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A relative has cognitive impairment. When we moved her to an assisted living facility a few years ago, we were assured she could remain in that apartment until the end of her life. Staff were aware of her cognitive issues at the point she moved in - the major problem being she finds it difficult to find the appropriate word, but she could make her needs known. We are now being encouraged to move her from the lovely assisted living apartment where she has all of her favorite items and furniture, to the dementia care unit at the same facility. In the dementia unit, one could have a few knickknacks & small dresser but there is a hospital-type bed in one room with private bath and small closet. We know there is high demand for the assisted living apartments at this facility. How does one determine that the move is in the best interests of the patient vs the facility. This relative is perfectly capable of dressing, bathing, and feeding herself. She walks the corridors, but otherwise watches tv or out the window in her room. With covid, none of the family or relatives have been able to spend any time with her in-person since March. Walking the hallways is her only outlet. We do know that moving her to the dementia care unit in the same facility (which she is very familiar with) will have a very major negative impact. If we didn't know about the high demand for the assisted living apartments, perhaps we would not have such a negative reaction to the suggestion. We know to the extent possible these days this woman is still able to function. Does any one have any experience with this issue, i.e., facility suggesting a move that you don't feel is necessary and which will have a very negative impact on the patient?

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How much choice do you have in facilities? You are not describing a person who, in my brother's facility when he was living, would be asked to move. His ALF had cottages and there were a limited number of seniors in each cottage. The rooms were either one or two rooms, arranged around a core that included office, dining, communal living, bathroom and snack room. Seniors could wander halls all they wanted as long as they knew not to enter rooms belonging to others. There came a need for more safety and the facility made two of the cottages locked with greater number of staff, and these became not memory care, but safety from wandering and up level of care. If this facility isn't right now I would look around. Some Board and Care's are better, fewer people, often run by a family, and more homelike and cozy for some. Often less cost as well. I would contact some organization such as a Place For Mom were I you, and tour places available. You might also ask for a detailed list of reasons your relative is being asked to move in DETAIL. That is "Exactly what changes have you seen in the last two years that make you unable to accommodate her in her current living arrangement.
Wishing you good luck. These are, after all, a business. Things happen often sadly from that perspective,
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One possibility is to have a meeting with the medical team and get more specific insight into their position that a move is appropriate, or necessary.   There may have been changes of which you aren't aware that occurred during the Covid isolation, but they should be prepared to give you more specific information.   Just telling you she needs to move doesn't provide any rationale.  

One issue I would discuss is the correlation, if any, between the change and the shutdown b/c of Covid.
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NobodyGetsIt Oct 2020
Hi "GardenArtist,"

Once again, we're on the same page. I was thinking the same thing about talking to a doctor/medical team and have her evaluated to be sure it's absolutely necessary.
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It does not sound like she needs to be moved to MC from what you are describing.
But .....
Have there been other incidents that you might be unaware of since you have not been able to see this person in a while? Has there been a decline that the staff sees that you might not be aware of? Is it possible that this person has tried to leave the AL facility while walking? If so did they actually get out?
If possible can you get another opinion, another person in to evaluate the cognition that this person has and if they are able to maintain a lifestyle in AL? I probably would not move them until an evaluation could be done. And is it possible to place cameras in her apartment so you can observe what he is doing so that you can have an idea what is going on?
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rovana Oct 2020
The problem with OP's description is that it may not be current due to COVID lockdowns. If family has not been able to actually visit with elder, how would they see for themselves how elder was currently functioning?
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A lot happens in few years with a person suffering from a Dementia. I don't understand why an AL would guarentee her being able to stay till she passed. ALs are limited in the type of care they can provide. They are not Skilled Nursing Facilities.

My first question would be does she need more help with her ADLs. What has changed to make them feel she needs more care in Memory Care. Which by the way is going to cost her more. I would tell them its hard to make that decision without seeing her. You could also take her out for a neurological eval. But may mean she will be quarentined. At Moms AL u kept your own doctor so I would not have made any decisions on the word of an RN. If there Is a doctor associated with the AL I would want to speak to him.
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Good insights from the other responders. I think the guarantee that she would never have to move from her AL apartment was contingent upon her cognitive or physical abilities to meet her ADLs never declining. If you haven't been able to be with her for several months due to the quarantining, much may have changed that you aren't aware of. I agree that you ask the facility to provide specifics about why they're making this recommendation, and if you still don't agree, get a second opinion.

"We know there is high demand for the assisted living apartments at this facility." If she's paying full price for the room then this isn't an incentive to move her since the room is at maximum monitization already. If she's getting govt assistance, then maybe. I wish you success in getting the clear answers you need to make the best decision for her.
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Since you haven’t been able to visit her, have you considered that perhaps months in isolation has caused her to decline considerably? I think you need to have a meeting with the facility so you can get the full picture here, they wouldn’t just suggest she needs MC for no reason. She had cognitive decline when she entered AL which wasn’t relayed to the facility. If she had it then, she ha a probably gotten worse. Especially being isolated.
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Sarah3 Oct 2020
Right exactly, and the other aspect to this is that when one entrusts a loved one to an AL they observe them 24/7 and can speak more accurately to what a person in there needs. Unless the op has valid founded reasons to believe the AL is not trustworthy ( and if that’s the case why has she remained there all this time)
If you look at it this way, life is a series of changes and with the first change was huge having her placed out of her home into a facility. Now that she’s there they’ve assessed at this stage they’ve observed reasons she now is best suited for Mc. The only way to have full control of her lifestyle is to keep her at home, in a way it’s that simple, once a lo is placed in a facility they are responsible for her care- if they have reasons to believe she’s better suited for that it’s their responsibility to move her to the different unit to accommodate her needs. As some others have said at this age things don’t stay static for years or even months necessarily, they can suddenly decline or experience other changes
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Recently went through moving Mom from AL to Memory Care. We got her the biggest room available, so although its a studio, there was room for a small seating area, along with her desser, bed, side table and little bookcase. She still has the same reqular full size bed she had in AL.
It ended up being the best thing for her. In Assisted Living, it required more individual agency to socialize or find an activity. They have to mask and social distance outside apartment. They will not stop them if they want to walk out front door. Need to remember when meals were being served, choose a table, choose from lots of choices, and there were fewer aides in that area. Most residents were nice, but still some mean girls around that didnt like that she sometimes told conflicting stories.
Mom can still get herself dressed, and choose a meal, and have a conversation. But as her dementia increased, her sundowning increased, and she started pacing the halls long in the night, and being very anxious ( looking for her children or parents)
In Memory Care because of the cognitive issues , they dont require residents to mask, and there are only a few tables where they eat communally. In the times between meals, they can sit in rhe communal area, and participate in activities or not, but the activities come to them. The aides in that area also seem better versed in how to roll with whatever mindset mom is in that day
None of it is perfect. Covid has complicated everything. I wish I had been able to get her to move to AL a year sooner. She moved in a couple of weeks before things got bad here, so nothing there is what we expected when we made the move.
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My LO did fine when first placed in AL, but, quickly she became to need more assistance than the AL could offer. She was past the point of needing reminders and help with things. Her AL told me that she needed more care. I saw what they meant and moved her promptly. The difference was immediate. She did much better once in MC. It was as if she could finally relax, because she sensed the staff knew how to care for her. It's difficult for me to imagine them telling you she needs MC, if she didn't. You can ask questions and see what they contend are the reasons MC is needed, but, I'd keep an open mind. In MC there really is more one on one attention and direct supervision at all times.

When you say that the resident is perfectly able to bath, change, and feed herself, I get it. She may physically be able to do it, but, the thing with dementia is that she may forget to do it. Then, they remind her...then she goes into the bathroom to do it, but, forgets or gets distracted. So, they then try to help...then she may resist...she may insist she already bathed...but, she didn't. They get confused and really need so much more attention and direct care. My LO would get lost going on the way to the dining room and forget where she was going and never get there for a meal. They told me that when reminders are no longer sufficient and assistance become completely doing the task for them, it goes beyond the scope of AL.

Maybe, they can explain their recommendation.
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I wonder if there was some confusion about being able to stay in her AL apartment, versus being able to stay in the facility until she passes? It sounds like they have multiple levels of care, as do many of the places here. Where dad was, they could move into higher levels of care as needed. Same with MIL, who moved nicely into MC from her AL room as she needed it. Yes they had a wait list for the Als , and several of MILs neighbors were moved when she was,, possibly up for concern, but really they all seemed to need it! Really MIL probably needed to be moved way sooner than she was,, she had to have a sitter all day long before the move.. which was expensive.
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Dear "ArthurKenneth,"

Once again your question is a reminder that every facility has it's own way of thinking and dealing with residents.

My mom was diagnosed with Alzheimer's in 2014 at the age of 89. I moved her into an ALF into a very nice one-bedroom apartment with a separate living room, kitchen, bedroom and bathroom. I tried to salvage the nice pieces of furniture from the home I grew up in to make it as homey as I could so the transition might be easier on her since she didn't want to move. She was able to walk, dress herself and eat on her own. She started at the basic level 1 care. Her main problem was not being able to take medications on her own and the Alzheimer's aspect was more time-related i.e. when did I see her that day, when did she eat last etc.

After a couple of years, I saw a social worker from hospice (even though my mom wasn't on hospice at that time) and had her evaluated. She did the MMSE assessment and felt my mom could still remain in the AL area but, should be moved up to level 2 care. When I told the Administrator of the facility, she said "no" your mom doesn't need it. So I had the exact opposite occur in our situation.

If it were me, I know I would find it unsettling to think they would want to move my loved one out of the AL side into memory care if it weren't necessary just so they could give it to someone else. I would definitely want a doctor's opinion as to whether it would be in alignment with what the facility thinks. At this point, it really doesn't seem like she needs to be moved.

Currently, because my mom did nearly die of severe dehydration and COVID in April we moved her to a new facility into their memory care unit and she's now under hospice care. She scored 14 out of 30 on the MMSE which is her lowest score to date however, she is there because she can no longer walk, dress herself, has lost 30 pounds and isn't eating very much. I moved her into a much smaller one-bedroom apartment because she is now in a hospital bed and there was no need for a living room, separate bedroom etc.

I can say this, I'm so glad she is in memory care just because she is getting much better and more frequent care as well as the caregivers and director of the memory care unit are better equipped to handle someone with Alzheimer's and other forms of dementias. My mom's attitude is very good considering all she has been through and as she approaches 96 in February.

I hope you will have a medical professional assess her before moving her.

I wish all of you the best and may you get some clarity when you make a decision as to whether to move her or not.
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My sister works in a facility with all levels of care. She says there have been a decline in all residents due to the isolation and banning of visitors. It is especially evident in the AL residents as they had been accustomed to much more autonomy.

My mother was in AL until March, then hospitalized for a week with pneumonia. We had her placed in rehab to recover and saw an immediate cognitive decline. On the advice of doctors she was placed in SNC and we thought that was the end.

Then last month the facility recommended we find her a place in Memory Care. They told us she needed more mental stimulation than they were able to offer.

So we had her moved to a new facility that does not isolate MC residents, doesn’t require them to wear mask, and has a policy of multiple daily activities for them. No TVs in resident rooms and everyone eats together. The goal is to keep them engaged and not sitting alone. This also has the benefit of tiring them out so they sleep better at night. A separate staff ensures their safety from Covid.

Within a week we saw an improvement in her alertness and physical well-being. It also helps that she was taken off numerous anti-anxiety drugs that were turning her into a zombie.

Yes, it is more expensive but they have a higher ratio of staff to residents, plus extra training.
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I would speak to her doctor about it. Set up an appointment with her doctor to look at her recent behavior. Or to see if a different pattern of behavior is occurring with her.

Ask the staff for specific details for their opinion. You deserve answers to your questions.

I would also express any concerns about how you feel that a move to memory care may effect her negatively.

All the best.
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Has anyone asked what happened to the promise that she could stay there until she died?

I would get that answered before I agreed to anything.

Then I would have an independent needs assessment done and decide if I was going to continue to pay a facility that did a bait and switch or move her.

Listen to your gut, because these places will say anything to fill a bed.
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NobodyGetsIt Oct 2020
"Isthisrealyreal,"

I had to learn the HARD way - any facility no matter how good or bad they may be is ALWAYS a business first and foremost!
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Don't see how an AL could make a serious promise that someone would be able to live there for the rest of their life. Suppose they became bedridden and needed a SNF?
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Isthisrealyreal Oct 2020
Rovana, I was told the same thing.

Unfortunately we don't know until we know what we don't know.
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Ask the administration to outline the reasons they feel your mother needs to move to the dementia care unit. Compare their list with their qualifications for assisted living. That should help you make your decision.
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I wholeheartedly agree with rovana.

A social worker referred me to this forum and I have found it helpful. I wanted to experience an in person support group so I searched and I found one that was held at an assisted living facility. This facility only had independent living and assisted living. It did not have memory care.

We would meet once a month and two of the women that attended our meetings lived at the facility.

Their husbands used to live there as well but they were asked to leave because as their health worsened, their care level went beyond what the assisted living could offer. Their wives placed them into nursing homes.

The assisted living facility told the wives that they do everything possible to keep a person as a resident but it isn’t always possible to do so.

So I wouldn’t take a promise that was made from any facility as being true. Who can predict the future like that? People’s health can go downhill and they don’t have any other choice but to change their plan. It’s sad.
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Had the exact same issue. They moved my MIL from assisted to dementia unit against our will. She was obviously the 'sanest' person in dementia. It was heartbreaking to see. We found another facility within a couple of weeks that could and would handle her needs. The old facility tried to hold money that was due back to us. One lawyer letter later they refunded out money.
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NobodyGetsIt Oct 2020
Dear "careinhome,"

I'm so glad that you were able to find another facility within such a short time especially one that could and would handle her needs.

Thankfully, for you and your MIL it had a good ending and you were also able to get a refund having gone through a lawyer!

Hope she is doing well now in her new environment!
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We felt the same way about our family member.  We started with someone coming into her home to help her and spend time with her.  That caregiver told us she needed more care, so we shopped for an assisted living facility and also looked at locked dementia facilities.  At that time we felt she wasn't "as bad" as the folks we saw in the locked facilities so we chose assisted living.  We were wrong in our assumption as we had not spent day after day with her nor had we been with her for a 24 hr period...so we did not know how bad she really was.  We had to move her within 3 to 4 months out of the assisted living and into the locked down memory care facility because she wandered out the door and into the parking lot and didn't know where she was..  My point to this story is that visually she may seem fine or the same to you, but she may have worsened and you just don't realize it since you have not visited during covid or spent extended periods of time with her.

I truly don't see how the facility could have promised you that she could stay there for the rest of her life when she has dementia which we all know worsens.
Even without dementia, she could worsen physically and need more care.

Those pretty little things you've brought to her apartment are probably more important to you than to her.  I guess my advice would be to ask the facility what has changed that makes them feel she needs more care.

Good Luck.
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BurntCaregiver Oct 2020
Or the AL wants the bigger money for her and placement in the dementia care lock-down will bring that in. I will tell you something about assisted living facilities. They start to get antsy about a resident who has remained in their small apartment for more than a year and will start insisting that they need more care. If they haven't declined all that much physically then they will use worsening dementia as the reason. If a place offers a dementia care somewhere in the facility you can bet that their AL residents will be moved there after about a year. It means more money and their apartment becomes available for a new resident. Before you take anyone's word from any staff member at an AL or nursing home as to whether or not your person needs to be moved or needs different care, demand to see every and all documentation of incidents they have on file first. Believe me, I worked in these places and I know the under-handed way they operate. Even when the the living conditions are decent and nice. Never take their word on anything in even the best places. A person must always see for themselves before they decide anything for their LO.
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Did the AL give you actual reasons and examples of incidents happening as reason for why they want to move her to the dementia care part of the facility? They have to document any and all incidents or changes for all their residents. Demand to see every article and record for your relative. Do you have any official paperwork outlining what the criteria is for a person to be in the assisted living part of the facility? They always give you a packet explaining the level of independence a person must have to qualify for AL. I worked in an assisted living. It is different from a nursing home. Their criteria for the residents was that they had to be able to walk independently (using a walker and cane was fine), they could not be diaper dependent, and they had to be able to do basic ADL's on their own like getting dressed, going to the bathroom, and coming to the dining room for meals. If a resident couldn't manage these things independently they had to go. My place managed and administered their meds, prepared the meals, did their laundry, and assisted with bathing a couple times a week if a resident needed the help. That was it. AL is different than a nursing home. Make the administration of the place your relative is in, show you in writing what their criteria is for a resident in their AL area of the facility, and then make them explain to you in what ways your relative no longer meets this criteria. Don't take no for an answer either. From what you're saying it sounds to me like they want her up in dementia care for one reason: $$$$$ they charge more for that. Your relative sounds like she still has enough independence not to be in need of all that much hands-on care. A resident like her is easy-peasy for them up in dementia care. She's bringing in the big bucks but doesn't require all that much care. Don't let them get away with this.
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Do NOT move her! It is horrible that they would do this to her. So often the people in these facilities are LAZY and do not want to take the time to actually help the people in their care. If the main problem is communication then they could look at alternate ways to communicate. If she is having problems speaking you can even get her an iPad or device that has a keyboard where she can type a message and a button to speak. Dynavox has devices also with pictures if they can not type the words to show what they need. IT IS NOT IN HER BEST INTEREST TO MOVE HER! I do NOT trust their motives. She would become depressed and more confused taking away the things she loves! No, do NOT do this to her.
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Dosmo13 Oct 2020
Doubt she could use an ipad or other unfamiliar (to her) device. Her trouble communicating would not be helped by a device. Problem with word-finding is typically due to dementia. Even old familiar and simple procedures (e.g. using a coffeepot or microwave) become difficult when dementia sets in, so forget new electronic devices! There must be problems the facility is noticing, that only those with her day to day would see. Find out what, specifically, are their reasons for wanting her moved to "memory care"? If there are problems they cannot handle, then she needs to move or get more help.
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i know you want her to have her nice apartment and everything she’s had thus far,...... when you place a loved one there however since they’re the ones who observe her 24/7 the reality is they naturally have a better grasp and understanding of where she is now, at that age things can change quickly so while she may have been ok to be in an apartment previously they’ve informed you there’s been some changes w her that in their best judgment make necessary a change. It’s a change and most of us don’t like change, she won’t have things exactly as she did before but there’s a reason they believe she needs memory care. Since they’re with her 24/7 they have a much broader understanding of where she’s at. Is your main concern that you really want her to be in a nice fancy apartment? ( there’s nothing wrong w that but I’m trying to make sure I understand is the change they feel necessary upsetting to you bc you want her to have the apartment and all her things she can have there - as opposed to the memory unit where she won’t be able to have the same environment? I’m assuming it’s not that you feel the care is subpar on that unit, but more a matter or wanting her to maintain her current amenities and apartment?
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First of all, how do you KNOW for sure that your family member hasn't dramatically declined since you've seen her last?? Many of these residents HAVE indeed declined, thanks to the lock down restrictions with COVID19 and not being able to see loved ones in person for months on end.

Secondly, your family member has been dealing with cognitive decline for 'years' now, according to your post, and dementia is progressive. That said, it may indeed BE time for her to move to the Memory Care section. What you don't see is how she's dealing with a microwave and a refrigerator and getting herself to and from her apartment and and and. There are a TON of things these AL residents are expected to do independently, with no help, that after a while, become impossible for them TO do when dementia is present. We don't get to witness that b/c we're not there 24/7.

Lastly, my own mother has lived in the same ALF since 2015; first in the regular AL section in her own apartment with a microwave, fridge, etc. She was diagnosed with dementia in 2016, but I knew she was going downhill for years before that diagnosis. She became more and more of a burden to the care givers as time went on, and on occasion, was a 2 person assist because of chronic vertigo. I knew they wanted her OUT of there for at least a year before she got sick with pneumonia and was hospitalized, then moved to rehab for 20 days. When it was time to go back to her apt at the ALF, the nurse came to the rehab to do an assessment and said No, you no longer qualify for your apt in AL, but we can take you in the Memory Care building. So that's what we did; we moved her out of her apt and into Memory Care which is a shrunken environment where she can function a whole lot better b/c there's less to deal with.

My choices at that juncture were........either move her into Memory Care or find another ALF that would be willing to accept her WITH a 4 year old dementia diagnosis and several health issues on her plate. There may have been an ALF that WOULD have taken her, certainly. I know that Morningstar Assisted Living does accept residents who are turned down by other ALFs for having too many issues, and they will charge nursing home rates to house them. That's the trade off.

You can always look for another ALF to accept your loved one, or, you can accept that it's time she's housed in the Memory Care section of her facility. You can also get her doctor to come in and give you his or her professional opinion of where your loved one would be best off living.

It's a catch-22, in reality. My mother says she 'doesn't belong' in the Memory Care, that there's nothing wrong with her at ALL and it's the others who are all 'stupid morons' and 'crazy' and yada yada. Meanwhile, she is lost in time and space and has no idea WHAT'S going on, even with an Alzheimer's clock to TELL her what day and time it is. Denial is very common for patients AND family members when dementia is involved. We tend to see them as 'much better' than they really ARE, and they tend to see themselves in the same light. When I worked at a MC ALF before the plague hit, we had one lady who insisted she was only staying there as a 'hotel' b/c she was perfectly fine (similar to my mother) and her daughter agreed. That hotel, however, was costing her $6500 a month. And I listened to her repeat the exact same stories 200x per day, day in and day out for a solid 7 months.

Sometimes, you can't win; they're not going to be happy EITHER way. But the bottom line is, the AL decides where your loved one belongs and they get to make that decision. If you disagree with it, you get to move her to a different place if you can find one to accept her. And then, if/when she declines a bit further, you'll be faced with the SAME decision all over again. If you do move her, be sure to find an ALF that DOES have a Memory Care wing.

Best of luck! I know how dreadful this whole thing really is.
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NeedHelpWithMom Oct 2020
Great point!

The facility is trying to function as best as it can. I bet the staff appreciated that you were cooperative.

People with dementia or ALZ will certainly decline. There is no telling how and when it will occur.

My godmother declined horribly. She was a huge burden to the staff at her nursing home. She would have been kicked out of an assisted living facility.

Caregiving is a tough job, even if a person doesn’t have dementia.

All the OP can do is question their opinions. If they are there on a daily basis and I am not there everyday I would certainly take their comments seriously.
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I have a girlfriend like you. She couldn't believe her husband was as bad off as he was. She fought every downward step he took. Like you, she would argue with the professionals. Just remember you are looking at her with the eyes of love, they are seeing the real her and where she is. She is going to go downhill where she stays where is or not. You said she is still able to function. How do you know this since you haven't been able to see her since March? That is 7 months ago.
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The first thing that strikes me is the comment about your mother walking the halls. Has exercise always been an important part of her life? I ask this because it sounds like your mother is at high risk for elopement, a technical term used in the care industry. It means wandering outside of the care home unsupervised. People with memory loss are kept in locked facilities for their own safety. I was horrified when I first learned of the key pads and locked doors, but soon came to understand the necessity. Elopement has led to the death of more than one resident. At a home in Colorado back in the late 90s, a woman in an assisted living care home walked to a neighboring market. She took a short-cut through an alley, slipped and fell on the ice and banged her head. The facility did not know she had left as AL residents are not required to check-in or check-out. She was discovered two hour later frozen to death. A person with memory loss can easily wander out of care home without secured doors. That person will immediately become disoriented because they will most likely not recognize where they are. We regularly hear in the news about missing people with memory loss.

Being able to dress and feed oneself are not determining factors for the move to memory care. Many people with moderate levels of dementia are able to feed and dress themselves. My Mom used to wear scarves everyday and dress herself in an elegant manner, but she could not follow a recipe or remember why she left the kitchen. She knew exactly which eating utensil to use if the Queen of England came to visit, but she could not remember my friends who had visited many, many times. Your best bet, as many previous commenters posted, is to meet with the facility and ask for specifics. All facilities are expected to keep a care plan for your mother, so ask to see the comments in the plan. You have a right to the plan.

I would also discuss with the community bringing your mother's furniture to MC. That is unusual that they do not allow her own furnishings and bed. MC is not a medical model, so there should be no requirement for a hospital bed. Do not place any valuables in her room (misplacement and theft) and, to make her comfortable quickly, bring along items she knows, like her bedspread, photo albums, artwork, furniture, memory box and anything management recommends.

Carefully review the terms for termination of the contract. Consult a lawyer. If the facility determines your mother needs to be in MC and you refuse, that could be cause for termination. When senior care communities promise to keep a resident for the rest of their life, do not believe it. Period. There are many factors than cause the relocation of a senior, including behavior problems (sometimes caused by poor management), health changes, memory loss, ability to pay, etc. Know your rights and responsibilities so you can give your mother a good life and have more effective communication with the operators of the community.

The vast majority of operators have your mother's best interest at heart. If they think she needs to move to memory care, then listen to the reasons and examples they give. You mother will have a higher quality of care with greater staff accessibility. The fact that the AL rooms are in such high demand speaks well for the community.
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NeedHelpWithMom Oct 2020
Great point! I actually know a caregiver that told me of a resident that kept getting out of a facility. After she was found walking down the street at night she was placed in memory care. Memory care is for the resident’s safety.
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I am truly mixed about this. I just spent four months day to-day 24 seven with my mother who I thought was moderately impaired with dementia… Turns out she is severely impaired and gets worse by the day/week. There is also some thing called “show timing”. Look it up ...people with dementia who know they have dementia even severe dementia can light it up for whoever is currently around them even for an hour or more and they’re pretty good at disguising how cognitively impaired they are. This of course is exhausting and cannot be kept up for any length or period of time. Yes dementia is progressive and only gets worse over time; it never gets better. When it takes more than one aid to help someone who is constantly getting lost going back to the room they are so familiar with and even when outside occasionally forgets where they are or what they doing is too much for assisted-living sad to say. She probably is in need of a memory care and yes, by the way it is more expensive! I’m sure that a lot of facilities are motivated by money, but I can tell you that especially during COVID-19 when aids are probably fewer than normal, there are just too many patients and not enough caregivers available in assisted-living!
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Hello. Having a LO in Assisted Living can be a challenge. Even when the place has the best of reputations, staff and living spaces. Mom was in Assisted Living for nearly 8 years. She complained frequently and I finally learned to say "No". But for the most part she would say she was happy. What I found as the Dementia and Memory problems increased, she was loosing the ability to be even slightly independent. She mostly wants attention. I guess I was really lucky when I found the place she was moved into.

They treated her like a "queen" and loved her as much as her family did. She was also fortunate enough to maintain a sense of humor. Why this happened is a good question -- All I can say is she reacted differently to me than she did the caretakers at the AL. I found it interesting that they could say to her "It is not nice to talk to your daughter that way", - and she would stop and then say she was sorry to me. They would know when she wasn't feeling good because her sense of humor would stop.

I know it is difficult, but I found that getting to know the caregivers on a personal basis helped both Mother and Myself. I Do now understand however, why they would want to move your LO with the explanation you have. When Mom first moved in they told me that she would have to be moved to MC only if she was to become a danger to herself or others. That never happened. Is there something going on with your LO that you have not been made aware of? Talk to the facility in detail. Get more answers. Good luck, this is never easy!
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Imho, your being "assured that she could remain in the [assisted living] apartment until the end of her life" was a rather BOLD statement. Certainly the relative with "mild cognitive impairment" may worsen. Prayers sent.
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notgoodenough Oct 2020
I thought the same thing about that statement - I don't know how any facility can make an assurance like that.
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My mother was moved to memory care last month after almost 3 years in AL - same campus. She declined during COVID and I had not seen her since March. She was frequently trying to leave and they were mostly concerned for her safety, calling the police, etc. I really didn't want her to move, mostly because of the cost (close to $10k monthly, up from around $6k) and her leaving the staff, residents and all she had known for several years. Honestly though, it has been the best move. She doesn't really know she moved and was able to take most of her stuff. I no longer am getting calls that she is misbehaving, and she is being kept busy with the increase in staff and better trained. They also were able to adjust her medication and have a geriatrician that comes frequently. I have been able to visit briefly a few times recently and she seems more calm and peaceful. Good luck - not much advice but you are not alone.
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Dont move her.
Even her Dr says she's fine where she is.

They probably just need her apartment for someone else and have beds available in the Dementia Care Unit.

Stand your ground and they can't make you move or yell them you will take them to Court and win because they told you she could stay there along as she lived and her Dr says she is fine
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worriedinCali Oct 2020
LOL they can and will make her mother move if she needs more care than they can provide.
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It is the "doctor's decision" what level of care a resident needs.

I just witnessed a similar scenario. Nursing Facility Administrator was suggesting a "higher level of care" for a resident. The doctor stated "he disagreed."

The doctor had the final say.
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Dosmo13 Oct 2020
The nursing home decided to follow physician's lead, but they were not required to. It is totally up to them who they accept for what level of care.
If they want to move a resident, it is probably because she is requiring more from them than they can provide in independent or assisted living (wherever she is now) They should be able to tell you exactly why they feel she needs to move. Get a detailed explanation.
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