Tough Decision

Anonymousjpl123

I’ve posted a lot about mom’s move to MC and how amazing her facility handled things. She’s been there since August and it’s been hard (as expected), but mostly positive. Of course she says she wants to leave sometimes but I think everyone feels that.

Now, it turns out the former director - who left shortly before my mom got there - is at another place about 30 minutes away, run by same outfit. Two residents have moved from our place to there. Both of their loved ones (1 child, 1 spouse) told me the other place is nicer, Director is better, there’s a garden/outdoor space, and it’s cheaper (by lots - a couple thousand a month). It is not in the swanky downtown spot my mom's current place is, which is what makes the other perks possible.

My mom still has people she knows in her current place, but the two who moved were closer to her.

Where she is now is 10 minutes from me and 15 from her grandchild.

A few have said her place had gone down since last director left, but I think it’s still one of the best. I cannot imagine her moving. She is doing great, but they are just now starting transitioning her to full time depends and walking is starting to get harder.

What would you do?

M1

A, unless there is compelling reason to move her I probably wouldn't. A transition would definitely be difficult, and if you are not dissatisfied with the care and the finances are not killing you, I'd stick tight.

harshedbuzz

IME, this could be one of those situations where "sh*t rolls downhill". Perhaps the previous director is an exceptional team leader who brought the best out of his/her staff resulting in a better experience. Or not.

You could always tour the other facility. Pay attention to the outdoor space. IME, since this requires a higher level of surveillance (20 minute well checks, attention paid to appropriate clothing, sunburn and heat exhaustion, etc.) you may find they are available to the residents very often.

How far is the drive and does the grandchild visit often? By happenstance, dad's MCF was 2 miles from his brother's home. DU used to gripe that a cousin put his mom in a facility 40 minutes from his home and then never visited her while he made the trek several times a week. LOL, DU visited dad once and then only to complain that he didn't have a TV in his room. I live in an area that is freakishly well served in terms of MCF options. I drove past 10 MCFs on my way to visit his 6 years ago. They have since built 2 more on the route. I'm retired so the 20+ minute drive wasn't onerous.

I wouldn't stay locked into a current setting based on other staff or residents as, IME, these communities can be very fluid. Dad's MCF was both my mom's and my second choice; she liked a "fancier" MCF walking distance to her home that didn't accept him and I like the masculine feel of the state veterans home which had a 4-6 month wait list. Staff at dad's place was unusually stable, but residents came and went. When placing dad, we opted for a "neighborhood" with 3 other men in it. Within a month, he was the last man there. One had died, one was transferred to a SNF after a hospitalization and the third was moved to be closer to family in another state.

That said, while I did move dad a lot prior to his placement, I didn't once he went to MC. M1 speaks from experience on this.

HB

Quilting brings calm

mom’s been in the same AL for 4.5 years. Staff, directors, and residents have all come and gone multiple times. I wouldn’t move a PWD just to follow someone because they could leave a week later. I won’t move mom from her AL until her care level or finances require it. It was bad enough moving her from one apartment to another last month. I feel the familiar surroundings and routine are more important in keeping her stable than the presence of a specific staff member or resident.
You mention the cost and that I can understand. Do you have any idea of her life expectancy to guess at the accumulative effect? Or the cost basis at both places to know what the cost difference might actually be a year from now?

Anonymousjpl123

Thanks as always for your clear-headed advice and thoughts.

@M1 spot on. I would be really, really concerned about another move for her right now. The finances are not killing us. The location is what makes it more expensive but being 10 minutes away from my house is worth the cost.

@harshedbuzz I ran into the director tonight and we had a long talk. Would you believe what her old job was? The other location! Old director left mom’s MC, new director asked to be transferred there, old director wanted job back but they already gave her job away so they swapped jobs. Which makes me think they are both competent and it’s not such a big deal.

Which is a relief, because the outdoor space is an issue. The trouble is apparently my mom is still a high flight risk, so they don’t take her out as often as others. Who knew? I guess she tries to sneak out all the time. Director thinks she’s actually happy there overall, but still hasn’t fully adjusted to her new reality. She is confident she’ll be able to go out more. In the meantime, she said my trips outside (just a few blocks) do a world of good. Also, you bring up a good point: my mom still has 4 friends in her MC (seems like a lot to me), and apparently someone she knew from the AL is about to move in.

Quilting, The finances aren’t really an issue - NOT because we’re rich but both parents had good pensions. I can afford the MC, but AL with an aide I couldn’t swing. Also because she’s a flight risk they may not have kept her. She can swing this if she lives 20 years (she’s 83) so that shouldn’t be a problem. Plus when she’s at the point where it doesn’t matter, she can move to a “suite” (two bedrooms and shared living room) instead of her studio. Not to mention the stress of a move, which (from the AL side to MC side of same building) was enormously stressful, day of and for months after.

I’m gonna drive over to the other place just to see it, but I think you all helped me get the clarity I needed for now. I’m glad I was honest with new director. One of the things I like about this place is they are fairly open and very communicative.

concerned_sister

It is possible the second place you're considering is benefiting from the policies your new director put in place in the old location. Kind of like chasing past performance. There's no guarantees about the future of the currently 'better' place.

Anonymousjpl123

@concerned_sister seems like that’s a little bit what happened! And I 💯 agree with you. I just needed to talk it out. It gets hard when my mom seems so unhappy. Fortunately mostly I think she knows she’s in a good spot. Thanks for giving perspective it really helps a lot.

concerned_sister

You're welcome. This forum is wondeful for that sort of thing. There are so many knowledable folks that can speak from their knowledge or experience, or just add another perspective. Sometimes I just read through and I'm amazed at the quality of advice and support that can be found here.

Anonymousjpl123

@concerned_sister sometimes I think this place is what’s keeping me sane. I feel like she’s in the best place for her, but always do question it because she constantly talks about how much she hates it.

At the same time, she is stable and not progressing nearly as fast or as badly now that she has settled in.

Someone here I think said we want them to be safe, cared for, and happy and sometimes we have to settle for safe and cared for. The good news is when I take her to my house for overnights she really IS sort of happy, sometimes. I guarantee she wouldn’t be if she lived here. Because I would go crazy.

M1

A, I wonder about the wisdom of taking her out for overnights. My partner continues to tell me she doesn’t like her MC facility either, but I don’t take her out because I think it would be triggering for more unhappiness as well as disorientation . I also don’t know that I could easily get her back. Have you thought about that?

Quilting brings calm

I no longer take my mom out of the AL except for doctor appointments. It’s a mobility issue in our case. She uses a rollator walker. The new one she got ( replacement for the old one) is just slightly bigger. It’s hard for me to lift into and out of my vehicle - and I can’t fold it ( even if I knew how) , the seat container part is always full. Mom walks so slow with the walker that I can’t stand it. I don’t walk all that fast myself so that tells you how slow she walks. There’s no way I’m walking through a store with her. If she’s gone from the AL too long, she gets very anxious and wants to go back. No way am I taking her to my house.

JeriLynn66

For my 98-year-old FIL who is now in AL but should be in Memory Care, even short visits to my home for a meal with family is taxing. He begins asking "isn't it time I should be getting back?" within an hour. I wouldn't even consider an overnight. It would be too disorienting and upsetting. YMMV

psg712

I've had my mom at my house overnight only once since she moved into a facility (AL at the time). She had a tooth extraction and needed to have rinses and packing and pain meds. I just felt better taking care of that at home than asking the AL staff to do it. But I barely slept that night, worried she'd have trouble getting out of the recliner or be so disoriented she wouldn't find the restroom.

That was well over a year ago. She's in MC now and there is no way i would choose to have her stay here overnight. I rarely take her out of the facility at all, because it seems so unsettling to her. I can tell when she's overstimulated. She puts her head down on the nearest table and just tunes everything out.

Anonymousjpl123

Thanks everyone it is so interesting reading these after my last overnight this weekend. I’m so torn. Most people don’t take their LO home for weekends except me and I think a few others. A while ago I talked to the staff and they said it seemed to be fine, since overall her adjustment was good.

That said, this weekend it was really disorienting and triggering when I took her back. I may be winding down on the outings. I hate the progression. But it is true, I want her to feel comfortable THERE.

Physically, she’s better than she’s been in years because she’s getting nutritious meals and quality medial care. But mentally she is progressing (although it is up and down; thankfully not as much as in the beginning, which is another reason I’m not moving her no matter how much she says she hates it). But her short term memory is about 90 seconds at this point.

I know she needs to be there: she’s a high flight risk and very disoriented much of the time. But sometimes she’s alert and she’s so happy to see my place. Last night was rough though. She was just so sad and disoriented to go back and wanted to leave with me or have me stay. So it may be time to stop the visits.

Emily 123

Probably so- it sounds like it’s become more than she can process. At some point sameness and predictability becomes a haven.

I wouldn’t worry too much that her unhappiness with her current situation can be remedied — I know that you know it's more because it won’t match what she had when she was independent.