Changing Assisted Living Communities - VENT

P.S. Glad you posted here, that alone may help you feel better. Welcome

@OnlyDaughter123

Hello and welcome. I am sorry for your reason to be here, but pleased you found this place.

To my ear it sounds as if you are doing all the right things-- especially moving her from a hospitality-model AL to a MCF near you where you can have eyes-on. Your mom is fortunate to have a thoughtful and capable daughter as her advocate.

The timing of the move was likely fortuitous even if it doesn't feel that way to you. The pattern of vascular dementia progression tends to be a series of steps and plateaus versus the steady decline she experiences as a consequence of the Alzheimer's. Mom's loss of her ADLs around bathing and potentially toileting are most likely the result of disease progression rather than you moving her as she's not returning to a baseline. Care should always be appropriate to her needs on her worst day.

If it's early days in the MCF, I would speak to the DON about their plan to deal with her hygiene issues. Most good MCFs will allow a PWD to settle in and bond with their caregivers before inserting themselves into more intimate forms of hands-on care. At dad's MCF, they gave him around 2 weeks of building relationships with him which frustrated my mom who was crushed by the love of her life looking like a food-encrusted yeti. The first time they tried a shower, they had mom there to reassure and help him. They did the second time as well although she wasn't as hands-on that time. After that, they took care of it.

I agree that medication would be a good idea. Dad's MCF had a geri-psych affiliated-- maybe mom's does, too. Sometimes refusal with care is driven by anxiety which can generally be treated successfully without sedation although sometimes a nighttime medication is used to help a PWD fall and stay asleep.

HB

Sending virtual hugs. We moved my mom from an Assisted Living where she was comfortable, there was consistent, long-term staff who loved her, and where she expected to spend the rest of her life, to be closer to me halfway across the country. It was rough in the beginning. I felt horrible because one of the things she really enjoyed was looking out her window and watching people walk, bike, skate past, watching the birds, etc and her new room looked out on other buildings. In the end I think she was very happy that she moved closer to me, but not as happy with the facility, though the first place wasn't able to meet her needs any longer.

Re bathing - lots of information in other threads. One thing that worked for us: there was a hair salon in the building and she decided she liked the woman who did her hair there (thank goodness). I signed her up for a weekly wash and set, and they scheduled her shower assistance for the night before her hair appointment, so both things got done on a schedule (sort of...). She didn't like the assistance part but they built it into her night routine and that seemed to help. She was generally pretty cooperative and knowing that "everyone gets help at bedtime, just in case they need someone there, it's a service we provide" was somehow more acceptable to her than "YOU get help at bedtime because YOU need it."

Re wandering at night - my mom did that, too. We wondered how much it had to do with being off her normal schedule - she was a night owl and an early riser, both. They sent everyone back to their rooms fairly early and did the bedtime assistance pretty early, so she'd fall asleep then be awake in a few hours, thinking it was morning. Eventually they gave her some melatonin and that helped for a while. She would also get up to use the bathroom and then go wandering around the "household," looking for someone to talk to. If she didn't find anyone, she'd call me at 3am.

My brother and I had to learn how to work with the AL staff. You are the expert on your mom as a person and they are the experts on working with people with dementia. You have to figure out how to work together, figure out where they can do things you can't, and where you get to be her daughter again and they get to be her caregivers. There was a great nursing supervisor who said to me, essentially, "honey, I"ve been working here for 10 years, I've seen a lot of women just like your mother and we know how to handle this." And they did.

Build "mom time" into your schedule and find a way to enjoy it. Starbucks and chocolate go a long ways!

My favorite "how to be a daughter" things usually involved asking for her help with something -- a recipe, mending something, things she absolutely knew more about than I did. It didn't matter if it was real or contrived and it didn't matter what her actual answer was. One day she mentioned that one of the other ladies was knitting, and I asked if she'd help me re-learn how to knit - she had taught me as a child and I never really cared for it, but I was just bad/good enough that she could watch and help me fix my many mistakes. I tried to come to activities at her AL whenever I could; they welcomed family members and we had fun doing art or listening to music together.

The other "how to be a daughter" advice - I laid it on pretty thick that she took care of us for all those years and now it was my turn to help her; "you earned the chance to have people help YOU for a change;" "you were smart enough to save your money wisely and now you can afford this" (well, sort of). Can't find something? "It's in the storage unit."