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Does anyone know the criteria for needing to be in a locked dementia care special unit, versus regular nursing home care? My mom is no longer aggressive, anxious and scared. We have taken medications away and now she is just a sweet confused woman who can’t walk without assistance. She requires total help with ADLs toileting and dietary supervision. She seems like an average nursing home type patient now. Where she lives is 40 minutes away and I would like to move her closer to home. I know why she had to go to that unit, but I am not sure what the criteria is to get her out. She has Parkinson’s disease or lewy body dementia.

I think if I were you I would bear in mind that the aggressive behaviours and hallucinations may have stopped because of the level of day-to-day care and support, and possibly the facility's enhanced ability to prescribe medications and use behaviour management techniques; so that in a less specialist facility your mother might relapse. On top of that, the disruption of a move might set her back too.

I wouldn't say never, and I agree you should keep researching and discussing possible options, but I certainly wouldn't be in a hurry to change what's worked so well for her.
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Reply to Countrymouse
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Each facility has it's own rules. I would check with the facility. There are "levels of care" and they vary. The place where my brother is finds it the hardest single thing to do, the adjustment for level of care and where someone can thrive. Speak to the facility involved; make an appointment, attend as a family. Let them know what you would like. They may do an assessment that will take a bit of time, assessing the patient for ability to be in a different level. Work with them.
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Reply to AlvaDeer
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I agree with CM. Meds have to be monitored closely. I would not have any confidence in a NH doctor who is probably a GP that sees patients maybe a few times a month. Otherwise, he relies on the DON to keep him updated. Me, I would keep her where she is as long as she has the money or Medicaid is paying.
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Reply to JoAnn29
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Moving her to a nursing home or assisted living? She is in memory care now and doing well from the sounds of it. What is not broken do not try to fix. Each move will cause further decline.

What if you move her and there is a sudden, rapid decline? Then what? A new place may not have the services she needs, then another move. Another decline. The new place could request that she hire a private caregiver to monitor her as needed. That would be separate cost from regular monthly fee. This happened to my mom, her behaviors were unmanageable. It was on and off private care for two years and not unusual for her monthly expenses to exceed 10k a month.
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Reply to gladimhere
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chrissy56 Sep 2, 2019
I guess I was not clear on my moms current level of care. It is a locked dementia unit. A much higher level of care than memory care (where she lived 2 years ago). She is there due to violent and aggressive behavior like hitting, kicking and biting. It is a nursing home (not assisted living or memory care) with a special locked unit. Because she no longer does these things and Is not a wanderer I am questioning why she can’t step down to a regular nursing home where 80% of the patients also have dementia. I agree good nursing care is important and know she will get worse as time goes on.
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I would not move your mother from this facility where she seems to be thriving. Rather, I urge you and other family members, to make efforts to visit her on a regular basis. It's only 40 minutes away and the peace of mind that you will continue to have with her there is well worth such a short drive.

Remember, it's not the doctors but the nurses and nurse assistants who are doing the day-to-day care of your mother. You can still advocate for your mother without moving her to a regular nursing home.
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Reply to NYDaughterInLaw
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I work in a dementia unit. You can transfer her out but it's not recommended. Your mother is used to her care givers there and the routine. If you upset that by moving her she may revert back to some of her old ways or develop new ones. However if you don't like the care she is receiving then by all means remove her from there. I'm afraid though that most if not all dementia units are locked for the residents' safety. We recently had a resident who got past the locked door to mail a letter. She got lost trying to get back to the unit. And of course staff was franticly looking for her. All ended up well but these types of scenarios don't always!
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Judy79 Sep 5, 2019
Speaking of that. When I would bring her back after an appt or church, I would ask her if she knew how to get back to MC, and she said no. Of course, she never paid attention because she always had someone take her back. She has been there for only 2 months.
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I agree with the above advice.

Why are you thinking you should move her out of MC? Are there any issues with her there? It seems like she needs a lot of care.
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Reply to againx100
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For us, my mom was moved into MC because of the 3 times that she was wondering outside of her apartment. Loneliness and depression, I feel, caused a lot of it. But I am with those of you who say that if she is moved, she can decline even further. I would love to move her to AL but within a year, she has sold her home in 1 day, 30 days to move out. Moved into an apartment last Sept. Then this past July she moved into where she is now. She is better off where she is. She told me that she shouldn't have moved from her house. I think that's it's finally getting to. Just hope that my brother won't move her next January,just because of the finances. Waiting for her LTC policy to hopefully kick in.
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Reply to Judy79
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Thank you all so much for the information and advice. I do appreciate the care my mom receives now. It is under a general practitioner who only sees her twice a month if that. The improvement in her condition came from my requests to take certain medications away. The staff agreed to try this and it has made a world of difference. So I just feel that without aggressive behaviors she doesn’t need that unit and therefore can live closer to home. She just seems like a regular nursing home patient now
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worriedinCali Aug 30, 2019
But you realize it won’t last right? She’s going to get progressively worse. Moving her can be a trigger, it’s really not good to disrupt dementia patients and throw major changes their way.
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In direct answer to your question, residents have rights under federal and state laws, and the ombudsman can help. The return to another section of the same home probably wouldn't be that hard on your mother, but a common issue is whether the other unit or any other place would ACCEPT your mother due to past behaviors. In my state, residents have trouble getting into any other place with such a history.
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