Assisted Living Transition Best Practices

JED2022

Hello, 

My mother-in-law has cognitive impairment, most likely Vascular Dementia due to other illnesses.  She has been on hospice care since March of last year and we have kept her in her home as long as possible with care givers.  Due to her safety risk, her main care giver leaving the agency we were using, and a financial concern with at home care as she continues to decline, my husband, her POA, arranged for an assisted living facility.  We moved her about 2 weeks ago.  

Although we spoke to her about this option and talked with her about the place.  She has not accepted it and is homesick, just wants to go home. The first week there she had family/friends stay with her. Although sad, she was safe and well cared for.  She is on her first week alone and is threatening to call the cops, when she sees us, she continues to think we are checking her out to take her home, lots of delusions.  Very emotionally unstable - rollercoaster.

I am wondering if we should step away for a week or two to somewhat force her to rely on the staff.   When my mother put my grandfather in a care facility at 90 with dementia, they had her stay away for two weeks so he could assimilate to their care and routine.  I know this assisted living option is not as regimented and there is more autonomy, but I am wondering if there is a best practice to help the transition take hold.

Also, although I don't want her more drugged than needed, I am wondering if we work with her hospice nurse to increase her antianxiety/depression drugs for this transition?

Everyone is different, but if someone has experience with a transition turnaround and techniques that were used, I would love the feedback!

She is only 68, and we know she could have a safe and good life here rather than being unsafe, isolated and inactive at her home.  

Anonymousjpl123

Jed my heart goes out to you and your husband because it is so so so hard to move someone who doesn’t want to move. That being said, in my case, the actual moving day was literal hell but it did get better.

Like you, the first week family was there a LOT - every day, all day.

The 2nd week family left (we moved my mom from out of state to near me), it was just me, and I was terrified. She was not happy and she was very hesitant about the place. She wound up sleeping at my house on the weekend. She was VERY disoriented. 

Others may have different suggestions, as everyone is different, but I invested a LOT of time visiting and calling her the first month and I think it paid off. Like you, I was terrified we had made a mistake because mentally she seemed to take a nose dive in terms of her connection to reality and the paranoia was worse than I had ever seen it (it began getting much worse as soon as we told her she had to move). God even writing this I feel for you.

Here is the good news: I worried I was visiting too much, that she would never adjust, but she did. Faster than I thought. I am a firm believer in having whoever she is comfortable with call and visit as much as possible. It comforted my mom to know I wasn’t abandoning her. She really was terrified.

Then, at 3 or 4 weeks, it was amazing how she started adjusting. Little things: she got her good tv hooked up, her room the way she likes it, and could have coffee and watch tv in the morning. The shift (she loves it now) was much faster than I thought it would be.

Socializing, taking her for walks, having some of my friends visit - it helped a lot. I was worried I was prolonging things but eventually she started asking me if w could end the visit because she was tired . Now, 2.5 months in, I can truly say she has settled in.

Others have had the opposite experience, had to bring their LO back home, and found a way to make it work.

Best of luck. Hang in there. You are absolutely doing the right thing.