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?
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.
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.
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
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.
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?
One issue I would discuss is the correlation, if any, between the change and the shutdown b/c of Covid.
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.
Wishing you good luck. These are, after all, a business. Things happen often sadly from that perspective,