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Pjmoma Asked January 2016

How to talk to my Mother about moving into an assisted living community that also has memory care?

She was recently diagnosed with moderate dementia and we were told that she should definitely not be living alone anymore. She is still with it enough to express her displeasure at the prospect of living in an AL community and believes she will eventually be able to return home to her apartment. She will definitely not want memory care although we think there is a good chance she will not be able to stay in assisted living for too long. Should I have the conversation about such a move a few weeks before it is scheduled or right before it happens? Any other advice is much appreciated.

jeannegibbs Oct 2016
Pjmoma, I'd like to mention something about memory care. Some persons with dementia eventually need it; many do not. Wandering is a symptom of Alzheimer's but not the other 50 or so kinds of dementia. Wandering typically requires a secure environment. The other common reason for needing memory care is disruptive behavior. Many persons with dementia never develop either of these issues.

Sometimes persons with dementia develop more physical impairments, need too much help with ADLs for assisted living, and move to a nursing home environment.

So your mother may or may not eventually need a different type of care environment.

I used to think that a community with continuous care options would be best for the person with dementia, to minimize the disruption of moving. Experience has revised my opinion on that a bit.

Moves and changes in environment are often very confusing and disruptive to persons with dementia. But if Mother needs to move from ALF to Memory Care or NH it is a move -- whether it is across town or across the care complex.

My mother had to move to different room for a few days while the facility painted and maintained her room. She was extremely confused. She ate with the same friends, saw familiar faces in the hallway, and was familiar with the routines. But it was a move. It was disruptive. And she was confused again for a few days when she returned to her room.

Her facility had memory care, assisted living, and nursing home care, in different wings. But moving from one wing to another would have been a full move, just as if she went to a facility in another city. The dining room would be different. The staff faces would no longer be familiar. There would be different people at the dinner table.

Having all the care levels in the same facility is somewhat easier for the POA -- billing system is familiar, lots of routines are familiar -- but I've come to realize that it isn't as important to the resident as I had originally assumed. A move is a move. It is going to be disruptive regardless of the distance. That can be (and has to be) dealt with.

Personally, I wouldn't give the all-in-one feature a lot of weight when selecting the best care center for someone with dementia.

Countrymouse Oct 2016
H'm. Have you consulted a lawyer?

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upsett Oct 2016
Yes I have reported it he does it at another residence its call hydroponics. They don't care either

Countrymouse Oct 2016
Upset, if you are entirely in earnest when you say that the person live with your mother is a drug dealer, have you tried the police rather than APS?

upsett Oct 2016
I have POA for my mother doesn't help in the eyes of Adult Protective services. She had agreed to assisted living then the rest of the family got involved. APS could care less that a drug dealer is living with her and doesn't give her her meds regularly. I am totally angry at these agencies that are there to protect the elderly. It is a crock. They don't care that the rest of the family are felons, drug dealers, been in prison. I go down every two weeks to make sure she is okay. She cries when I leave and says she is so lonely cause her caregiver doesn't interact with her he is too busy smoking dope and drinking. Thank you APS Stockton Ca.

KnotResistant Jul 2016
pjmoma, yes, the sooner the better. Memory care is probably inevitable if you are talking about it now. AL is not necessarily a solution for dementia residents! Ok, let me put it another way, "most Alzheimers residents require more than Assisted Living. " I fell way behind and lost tens of thousands of dollars underestimating the care required for my mom. Move her to the worst situation, but, the best conditions.. (I moved my mom 3 times and it totally messed her up...)

CarolC75 Jun 2016
Oh pjmoma, I didn't answer your actual question about talking about her move weeks before or right before it happens. Definitely don't do it way ahead of time. I learned that the hard way.
People with dementia tend to be worrisome and fearful. She would be anxious and apprehensive and probably ask about what is happening all the time. For some reason, they know when something is up...
Just enjoy her and be positive. Go visit places which will be enough to let her know that something is going to happen. Then, just before, let her know and go out her in.
I told my hubby on the way to the memory care!

CarolC75 Jun 2016
Good answers above...and good questions too! Make sure you do get power of attorney if you don't already have it. It will save you lots of trouble later.
Any of the AL's will give you and your mom very nice tours and include lunch. Go with her to several and see if there are any where she feels comfortable.
Also, it would be best if she didn't have to move later so find a facility that can care for all levels in the same facility. Less moving is better than going through this again.
You'll find that most people in the facilities are used to people being reluctant to move and will make the transition easier for you.
Be positive about the move and be reassuring to your mother while "shopping" for the right place.
My husband ran away from two AL's before I got him into a more secure memory care facility. He was running away and calling for me....breaks my heart! Now I'm waiting my two weeks before I go see him and hope he has settled down a bit better.
This is just not easy....best of luck to you!

Countrymouse Jan 2016
Your mother is still living at home at the moment, is that right? With what kind of support? How close are you to finding the right ALF placement for her?

Regarding the move from ALF to memory care, I think you might be getting a bit ahead of yourself there. It sounds as though you still have quite a lot of negotiation to do with getting her to agree to the ALF; and even with the diagnosis, until it is formally determined that your mother is no longer able to make the decision she is still in charge of where she lives.

Do you have Power of Attorney for her?

Sorry, more questions than answers - could you fill us in on the background, please?

freqflyer Jan 2016
Pjmoma, if your Mom can go into an Assisted Living complex where she can age in place, that would be great.... but trying to convey that interest to your Mom won't be easy.... no one likes to move away from some place that is "home". I would stress safety as the number one issue.

Recently my Dad [94] moved into Independent Living which allows him to stay even if he needs a higher level of care. He's happy as a clam being there as now he feels safe. He saw what had happened to my Mom attempting to live in their single family home with a lot of stairs, and he is scared that he was going to fall at home, too. Mom passed away due to a fall. Now he doesn't worry about that.

geewiz Jan 2016
Dementia is a challenging illness. No one wants this diagnosis and since your Mom is at the moderate level already, there seems to be little benefit in putting it 'in her face' so to speak. Visit the ALs in your area. Many in my community have traditional AL as well as memory care. The residents are typically allowed to stay in regular AL until there is a wandering incident. For example, my MIL is coming up on her 4th anniversary in AL. She too has moderate dementia but has never wandered. Her table mate was relocated to the memory care section this summer after someone brought her home after they found her wandering the streets.

When I moved my Mom to memory care (she WAS a wanderer) it followed a hospitalization and rehab. I simply said that the doctor wanted her to get more practice walking and to get stronger. I was blessed and she never questioned me or gave me a hard time. I'd keep her in regular AL as long as possible and if she needs to be moved, keep any explanations QUITE simple. In my opinion, you can't relaly reason with the dementia so the less said the better. Good luck and keep us posted.

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