My 85 year old mother with dementia has been in assisted living since July, She immediately had started having sundowners ( which we suspected she had been having even non her own home before moving). She threatened everyday to call a cab and leave and she threatened the staff physically. Is was advised to send her to a senior behavioral unit to be evaluated and to get some meds for agitation and aggression. She was there for 9 days. When released, she was calmer, but still mentioned going home. Once back in AL, it was corporate policy to have sitters for 24 hours a day for a week, then down to 12 hours a day, then down to 4 hours. Two days after the sitters stopped my mom threatened a nurse with a butter knife, so back to the senior behavioral unit she went. After 10 days she was back to AL with sitters once again and overmedicated to the point she couldn't function alone. We got her meds adjusted and she is better, but still not the same person she was before moving to assisted living. I think she has gotten so used to having sitters and the attention and helping hands that I don't know if she will be able to truly live with out the help. The sitters are costing the same as the assisted living cost, so she is paying around $9000 a month. If she moved to memory care where the staff ratio is 8 to 1 as opposed to 20 to 1 in assisted living, she would get more attention and help while reducing the cost dramatically. I'm not sure if she needs memory care right now. All the staff at AL talks about how funny she is and what a great personality she has. She can walk (a little wobbly from meds) and feeds herself just fine, carry on a conversation, participate in activities, but she struggles with her hygiene and daily living activities. I just don't know what is the right decision. I would keep sitters with her 24 hours, but I am afraid of draining her money. She is in good health and may live for several more years. I want her to be able to live comfortably.

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When a dementia patient is in a facility that can not provide them with the right level of assistance, you will see lots of issues. I went through that with my cousin. She seemed fine at times and was very communicative, but there were too many things that she needed assistance with, plus she needed the supervision and protection of a Secure Memory Care unit. Plus, in regular assisted living, the resident can just walk out the door. The director told me they could not prevent this.

It sounds like your mom needs that extra supervision and protection. In Memory Care assisted living, the residents are not given free reign over items that could pose a hazard. (At least the places that I have seen,) They don't have things like lotion, scissors, knives, clippers, etc. in their rooms, since they could be misused by the dementia patient and cause themselves or others harm. Also, the staff is trained to handle them and they aren't constantly calling the family for unnecessary things.

When I moved my cousin to Memory Care, she seemed to be more relaxed and content. The constant calls from the facility stopped and we all found peace. I would encourage you to take a tour and see that the differences are. I would consider it before you mom does something violent that makes a new facility hesitant to accept her.
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Your mom may not be getting the level of care she needs in the AL. It sounds chaotic and stressful for your mom being on this merry-go-round. You said it's draining her finances and the facility doesn't have the staff to care for your mother's needs. And once that "assistance" is lifted, when the AL cuts back the caregiver's hours, the whole process starts over again. It can't be easy on your mom.

With full-time "assistance" your mom does well but once that is cut back your mom regresses. Why not place her in a facility where she can benefit from around the clock care and assistance? You said she does well when she has caregivers. Place her in a facility where she has caregivers 24/7. The move and upheaval may be difficult but it can't be any more difficult than what she's going through now. Her finances won't be drained and she'll get the attention she needs.
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