Lessons learned about where one's parent fits in the Independent Living/Assisted Living/Memory Care/Nursing Home continuum.

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Now that things with mom have calmed down a bit (SW emails me several times a week with progress reports; I have the Ass't DON's phone number and get quick call backs from her when I need accurate information), I'm reflected on how many stumbles and fumbles we as a family made in placing mom in various facilities. We are a fairly functional group and we're all smart. But we've made really dumb mistakes all along the way.

1..Mom was living alone in the suburbs. It was not working out. She was depressed and hysterically anxious, needing to go to the doctor all the time. She was worried about a dozen small physical ailments that all seemed to her terribly dangerous, but she wasn't telling us what was wrong (it turned out that she was afraid she was going blind; that she had fecal incontinence and couldn't figure out what to do about it but wouldn't talk to her doc or anyone else about it). We placed her in a "lovely" assisted living facility where several other family members resided. We did NO research. The facility kept emphasizing that they were wonderful because they didn't have "assisnged seating" at meals. "Can you imagine", they said. "Assigned seating? How institutional". Mom did miserably there. Mom was not ill and not all that impaired cognitively. Most of the other folks had walkers, some had dementia. My mother became more paranoid than she had been before. The DON turned out to be a really miserable human being who thought that my mom was a whiner (which she's not, but her BP DID keep spiking and my mom wanted to know what to do about it. 210/100 is not whining). Mom ended up in the hospital and we had some time to think about what was going on and brought two key players on board--a Geriatrics doctor and a Geriatric Psychiatrist. The Geriatrics doc taught me the mantra "if you're not going to do the treatment, don't do the test". the Geriatric Psychiatrist pointed out our mom's depression and anxiety and noted that she needed to be under the continuing care of a GeriPsych for medication management; and that what my mother needed most of all was SOMEONE (Social worker, activities director) who would make sure that she felt welcome in whatever new community she was in and that the socialized more. My mom was never a socializer and tends to isolate herself, not good for one's mental health. So while she didn't "make it" in AL, which led my SIL to think that she needed "MORE" care, it occured to my brother and me that what she needed was DIFFERENT care. Mom was still able to do all ADL's, walked extensively, was cognitively very intact. If she were living in an apartment building close to public transportation, food stores within walking distance and neighbors she would see every day in the lobby, she'd be fine where she was. We ended up choosing an Independent Living place for her, close to where she used to live. It wasn't perfect, but it was a good fit for more than a year. Lovely meals (WITH assigned seating which was a very good thing), a doctor she could walk to, an on site geri psych who saw her once a week for a little "talk" and an activities director who insisted, nicely, that my mother try everything. She even got her interested in the Stock Market club! More later, but I think that a thread like this can be useful to people at the beginning of this journey. Also, tell us what the defiinitions of IL/AL/Memeory Care, etc are in your locality.

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