Adult Day Care vs. MC

vab2024

Hi everyone,

In your experience, is adult day care more like respite care if the LO with dementia lives with their primary caretaker? My mom lives alone, and I'm trying to figure out if adult day care can help her continue to live alone at home through stage 4 so I can delay putting her in MC until stage 5, or if it functions, essentially, as daytime MC for people whose caretakers live with them. I'd appreciate any insight!

M1

The MC where my partner lives runs a day program for folks who live with their primary caretakers. It gives the caretakers a break during the day and provides some socialization for the participants but doesn't provide services such as bathing, dressing, or medication administration. I am pretty sure all the participants are required to be continent regarding toileting.

I doubt that it would make a difference regarding your mother living alone. She would still be very much at risk in the hours she was not in the day program. Stage 4 and beyond typically need pretty much 24/7 supervision. My partner was stage 4 when she went to MC and I could absolutely not leave her alone without her getting into trouble. If you are worried about it, it is probably time to make a change. Sorry it is so hard.

vab2024

Thank you @M1 , this is very helpful. When in stage 4 did your partner start needing 24/7 supervision? I hear for many people, early stage 4 they can still be fairly independent. I'm trying to plan for when to best move my mom to AL then MC. Thank you!

M1

She got so she did not recognize me, started threatening violence when i wouldn't let her drive, and could not be left alone at all without getting into things (like my wallet, medications, old bills). Every person is different, but as i said before, if you're starting to be concerned that she shouldn't be left alone, listen to your instincts. Would she know to call 911 or how to handle a fire or water emergency? If not, she shouldn't be alone.

Anonymousjpl123

@vab2024 i totally understand where you are coming from. I tried to figure this out in my head so many times, so many different ways. The truth is you will know your LO needs more supervision when you fear they may get hurt, engage in unsafe behavior, or when their needs are beyond what you can give. And you may still fight it.

A friend I grew up with’s mom had Alz and stayed at home, BUT she had a very unique situation: my friend’s dad (no cognitive decline) lived with mom on ground floor, adult daughter (stay at home mom) and SIL w/teens lived above. Everyone pitched in and from what they tell me it was still very very very difficult. Most of us have far less help.

My mom was likely in stage 4 when my dad passed, and things declined very quickly after. In stage 4, Adult Protective Services called about her twice, I got calls from her coop board, she flooded a downstairs apt twice, couldn’t eat properly, got lost, couldn’t socialize appropriately, and became very paranoid. I didn’t think she needed MC because on good days, her mind functioned. She could hold a conversation and dress herself. She did fine on the short cognitive tests. I thought that was the bar, so moved her to Assisted Living. About 11 months later I transferred her to MC and I still questioned it.

She’s now solidly in Stage 5. It’s hard, but I could never take care of her at home. I have a care conference Friday and will see her facility’s take on it, but I doubt she can be in Assisted Living again, even with an aide. I wish it could be different but dementia is progressive. I’m still coming to terms with that.

So…you will know when the time to place her comes; and if you don’t, others will tell you or your hand will be forced. I wish it was easier. There is LOTS of solid advice on this topic here. Let us know how things evolve.

mommyandme (m&m)

I lived with my mom and also used adult day care a couple/few times a week for more respite. It was a stand alone facility and did provide bathing and meds for an extra charge. I didn’t use those services. She was stage 5 or so when we started but it only lasted a few months. When mom became dependent on two person assistance to stand and pivot for toileting, they fired us. I was still able to assist her at home alone but I understood their boundaries.

Emily 123

Hi vab2024,

It will give the caregiver a break during the day--you know where they are and that they're safe. But that still leaves at least 16 other hours where they can make unsafe decisions. Unfortunately the disease physically alters how their brain functions, and so daycare won't delay the physcial advancement of the disease.

vab2024

Thank you all so much, very helpful! I think the best option for my mom is AL and eventually MC

MN Chickadee

Adult day care was a life saver for my family and allowed us to keep mom at home probably 2 years more than we otherwise could have but she always had a caregiver at all times. We could manage the evenings but filling the day was hard and daycare kept her busy. She came home tired out at night and content to eat, watch a little tv and go to bed (and a sleep medication was also part of the secret sauce.) She started at 3 days a week and we upped it to 5 eventually. The staff were trained in dementia and could handle assisting with ADLs so eventually she even got showers there when she wouldn't do it at home, was more cooperative with outsiders. By the time someone is a candidate for adult day care I can't imagine they are safe home alone at night though. Pretty much everyone is living with a caregiver of some type.