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MaryAllyn Asked April 2017

How risky is it to move a 94-year-old woman with dementia and osteoporosis across the country to live with her daughters?

My sisters want to move my mother from her assisted living facility in my city in Minnesota, where I have cared for her since 2010, to Arizona. They think they can take better care of her by having her share a residence with another 94-year-old and one sister, who has Meniere's disease. Mother is currently on the waiting list for a memory cottage at her current health care facility in MN. Mother is prone to falls, needed a shoulder replacement in 2010 and she fractured her pelvis in 2016, but has recovered. I am thinking the trauma of a major move will hasten mom's death. She will be leaving friends, other family, current caregivers, and doctors to start over. I believe even the travel will cause her more confusion and anxiety. She is in the moderate stage of dementia. Arizona's heat will also be difficult for her. My sisters believe they can make her happier, facilitate more socialization for her, and would like to take her off of BuSpar, which she's taking for anxiety. She is also on gabapenten for her stenosis of the spine.

daughterlu Apr 2017
Regarding moving your Mother, ask the Dr. Mother took a trip with me in 2012 when she was 94. We went to her Dr. before her trip. He checked her out, new her history and told us to go. There was no reason for her not to go. We flew. Mom and I rode on a inside motorized vehicle to her plane. The airline staff went out of their way to make it a friendly flight including getting us among the first batch of passengers loading the plane and they provided a wheelchair to get her to the seat. We also had assistance getting to and picking up her luggage. Check it out with a Dr. if she is able to fly. If not approved by the Dr. check other alternatives but clear your plans through the Dr. if this is what you decide on.

moecam Apr 2017
I am even debating moving mom 30 minutes closer to me - how would your mom deal with the actual flight? - I'm a former flight attendant so I ask this quite seriously - if she has not flown for a while it may make her have a episode - I have seen this happen in mid flight ... not a good idea - what if they may need to make emergency landing to get her off then you'd be somewhere with no help

I hope they are not going to drive that distance with her either - how to get her there? - if you do it I'd think train or sedated on flight with a nurse in attendance - big bucks here just for the trip as 1 or 2 sisters would have to come up to Minn. + mom's fare + nurse [&return]'s fare + nurse - you might even need first class with that hip so she has room

What were they thinking of? if they want to help let them come take care of her when you go away sometime

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MaryKathleen Apr 2017
Another thought... What about insurance? If she is on Medicaid it could turn out to be a hairball.

iggyziggy Apr 2017
My first consultation would be with her doctor. We had a similar issue, and the doctor said that their plan would be "catastrophic". They also had a strong feeling about which the drugs she was on. Turns out, the drug they thought would be best was a terrible choice, as it causes dizziness and other problems, and the one the facility wanted to use was the proper one. When she moved up here, the doctor went over how many drugs given to the elderly cause problems and even death, and went over all the choices with me, and why she was choosing the same one the prior facility had chosen.) Many people have "good intentions" but when it comes to actually following through...well, that is another story. When my aunt's husband died, many cousins said they would visit her, and even committed to how many times a week they could do so (she had no children of her own but was very close to her nieces) so I moved her to a memory care facility up here. Well, it's a good thing I did not rely on them - it's been 4 months, and not a single one of them has visited - save for one who made no commitment and was not even asked to visit! I cannot believe the same people who were oh so concerned and wanted to be involved in the joint instant message family conversations about what to do have not even visited once - they all live within a half hour's drive! So if you are taking care of her and it's a good situation or not a situation where you would welcome having "shared care", I would not move her - there's no need to. Moving is very difficult on elders. Routine and seeing the same people every day is very comforting to them, and while they can adapt to changes, changes should be limited. Also, would they have a visiting nurse come to check on her regularly - at least once a week? Assisted living facilities have nurses there every day to check on residents and notice things. For instance, many falls happen when there is a UTI. Often, blood oxygenation has to be checked regularly. Any unexplained bruises, loss of appetite, "sundowning" are monitored. Many elderly go through a phase (for some it never ends) of constantly checking doors and windows, trying to get out. It isn't just "every so often" - it is a constant wandering to every door and window. I have seen it in each of the 3 facilities I have been involved in. Are they taking care of the other 2 people now? How is that working out? Are they able to be there 24/7, or are the other 2 in a facility? Do they think that where your mom is now is a problem? Do you? (You mentioned you are waiting for a new placement). Obviously if where she is at is not doing a good job, then a move to a better placement is the way to go. I don't know if any of this is helpful. Sometimes, in order to preserve the family relationships, exploring the options together and asking the hard questions is helpful because those with "a better idea" may realize or rethink just how easy their "simple solution" won't be.

daughterlu Apr 2017
Adding to previous answer, There is in home care services that could assist you sister. They can assess the situation and make a recommendation. This might be an ideal situation. If you are not familiar with in home services, look into it. The cost of a memory unit is very high. For less than the memory unit charges, your Mother could have as much care and more attention in a home setting, a daughter, other daughters nearby and another woman her age at home for companionship. She wouldn't get lost in the crowd. I'll keep your family in my prayers.

daughterlu Apr 2017
I moved my Mother at 99 years old from a rogue Senior Care Facility when my brother and cousin sided with the rogue facility. The facility first injured her in forced physical therapy when the Dr., myself, POA, and Mother were against it. Her decline went on from there due to their continuous negligence and what I believe were intentional acts to the point that she went from being sharp and independence to being a confused invalid. Your Mother, being "prone to falls," a shoulder replacement and a hip fracture sounds like the language the rogue facility used when the falls and health problems she had in her decline were their fault due to negligence. Once the rogue facility took command/ took me off of 16 h- 24 h a day to lesser hours an even worse decline in her health started. Further, Because of their failure to properly administer her Glaucoma eyedrops, her condition is now severe and likelihood of her losing her eyesight in the ending stages of glaucoma are great. My son and I moved her from the rogue facility to another facility with my brothers approval and to the embarrassment of my cousin who remains in the grip of the rogue facility, flattering his ego and hiring his jazz group several times a year. Mother is doing great at the new facility. She has improved from being unable to sit up without falling over to using her walker 50 yards and having good balance. She is lucid and her memory and mind are improving. I am with her every day, glued to her so that she doesn't fall. The staff at the new facility is supportive and in all ways loving and caring. I would be suspicious of multiple injuries you have mentioned and take another look at what has happened in the way of injuries. A friends' Mother at the rogue facility had dementia. They had a private duty nurses Aid from the facility with her 8 hours a day. it was their practice to take an aid away from their charge to assist another resident if they thought they could get away with it. Needless to say, they did this and the Mother wandered out of her apartment and fell down a full flight of back hallway concrete steps breaking her shoulder. They put her back in bed, didn't take her to a hospital. The family moved her after that and found out about 6 months later that she had broken her shoulder from xrays taken for another matter. The initial fall started a more progressive decline and she passed. A bad facility has all the cover up excuses and answers to remain credible to the families. It could be even worse as they move her up in level of care to a memory unit.
Reading back to your description of being "prone to falls," this is what a facility said to me after she fell from Nurses Aids bringing her back from breakfast and sitting her in front of her TV instead of taking her to the bathroom, assisting her and getting her back to bed. The staff was angered when I posted a sign above the TV as to her needs. They ignored the signs and mother had subsequent falls that were preventable. Each fall left her in a more confused state. If you have overseen your Mother for several years and she is facing a memory unit, those are not pleasant places. A home situation could be much better and with multiple sisters, and in a home setting, your Mother might be far better off. Don't let sibling rivalry get in the way and take some trips out to see your Mother if you let her move. I would say, let the sisters have a chance with her at home and if it doesn't work out, then to a memory unit. Buspar is not a strong medication. I have heard of younger people taking it but not anyone at a Senior Facility with dementia although it could be. Blessings

jacobsonbob Apr 2017
Has MaryAllyn's mother been asked about this, or is she even aware this conversation has been going on? As she would be the person most affected, she should have some input if she's still capable of logical thinking. It could posed indirectly, such would you think of living in a warmer climate, etc. The point is that it would be ideal if she is "sold" on the idea if there is a serious possibility of this change being made.

mickimcmurray Apr 2017
Not to be the bad guy, but what’s in it for them? Would she be living in their home? Who would be providing the care she is receiving now and what is the plan if she goes there and they cannot provide the level of care needed. Will she be placed in the 1st facility they find or shipped back to you to deal with? When my mother needed more care than what we could safely manage in her own home I, as the only child, made the decision about where she would go and kept her as close to home and her community as I could. That meant her younger sister, who had been caring for her Mon-Fri, could visit her daily. I on the other hand added an extra hour to my trips to see her on the weekends. My only regret was that had I known she only had a couple of weeks left I would have found a way to make keep her in her own home work.

MaryAllyn Apr 2017
Thank you to the three who have thus far responded to my question. I am mother's POA and healthcare primary. So, I do have legal authority. I am also going to speak with mother's attorney in order to anticipate any potential legal tussles. However, I am hoping we won't have to resort to a legal battle over this. Already, there are hard feelings ...

Sunnygirl1 Apr 2017
Your sisters sound woefully uninformed. Their idea sure sounds very risky and unwise. I hope they will listen to reason. Who's in charge? I might seek legal advice on how to stop this, if they wouldn't listen to reason.

freqflyer Apr 2017
MaryAllyn, oh good heavens, you are so right that this move wouldn't be in your Mom's best interest. The change would accelerate her dementia and her falls. It's hard enough for a healthy young adult to move to a new city much less an elder with dementia.

Do your sisters understand how much is involved with caring for a person who is a fall risk and has memory issues? You mentioned to live with another 94 year old at your sister's home, is this person a mother-in-law? I wonder how the two elders would get along?

I would tell your sisters that thanks for the suggestion, if it was 5 years earlier it would have been a good idea, but not now.

BarbBrooklyn Apr 2017
Who has Medical POA? That is the person who has the authority to make decisions about where your mom should live.

Frankly, the fact that your sisters want to get her off Buspar is what makes me think that they have no clue what they are doing. Have they ever cared for her for an extended period of time? Do they realize that dementia is progressive?

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