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My 90-year-old mother was diagnosed with Alzheimer's 2 years ago. I am the only child, so when I leave town I would arrange for respite stay for her at a nice nursing home. She is an intelligent, physical fit person. I have managed to keep her in her own home by spending a lot of time with her and hiring a retired nurse who comes in 3 hours once a week. But it has been exhausting and often times there have been arguments between us. For the last year she had been gradually going down hill.


This recent respite stay the nursing home reported that she began to wander. They placed her on 30 minute watch, and then an ankle monitor which she has removed twice. The NH said she needed to go to a memory unit because they can't manage her wandering safely. The unit which they are associated with doesn't have availability, so the solution was for me to hire 1 to 1 care 12 hours a day from an outside agency. I have done as they have asked.
This has occurred in the last week and I keep having such range of feelings about this. If feel relief because I am not doing this alone, but I have huge guilt because I am second guessing if this is the right decision. I scheduled a separate appointment with her GP, but he wouldn't advise as what to do. His view is that her problem is something which he can't medicate, so it's not his problem. My mom doesn't know that I am back in town because she will want to go home. I have called her and she asks me when I am going to be home. I was willing to have her stay at the NH because she has made friends and has a better social life than I alone can provide. But I am concerned that having her in a memory unit will sacrifice her safety over the socialization and comradity she has made at the NH. I am very conflicted about doing the right thing for me mom. Any insight would be very appreciated.

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Tough issues, here.

In my experience, the folks in the one memory care unit my mother was in briefly were, overall, higher functioning than the folks who are currently on her non-dementia unit at a nearby NH.

Have you toured the memory care unit? Have you been to others nearby? If your mom still has the brain cells to socialize, she will find opportunities to socialize wherever she is, I think.

I would resort to therapeutic fibbing (the doctor says you need to stay here until you get stronger; I need some time to recover from my own recent illness; something like that) to get her over the hump of what will most likely become a permanent placement.
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It is a big consideration. I'm not sure what level of interaction with other residents that she's having at the NH, but, you could check the Memory Care units and see what their situation currently is.  This changes from day to day though.

 I know that when I toured facilities, I visited a Secure Memory Care facility that was very upscale. It actually resembled a spa resort. While touring I saw a group of ladies in the social room, playing cards. All were dressed nicely, wearing jewelry, nice hairstyles. and they were chatting as you would expect to see at any regular senior center. I suspected that they were there due to wandering and perhaps had pretty good skills otherwise. Most of the Nursing homes that I visit, have very sick residents who are bed bound, so, it's really something I'd just explore.  Of course, the condition of the residents will progress.

You are making decisions for her best interest and whatever you chose will be the right decision, imo. I'd feel guilt if I left her free to wander, but, protecting her is the right course. I'd try to move forward with that belief.

I will say that, when I moved my LO from a regular AL to a Secure Memory Care, she seemed to finally relax. I sensed that she felt safe and at home there. I think she sensed that she was with other people who had dementia and that the staff was able to care for her properly. She needed more can than a regular AL.

I might discuss the progression of the dementia with her doctor, so you will know what to expect as she progresses. That would be a factor to consider as well as the costs associated with having a one on one sitter. I would imagine that would be rather expensive.
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PS

I remember someone saying that placing their 90 something mom in memory care was the wrong decision simply because she could still talk and the other residents couldn't

Please tour facilities and ask to go in the evening hours after dinner as well

They are not at all what they are like on a Saturday afternoon
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I have toured memory care units vs nursing homes & do prefer a memory care specific for ALZ, dementia & memory impairments. Some of the memory care facilities have different areas depending on the stage a loved one is in. Later stage individuals requiring more one on one attention may have a private area & when needed may be moved to a nursing facility or a hospital for medical care. In a memory care facility I've found staff to be more experienced & knowledgeable in memory impairment. The whole purpose is to keep most everyone engaged & socializing. A schedule with routine, consistency & structure seem to be what a good facility strives for. Mind you there are all kinds of facilities & the ones we love are not cheap, you get what you pay for is true. Lower cost ones, don't waste your time even touring, run don't walk from these. If there is wandering a lock down is peace of mind for you & the monitoring tags are an extra protection as well. An assessment is usually done to determine what level of care is needed, be forthright & honest, experienced personnel should know the right care needed. Some facilities offer trial periods to make sure it's the right fit. Make inquiries, visit more than once, speak to others. You should get "that good feeling." Trust yourself. Good luck & God Bless!🌸
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Goodkid

Your mom sounds a little like mine. My mom is 93 with Alzheimer's. She lived with me for 2 years (she thought she was just visiting). During that time she went to an adult day center that specialized in dementia and she loved it. They kept her engaged and entertained. She moved in to a locked memory care unit this past August. That was extremely difficult because she was happy at the day center, the socialization was good for her and she believed she was going to work every day. The move to memory care was a big adjustment. I moved her because an opening came up at the facility I liked and I took it.

Things to consider - tour several facilities - they are all different. Each Sunrise I toured was different. Some places looked like a nursing home and some looked trendy. Know what her finances are. Is your mom considered high functioning? If the NH recommends a locked memory care unit - than that is probably what she needs. Dementia is a progress disease and she will get worse. You don't want to place her in an AL or NH facility and then have to move her again because they can't handle her when the disease progresses. She really needs to be in a dementia specialized facility.

Think about what your mom likes. I wanted a place that had activities, that looked more modern, had outside gardens, a place to get her hair done, and that provided end of life care. When I first placed her, I was sad because many of the people were worse off than her and she didn't have the socialization she did at day care. That has changed over time and higher functioning memory care residents can participate in functions on the assisted living side. I really am happy with the facility where she lives.

There is no perfect scenario here. You can only do the best you can and work with the finances you have. Wandering was starting to become a problem for my mom too. When she gets upset, she wants to to live with her parents. There is help out there, A Place for Mom was very helpful to me. Good luck.
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When I was made POA for two childless friends of mine, I started researching AL facilities in our area. Only one had memory care apartments large enough for two people--a choice of two bedroom, one bedroom or efficiency. When the wife began to wander and was incontinent, I was told she needed 24 hour care and convinced them to go to a one bedroom apartment in that facility. While another friend took them for breakfast and to have their nails done, Caring Transitions and I moved their bedroom and den furniture to the new apartment, making it look just like home. They immediately adapted to it and began to make friends with the other residents. The care was quite good and we were told they would never have to leave. The wife only lasted another 5 months before her brain was just shutting down and she could no longer swallow. The care and advice I was given to meet their needs was excellent and they kept meticulous records of their observations and staff interactions with them. The husband is still happy to be there. He likes the socializing at meal times but doesn't enjoy games. He will listen when there is a musical offering, but otherwise watches TV and reads the paper. I feel so fortunate to have found a place that worked so perfectly for them. They also agreed to accept public financing should we run out of money once 18 months of regular payments were made, so my friend will never need to leave. Hospice came in for the wife's needs near the end of her life and did an excellent job of monitoring her and keeping her comfortable.
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My best friend's husband needed to go to a lockdown facility. She lives in Palm Springs, CA. There were three in her area. Two were like jails where you never were allowed outside. The third one in Rancho Mirage was wonderful. They had three buildings for different levels of dementia. They had double fencing and the inside fence enclosed the buildings, and a lovely garden with sidewalks. The doors were unlocked during the day and people could go out and wonder around without ever leaving the compound. They had kitchens with no sinks or stoves, just cupboards that the ladies would clean and rearrange the plastic dishes. A wonderful place, and cheaper than the ones in Palm Springs. Go figure. So, like everyone else said, go look at what they have. Not just for now but for the future. My friend fought with them every time Bob had to go to a more care building, but they would assure her it was time for him to go.
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Goodkid, if your Mom can afford to move into what is called in my area Assisted Living/Memory Care that might work the best.

My Dad moved into one in a place called Sunrise Senior Living, and he loved it there. The building had one floor for Memory Care and the other floors were for those with mobility issues or issues where they just couldn't live at home... or were tired of home and wanted a safer environment.

The building my Dad was in, it was built like a Victorian hotel, the building would lock up at 9pm right after the front desk Receptionist would leave at night. The only way in or out of the building was through the use of codes. Even the elevator after 9pm wouldn't go down to the basement area, one would need a code. I know I was worried about my Dad wandering when he was over at Independent Living.

When my Dad lived at home, he had hired 24 hour caregivers, but eventually the cost was extremely expensive [but worth every penny] but Dad liked the idea that IL and later AL cost cut the cost in half.
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Thank you for your all comments and insight.
BarbBrooklyn- No, I have not visited a memory care unit. So yes, that is the first thing I need to do. I was informed of her wandering about 3 weeks ago and was hoping that it was an adjustment phase she was going through being back at the NH again. However, the nurses have told me she still tries to leave the NH thinking her parents are picking her up. Wandering had not been a concern when she stayed at the NH pervious 4 times. Nor was my mom wandering when she was living her own home just over a month ago.

Sunnygirl1- I wish I could get more guidance from my mother's Dr. I have scheduled separate appointments to discuss the matter with her Dr but he speaks in generalities. He has suggested that I speak to someone at the Alzheimer's Society ( which I have done-- but my mother is his patients not a patient of the Alzheimer's Society) The closest her Dr would tell me was that if she can make good decisions than she shouldn't be living at home.
I knew this day was coming, I just didn't think it would happen to quickly. While we have her at the NH with 1 to 1 care I am going to take the time and visit various facilities. At the moment, I know she is safe and relatively happy where she currently is.
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Good kid,
We recently placed our mom in a Senor Care facility (3 months). We visited a number of different places until we found the one with better care. You need to do your research because each facility is different based on the patients needs.
Some things to look for are, how long has the staff been there, check the board to see what their inspection results scores have been or ask the administrator. Ask if they leave the patients in their rooms alone for a long period. There are facilities that have different sides based on the patients needs. At mom's place the memory care side houses those that wander at night and do not sleep, and wander into other patients room and sleep in their beds and those with other serious conditions. The side mom's on they're allowed to wander around with some redirection required and not allowed out the front door. We're visit mom almost everyday just to make sure the staff knows she means the world to us and she doesn't feel alone. You may have better luck if you're private pay. Irregardless of what facility you decide to place you mom keep in mind that the odor will always be there and the sad site of the elderly.
Please let us know how things go for you.
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