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carolion Asked February 2016

Where to place mom who needs high level of care but mind is intact?

Where to place mom who needs high level of care, (toilet ing,showering,dressing,cannot walk alone) but mind is intact. Mom needs assistance with dressing,shower,is urinary incontinent,cannot walk alone,but get mind is still sharp. All board and care homes have people whose minds are compromised, moms mind is good. Can't find appropriate living situation for her that provides high level of physical care with other residents who have minds still intact.


 


 

EXPERT Carol Bradley Bursack, CDSGF Feb 2016
Carolion, you have a situation that is frustrating for many. As was mentioned in this thread, just because a person is elderly and has physical issues doesn't mean the dementia is present.

Yet most care facilities have a majority of people who aren't sharp mentally. This makes it hard for the person with good cognitive skills but poor physical health to find a good place. You'll find nursing homes with people who are in their 50s and are there because of MS and other diseases. They struggle with the same issue. If you are lucky, you may find a home with a few people who are cognitively sharp.

You have to do what must be done, so get her the physical care that she needs. Then keep her supplied with social and mental simulation and work with the social worker to make good things happen.
Take care,
Carol

judypanama Feb 2016
I don't see how you can conclude she has dementia. Just because her body isn't working right doesn't mean her intellectual processes aren't intact. A stroke could affect motor functions without affecting the mind's sharpness.

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carolion Feb 2016
Thank you for all your answers to my question. I found a wonderful Board and Care 15 minutes from where I live. The caregivers are wonderful(4 very loving to 1 resident ratio...6 residents. Great food, beautifully presented. I am, finally, very satisfied with the care she will receive. One woman resident there is 100 and mind sharp and actually in good physical shape, mobile with cane, not incontinent, hears well, ex librarian, loves music (as my mom does). My mom is 96 with sharp mind. All are in their 90's. Wonderful place and reasonable priced. Very grateful.

pamstegma Feb 2016
What you describe is advanced dementia. No, the brain is not good if it can't get the right commands to the body. She is well past Assisted Living and would need skilled nursing care. If she is high functioning and social, the nurses will adore her.

Lizdevine Feb 2016
My mother was the same way, competent in mind, but her body was failing. It seems your Mom needs 24/7 care for ADLs. Not "all" nursing homes are full of dementia patients... that is a myth perpetuated by the uninformed. According to the alzheimers association, ONLY 1 out of 8 people over 65 and less than 1/2 (45%) of people over 85 ever develop dementia or alzheimers. Wish more people knew these stats..Just because a person is old or frail, does NOT mean they have these diseases. Some NHs have a separate unit for alzheimers patients, (at my old NH, they were mixed with the general population), others dont. Mu suggestion is to just do some research, reviews and pre-admission visits and find a good place for mom. Best wishes at this difficult time ...

Deez2502 Feb 2016
I'm not sure where your located.. but in the U.S. finding the "right fit" takes some researching. I've had the same issues with my Mom, who does have Alzheimer's, but she physically was still able to do ADL's independently. She lived in a facility that was Independent Living WITH add on services. It worked out well for her, as she only had and paid for the services she needed when she was newly diagnosed, which was only for about a year. Now, fast forward 1 year, and she is in need of Skilled Nursing Care (NH). Her Alzheimer's has progressed to the mid stage, she cannot walk without a caregiver nearby and her walker, some days, she can't walk at all. She needs help with all ADL's now, and is beginning to have wandering behaviors, as well as hallucinations. In hindsight, I wished I'd moved her to a facility that offered independent living, assisted living, and nursing care all at the same place. Multiple moves are very difficult for the elderly and especially those suffering from Alzheimer's. Good luck to you in your search, my best advice is to do your research and look ahead as well as where your loved one is today.

Countrymouse Feb 2016
I see that you posted an earlier question asking about funding - is money the key issue here? Is it that she is being required to move from her current ALF because she can no longer afford the supplementary, intensive support she needs to stay there?

help2day Feb 2016
Whoa. "What you describe is advanced dementia." Not necessarily. As others have stated, just because someone can't do ADLs (activities of daily living) does NOT mean they have dementia. MS is just one example. Mind is fine. A friend of mine was involved in a car accident and became a quadriplegic at age 25. His mind was as sharp as the day is long. Unfortunately, he could no longer speak but used alternative communication devices to communicate with family and staff. He lasted this way for 25 years and succumbed finally to pneumonia at age 50.

To this day, I struggle to understand how he maintained a good disposition. If I was in his position, I would have begged to "end it all." He was completely dependent on staff, family for ALL of his needs. Again, his sharp and excellent mind was trapped in a body that no longer functioned. It would have been the ultimate torment for me. I admired his courage and strength. He was a stellar example of making the most of a horrible situation. He was my hero.

That said, try to find the best facility for your Mom's needs. One that has an active "activities" program to keep her engaged. Yes, there are facilities will elderly and middle-aged people mingled. I would consult an elder care manager, a geriatric psychiatrist/psychologist, caregiver support groups. Elders in your Mom's situation can become easily depressed with thoughts of their situation which can spiral out of control and cause even more complications.

You mention board and care homes so I'm assuming you do not live in the United States. Therefore, it's hard to give advice when most of us are answering from our knowledge of care in the United States. Do you have a gov't entity in your country that deals with the aging population? Start there.

BarbBrooklyn Feb 2016
In my mom's nursing home, many if not most of the residents are mentally intact. It may be that because this nh has a separate memory care/nh floor, the more severely mentally impaired patients are not mixed with the general population. I would seek a ltc facility that does lots of rehab work. They tend to have younger, healthier patients. Good luck!

jacobsonbob Feb 2016
Unfortunately, some residents of nursing homes have sharp minds but may be so hard of hearing that communication is difficult. However, where my mother is, there are some younger residents with sharp minds and good hearing, and a few older ones with these faculties as well. As Pam mentioned, if she is pleasant and sociable, the nursing staff will respond in kind (I see this with my mother)--but you'll have to overlook their patronizing "Sweetie"!

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