

She wasn't thrilled, there were meltdowns, but at least she was there. Also thankfully, she acclimated after about a month.

I won't lie, it was really hard, and I hated every moment of it. And my catholic guilt went into overdrive. But really it was all for the best. Peggy's doing well there.

CanyonGal

My mother was diagnosed with dementia several years ago, 2019. About every 6-12 months, she seemed to move to the next dementia stage. After surgery, rehab, sepsis, rehab of this year...I requested that my mother be tested as she was exhibiting severe cognitive loss, not eating and drinking, and just either lying down in bed or sitting in a chair, no engagement. At that time (April in rehab) she tested out at Stage 5/moderate dementia. We were told she should not be left in Assisted Living but moved to Memory Care. However, her facility recommended that she return to Assisted Living to see if her being back in a familiar routine, might re-engage her into participating in daily activities. 

After 3 months back at her facility, she refused to participate in any activity, refused to go to the dining room, refused to eat or drink enough fluids, and continued with the invalid behavior. She became severely constipated and said she had shooting pains in her legs. I sent her to the ER where they ended up keeping her a week - but resolved the constipation. A "failure to thrive" notation was on her chart because she was refusing again to eat or drink. At discharge she returned to Assisted Living under Hospice Care. (She had lost 25 lbs. by the end of June.)

I spent 3 weeks in her room, trying to get her to eat, with some success, but if I wasn't present, she would forget the food was there. I told the director she would eat if someone kept encouraging her or reminding her to eat. The director said in Assisted Living the residents are expected to go to the dining room or if they are ill, food can be brought to them, but they do not have the staff to sit with her daily meals. In Memory Care they could assist more often, due to the lower ratio of staff to residents, plus they have more of a daily routine. In retrospect, they really tried to accommodate my mother in Assisted Living, but she was starving herself. Often, she was left alone for hours, and she mentally lost the capacity to press the alert button to notify staff she needed assistance in transfer to the bathroom or from her recliner to her bed.

I signed the paperwork to move her to MC. The director recommended to let their staff move her and to stay away for several days. They did a really nice job of setting up the new room, keeping her occupied, while they moved everything. They brought her to the room and said "we have a new, beautiful room for you to stay in. There is going to be lots of people to help you. You have a beautiful view of the grounds from your window. It's going to be wonderful" which it was, until she figured out, she could not return to the old room. Then they told her the elevator was broken so she had to stay in the current room (her previous room was on the second floor).

Once she saw me, she was extremely angry and demanded I take her to my house and take care of her. I told her I was unable to take care of her and her various medical issues. I am not a nurse, nor do I have medical training. I have told her that her doctor and health professionals recommended that she be moved to the new room for her safety and where she can get more assistance. She eventually calmed down but visiting is difficult in that I cannot give her what she wants. We just redirect the conversation to something else.

No one wants to move someone to memory care. In my case, leaving her unattended in Assisted Living was not a solution. She was slowing dying due to starving and dehydrating herself, uncooperative to make changes to limit the fall risk, refused to do PT, bathe, or change clothes and wanted someone to push her around in a wheelchair when she did leave the room. 

In Memory Care she is dressed, uses the walker to go to the dining room, but is still resistant to participating in activities unless it is one-on-one. She is on hospice due to the weight loss and cognitive loss. Hospice has several patients in MC so they routinely check in on her when they are in the building. She is a bit better than when she was several months ago, and at least you can have some conversation. Mentally she is still confused and unable to grasp some long-term memories - such as how old she is, pictures of people, what year/month/day it is. She wants to see a doctor to "fix" her so she can return to living in a house by herself and driving a car - basically her independence returned - but that is unfortunately a reality that will never happen.

I think you have to keep telling yourself that you are doing a good job, you made the right choice for your mother, even if it makes her unhappy. You will feel guilty, that is common, but remember YOU can see the big picture, your mom cannot. She will eventually adapt to the new situation and there may be days when you have to redirect the conversation to something else. (My mom has days when she is agreeable and other days when she is agitated and fighting everyone, just nasty to be around because there is no pleasing her. She forgets that I live in another state and her "friends" and my sisters have other responsibilities and cannot visit all the time.) I know I am doing the best I can to help her.

Hang in there. You will get through this period of change in location and the new reality.

Care4dad22

I’m an only child caring for my father alone. My mom just died on July 4th, and she did everything for him before she was too ill to do so. These last few months have been a nightmare. I haven’t had one day to process my own grief because my dad needs constant care. I’m moving him to an assisted living facility this week as soon as the bed I ordered for him finally arrives. I’m terrified about the move. He’s a big man—6’4”—and prideful. However, the move is long overdue. He asks me everyday (usually at least 6 times) where my mom is and he’s angry about it. He hallucinates that people are in his house. This morning at 6:30am it was that a man was standing over him with a gun; a few days ago it was that tiny women with babies were hiding in his cabinets and he was worried authorities would come after him. He’ll have diarrhea and try to clean it but forget mid-process and end up tracking it all over the house. Last night he came to my door wondering where his daughter is (that’s me!). It’s the first time he couldn’t recognize me. I’m going to try to start packing his things today, but I don’t know what to tell him about the move, and I’m scared of the confrontations. He says he’ll never leave his house “without a bullet” or he’s “got a bullet for that.” Of course, we’ve taken the keys and combo for the safe with the guns. What do I tell him about packing his clothes and things? What should I tell him about my mom? I like the idea of showing up for lunch or dinner and then showing the room, but I’m scarred he’ll be violent when I say he’s staying.

pickleballhelps

We just moved my dad to memory care.  My mom and he were in independent living and refused to get help, or to move. They wanted to wait until "something" happened. Well it happened:  Mom fell twice in 2 days, 2 trips/ambulance to the ER. Dad also fell trying to pick her up.  Adult protective services got involved (case closed as they are both in safe places now).  3Siblings and I stayed with Dad 24/7 and realized that none of would be able to handle him.  We invited Dad to have lunch.  The lunch was actually served at Memory care place.  The nurses distracted him and we walked away.  Not easy. Since his admission they have called me 4 times wanting someone to visit. My visit was awful- how can you abandon me here?  Can't I live with you?  Where's Mom?  You have hurt me SO bad etc.  My last call was for me to talk him down, as he was in a panic asking all the other residents to call the police. We asked to meet with the care team the next morning.  Reviewed the care plan, and expectations on both sides.  I expect them to implement strategies OTHER THAN calling me.  It doesn't work anyway.  IN short, I really don't see how (in our situation) that we could have told him about the move.  WE would have to call the police.  Not sure what is right or wrong.  So many things about this are in the gray area. We are flying by the seat of our pants...

mommyandme (m&m)

Care4dad22,   Sorry you’re here but glad you came! And so so sorry you lost your mom. 

If you will add a new post by hitting the green button “Add Topic” at the top of the Caregivers Forum, you may get some added support from the other members here. You’re new too and may receive some really good advice.  

sandwichone123

Hello Care, this is my experience. I packed fairly minimally when I moved my dh, and only after he had been there for a while and was starting to see it as "his" place did I bring in more of his belongings.

I took him to the place at lunchtime "for lunch" and when the staff distracted him I went to his room and unpacked with the admissions person and left without telling him. I will say he was pretty mad for a couple of weeks, but then calmed down. I am able to visit him twice a week now and he know that's where he lives. He doesn't like it, but he knows it.

Peonie60

Hi Caring62, my dad and I are also moving mom to MC this week. My dad is 86 and caring for her 24/7 is just too much for him now. Every single person we’ve talked to who has been thru this tells us to not tell her ahead of time. But as moving day gets closer this is harder to do. My dad and brother will take mom out to lunch while dear hubby and I coordinate moving things from their apartment to her new room. All details of the physical move are covered.

But how does the conversation go when she arrives at her new room? That is the wild card. She is aware and will know that she’s not home. She loves my dad and knows that caring for her is too much for him. He will be there daily to visit. But there is no easy way to do this transition. We will be deciding what to say by the minute. And we won’t be sneaking away.

I wish you and your family peace and love during this week. We are both doing this so those we love can get the care they need. Best of luck to us all. 

Caring62

Thank you all for sharing your experiences and advice.  It was so helpful! 

Mom's transition to MC went well, however I think it is a temporary "reprieve".  I had a lot of support from my brothers to get her new MC studio setup in advance and day of while I had Mom out to visit another brother.  Mom did not know in advance about the move, she took the change when my brother brough her as a place to get more attention for her increasingly painful back (arthritis-related).  We stayed with her and ate dinner in the main ASL dining room with her before getting her settled into her new room for the night.  

All that being said I anticipate more challenges to come as we get Mom's back pain under control within the next several.  

Hope65

I will be in your shoes within the next month.  My mom sounds so much like yours.  She's definitely declining, but still aware enough in lots of areas.  Only difference is that she's currently at a physical rehab ctr after being discharged from hospital for cardiac probs, so she'll be transitioning from there. Worse b/c she wants so much to come home, but it's just not a safe environment given the context of everything -- i.e., i'm the only caregiver, some complicated med mgmt, increased need for dressing, planning, etc., dad recently passed, my sibling not involved. 

While I appreciate everything read on this thread, I'd be lying if I said it didn't scare the (%^#* out of me.  We've had some brief conversations, which have not gone well.  She's not angry at me, but very angry at the situation -- just projecting anger at me, under which is huge fear.  (For me, too.)  I'm enlisting the help of her psychologist at the rehab center, the social worker, hopefully doctor, and also the geriatric care mgr with whom I'm working.

Long story short, I hear you.  I'm in your shoes.  To say it sucks doesn't even come close.  Scary is a bit better, but not even that nails it.

Take good care and check in again...