Mom is 95 years old. Her memory has been slipping for years. She has been in assisted living for 2.5 years. She has macular degeneration and it is getting worse. She has fallen many times in the last 6 months, some due to eyesight. Her mood is worse since they have been restricted to their apartments because of COVID. She thinks people take stuff from her room, eat her snacks and watch her tv at midnight. She has accused me of stealing her credit card, checkbook, etc. I am the only daughter living close by and her main caretaker for everything that the community does not provide.
The director and nurse at assisted living is pushing us to move Mom to Memory Care at the same facility. Her new room is tiny and I think she would hate it. She has good days where she is lucid and happy.
How do you know it is time to move someone to memory care from assisted living? Has anyone else had to do this? Any tips, suggestions. I am so sad. She does not know yet. Thank you in advance.

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Generally, I think that if AL says a resident needs MC, they likely do. This is what I experienced. I hope it helps.

I wasn’t surprised when AL told me my LO needed more care. Wandering was the final thing. But, my LO had other needs too.

She needed more direct supervision. Prompting her to the dining room wasn’t enough. She’d forget where was going on the way to the dining room. She resisted care, didn’t want to bathe, didn’t want to get out of bed, couldn’t engage in conversations with other residents, couldn’t remember anyone’s name, was scared and confused, FELL a lot, became incontinent, made repeated calls to me in a panic, repeated calls to me from the AL staff due to one thing or another EVERYDAY. They did not have the staff to giver her so much one one time and attention.

Two things helped my LO tremendously: Medication for anxiety and depression and MC. The change was immediate, she seemed to sense that she was safe and understood there. She needed a smaller place (secure MC) to help bring her comfort. Regular AL residents and activities were over her head. This was more on her level. At the time she was very verbal and able to read, though she couldn’t retain info. She was in a wheelchair, but could walk a little bit. It made a huge difference. MC staff knew how to care for her and I never got a call that there was a problem again, so far. When she was still verbal, she’d tell me regularly that they were good people. That was 6 years ago.

The rooms at her MC are actually very large, but, my LO spent little time there. She was usually in the halls, dining room, activity room, etc. Things like the size of her room didn’t seem to matter anymore.

If you move her, I’d try not to make a big issue about it. She may not be able to process it.
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To be frank it is time when the facility cannot any longer safely care for her in the upper levels of care for Assisted Living. They clearly feel she now needs more and safer watching. The staffing is different at Memory Care. You may need to make it clear that you will explore options. Often when it comes to this you are better with a good Board and Care Facility in your area, one where there are only say 6 or 7 patients total. It is much less in cost usually. If you make clear you will need to explore this and all other options then you will know it is not just a matter of their wanting to bump up the costs from average 4,000 a month to 15,000 a month. So do make that clear; tell them you are responsible for making her money last for her lifetime. On the other hand, if you suspect they are correct, and if you believe she is in a good facility, it may be time to think in terms of palliative care ongoing, hospice when it is time. She is 95. Things will not get better or easier for her. Eventually she will break a hip or something other, and it will be the sad slow decline of pneumonias, of UTIs from catheters, and so on. So sorry. My best wishes out to you all.
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We just did this with my mom. She moved from a one bedroom with a kitchenette, to a large studio with a small seating area. I had moved her home for a couple of months because the isolation in ALiving after a covid scare at the facility had a detrimental effect on her dementia ( hallucinations more agitation and fear) . But an evaluation prior to her move back indicated she should be in Memory Care. So that's what we did - I could not have her living with me 24/7 anymore.

There are people at all stages of the disease in Memory Care. My mom ( completely unaware of her own deficiencies, whispers to me on video call about the "old people she helped today")
One small benefit of Memory Care in her facility, is that they have more social interaction - my mom was really isolated in Assisted Living - the staff is masked, but the residents aren't and they have group activities and all eat together, instead of having to eat alone in rooms. They restrict which staff can come in, so there's less chance of covid transmission in theory. Because they have memory problems there's just no way to enforce mask wearing or social distancing - they don't remember there IS a virus to protect themselves.

It's worked out ok, she does sometimes say she liked her "other place" better, but complains more about the food than anything else - but she's picky about that anyway.

There's lower staff/resident ratio, and supposedly have staff trained/experienced in working with dementia behaviors.

She moved to Assisted Living in March, a couple of weeks before outings and activities started getting cancelled, and then visitors stopped being allowed inside. I wish she had been able to have the experience that we promised her when we made the move - activities, and socializing there, outings with me and the grandkids, Sunday dinners at my house. Covid wrecked that plan, and I hate that I couldn't handle her here at my house, but you have you know your limitations and she safe and well cared for there, and we do connect video calls at least twice a day, and my sister calls her also. I was going to be able to social distance/mask visit on the outside deck( still no inside visitors), but the week after she moved back ( I wanted her to settle in before I visited in person, so we didn't get to do it) cases spiked up in central Texas and they locked back down. We can still do a window visit, but I haven't tried it yet - they have to keep their window closed, and she's hard of hearing - it might be more upsetting that comforting.
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This COVID has certainly caused havoc in care facilities because of the visiting restrictions it has necessitated and the confinement of the residents to their own rooms. If the facility thinks she needs more care than AL provides, MC may be the best for her. Her delusions are certainly an indication of dementia that will get worse and could hopefully be better monitored in MC. The staff ratio should be better in MC than AL but that's not always the case. MC rooms are typically smaller so try to provide as many things she is familiar with in her new room. I hope the director isn't "pushing" you to have her moved but rather suggesting she be moved.

Many people in this forum have had to move a loved one from AL to MC so I'm sure you'll get some excellent support and advice.
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