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Mom has moderate stage Alzheimer's and just recently began to wander. We are weighing the options regarding either 1) having her come to live with me with a care companion helping out; 2) staying in her home with a caregiver who comes in daily or lives in; or 3) placing her in a Memory Care Facility. Mom denies having Alzheimer's and refuses to consider any of these options because "she still has plenty of sense and can handle her own business." I have Medical POA and her doctor has written a letter saying she no longer has the capacity to make reasonable decision regarding her care. My question is how do you get a parent through the transition from living independently to having full-time care? She becomes very combative and angry when these things come up. Do you just make the decision and go ahead with it? Do you continue to try to make her understand? I would appreciate any guidance you might have.

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If she has started wandering she needs some kind of supervision 24/7 whether it is a person or some electronic monitor. I used an on person tracker (super glued to the exterior side of shoes) and a security system that alerted me when an exterior door was opened during periods there was no in person supervision. My dad had vascular dementia and this worked well because he never left the bed without wearing some shoes (didn't want his feet to get cold from the floor even on 90+ degree summer days).

I would encourage you to transition Mom to MC as soon as practical. With ALZ she is going to require MC at some point and my understanding is the sooner she transitions the easier adjusting to the MC will be. My father didn't want to enter an MC either, but he is doing much better there with 24/7 support than he did with in home support; proper medication management had a great impact.
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A suggestion from a professional, is find an agency who can provide a good caregiver for few hours a week and then increase to few hours each day, little by little and she will realize that she needs the help. As an agency owner, we have tried this with many clients and it works well. However, she might still fight it and probably will mention how she doesn't need the help daily but nobody can take this at heart or take it personally. We do deal with resistant people.
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Thank you! Mom saw the geriatric psychiatrist who has prescribed Lexapro and Donepezel.

The doctor told her that she needs someone to come in everyday to make sure she is taking her meds and eating,etc. Mom said “when I get to that point where I need help, I’ll hire someone.” The doctor said “Miss Martha, you ARE at that point.” Then the doctor said, “as your doctor, I am telling you that I am ordering this for you. Also, you have trusted your children to make decisions in this regard (then doc told Mom how smart she is to have prepared for this by having a POA) and that there are going to be decisions made based on that trust in order to keep her safe. Then the doctor looked at me and said to go ahead and find someone and then just do it. She said, “I’m officially relieving you of any guilt or hurt you may feel about that because you are doing what is best for your Mom.” So far so good.
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Mom went into the hospital twice in 1 month because of undiagnosed CHF. Until then she lived alone but had a housekeeper 3 times a week to clean & cook. When I took her home I took a leave of absence & stayed 24/7. I told her the doctor legally stated she needed to either be in a facility or home with 24hr care. She was angry, she’d tell me it wasn’t necessary. I told her I was doing it to help her stay in her own home. I started to increase housekeepers hours, next I hired 1 caretaker at a time. Each new person, I explained legally doctors orders or she would go to a home & I could go to jail. It will be 2 years next month & I have 5 part time caregivers. It isn’t perfect & some days she’s still angry but resigned. My advice is blame the doctors & the law.
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freqflyer Feb 2019
Momshelp, I remember telling my Dad that Mom needed around the clock caregivers or I could go to jail for neglect. Dad said "I will hire a good lawyer"... [sigh].

My Mom shooed out the caregiver after only 3 days. So I had to back off since my parents [in their 90's] were still of clear enough minds. Had to wait for that other shoe to drop, which it did. Sadly, my Mom was seriously injured in a fall and spent her final months in long-term-care.
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Trying to get a dementia patient to understand reason is sort of like teaching a pig to fly.

Get and take advice from the MC people about how to best handle this situation. Do NOT take her into your home. Get a geriatric psychiatrist on board so that staff has meds in place for agitation.
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