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After the holidays, my sister & I will have to move our mom (91 with dementia, auditory hallucinations, & CHF), out of her private room and into a semi-private with a roommate. Money is basically gone after her 5 years there, so ALF is offering this as a cheaper option instead of her moving her into a nursing home.
We're truly lost on WHEN and HOW to have this discussion because we know she will be irate, disgusted, and angry. She has not been happy there, never participated in activities, and doesn't believe she belongs "in a place like this with these kind of people". Reasoning skills are gone, so a logical discussion about finances probably won't work.
We're sad that she'll be sizing down & having to share a closet and bathroom; we know it's going to be brutal. However, it's the only way to stay out of a NH. She'll say we've taken away MORE of her "stuff", might as well send me to the NH, that woman stole my stuff, she's nasty, etc. We KNOW this is coming and probably so much more.
Please share helpful ways that we can deal with this upcoming situation.

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I may be facing the same situation myself sometime soon. Mom's money will run out and then, if she's still alive, it's off to a SNF with a roommate. God help us both, too, because she hates women in general and with advanced dementia, still fights me tooth and nail on EVERYTHING. It's not like we can't tell them what's happening bc they have dementia and "can't understand"......they'll certainly know things have changed and WHO IS THIS WOMAN IN MY ROOM AND SHARING MY TOILET??? Honestly, unless they're comatose, they'll know there's a big change and they deserve an explanation! I'm just going to tell her the truth: the money ran out and here's where we're at now. It's not ideal but hopefully it'll work out well and you'll be friends with your new roommate. I've done my best and I love ya mom.

I hope things work out well for you and for your mom too.
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Marylin Dec 2021
A small amount of her money remains. We may need to buy a single bed instead of the "provided" full bed she's had there for 5 years. So, I'll say your room rate has increased (this is true) & to stretch your remaining money, we have to "size down & share". The facility has negotiated a rate & we'll use her SS & a Medicaid program to pay rent. Then, we'll cover medicine, hairdos, toiletries, etc.
I am searching for something for her to do while we do this room swap because she doesn't need to be present. She doesn't leave the facilty.
I will pray for us both after hearing about your situation. Keep us posted.
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You already know how it’s going to go so I’d suggest you say as little as possible and don’t stick around for the wrath. Sadly, whatever happy was for your mom is over, she’s lost reasoning abilities, and this leaves you trying to help what can’t be made better. Remind yourself that you’re doing a good job looking out for her best interests, even though she’s not capable of appreciating it. I wish you both peace
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Marylin Dec 2021
Thanks so much!
I will be the one who has to sort & separate her belongings, so there's no getting lost for me. I'm hoping I can have someone remove her from the room & let me work on getting her most needed things into her smaller area. The facility might let me move out the things she doesn't have room for the next day or allow us to donate her couch, extra chair, etc. This is such a challenge.
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I hope she's in memory care, not in assisted living. She doesn't belong in AL.

If you know how the conversation will go and that she has dementia and can't reason, then I suggest there be no conversation at all. It is what it is, and what's the point if she can't understand what's going on?
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Marylin Dec 2021
She lacks logical reasoning skills & argues against our decisions; therefore, she wants her way, not ours or what is better. She's been told her rights at ALF & knows them. We're just her 2 bossy daughters & everything is our fault! We must tell her ahead of time, allow it sorta sink in, and we'll have to physically do the work (& try to get her out of the building while we work).
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Marylin, you can try "therapeutic fibs". Example, you can tell your Mom that her room is being painted, re-wired, etc and see if she can understand that, and that she has to stay in another room until everything is fixed. I had to use therapeutic fibs numerous times with my Mom [98] when she wanted to go visit her parents and siblings.

I honestly believe your Mom needs to be in Memory Care, as the Staff in that section are more familiar with the quirks of dementia. My Dad went from Independent Living to Memory Care which was in the same facility. I used a therapeutic fib by telling him it would be less expensive [which it wasn't], Dad liked that idea of saving money.

Try to arrange the bed, night table, and dresser the same way in the new room, as the old room. I found that worked best for my Dad. That way when he woke up in the middle of the night, he felt like he was in the same room.
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Marylin Dec 2021
I've used "therapuetic fibs" on several issues.
Unfortunately, the staff at ALF will tell her differently about her old room. She's has moments of clarity to either find out or hear the truth.
We cannot afford Memory Care faculty. We're lucky to afford this place using her SS, her Medicaid program, & our money. The facility offered us a negotiated price since she's been a resident there for 5 years.
I do believe the new room arrangement can allow her a similar path/routine....at least bed, nightstand, & chair.
Thank you!
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My Mom does not have any form of dementia but when my Dad died I had to move her to a smaller efficiency room to save he put of pocket expenses.

she was very resistant. On some level she understood the move but she was resistant. She is also a hoarder and so there was no way she could go from 750 sq feet to 300 without getting rid of stuff.

I started talking about the move in advance. I enticed her with the promise of a very nice space I would decorate and made sure all her favorite things were moved to the best of my ability.

one of the items I had to dispose of was a second hand oversize dresser. The first thing she did was do a sideways glance at the new smaller dresser and she was not happy.

the staff understood the trauma to her and to me. I busted my rear dealing so the Dads death, the move, clean out.

it took a few days and then she absolutely loved her new room. The staff comments on how beautiful it is, the hospice nurses love it. I really made it her special space with some artwork etc.

so,e times they don’t realize how much change will be good for them. She may thrive having a room mate she can converse with, she won’t be so isolated.

I get it about the bossy daughter statement 😂

hugs, I would love an update on how she adjusts.
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Marylin Dec 2021
Thanks for your story & encouragement! Unfortunately, my mom will not be happy or accepting anywhere!!! She has never been happy with or without a roommate (my poor dad).
I do believe in miracles though.
This arrangement to remain in ALF is the miracle.
Her current room is decorated well, the best looking one in the faculty. She's packed her closet though. This move will greatly decrease her decor, supplies, space, etc. It is necessary but will allow her to "stir the stew", give her stories to tell, and make her more miserable.
We see it coming! It's going to be rough. We're praying for her roommate whom we've not met.
Let's stay connected. Thanks!
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Seems you really have only 2 options: roommate (if she doesn't cause problems for her roommate) and memory care. Look into memory care options that take her finances before committing to room sharing. You might be pleasantly surprised at how nice a lot of them can be.
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Marylin Dec 2021
Memory Care is too expensive. We cannot afford it. I wish we could.
Thank you.
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It is sad, but it is also a fact of life. So I think you say it as gently as you can. You already expect her wrath, she is already an unhappy woman, and the fact is there is not a lot to be happy about in the losses of age that come one after another. So tell her you are sorry, but this is now the facts of life. After long life and many disappointments she will likely be well versed in the sad facts of life. Not everything can be fixed, and we can't always be happy about the sad parts of life.
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Marylin Dec 2021
Thanks for your kind & commonsensical responses. I'll re-read them to remind myself before I tell her. As her POA, I'm enemy #1 but voted as the one to tell the bad news. I'm very uneasy around her as she's mistreated me to the point that I've been to counseling, been hit, cursed, etc. I'll probably take a "relaxing pill' beforehand so I'm not as bitter or ugly. Thanks!!
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I know it’s her deficit area, reasoning but I would try to give her some control, participation in the decision. We have also found that revisiting major topics like this helps a lot as well. I know my moms first reaction is going to be resistance and probably denial, this is where the fight/flight thing usually happens because it takes her time to process the major things she doesn’t really want to think about. The next time we visit the topic usually goes a bit better and is often initiated by Mom, she will ask questions and we can talk more rationally at least for a bit. I’m not saying it will go that smoothly but at the very least there is a chance. Maybe have your sister there too and make it simple, “Mom the money is running out and won’t last much longer. When it runs out we won’t have any choices about where you live. The staff here really wants you to stay here and they offered a way for you to stay. But we know you haven’t been happy here so we should discuss our options. They have offered to put you in a semi-private room here which would be considerably less expensive or we can look at moving you to another NH facility. What do you think?” She May yell and scream or she might be so surprised at being given the “choice” it cuts back on the confrontation you dread but even if it doesn’t change anything you will know you attempted to include her, she will be somewhat forewarned and you might have a clearer picture of how to make the transition.

Im assuming the facility she’s in knows how resistant she is likely to be and knows what her tantrums look like. Do they have a roommate
picked out and a plan for the transition knowing your mom may not be cooperative? Have you looked into NH facilities in the area in case that’s what mom says she wants so you can call her bluff? The other consideration along those lines is that if it’s likely she will run out of money no matter what you do and need to apply for Medicaid eventually it might be the time to find a NH. Less moving and disruption is going to be easier on and better for her and getting her into the nursing home of your choice is likely going to happen if she enters as private pay and transitions to Medicaid later if needed, the facility will help with the paperwork, know the best timing and usually wait to be paid if the application is in and she runs out of funds before it comes through. Just a thought since Mom isn’t in love with her current place anyway.
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Marylin Dec 2021
She is currently on Medicaid.
Her SS & the Medicaid Choices program together will be her rent payment at ALF. The other expenses will be mine.
She has always refused anxiety meds because she was prescribed one when she was raising her children that was too strong & she reacted badly.
Thanks for your suggestions about giving her the options.
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Tell her right away. Let her know this is all you can afford. Nursing Homes are Horrible and not a place to live.
Maybe she could visit a roommate before actually moving in.

Who knows, maybe she'll decide she likes being with a roommate.

Prayers
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It's hard when it comes to this. Since my brother is on Medicaid the number of beds are limited so that's decent that the ALF is offering a solution. My brother started out in ALF but after major brain surgery had to have care that the ALF couldn't provide. I went to the Medicare website where there are ratings of nursing homes. I found one with an overall 4/5 stars and 5/5 resident care that had room for him. They have been amazing, even updating me on weekends. Now I can sleep. He's an introvert and wasn't happy about having a roommate, and then cried when she started to leave. But he has settled in well.

While residents have the right to refuse meds, she might be a candidate for something to dial back her anger, which may be how anxiety manifests itself. I do agree that MC might be a very good option since they are well equipped to deal with residents like her. And they may have some ideas on how to deal with the transition. Good luck.
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Marylin Dec 2021
We've all discussed anti-anxiety meds with her for years. She had a terrible experience with such when she was child-rearing. So, she refuses all notions of it, even now as she's having auditory hallucinations.
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