When should a parent with Alzheimer's be placed in a memory care unit?

Sasebone, your original question is: When should a parent with Alzheimer's be placed in a memory care unit? As far as I can tell, maybe never; depends on what the person is doing. Consistently hitting or repeated escape attempts require memory care, or at least a locked down unit. Some have walking paths out back that are fenced and escape-proof for folks to 'escape'. My mother has been in assisted living facilities after she broke her hip then got a horrible gut disease in rehab. I moved her each time her care level required more help that the place was able to provide. As you tour various places take note of the type of people already residing there. Some ALFs are party-towns, some are indoor activity specialists with great activity directors, some specialize in care of wheelchair users. Close supervision on your part, or other family members/friends seems to be really important. But balance it with surviving for yourself. We are ourselves really sandwiched in between dementia in the older generation and mental illness in the younger generation. No way out, just keep on keeping on. The government is not out to help you. They want to transfer all the expenses on to you. And they do a darn good job of it, too. My parents played and traveled and boated for years in retirement. No such luck for me. It's just how it is.

Felix - I suggest you find a support group because you DO sound angry to me.
I get angry with my mom. I get angry for many reasons....the same question over and over, or her asking me how to do something that I know full well she knows how. My mom is an alcoholic as well. My mom has Wernicke-Korsakoff syndrome. It is like Alzheimers or dementia but it was alcohol induced. My mom is a "happy" drunk so we don't have that issue.
The reason my mom doesn't live with me is because I AM NOT DAUGHTER OF THE YEAR and I get frustrated AND angry sometimes.

A lot of money is being spent on EU-wide studies into how to care for senior citizens with memory-affected diseases. They all widely condemn the current practice in care homes of lumping Alzheimer's patients in together with those suffering from various forms of dementia.
But the answer always comes back: "there is no budget/space" to create parallel safe facilities for those who are lucid between memory lapses and those who are not. They cannot pay for two parallel teams of nurses.
In Belgium, all care homes advertising spaces for Alzheimers sufferers have to pass rigorous new legal requirements. If they fail, they are not allowed to take in people with any stage of Alzheimer's. Over two years this led to a 50% loss in offer of available residential spaces.

Quenneannabelle
I'm in total agreement with you - I placed my near 93 year old mom in a leading memory care facility and it is a nightmare - I am now paying for a private caregiver 12 hours a day on top of their high facility fees - all levels of Alzheimer's are placed together and the men especially get quite violent - staff are afraid of them and they're supposed to be memory care experts

my mom who can do math in her head and spell backwards doesn't understand why she's with these folks - when I take her out for a treat or to the doctor she wants to know why I turned down the wrong street to go home - she can draw a map of where she lived for nearly 70 years

Clearly she has memory loss and is easily agitated but
Memory care is no real care - they don't help her get ready fo bed and she fell shortly afte getting there from weakness and dehydration from a UTI - often they don't even put a diaper on her

She is not bedridden but one more fall could change that - she needs a safe place but memory care is scary

My mom was dx'd with dementia, not Alzheimer's, but when we brought her to a Foster Home, she did ok for the first several lweeks then she became 'combative' and threatened to hit someone with her walker. From there she moved into a Memory Care unit that housed people with all forms of dementia, at all different stages. She kept asking why she was here and what were all these people doing and what was wrong with them? My sister and I thought we'd made a mistake but she couldn't go back to the Foster Home, she couldn't return to her condo where she was falling all the time and not remembering or asking for help, and her memory was bad enough that she'd forget where she was at any time of the day. She needed to be in a place in between ALF and a Memory Care as she wasn't quite 'there' when she arrived. I still have a lot of guilt about moving her there and now after 3 years, she's rounding the corner and her 97 years of life is coming to an end. I wish someone would look into researching where people who are right in between these two types of living situations could go.

The true deciding factor is the safety of the Alzheimer sufferer. Can he or she really manage in their own home, even with a team of nurses to administer medication, someone to bring cooked meals, someone paid to look after their finances and a family member or close friend taking on the role of the Close Personal Assistant? Even this setup cannot prevent a person from falling and hurting themselves, unable to phone for assistance. Even with health visitors, the patient may regard them as intruders and as a result shut themselves into a bedroom or bathroom until aliens have gone. Even if the sufferer is living in a family home being looked after by the family as carers, falls can still happen, choking fits can happen, and bronchitis and pneumonia can set in fast if anybody at home happens to spread the virus of a common cold.

The best thing to do is to put personal feelings aside and find a nursing or care home where the atmosphere feels friendly and warm, where the staff are kind and patient with the inmates and where a lot of effort is made to keep their spirits up with entertainments, changing decorations to illustrate the seasons, and accompanied visits to sit in a garden on a sunny day. You should not choose just the home that is closest to you. Alzheimer sufferers have absolutely no idea of the passage of time, so afthey won't really notice if you haven't paid the usual weekly visit. If you get the patient to regard the new place as a hotel, it's amazing how quickly they will settle down and become so used to the routine that it will be difficult to take them away "for a treat".

Don't put off the decision to move the patient to a home too long. Patients get stressed when their carers are stressed, and your idea of what makes them happy is not the same as theirs. Patients over the age of 80 will start retreating into themselves anyway. It's the patients in their late 60s and early 70s who will need careful persuasion to move into the "new hotel" and it can be weeks before they stop asking to be driven home and away from their fellow inmates. But give it a few weeks longer, and the "hotel" will have become their home.

Your feelings about this will not matter. For Alzheimer sufferers, the greatest need is security, knowing there is someone on call 24/7 and working out what to do next. If they can't, sleep is often the answer.

My Deaf husband of 45 years is now an Alzheimer. I am Deaf and caregiver since Fall of 2009. When I was retired in June 2009, I had noticed my husband begun to forget and his behave change so I took him to see our doctor and was told what he has. I was shocked and cried. Also that year of 2011 I move my mom to our home to take care of her. At the same time I took care both are a lot of respondiable. I love my mom to stay with me until I place her to nursing home at the age of 90. She died 4 months later in 2013. I miss her terrible. Now I am talking care of my husband since 2009. I have noticed he is not himself. Of course he hurts me a lot but not really bad. I went to see the place a memory center near our home and saw what is good place for him. I did not place him sooner because I love him so much and I must protest myself from hurting me. Communication is one thing my husband needs to understand thru sign language that the memory center does not have. I have no choice how and when should I place him. I really need myself and I have enough since I took care of my mom at the same time of my husband. I don't know what stage he is now since one said 1 to 5 other said 1 to 7 stage. I don't know what is different between two stages. Nurse said he is on 4th stage which means what?? worse or what??I am holding him with me too long. One person said better call 911 of he hurts me then place him at memory center. Other say go to Social Security department ask for Medicaid and other say place him myself that will cost a lot of money that I can't afford since I have a condo to pay mortgage. Be the way, since 2010, my husband stopped his medicines that he must take for his heart. Guess what before he become Alzheimer he told me not to give him any medicine because it is not worth to continue his life as Alzheimer. He has now lost a lot of weight and very strong. Doctor had check his health and he is good so far. I promised him no more medicines but I still hide his last medicine that he doesn't know is Resgeroidine 9to calm him down). I am giving him very night to put him a good sleep. he spit food a lot and confused what he eat. Simply just serve him cereal and sandwiches. Yes he was gone from home since few month ago and found him 12 blocks walking himself. Now I bought a Alzheimer Lock and it is worthy to have that since then. Now I need to know when should I place him and I am now thinking for my security and life.

Jackieh,
Your question is posted on the end of someone else's thread from 2011, so I'm not sure how many responses you'll get, since it may not be viewed that much due to its age, You might generate your own thread so more will view it.

Since your dad may not have envisioned that your mother would have declined as she has, I would not hold on to that promise if your mom's care is at at stake. You have to do what is best for you and her. Plus, you have a special needs child who you are responsible for. I would set the priorities, make the decisions and have peace with it. No one should feel guilty about doing the right thing.

What I might do is have your mom assessed to see what her level of need is. With less than a minute of short term memory, she likely needs assistance with all aspects of care. I placed my cousin in Memory Care and it was absolutely the right decision. She needs all things done for her, such as bathing, dressing, etc. She is double incontinent and in a wheelchair. You say your mom can barely walk. There are a few residents who are able to walk in the Memory Care unit where my cousin is residing, but most are in wheelchairs. An assessment would determine if your mom needs Memory Care or Nursing Home care.

Do you know of a Memory Care nearby? I might consider if your mom qualifies for Medicaid. This is different from Medicare. Medicaid is based on income and assets. If hers are low enough, she may qualify. The details can be found on line, though their rules are complicated and research is highly advised. It would likely cover the cost for her care if she is deemed to need it. I would read about your state's requirements to get Memory Care and Medicaid. A social worker or rep from Memory Care might be able to offer you guidance.

AND do you have Durable Power of Attorney and Healthcare POA for your mom? That would help you as you proceed. She may not be competent to sign that now. I might check with an attorney about that.

my mother is not violent yet but she has sun downers and she wakes up from midnight on every hour. I have a 43 year old downs that is totally depend on me and my husband but my husbands health is not real good. I promised my dad before he past away 12 years ago I would always take of mom. the quilt of even thinking of putting her in a home is eating me up but I know I can't go without sleep her memory is about 1 minute long. she is getting very feeble walking is real hard for her. she has no money what do I do.

I am considering putting my mom in a memory assistance home at this time. I moved her to TX to live near us 3.5 years ago...up until now, she has been able to live alone with the help of caregivers who come during the day. But she is getting more confused and had an incident last week where a woman found her on the street(she had tried to walk across to see a neighbor) and to make a long story short, the police had to be called. She has periods of lucidity which make the decision to take her independence away that much more difficult but at this point, I feel I have no choice in order to assure her safety. The idea of searching for facilities is daunting but I am blessed to have the guidance of a caregivers support group at my church.....I highly recommend looking into this if you belong to a church.I have made a valiant effort to preserve Mom's independence but when it comes down to safety, other options now have to come into play. Pleasant, NO...necessary, YES.

What is the difference between vascular dementia and Alzheimer's?

Katefitz123 - I hope YOU get peace of mind soon.
It is never wrong to put a loved one in a place that can handle the dementia changes, behaviors, and needs. A place that will keep her safe from the world and herself, and a place that can make sure she is clean, fed, exercised, and has social interaction (vs. passively watching tv all day long at home). Please don't feel guilty.

The guilt we feel after a change like this is often not really guilt from doing something illegal or immoral, but regret and other complicated emotions.

The end of opportunities, the end of or a big change to a lot of family traditions.
Fear of the unknown. Fear of suffering and pain.
Loss of control. As long as people are at their house, wearing their own clothes, we have an illusion of control and normalcy. Going somewhere else pops that bubble. We never had control anyway.

Go out of your way to get mom connected with any pastoral care the facility might offer. It might help mom to talk to somebody if she can. Also make sure her doctors are on the lookout for depression. Grief and sadness are hard enough for a normal brain to deal with, but a dementia brain is operating behind the 8 ball. It's OK to let her have some meds to take the edge off. At this point, we don't worry about anybody becoming an addict.

Give mom time. Lots and lots and lots of time. It will be impossible to discern the emotional changes from dementia vs. grief. Even without this kind of event, it can take some people months to adapt. My friend who is a social worker told me to give my mom not less than 3 months when we moved her into care.

If mom asks about Dad, don't remind her he's gone. Make up something believable that will keep her calm. Forcing her to comprehend and relive the loss is not kind. Reality orientation is no longer done for dementia patients because they are physically unable to retain the information, but can often relive the trauma.

Sending peace and comfort to you & your family. This is a very difficult time for so many reasons.

my mom has just became a resident of a nursing care home. mom suffers with demensia /alzeimers my dad passed away on april 8th this year, my dads wish was that mom stayed with him till the end then she needed to be in a care home, the guilt that we as a family feel is tremendous, and mom is very lonely, and sad, the home is a wonderfull home, and staff wonderfull, however mom is ours and we are grieving also but mom is grieving on a massive scale, I hope she gets peace of mind soon

Letting go, is the hardest part. If your family member has limited income usally under $3000 a mo. maybe Medicaid can help you, they do take all the income, with $50 a week left for the patient but you can go to DSHS and get advice, evaluation, find out if patient qualifies. If your loved one has a limited income. You don't pay. You need Power of Attorney etc. They can printout a list of homes that will take Alzheimer's a nursing home is best if they are uncontrollable. Talk to your doctor, if he or she has been helping you. Don't destroy your health.
If I'm incorrect, please verify.....

Dear Felix1giveahug. Suzanne; my heart goes out to you. Dealing with an alcoholic is difficult at best. Your mothers problem is worsened because the Alzheimer's is getting much more advanced. Can you get advice from your doctor. I do believe you need to place her in a facility. We all worry when the time comes. I have watered down my husbands whiskey and added food coloring. The sense of taste deteriorates. However if you can find a light grape juice and water it down, and some food coloring. I managed to start with, 2 parts water , then later on 3 parts, up to five parts water. I saved the bottles. Since she is alcoholic you need to taper it off gradually, but if she isn't aware it might work for you. However is she receiving meds for her memory, depression etc? I have the alcohol problem managed, but my husband is getting to the point where I'm wrestling with the decision of "when". It's true we don't realize the unbearable stress until we are overwhelmed. My husbands doctor said 4-6 mo. My husbands memory loss started in 2005. It's heart wrenching when they know you and appreciate you, but his short term memory has been gone for a few years. And he's 4th stage. I broke out with shingles last week. Take care of yourself.

It must vary by state, as I read differing opinions about Assisted Living, Memory Care and Nursing Homes on this site. I've read a lot about them and talked to a lot of people about them in my state of NC. This is what I learned so far.

In our state, most of the Memory Care facilities are assisted living. facilities. They are designed for dementia patients who don't yet need skilled nursing care and who are able to ambulate from the wheelchair to bed with the assistance of one other person.

Most people with dementia who need substantial assistance with daily care, qualify for Memory Care, which is assisted living. If they need nursing care, then they would go to a nursing home. If not, they can remain in the Memory Care Unit for the duration of their life.

Regular Assisted Living here, is for those who have mobility issues and need some assistance with daily care or have dementia that is not severe. And for those who do not wander.

If a patient wanders, then I can't imagine the Assisted Living facility would allow them to remain. The liability is huge at that point. A patient may seem fine one day, but wander away the next. When my loved one wandered, her doctor immediately recommended a Secure Memory Care facility. She needed it and is much better now.

I forgot to add that mom has moderate to sever Alzheimers, sever loss of cognitive ability over the past year, and multiple other medical problems she can no longer manage on her own. Lots of medications. She had been living in a filthy house as a shut-in, was missing doctor visits, could no longer drive in a very rural county, and was having hallucinations while in her home alone.

My mom was placed in a secure memory care unit due to some psychiatric crises she had while in an independent apartment unit and a skilled nursing care unit. It wasn't up to me. The doctors and psychiatrists intervened and made that recommendation, and she was moved in. I can't imagine arguing with the specialists over something like this. Best move ever made for her. Mom had no business living alone or outside a structured secure building with full time care staff.

TEEBERRY1, as I understand it sleeping most of the day and night is a sign of the final stage. Have you considered asking for a hospice evaluation? They can be very helpful for people who stay in their homes until the end.

my husband is 68 years old and has Alzheimer's in 2013 he came close to dying he has diabetes and his kidneys shut down they told me to call family in than he got better. Than this year he fell and had brain bleed with emergency surgery I believe he is in stage 6 but all he wants to do is sleep not just during the day but all the time I'm at my wits end. Any suggestions

My 95 y/o mom is now living in a memory care unit since she was falling too much at home because of her forgetting she needed a cane for her imbalance and became 'combative' at a wonderful residential care home after 6 weeks. She was put in the hospital to be 'controlled' which turned into a nightmarish 3 weeks of their trying different medications while her current doctor was out of the country. She was so badly medicated that she was unable to hold up her head and could barely talk. My sister and I kept telling them she wasn't like this, the medications were TOO STRONG but they kept insisting it was just 'part of dementia'. When she was released from the hospital, she was placed in a memory care because she couldn't go home safely, the residential care place wouldn't take her, and she was too dangerous to live behind a closed door in a assisted living place. She's been there for 6 months now and is one of l7 people, 2 of which can actually hold a conversation. She is allowed to attend other activities in the assisted living facility next door but then she returns to her memory care and I feel awful when she's lucid enough to realize she's only one of two who can actually converse.

Please Note: Urinary Tract Infections are caused from lack of fluids, water, juices and etc. in men and women. What to look for? Slurred speech, very tight skin, or lots of wrinkles in the skin of the elderly, more repeated short sentences, or questions, more sleeping, naps and increased short term memory loss.
Also, the strong smell of concentrated urine.

Remember to push the fluids (minimum of 2 quarts/half gallon per day) and stay in contact with their doctors.

It is a blessing to find this blog!!! My Mom also has dementia which doctor says is stage 4 but SOME days she is coherent enough to have a good conversation with me about our childhood and HER childhood in DETAIL! But most days are trying and she doesn't know my name anymore. She knows I'm her child though. We are at the crossroad soon to decide if she needs a nursing home. She cannot do anything like cook, clean herself, or put on makeup...or she looks like a raccoon!. She has always been glamorous her whole life. So I try to do her makeup like she used to do. It is so emotionally hard. Physically too with my bad back. I can't lift her or bend to support her even. This is why I feel she is nearing the point of safety needs in a nearby facility. We have lots because this is retirement haven where we live. I prefer to place her in a 6 bed facility so it is similar to my home. Hate to think about it but if she fell again...I would feel awful. She was under medication for memory 3 yrs ago and it made her dizzy. She fell twice and now sufferes the loss. Brain injury when she fell and we didn't know about it for a week cuz she didn't call us. She was living by herself then. Four children and I am the only one who will or can do it. My brother and wife had her 3 weeks and was ready to put her "away". My sisters do the legal stuff but haven't visited but once. I know it's hard when you work. Some just can't handle seeing a parent's demise. I can't either but the alternative is too heartbreaking. So I am faced with this decision sometime this year I know. These blogs have been so helpful. Thanks to all.

my mother has Alzheimer's...what you would call early to mid level stage. Additionally, she goes to Kidney Dialysis 3x per wk. She is also an alcoholic, who has been in lock-down 30 day trtmt apprx 25 yrs ago. This served no useful purpose, being that she compared her condition to numerous other women, and had concluded she was not in any way shape or form near as bad as them. She continued drinking almost immediately upon returning home, and lied to our entire family about it for 2 yrs. Her alcoholism has been the biggest problem regarding the overall dysfunction of our family for the past 50 yrs. Her profound state of denial has not only hurt each of her children, her husband of over 40 yrs (passed away 2 yrs ago), but also her grandchildren. She has always been the "closet alcoholic type, with extreme pride. Nothing has changed, even though her health this past 19 months has made it necessary for her to start Kidney Dialysis. This is because she has had an ongoing protein/urine problem for most of her life, which finally reached a serious level. Also, her family line carries "Alports Syndrome"..which destroys the kidneys. All the more reason she should NOT be drinking. Her primary dr is aware of everything, however, has, for reasons I do not understand, told her she is allowed to drink one glass of wine per night. Perhaps it's due to her age, and she knows at this stage in her life..my mom would never submit to a alcoholic recovery program. This is the situation...she can, nor will not stop at one glass of wine per night. So, as of now, I told her I will no longer purchase anymore alcohol for her. Also, perhaps more importantly, her memory is rapidly declining. She is now at the point of no longer knowing the days of the week. She has almost entirely stopped showering. She leaves the burner in the kitchen on regularly. When making coffee, she now forgets to put the urn on the burner, causing it to overflow. Just yesterday, she locked us out of the house, thus causing me to get a locksmith (we had to wait outside in the cold for an hr and pay $138)...I had clearly communicated to her that WE were not ready to leave for the store, as I looked directly at her. It is very apparent her memory is declining much more rapidly. I could add pages to this. Her choices of clothing in cold weather is a severe health concern, as she refuses to ware her warm jacket. This is the kind of woman you cannot force to do anything...only suggest, even then, she often gets extremely offended. This has become unmanageable for me. Due to her prideful nature, I am pitted into the "bad guy"...which is typical and what has happened in the past countless times when I have called attention to her inappropriate behavior. This time...I do realize, it's not her fault she has memory loss. I am very frustrated, but not angry, despite the fact when she drinks her alcoholic personality comes out full force. I'm use too this, as I have dealt with it my entire life. Question remains...would she be better off in an asst living environment? At least she would NEVER have access to alcohol (I seldom drink, and have been tested for alcoholism, which thankfully I am not), nor be able to ask me repeatedly to buy it for her. The other issue is...she receives alittle over $1,700 in social security per month. We do not have any additional money in which to add. Is their an Asst Living Facility that would accept that? Any help would be greatly appreciated. Thank you. Sincerely, Suzanne

It is somewhat of a relief to see that the feelings I have are shared by others. We are positive that we cannot keep doing this. Mr. S has severe dementia, is violent, schizophrenic, poos all over the house if you do not have an eye on him 24/7, keeps taking all his clothes off, will not take his meds at times, has torn up his bedroom, (we had to take all the drawers, loose objects etc out) and the list goes on and on. No one in the family helps my husband and I because Mr. S was a mean man when he was well and nobody cares about him. He abused my husband as a child and now the tables have turned and the only to cacre for him has had to give up his life again to care for him. We had to leave the state we were happily living in, quit jobs, give up everything we had to come here and care for him. hank God my husband is a caring person but he is getting sick now because he cannot get any sleep and he is exhausted. He has lost his appetite and we are both in danger. We are at our wits end and that we have found that we must contact the VA. I certainly hope they can do something or we will have to put him in a psych ward.

PegofmyHeart, if you don't have money for help, how will you have money for a care center? If you are thinking Medicaid, then you should know that they have a program to keep seniors in their homes. It provides things like incontinence supplies, equipment, bathing aides, personal care attendants, etc. I am not saying that you should keep your husband at home, but if that is what you want to do, with help, then I hope money doesn't force your hand.

I agree with OncehatedDIL. We should not sacrifice our lives and families to take care of someone who really needs more care than you can give them. I have struggled with what to do too, but finally realized that the best choice for my mother with Alzheimer's is where she is , in a decent nursing home. It is not perfect and I wish she could be in a more home like setting, but I can see her deteriorating and I know I could not take care of her at home as it would not be safe and I would soon be worn out. That wouldn't help anybody.

I may be using the wrong terminology here. I thought that memory care was the more expensive care for those at the more severe stages of their dementia. But some seem to call memory care something lesser than a SNF- closer to AL. What is the correct terminology for the more serious and more dementia care units?

My mom and dad lived in Florida for their retirement. A common subject in their crowd's discussions was the number of caregivers that died before their carereceivers. Living with constant exhaustion and stress will destroy your health and bring on an early death. While I am sure that there are people who feel such self sacrifice is your duty.....I don't agree. I believe we should make sure our loved ones are in a safe place. I don't believe that sacrificing our lives and homelife is required. To sacrifice everything for the care of an terminally ill person can be a self destructive behavior.

We knew in just one week that we were over our heads with my MIL's care. She requires 24 hour survellience and support. At times I wonder if we need to consider placing her in memory care. Her SNF says not yet, but on her bad days I think we are asking too much of them in regards to her care. The other patients are depressed by her crying jags.

My husband gave up driving, his car has been sold. He sleeps 75% of the day, my problems are 25% of his waking hours. I try so hard to be patient, loving - but then he gets to accusing me of taking his money, making him sell his car, etc. He is not physically abusive. The dr said that I could die before him because of what I am going thru as his caregiver. I don't have any money for someone to come in and help, but will get more information from the VA. Besides becoming violent - does anyone feel that the caregiving has to end before you end up in the hospital?