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cindyann Asked November 2017

Can NH force us to move mom to memory care unit when we don't feel it's necessary? We feel that the MC has mostly late stage Alzheimer's.

My 93 yr old mom has been in NH in MD since May. Prior to that she lived alone. She went there as rehab patient after pacemaker, fell & broke her hip in late June. Her dementia has definitely progressed after the hospital stays & a UTI. However, she's usually calm & content except for a bit of confusion here & there. She participates in most activities, plays bingo 3x's a week, mostly independent. She cannot walk & wheels around the 3 units because she gets bored. She likes to be around people.
I'm sure she needs help getting back to her room & will say "Help,help". The staff all know her well & usually redirect her, get her a snack. But the administration doesn't seem to like when she's wheeling around & they think she should move to the memory care unit on a different floor. My mother-in-law was in this unit for 2 weeks so I have firsthand experience & I truly don't think my mom needs to be there. I feel that this move would really confuse her & the atmosphere would make her worse. My 2 sisters & I take turns so 1 of us visits everyday & spends 2-3 hrs with her. The aides all seem to like her & do say that occasionally she doesn't want to go to bed & says she wants to go home. She def has signs of Alzheimer's & asks about routines & if she stays there, etc. But most days are good. She can still solve a Wheel of Fortune game, follows worship service reading, and has a sense of humor. Admin wants to meet with me to discuss her move. This would be awful with Christmas coming.

pamzimmrrt Nov 2017
My MIL is in her 90s and deaf as stone. Sleeps a lot. Her AL moved her to MC along with several others all at the same time. She is not showing dementia or ALZ,, just confusion because ( we think) she is in her 90s and also can't hear what is going on or being asked of her. And she has some incontinence, wears depends and liners. We have a friend who is a hairdresser at the facility, and she told us they moved her because she wet several chairs. I feel they should have been more on changing her pads! But AL is for minimal assistance, and I do understand she was above minimal with the wetting issue. So perhaps the real issue is she needs more hands on care. GOod luck!

jeannegibbs Nov 2017
They can't force a resident to go somewhere in particular, but they could, I assume, claim that they can no longer care for her in the regular unit.

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freqflyer Nov 2017
CindyAnn, it is so much better to move Mom now while she is still able to find her way around, for her learn the new Staff, and to make new friends. If you wait, it would become very difficult for Mom to adjust to her new surroundings.

Depending on the Memory Care rules, she could be allowed to roam around the other floors and meet up with friends she already made up until a certain night time hour. Then those on Memory Care need to back on their own floor.

As for empty bed in Memory Care, grab this bed while it is available. Most memory care centers have a long waiting list. Probably there is an exception to a resident who is already living in the complex.

I had placed my Dad on one such waiting list, just in case he didn't like were he was living and it was 6 months until that other place had called me with an opening. Dad loved where he was, so there was no moving him :)

cindyann Nov 2017
Thank you for the responses. Mom is always in view of someone, she doesn't try to leave. She, along with several other residents wear a wrist alarm for the one area that leads out to elevators. The nurses station is right there. Some of the activities are in the other wing, it's quite open & they are allowed to go on their own or aides will bring them. She is not at all violent & the only disruption might be a calling out saying, "help me" when she gets confused. I've been told by aides that she has gone into another room but not more than 4 times in 60 days. And other residents have done that also. The social worker only seems to contact me when she sees her saying "Help" and 1 time a visitor asked a nurse if she could help mom. I get the feeling it's more about how it looks rather than her safety. Sometimes, I get the feeling they need the room for a possible admission from a resident who already lives on the retirement campus. Mom is on Medicaid. Wondering if that makes a difference.
My mother in law lived in AL there & after hospital stay, she was quite confused & disoriented. This was just 5 weeks ago. She was down in the dementia unit for 10 days. Her delusions were a result of steroids. She is now living at another nursing home which is not as expensive. This home that my mom is in is the most expensive in our area.
I have visited the MC unit on several occasions as the nurses & aides know me. I was just there yesterday, as I try to get as much observation as I can. The staffing is the same & they rotate their nurses & aides so most of them know mom from rehab & the SN unit.
I'm just wondering if they can force this placement or will I have last say being POM?

Veronica91 Nov 2017
Cindyann do you think the main reason for suggesting Mom move to MC is because they never know where she is and are concerned about safety issues? She does not sound as though she is ready yet because of her dementia issues. you did not mention violence or disruptive behavior or non compliance except for occasionally not wanting to go to bed. Most people do say they want to go home for which there are many reasons.
I feel that all residential facilities should have secure outside doors not just memory care or at least have alarms on the doors and patient's wrists if they are likely to wander.
When i was in rehab a nursing home patient told me she knew how to get out. So i asked if she had the phone number for a taxi to escape. She said she didn't and anyway they would track you down and bring you back!!!!!!!!!!!!!!.
When I had to visit a patient on Hospice in a local nursing home memory care unit i came away shaking. The noise, screaming, banging stuff on tables etc just sent shivers down my spine.
Decided there and then I would lock the doors and let the grass grow up over my windows.
Try and find out the real reason they want to move Mom to MC and make your decision from there.

freqflyer Nov 2017
CindyAnn, here's an idea, see if you can spend 72 hours straight with your Mom to see how she is reacting. It could be when you do short visits, Mom is able to "showboat", but she wouldn't be able to do that for more than a certain number of hours.

I remember when the Staff at my Dad's Independent Living facility said it was time for him to either move into Assisted Living/Memory Care, or for him to bring on a couple more shifts of private caregivers. I was so surprised by this request. Boy, they are so right.

Turns out when my Dad goes into "sundowning" he will wander with his walker, and could easily go out the front door. Thus Memory Care was the answer. Dad liked his "dorm room" and I knew he was secure being in that section of the complex. He became good friends with the gentleman who lived in the next door room, who had also recently transferred from IL to MC. They had all their meals together in the dining room, along with another fellow. Dad learned immediately where the dining room was located :)

Safety was the #1 concern. Yes, the Staff faces were new to him.... but the nurses were the same, and so was the Med Tech.

Countrymouse Nov 2017
How terribly difficult, Cindyann.

Other than the severity of the other residents' impairments in the MCU, do you also have reservations about the staffing, or the range of activities residents could participate in if they were able, or any other differences in approach to care?

And how long ago was your MIL in there?

I'm just wondering if it might be a good idea to go and have another close look at the MCU. A visit like this would either confirm your feeling that your mother isn't ready for it yet, and give you an opportunity to state your reasons while the staff are looking at exactly the same things; or it might be that the unit is different now from how you remember it and on closer examination could be a good fit for your mother after all.

So if you've got the meeting scheduled anyway, I'd request that it include a tour of the unit and go with an open mind - which you are equally entitled to expect of the the admin people, by the way.

Don't get bullied! But don't paint yourself into a corner, either. Best of luck, I hope it proves to be a really constructive meeting - and that your mother keeps winning at the bingo :)

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