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I am hoping for some guidance on whether my aunt needs to be in a Memory Care facility or whether Assisted Living would be enough. I am the only caregiver to my 94 year old aunt. Physically, she is in excellent shape for her age (she takes zero prescriptions!), although she is increasingly frail. She is also extremely hard of hearing to the point where her (very high end) hearing aids don't help too much, despite getting regular adjustments, so all her doctor's offices have my phone number to confirm appointments, etc. Her mental cognition has been noticeably slipping for almost 2 years now (my mother, her sister, even noticed it, before she passed over a year ago at age 95). She lives alone in a 55+ community about 3 miles from my house. She has neighbors that seem to look out for one another. I check on her every day, and I make all her doctors' appointments, take her to the doctors, for haircuts, grocery shopping, etc. At this point, I also take care of all her paperwork, since she has become increasingly confused by it. I have prepared her income tax returns for decades, since I was a former tax professional. She's always been impatient with paperwork, but lately she can't seem to handle even the most basic forms. So I pay all her bills (she signs the checks), do all her filing, fill out doctor's office questionnaires, etc. She doesn't really cook anymore, but buys things like soup, fruit, yogurt, whole grain waffles, etc. (she's always been a healthy eater, although she has a huge sweet tooth). I also package take-out containers with food that I've cooked. She doesn't eat large quantities anymore (she's 4'9" and 100lb), but food like soup or chicken seems to last her for much longer than it should, while baked good disappear almost immediately. So far, the worst that has happened is that she's left rotten food in the kitchen trash so long that it was infested with flies. But I'm worried that as her condition slips, she could come to harm. She got a medical alert, but stopped using it, because she was always setting it off by accident, no matter where she placed/wore it, and she got terribly confused at having to tell the alert company that it was a false alarm. My husband is a cardiac patient, and I have a herniated disc in my back, so living with us is not really an option. Plus, it seems as though she would be happier with people her own age and some activities. A couple of months ago, her doctor did a short "memory test", which she basically passed with flying colors (she knew what day it was, who is President, etc.). However, since we deal with her on the most regular basis, my husband and I are very aware of how her cognition is slipping more and more. For example, her conversation is on an increasingly short loop, where in the course of an hour, she will repeat the same statement at least 10 times. She has said that living in her current house is too much for her (she has a cleaning lady, lawn care, etc.) and that she would consider moving to a smaller apartment with other people her own age. But she is worried about the process, even though I assured her that I (and my husband) will handle all the logistics.
Would she be a candidate for Assisted Living or does she need Memory Care? I don't want to subject her to the stress of moving, only to have to move her again in a few months. But I would hate to put her in with people who are too "out of it" to make friends, etc., since she is very outgoing and friendly. Any guidance is greatly appreciated.

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In my opinion, she sounds able to function quite well in Assisted Living. My mom has zero short-term memory, some long-term memory and very good physical health. She has been in Assisted Living for over four years. I was told that there are a few things that would require a move to memory care such as the inability to manage incontinence, aggressive behavior or wandering into other residents private living spaces. It seems that your aunt might welcome the freedom from household responsibilities and benefit from the social aspects of AL.
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IMO- NO and MAYBE. My mom was very similar to what you describe and your mom is an accident just waiting to happen. MOST Assisted living doesn't have regular enough, daily welfare checks. They are basically for those who - in the event of an emergency- can push a buzzer. They can cook, shower, and dress. They may have their room cleaned once a week and bedding changed 1x a month- But they still do their own laundry. My mom fell while putting on shoes, broke her hip, and layed on the floor for at least 3 hours. I saw her at 2pm, she then missed dinner downstairs and *that was what prompted them to check on her. Most assisted living places will give daily meds, serve meals if requested- but they frown on meal delivery and encourage residents to go to the dining room. Im sure assisted living can vary in services but, with each new service, a charge applies. Most seniors in assisted living do so for environment- they are a community. Many still drive and are in good health. They provide bingo, cards, refreshments, reading rooms and special functions. The rooms have pull cords- but my mom fell out of reach. Some assisted living buildings have special wards- based on increased needs. But its so pricey- my mom will probably end up back with me because insurance doesnt pay the bills. So this is my experience - my mom just got moved into the memory care ward in her assisted living facility where she has every 30 minute wellfare check, they give her showers, they help her dress, she has a "stand by" for getting in and out of bed, to the toilet, etc. She needs all of this because she emerged from surgery "post anesthesia dimentia". She also wears a pendant. She has fallen 3x since the major fall last January- and now she has 8 stitches in her head. Fortunately - she still has the cognitive ability to push that pendant! Long story - please check all services to be included. And please get her a Life Alert pendant!
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akdaughter, thanks. It sounds like that might be a good fit for her.
Nana2Nanny, my mother was in assisted living prior to her death and they found her right away when she had a stroke because of their welfare checks. My aunt can do her own laundry and all the other tasks you described. In my original question, I explained that my aunt got a medical alert pendant several years ago, but stopped wearing it because she was setting it off by accident whether it was on her wrist or around her neck, and she became confused by the need to tell the company it was a false alarm. This has more to do with her innate personality (impatient, doesn't follow instructions, etc.) than with her mental state. I will investigate residences where she could transition to memory care should the need arise, but it doesn't sound as though she needs it yet.
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