Actually got Mom to visit some Independent/Assisted living places this week. We've seen four, and while she's still not really wanting to move, I had to really work on my poker face when one of the complaints was all the "old people" here. She's 89, so not exactly young, but doesnt use a walker or cane, which seems to bother her when she sees residents moving around with one. Also really worried about diseases.

Anyway, the main reason she needs to move out of her home ( living alone in a house 200 miles away from me in a small town) is her mixed dementia diagnosis (vascular/Alzheimer's). Now in the moment, she's ok. She can get herself dressed, she can bathe herself, she can eat by herself. She knows her family and friends when she sees them.

But she has been told no more driving (both by doctor and a driving evaluation). She gets overwhelmed by tasks that require multiple steps, I had to help her fill out some Christmas cards for 4 grandkids, and it was something that took a hour to do. I've taken over bill paying, because bill's were past due,because she would get them, and set them down, and sometimes things would get placed on top and then the bill was forgotten.

She was hospitalized this fall, due to low blood count and iron, which after ruling everything else out was probably due to her not eating well or forgetting to eat, she will snack on junk food, but not cook anymore, and maybe not taking meds correctly.

She can't remember how to operate the microwave, I've had to hand hold her over the phone to operate washing machine. Sometimes even the TV remote is problematic

She can operate her cell phone, but just barely.

Sometimes she gets confused as to names of people and things especially when tired. Had to remind her today what city she's in.

What she needs is someone to bring her her medications

Someone to check on her in the morning. Sometimes so confused when she wakes up, " I dont know what I'm doing". Maybe to tell her, hey get dressed and come eat, here's what's happening today.

Meals readily available, with her favorite snacks and drinks available in her room, maybe someone to notice if she is not coming to meal times

Light housekeeping, someone to help with laundry

Interaction with more people than mostly me

Fall monitor

I intend to be present multiple days a week, and as long as she physically and mentally able to take her with me to activities like plays or grand kid events, family dinner, church. But I need time for me too, to workout, read, take a vacation,. I have adult kids that will visit also.

I keep hearing she needs to need help with 2 or more ADLs to qualify for assisted living, would the above qualify?

She doesnt need memory unit yet, but its probably only a matter of time, significant changes over the last year.

I have med and financial POA, with the dementia diagnosis, would I have to sign lease agreements?

Also what is a reasonable community fee prior to move in ? We've been quoted any where from 1500 to equal one month rent.

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I told mother once I wrote the check for the deposit, it was a done deal, she went for that. She is in a very nice A/L she absolutely loves it, my brother and I fought her for 10 years to move out of her house, where she sat alone 24/7 as every time we would hire help as soon as we left she would fire them.

Sometimes a little white lie does the trick.
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"I really want to move to Assisted Living!" said no elderly person, ever!
None of them ever want to leave their homes, and it is very understandable.
I'm sure we will all be the same way. A doctor will almost always sign off on the paperwork, especially for an elderly person who is showing cognitive decline and is in danger of leaving the stove on or needing help remembering to take meds.

It is amazing to watch them practically kicking and screaming when they are taken to AL, and then smiling and having lunch with new friends they've made just a few weeks later.

My aunt was like this. She now thrives there. She attends weekly Bible study, plays bingo, Wii bowling, morning exercise class, and has a group of friends with whom she eats all her meals. She gets up early and gets herself to the dining room for breakfast. When she was at home, she dragged herself into the kitchen, attempted to cook breakfast, frequently left the stove turned on, went back to bed for hours, left dirty dishes piled high all over the kitchen, forgot her meds, etc.
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Your Mom needs an AL. Cleaning and laundry were included in My Moms room and board. The AL Nurse will evaluate her to see what tier of care she will need. The earlier she adjusts to living in an AL the better. If you have POA and she can no longer make informed decisions, then you need to decide. Its now what she needs not what she wants. She may be better in an AL. More socialization and things to do.
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Gracie61 Jan 2020
Thanks for answering.I actually got her to put a deposit on a really nice, new AL 7 miles from my house. She will be evaluated next week by their people. The lady that showed her rhe apt that was available was great, it helped that she actually grew up and had family still in the area where my mom is from.
But still a long way from accepting the move. "I wont know anyone". Come to find out, she wrote the check and agreed to the depisit because she got confused and thought she was in her hometown!
But Ive got 30 days to make it happen.
I have an apt with the social worker on her Memory Care team, and then my mom and I have an appt together with her neurologist and the socual worker at the end of the month. Hopefully we can convince her that this needs to happen.
Gracie, my mom didn't want to move either.

We started a campaign of pointing out to her what was wrong with her living situation.

"Gee, mom, so sad that there are no sidewalks here. Not safe for you to walk".

"Terrible that your help can't get here by public transportation. If there's a storm, I hope she's here already and can stay over".

"Sad that there's no one home in the neighborhood during the day".

"The local drugstore doesnt deliver? Boy, that really sucks".

And on and on and on. And no, we didn't "step up". We made it clear to mom that her emergencies were going to be owned by her, not by us.

We didn't argue or try to convince her. We just made it untenable for her to be in that house. And when neighbors asked what we were doing, we included them in the "plan" so that they got on message as well.
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Thanks for the responses. Mom really doesn't want to move to "those places " It was a victory for me to get her to visit for a tour
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You should have one of the agencies that assist people in chosing ALF, or consider using one. They can be wonderful. They are paid by the facility that you choose IF you choose one, and are free to you, will drive you to facilities. They will take a needs assessment much like you gave above so that they can tell you which facilities are able to fulfill, and what costs are, and etc. And you will get to see the grounds, visit with residents, often see a room, share a meal, and speak with those who run as to costs. Generally there is a room rate (some have more than one room if you wish/can afford) and a care rate which goes by level of care needed. For instance my bro handles his own medications, and that is a cost savings of about 400.00 a month in his case, would be about 700.00 a month in the Bay Area. So it is highly variable. There are many agencies that do this "A Place for Mom" work, not only that most well known name. You might call an assisted living in your area and ask if there are any suggestions of people they know who do this work, being aware they may give you the names of those who most often "steer folks their way".
When you choose a place an initial assessment will be done by their own doctor or your Mother's, to assess need and appropriateness of placement. Wishing you luck. Hoping you will update us as you make this journey with your Mom.
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FloridaDD Jan 2020
I would be cautious about using agencies that rely on financial support from facilities.  Where I live, they do not recommend the really good not for profit places that do not give them support.   I would also tell OP, see if the facility has an arrangement for when their money runs out.
You’re very wise to look for a living facility now rather than later, especially since you live further away.

When I was touring assisted living facilities I was told that an assessment is done prior to being accepted. Once accepted they do everything that they can to accommodate their needs.

The facilities I looked at had a check list of what services were needed for the residents and the additional fees for those services.

Fees beforehand varied according to the facility.

Best wishes to you and your mom.
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Have you gotten a "needs assessment" done? This can be ordered by her doctor, gotten through the local Area agency on Aging or a facility. It is a dispassionate, professional, scored instrument that will tell you how much help your mom needs and with what.

There are ADLs and then there are IADLs (instrumental activities of daily living). So, yes, your mom can feed herself, but she needs help with planning and executing food preparation. She can dress herself but needs help with maintained her wardrobe (washing clothes).

It sounds like for now, your mother would do well in Independent Living with an add on Medication Management service if that's available.

My mom was resistent to moving to IL. Complained about folks who didn't use walkers properly, who didnt "speak up" and who were less able than she was. It was all part and parcel of a lifelong need to be "better than" other folks. We ignored what she said (yes, the poker face. Never argue with someone with dementia).

We created a nice fiction that she needed to move to IL for the winter months because she would become agitated when a storm was predicted. My brothers and I maintained that it had gotten dangerous for us to try to get to her isolated suburban home during blizzards. We really left her no choice. We said "no, mom, we can't do that anymore".

By the time Spring came along, she had made new friends and was engrossed in the stock market club and chair yoga and wanted to stay.

One month rent "community" fee was pretty standard in Westchester, NY.
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