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Avail71 Asked February 2021

How do I tell Mom with Alzheimer's that she's going to a care facility?

I've been caregiver for my Mom for a year and a half now. She has Alzheimer's and I've decided that she would be better off in a care facility. How do I tell her? She gets angry anytime I try to talk to her about moving and selling the house.
I'm at my limit mentally and physically, my life has been completely taken over and I'm ready to start living for me again.

psuskind1 Mar 2021
Don’t tell her. Just do it. You can’t reason with this terrible disease

Brenda132 Mar 2021
Dont tell her just do it. she will adapt and you need to get on with your life.

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disgustedtoo Feb 2021
My mother's own plans included AL if/when she felt the time was right. One of her neighbors moved into one. She used to go to local places for the free meal and tour (probably more for the free meals!) She lived alone in a condo at the time.

When she was 90-91, I realized she was in early dementia. We COULDN'T discuss this with her, because her idea of dementia is you were crazy, off your rocker. There was NO way to change that mindset (it existed before the dementia.)

Of course dementia lies to those who have it. In her mind she was fine, independent and could cook. That was HER reality and there was no changing that. Any mention of forgetting something, Oh, I'm old and entitled to forget sometimes. Oy! Any mention of AL (regular AL, not MC) was met with derision. She would NEVER live in one of THOSE places! I tried bringing aides in, only 1hr/day, to get her used to them, with plans to increase time and tasks (initially it was just a sanity check and med check.) Less than 2 months later, she refused to let them in. So, plan B, find a place. I couldn't do it and neither brother would've been appropriate. Once the place was ready (rebuild, MC was last to open), we had a date set. OB coming up and YB to assist - I told them I did everything else, I was staying OUT of the move. I suggested messing with the heat - YB had put in a NEST thermostat, which he could monitor and adjust with WiFi. Make it hot, then cold, then tell her the heating system had to be replaced**. It was winter, so she'd have to relocate! Sadly because it was winter, we didn't have the means to move the furniture. I picked up other bedroom furniture and bedding instead and we set it up ahead of time.

In her case, she managed to injure her leg (and not tell us!) which developed cellulitis, just before the move. ER trip, 2 rounds of antibiotics and months wearing a leg stocking. Anyway, YB used this to write up a phony letter from "Elder Services" at the hospital, telling her she goes to a place we pick, or they will place her! Madder than a wet hen, but she went (couple days delay due to the meds.)

EC atty had told me we couldn't force her to move and we'd have to do guardianship (expensive and time consuming!) But, the place chosen wouldn't accept committals. They said just get her here, we'll take it from there. MC is locked down, so they can't just leave. I stayed away for the suggested 2 weeks. They did use (or at least ordered) anti-anxiety meds for the transition period (I managed her finances and medications, so I know there was no refill done. She only got that one time later, during UTI-induced sun-downing. One pill, later afternoon until treatment was done, and all was good! Not drowsy, sleepy, just nice and calm!)

If you'll need to move her furniture and there's no one to help, can you hire someone to move it? If you haven't already, check various places in your area (difficult to do at this time!) Choose the one that you feel is right (as best you can, check personally, see hear smell touch taste, don't just buy the spiel)

Once you come up with the right "fib", wait until just before the move. She likely won't remember and each time will give her a chance to complain, argue or fight. Have the movers ready to take her things, help her pack "for a few days", just until the "work" is done mom... You can bring other items later. Take her to a favorite restaurant for a nice meal, then to the facility. Even better/easier, if the facility can allow you two in for a meal, have it in the "hotel"! Hand her off to the "hotel" staff and ensure her you'll see her as soon as the "work" is done! Even if her room isn't quite ready, they can keep her occupied.

Your "fib" will have to be tailored to what would work best for her. You know the house. You know your mother. If you can't think of anything, perhaps a fake letter from the town saying the water needs to be shut off for a few days/a week, whatever works. Might look more "official" and necessary!
disgustedtoo Feb 2021
The ** where I mentioned the heating system... ironically it DID die, but thankfully later, closer to spring, otherwise we could have had quite a mess!

Question: does your mom have enough income/assets to pay for MC?

If so, you could remain in the home for as long as possible, working on clearing, cleaning over time, so that if/when it needs to be sold to cover the facility cost, it will be ready AND you can live in it. It took me 1 3/4 years to get mom's place clear, clean and repaired in order to sell it (I didn't live there, about 1.5 hours each way!) Meanwhile, it sucked down about 14k/year just in RE tax and condo fees! Never mind the heating and A/C replacement.... then all the glass started blowing seals and fogging up, more $$$ literally out the windows!

If not, are we talking Medicaid? Would she qualify both for income and NH? If yes, there is an exclusion that allows you to remain in the home if you've lived there and provided her care for 2 or more years.
Avail71 Feb 2021
Thank you, I never really thought of the fact that she doesn't remember a conversation we have had.

Avail71 Feb 2021
I do have POA and she has been properly diagnosed by her Dr. and a neurologist. We have been through courts and lawyers and everything is legal. I've lived with her for a year and a half, almost two years now and I'm the only one in our family or her Church who knows how advanced her disease has gotten. They all scattered when they figured out there was no money in it for them.
disgustedtoo Feb 2021
"They all scattered when they figured out there was no money in it for them."

Just like cockroaches when you turn the lights on! Scum.
Countrymouse Feb 2021
You don't say, but reading between the lines: your mother is still living in her own home, you are her primary caregiver, but are you actually living there? I'm guessing not.

What are your mother's care needs?
How advanced is her Alzheimer's Disease?
Do you have a formal diagnosis, and a formal declaration from her doctor(s)?
Do you or does anyone else have Durable Power of Attorney for her?
Avail71 Feb 2021
I do have a durable POA and she has been properly diagnosed. I do live with her and I have for almost two years. Maybe you have some advice now?
VeronicaJo Feb 2021
Before you do anything, do you have the appropriate authority in place? Are you her POA or guardian so that you can sign the appropriate paperwork? In most places a lawyer will not draw up a POA if the person is not able to understand what is happening and a guardianship is required.

We tried talking to MIL. We can honestly say we told her what was happening, and even took her to visit several places. But nope, she wasn’t leaving her home and wasn’t interested, so we gave up. As I learned from this forum, arguing with someone with dementia is pointless and wasn’t helping anyone’s stress levels.

When we moved MIL, we used the therapeutic fib approach. Told her we had arranged to have her carpets cleaned and she needed to be out of her house. Hubby picked her up early, I packed and supervised the move plus set up in her new place, and they met me for dinner. That was before Covid, of course, but the process works. Now, if she asks about home, we say the doctor wants her to be stronger. It’s not really a lie, but she is content.
Avail71 Feb 2021
Thank you! I am her POA, we got all of the legal stuff taken care of before she was diagnosed, right after her husband died. I like your idea.
AnnReid Feb 2021
You don’t tell her. If you have made the decision to place her because you love her and she needs full time care, and have found a pleasant comfortable place for her to live safely, you contact the administrator there, ask how you can bring her to them, and do what they say.

When you arrive, you tell her you love her dearly, you’ll see her soon, then leave.

They will take it from there.

Geaton777 Feb 2021
I agree with Jkm999. Now is when you start employing "therapeutic fibs" which will smooth out the moments and keep her calm. The staff at any facility will also be willing to participate in the therapeutic fib. "Mom, the house has to be fumigated for bugs and we need to leave until it's safe to go back. You're going to stay at this hotel for a while and I'll be nearby." Whatever it takes. We just had a care conference (by phone) for my MIL (85 in LTC and won't get out of bed). In the meeting she again asked when she can get out (she doesn't remember her house is sold and she isn't strong enough to walk on her own). We told her she can come home when she can stand up most of the day and walk around so she can take care of herself. No arguments from her as she pondered that.
Avail71 Feb 2021
Thank you!
jkm999 Feb 2021
With dementia each time you talk to her about moving is like the first time she's heard about it. You are better off not trying to prepare her or get her 'permission' because she thinks you are springing it on her. Just go ahead and make the arrangements, make certain everyone involved knows that she is not aware of the move and then tell her that it is happening at the very last minute. She'll be angry, furious, and ugly to you. You will need to just ignore all of this and get her moved in. The care facility can help you navigate this. It won't be easy but it is necessary and eventually everything will settle down. We all think that if we just try hard enough we can get our loved one to see reason and understand why they have to move. It's doesn't often work that way, especially when they have dementia.
Hjm1959 Mar 2021
Thank you for your advice, I am currently making arrangements for my mother and the situation you’ve described is exactly what I’m dealing with. I wake up at nights trying to figure the best way to get her there, and the way you suggest is the only way I see. Thanks again and it’s helpful to see I’m not the only one facing this situation.

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