Is there basic criteria to determine when someone needs to move into assisted living?


My mom is caring for my Grandmother. At what point does a person need to move into assisted living home? Are there basic criteria? My granny still drives, but comes home with dents and/or scratches all the time. She hords junk (broken discarded items) and compulsive shops at thrift stores. So much so that she has filled her home (twice) and her son's home up, leaving only small walking trails to a couple of rooms. She does not clean up after herself. Dishes, papers, food and drinks are all left where ever she used them. She digs in her garden and attempts to clean up, but is unable to "see" that she is still dirty/smelly. She is often told by family members that she needs to shower. She is very smart with money and her church and can carry on a sane conversation. She does have a few health problems, but nothing that would prevent her from living on her own. She is a very good manipulator and tells people what they want to hear then plays on the elderly in poor health card if someone questions. She often blames her behaviors on other family members. She admited to starting arguments on purpose, just to argue.

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First, she should see a doctor. She may have obsessive compulsive disorder, or some type of dementia. Since she covers so well in public (to the utter frustration of caregivers this is horribly common), the move makes it harder. She certainly seems to be a candidate for more care, though in-home care may help if she will allow it.

There's no real criteria for AL, but generally when people can't properly care for themselves, or they are in danger of falls or other issues, the move is made.

I do think a doctor could help you with the decision if you can get her there.
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Take her to a doctor, both a geriatric psychiatrist and a neurologist. Get an accurate diagnosis. Even if she has dementia or OCD, she can still live at home and hire someone to come to the house to clean up for her instead of going to a nursing home, as long as she is not poor. In my opinion, the only people who should go to nursing homes are either very poor and can't afford a private CNA or they are so sick that even a 24 hour private nurse can't care for the person (my father needed a team of nurses all day could never have done the job). People with dementia love to start arguments on purpose. They usually love to annoy people. The best way to deal with that is to "turn off the remote control" when they push your buttons. If they see you are not annoyed they will stop trying to annoy you.
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