How to get LO into assisted living

Chris20cm

DW is in late stage six, with complications of paranoia, panic attacks, tachycardia, separation anxiety and is highly likely to have a complete meltdown upon being admitted to memory care or assisted living. How is this handled? I have been putting it off for over two years. Are strong sedatives an option? At least to get her through entry and the first couple of weeks?

Timmyd

I have no experience with placement (yet). However I have visited several memory care/AL facilities in case placement becomes necessary. All of the facilities I contacted and/or visited were very eager to get DW as a resident. The staff always seemed experienced and prepared. If you have already picked out your facility I would start by talking with them about the situation. The people who do this for a living have seen a lot and should be able to get you some useful information on this difficult topic.

l7pla1w2

The first step is getting your DW to the door of a facility. If you get that far, the facility's staff can probably take over. They do this all the time and are very experienced with initial entry. They also probably have a consulting geri-psych who will know what medications to use to stabilize the patient.

To get DW to the facility, you will need a story. A common one is that "the doctor" said she needed to go to "rehab" for a few days/weeks. Another is that the house needs some repair that necessitates her being out of the house, although this story is more commonly used to explain why your LO can't come home yet.

Good luck I placed my DW three months ago. It's a big step and a difficult one, but you realize that your LO will get better care 24/7 than you can provide, and she will be safe. At a MC-only facility in particular, the staff are very experienced with PWD, because it's what they do.

dayn2nite2

At late stage 6, she is well past assisted living. Do you have a place in mind and have you visited it? You need to at least identify a facility and then find out whether they can provide the safety and security your LO needs. An important question to ask is "will you be able to keep her until end of life?" - you want this to be the only move.

SDianeL

if your LO is having hallucinations there are meds that will help her. I would contact her doctor asap and start her on them. They take a couple of weeks to work. Be sure to tell the doctor all her behaviors. I would select a MC facility and speak to their Social Worker. The Social Worker and nurse helped me with getting my DH moved in and settled. They will probably tell you not to visit for one or two weeks so she can settle in. The fib about the doctor ordered rehab might work.

harshedbuzz

@Chris20cm

We had a similar set of issues with my dad. His anxiety manifested in some passive shadowing and aggression. We were advised by the leader of our in-person ALZ support group to make sure he was adequately medicated ahead of placement to maximize the chance of a successful transition without the need for him to be transported to the ED for a geripsych stay and the chance that the MCF would refuse to accept him back.

If you don't have a geripsych (ideal as they're the experts in this class of meds) or a neurologist willing to prescribe antipsychotics, you need to find someone to prescribe. Please don't use the term sedation in the context of your wife as this will backfire on you. Facilities have to report the meds their residents take and doctors are wary of drug-seeking family caregivers who are seeking sedatives for a host of reasons including the caregiver seeking meds for themselves or to sell.

Behavior is communication and what you are looking for, I'm sure, is something to dial back the anxiety your wife is experiencing and help her be more content without knocking her out.

We took a different approach to SDianeL on the advice of the facility that embraces Validation and Teepa Snow kind of care. Mom and I visited the very next day and at least every other in the early days. He did settle in within a couple of weeks, but those first few visits needed to be in public areas of the facility lest he excoriate mom for what he saw as disloyalty. We stuck to the fiblet that he was in rehab on doctor's orders which meant we couldn't take him home as he initially demanded. On the second week, he started to bond with his main caregivers and they encouraged mom to participate in his first few showers to get him used to that part of his care.

Based on what you've shared here, your DW would crash and burn in a hospitality-model AL— she sounds like she would benefit from dementia-informed care coming from the kind of trained and experienced carers you can find.

HB