Rapid decline since moving to assisted living/memory care

sboyden

Hi! My dad was being cared for by his partner of 5 years. She recently needed surgery and we moved him to assisted living / memory care facility. He has been there for a week and we have noticed a rapid decline in his mobility (was walking with a walker) but now spending more time in a wheelchair. He has no prior history of falls but has fallen twice in one week (no injury thank goodness), and today was asking for his Dads phone number (he passed away 40 yrs ago). Wondering if this is typical experience leaving a home care environment to assisted living? Feeling guilty that this transition accelerated decline). Any advice would be appreciated. Thank you!

Quilting brings calm

Anytime there’s a change in routine - location, hospitalization, caregiver, physical health, etc - you will see a temporary decrease in cognitive status. Delirium is the term for it. He should gradually adjust to his new situation.

The falls could be from his confusion, unfamiliarity with the facility etc.

Colacho10

It is very typical, and it is often called transfer trauma or relocation stress syndrome when it's not strictly delirium. The good news is that it is often temporary. He will start to adjust over the next 3 to 6 weeks,

Make sure the facility knows about his fall risk, since they might need to change his sleep meds if he's taking any. Also, you can bring in some familiar items, like his pillow or a few pictures, if you haven't already. It can help bridge the gap between his old home and the new one

​fesk

I recommend checking with the facility to ensure none of his medications were changed and all medications are being given as they should be. Also, if you can, check that he's getting proper nourishment - meals being eaten, enough fluids, etc.

ESkayP

When we moved my mother from her house to AL, it was more traumatic than moving her from AL to MC. However, neither move was without relocation stress. The director wanted to put her on a higher level of care because Mom kept pushing open one of the outside doors and setting off an alarm. I reminded them where her apartment used to be in accordance with the dining room in AL. She got used to taking a left turn out of her apartment and walking down the hall to dinner. She was obeying her muscle memory. Unfortunately, the dining area in MC required a right turn. Going left led her straight down the hall to an exit door. The staff began escorting her for meals until the new path seemed familiar. I remember that Mom had a lot of bumps and bruises the first couple of weeks as she navigated corners and tables. I wanted to put a force field around her, but she finally got acquainted with her surroundings. It was sad when she stopped wanting to go outside even under supervision. She has become so used to the MC wing that she feels completely disoriented if she leaves it. I think your dad will get comfortable with his new arrangement in time. It may not be that his move accelerated his decline. It may be that his former environment was a scaffolding that helped hide the cracks in his foundation. The cracks were already there, just well-disguised. At least that's what I believe was the case with my mother. Moving her to MC didn't accelerate her decline; it just revealed her actual state of cognition.

sboyden

https://alzconnected.org/discussion/comment/254842#Comment_254842

thank you so much for your response. I have so much guilt moving him to assisted living and feel like I’m the cause of this decline but you are right it might be just shedding light on his current state.

towhee

You have gotten very good advice. Do check on how much hydration he has available to him, he might not be familiar with how to access water outside of mealtimes. Also, diet changes and medication changes can lead to constipation.

Change is hard, but you did not cause it, the disease did.