Mental illness and memory care

Welcome. I wonder if the Al director is simply trying to keep her there as long as possible for the financial benefit of the Al. I would tend to believe doctors at the emergency psych ward since they have no skin In the game. The dementia is only going to get worse and she is only going to need more care. The latest person to move into mc is probably going to be the person that is able to function at the highest level. That doesn’t mean they don’t belong there. I think your parents relationship has to be considered as well. This should be about what is best for both of them. In my experience Al did not have well trained and knowledgeable staff. I see it as a place for those in the very stages of dementia. The care offered was very minimal. I don’t think a good mc facility will take someone that doesn’t need to be there. I think they would come to her and do an evaluation or ask Al for information about the care she requires. If the latter happens I would make sure the mc facility receives the accurate information. So based on the description you have given my advice would be to move her to mc. Dementia is so complicated and decisions can be difficult. You are clearly thinking this through. Just do the best you can.

The AI director obviously doesn't see the big picture. Your mother's objective testing results should be used to determine her MC appropriateness. My DH was evaluated at 2 facilities, and, trust me, the rudimentary assessments they completed supported the need. Unless your mom can ace memory tests, the clock, etc. that will validate her condition.

It’s completely normal to feel disoriented by conflicting advice. The facility sees your mother’s daily capabilities, while the ER psychiatrist is focused on acute crisis risks. To help evaluate your options, ask the assisted living facility if they are specifically equipped to handle both dementia and mental illness simultaneously. Even if her dementia is mild, a memory care unit might better manage her explosive temper. Additionally, consider that your father sharing a studio with her adds another layer of risk. For clarity, seek a third opinion from a geriatric psychiatrist who can assess the full complexity of her condition.

I hope these resources can help:

https://hopebridge.care/memory-care-placement-decision-how-to-know-when-it-is-time/

https://en.wikipedia.org/wiki/Assisted_living

https://www.aarp.org/caregiving/basics/memory-care-alzheimers-dementia/

Just noticed the original post is from last year. PWD present themselves differently to different people. My mom's neurologist saw her three weeks before a major wandering episode. He thought she was "charming" and had mild cognitive impairment. It was her first visit to him and she was able to showtime. She was diagnosed with Alzheimers back in 2018 (along with lifelong mental illness). At that last appointment she was able to draw a clock, count backwards in series of 7's and have a somewhat fluid conversation. Had she been there another 20 minutes, the wheels would have come off the bus and her cognitive decline would have been exposed. We had been reporting her decline but not everyone saw it. Fast forward 18 days and she had a major wandering episode that landed her in the ER for a geri psych evaluation (along with paranoia and delusions). The doctor there said she definitely needs MC at this point. The director at the AL was surprised by this - with that said they required her to be stabilized before she could return to AL. We knew at that point that we had to make the decision based on her "bad days" instead of crossing our fingers that we would have to place her later on down the road after another crisis. Mom is probably the highest functioning person in her unit which can be difficult because she can do more than the other residents although she has pretty severe behavioral symptoms. She still has delusions, paranoia and agitation but we know she is safe and is being monitored.