New admission to memory care

Lobster · November 2023

We just admitted my dad to a memory care facility for 30 days of respite after an accident (he is ok). We have known that he needed more care but my mom was hesitant to make the move. We plan on keeping him in memory care because everyone agrees it is too much for my mom at home.

It’s been hard to know where my dad is in the disease process because he does not talk a lot and doesn’t engage very easily. This has been his personality, long before AD, but has gotten more pronounced. When they did his admission evaluation, he was not oriented to time/place, could not do/answer most of the cognitive assessment test questions. He cannot use the phone or other common household things, having increased difficulty feeding himself, has eaten non-food items, needs assistance with dressing, having some bathroom accidents, increased falls and unsteadiness when walking/shuffling.

So far things seem to be going well at the facility but I am just wanting to make this transition as easy as possible. For anyone who has made this move, do you have any helpful hints or suggestions? Also with Thanksgiving and Christmas coming we have no idea how to handle the holidays.

M1 · November 2023

Welcome to the forum. Someone will provide a link to staging assessments, but from what you're describing he's pretty advanced, stage 6 at least (stages run 1-7 in the common models).

The facilities usually have special dinners around the holidays, and you can go to those with your dad. I would not recommend taking him home for family visits, as they will disorient him further. You sadly have to recognize that the holiday is unlikely to have any meaning for him. Many people with dementia have no sense of time at all, such that one day is like another.

Im glad the transition is going smoothly and hope you and your mom can recuperate somewhat. Memory care placement changes the dynamics of caregiving but doesn't necessarily relieve the stress and worry.

Emily 123 · November 2023

Hi there,

Your family made a good decision. Your mom must be exhausted, perhaps questioning the move, so supporting her is still important, even though the move has been completed. (The Alz org offers support groups if that might help-sometimes those meetings are held at a facility, and the spouse forum here is excellent.) Much of her time was probably narrowed down to taking care of your dad, so she may need to rebuild her own days now--make offers to keep her in the family loop, but allow her time to relax if she needs it.

Don't be alarmed if your dad takes a bit of a jump forward in terms of the stages after this move. He doesn't have the capacity to take in and retain new information, so his mental energy will be spent on navigating new routines. The PWD has a finite ability to manage information day-to-day, and so what you might see is some slipping in the tasks he could still manage pre-move. Because he can't make new memories the process to adjust can take weeks to months. Sometimes people take a step forward and, because the disease is always progressing, won't ever come back to their pre-arrival stage. None of this is the family's fault. It's the disease, not you.

For holidays, please take into account that the need for having the PWD participate in family events exists on the family's side, not theirs. Given what you describe, probably the best (and easiest) way is to celebrate with Dad at the facility, and continue with the usual family gatherings without him. How that looks depends on each family and facility. It's a big thing for the family to let go of, but you'll get to a point where you realize that the need for their participation is all on your side. The PWD won't retain a memory of the day.

Too, it's early days to be taking your dad out from MC. Toting your dad back and forth to a family celebration will be confusing to him and stressful to the family. He seems to be at a point where he'd need a lot of assistance. I'm guessing your mother would end up being the one doing the lion's share, which will be stressful for her--she'll be focusing on managing your dad, not enjoying the day. For your dad, it'll be disorienting, with lots of overlapping conversations, people he might not be able to identify, and expectations for him to participate, not to mention the physical challenges of the incontinence and need for assistance in eating. And consideration should be given to whether he'd want to appear to his family like this, given his needs now. Would the 'old' dad want this? Ultimately I suspect this will be your mother's call. Sometimes you have to do it to realise that it will be easier to go to them than bring them to you...

Lobster · November 2023

Thank you for your comments. I just got called by the MCF that he fell in the shower - only 12 min after they checked on him. Sigh. I drove 40 minutes to the ER they took him too. 3 days after his admission to MCF my mom ended up in the ER (later admitted) with Covid and then I tested positive too. My mom (82) is now home and I am out of isolation but I am just overwhelmed and exhausted. I work full time (single, son away at college) and I just don’t know how to do all of this. I am a social worker so I’ve got those skills, but it’s so much.

harshedbuzz · November 2023

Most MCFs will have some sort of holiday event to which family are invited around-- rather than on-- the actual day. Since these are set up to be dementia friendly, it's probably easiest on him to do that as the family celebration. On the day of, one of two folks could visit if they wish to.

HB

Beachfan · November 2023

Snowdaisy,

Welcome, and sorry you have to be here. First of all, (not to sound callous), I think you should thank your lucky stars that your dad is doing as well as he is in MC so far. So many forum members have an awful time with MCF placement, even though it is the best setting for their LO. My DH entered a MCF for a 30 day respite and like your family, mine realized that returning home after 30 days was not sustainable. He was about as progressed as your dad, it seems, same deficits, same problems with day to day activities. He also no longer recognized me or any family members, so he settled into MC fairly easily. It was just another setting and a different set of caregivers; he was content and well cared for which was my greatest comfort. His MCF was 44 miles away and I visited once a week for several hours, usually over lunch, when, as time went on, I would feed him. I did not visit on holidays; the facility had get togethers several days before; I spent holidays with family, having missed so many while caring for him at home for close to 12 years. He resided at the MCF for 17 months; he passed last April. Today is his birthday; I miss him every day.

I hoped and planned to care for him at home forever; I did not. The decision to place is gut wrenching, but self preservation is just as important. I wish you and your family well. Stay strong.

youngest one · December 2023

https://alzconnected.org/discussion/comment/188965#Comment_188965

I agree it is so much more. I describe it as my part time job on top of working full time. I had no idea there is so much involved.

ButterflyWings · December 2023

Such great feedback here. Wow, covid for you and your mom on top of everything else! What a blessing you had already moved your LO to MCF. Trying to make this kind of transition while you and she feel well is tough enough, much less while ill. I am sorry for the additional fall and emergency.

The thing I wanted to mention is that even if your LO seems to progress faster after placement it could also be that you are just seeing more accurately what his real capacity and progression is, without the huge support and scaffolding your mom has been providing her spouse. Hopefully, realizing this may help alleviate some of the (undeserved) guilty feelings. His status is mainly due to the disease, not so much a result of the move.

New admission to memory care

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