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I’m 66 and have become the caregiver for my 80 year old sister. We are/were best friends and she lived across the country. I started noticing mental decline on my visits in 2020. She is twice widowed and lived alone, still driving and independent, but going downhill.


Her daughter and I decided (with her cooperation) to move her to a retirement community very near me a year ago. Her daughter lives in another state so helpful administratively, but not hands on.


My sister has a lovely apartment with a full kitchen and meals in dining rooms around the community.


We are very fortunate that she has resources. In the last six months, she has declined mentally dramatically. We have hired caregivers for several hours a day and she goes to memory day care 2x a week. I cover Tuesdays and weekends and still feel guilty for “passing her off." My family is not happy I have taken on so much.


Blah, blah, blah. My question is whether to move her to memory care or hire caregivers 24/7 when it comes to that.


Appreciate any advice!



Trish

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I vote for memory care. Please know that you are NOT passing her along. You are being responsible by seeing that she receives proper care by having her placed in a facility where she has 24/7 care.

Resume your life with your own family. You can be an advocate for your sister and visit as often as you like.

Best wishes to you and your sister.
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MC would be the natural step up, the sooner you make arrangements the better for all concerned.

There is no room for guilt when dealing with a person who has dementia. You do the best you can and accept the facts of the matter.

I have 2 in homes 1 AL the other MC, both are well cared for and safe, they are just where they need to be.

Listen to your family, they must come first. Becoming self absorbed with your sisters issues will help no one.
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Believe it or not, placing her in a memory care facility will be much less expensive than hiring 24/7 caregivers and lots less stressful for you trying to coordinate the caregivers.
Plus they will have activities that will keep her busy if she so chooses.
Your sister will be just fine in memory care and you will be able to get back to just being her sister and advocate.
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My mom is in MC and I have 7 day a week 4 hours a day caregivers to give her personal care of showers, lotions, walking partner, mouth care, fixing her hair, reading to her, hydration! And encouraging her to eat 2 meals-they take her to the AL dining hall and she loves it. I have snacks and her favorite water (Propel-electrolyte) in her room too. (this place allows a frig). What I like about this arrangement is that my hired help report to me! I get pictures of mom, I get a brief outline of the day at the end of each shift. They work 1-5. When I didn’t have private caregivers, I found that the AL and MC staff did not communicate with me and my mom would be upset and could not express herself when I called her. Her caregivers have bonded with her and she likes them. I have peace of mind knowing that she is cared for so well and they know how to negotiate with her without her getting upset. They can call me if she pushes back too much-doesn’t want to each/drink/wash up. My mom happens to enjoy sleeping a lot, but she enjoys their company when they are there.
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I agree with most of the responses here: Transition her into MC (memory care facility).

However, what are YOUR concerns?
You pose the question to us due to how you are feeling about it -
uncertain?
guilty?
tired/exhausted?
want more quality time for yourself/your life
- this is OKAY to feel and want, although it sounds like you feel some guilt around this desire - which could be partially why you are asking us. (And good for you for reaching out to us!)
- torn because xxx (write this out for you. Sometimes writing and seeing in b/w provides a different perspective).

* We are on the outside looking in and that is all we can do.
* Your heart will know what to do.
* And, therapy may help you figure out how you feel and what is right for you, and your sister.

* I am thinking more so of you/r - quality of life and your age. You deserve to live more of your life without this stress, no matter how much you love her, it is stressful. This isn't to say that you do not care, clearly you are a very loving sister. However, it seems to me that having your sister reside in memory care will serve both of you well.
- You will have as much access to her as you wish.
- You can take her out as you wish.
- She will be with constant (employees / CNA - she will get to know them) vs the possibility of caregivers 'coming and going' (and as one response here indicated, they may cancel a shift and then you are on again, and in an emergency situation. You do not need this responsibility (at 66) ...

(As you indicate), you are grateful you/she has financial options. In the nicest of ways to say. this "take advantage of these resources" - This is, in part, what they are for -
* When your negative 'self-talk' comes up, reframe it to positive words "I am doing what is in the best interest of xxx (sister's name). I will continue to do everything I can for her. I know she would want me to be happy and enjoy my life as much as possible."
- You can come up with your own positive responses. Write them down and read them.

Gena / Touch Matters
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LenLevin Mar 2023
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Memory care for sure! Managing home caregivers is very difficult, as is finding good ones. Read some of the posts on here to learn what's involved.

Home caregivers cannot provide as much care as a facility can. Socializing is better in a facility. Equipment is already there, and you don't have to buy it, rent it, clean it, find a place to put it, and make sure the caregivers know how to use it. On and on and on - I've done it for both parents. I'll never do it again as long as there's another option.

There's also an issue of personalities. The home caregivers must get along with each other and be able to cooperate. You'll need insurance to cover them in case they hurt themselves taking care of the patient. You'll need to master and manage the payroll taxes.

If sister is in a facility, you might be able to take more time off. Tuesdays and weekends is way too much time to take away from your own life.

I hope she's not still driving. If so, you'd better address that right away.
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Tmounsey56 Mar 2023
Not driving!
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I think she would transition easily to MC. Particularly if MC is in the same community.
You could start out by having her go to a few activities in the MC so she gets to know staff and some residents. (Is /if the Memory Day Care is in the same building or in the MC unit that works perfectly)
You could then tell her that her apartment is due for some repairs and she could then move in to the MC.
She is lucky to have you looking out for her.
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MC will be less costly. Caregivers can call in sick and you will have to jump at a moments notice. MCs provide enrichment programs and entertainment almost every day similar to day cares. If she was kept at home she would not have as many enrichment programs. This is also a place for her to meet new friends. My mom was very outgoing and enjoyed friendships in whatever place she was in
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Keep in mind that this could go on for years. I would transition her to memory care. You can visit her often. Take her lunch, be involved as much as you like, but the entirety of her care will not be on your shoulders.
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A memory care facility will be cheaper than 24/7 caregivers. I moved my older sister from assisted living to a memory care unit a few months ago. The facility was great helping me with the move. I'm not saying it was easy but it was what she needed. She could not manage daily living tasks, was paranoid, confused and hallucinating. The facility had an opening in MC and helped me get ready for the move the following week. I did not tell her beforehand--there is no reasoning with her. I didn't want to wait until it was a crisis situation and not have a place for her to go. She was not happy at first but she has adapted. Now she is safe and well cared for and cannot wander. She likes the staff. They also have activities and exercise classes if she wants to participate. MC has helped both of us.
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