Can an ALF handle my Mother with type 1 diabetes and dementia, or does she need NH care?

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We thought she was just slipping a little and having problems with blood sugar control, but soon realized that her impairment was greater than I thought. She just got the diagnosis of dementia/early alzheimer's last week. She lives alone 40 minutes away from me. I have 2 home aides that each have a 4 hour shift working with her right now. As an only child, I am trying to make plans and be as prepared as possible. She is very independent and will not consider coming to my house. The diabetes adds a very dangerous component to an already challenging disease!

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In my experience I have resigned myself to fact that Rehabs using Meficare money. Cannot deal with a Type1 JUVENILE insulin dep diabetic. So LTC facilities under Medicaid especially would be a disaster for your loved one.
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Thank you to everyone that answered. It is nice to hear from people that understand! Right now my mother is still in the early stages so she is capable of taking care of all of her daily needs (with a little help in meal prep, etc.) The diabetes management is the main problem. Between the 2 aides, my phone calls and visits, and a friend that is staying with her at night, we are managing. I can tell that this is not going to be a solution for too much longer so you insights are a great help.
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Personal experience with family friend in assisted living with diabetes, dementia and problems with incontinence.

He paid the base rate...extra for med prep and administration (including insulin), briefs, a clean-up fee for bowel accidents, escort to meals and special events. It worked well until his dementia worsened.
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Some assisted living facilities are prepared to care for someone with your mother's impairments; others are not. How is she with activities of daily living? Can she dress herself? Toilet herself? Take her medications? Mange her insulin? Get herself to the dining room? Many ALs can help with these activities, for an additional charge.

My daughter works at a nice AL. She says most of their residents do have dementia. They also have a separate wing for "memory care." Who goes there? Residents who wander and need to be in a secure environment for their own protection, and residents whose behavior would be disruptive to the rest of the population and need special attention.

My mother is in a nursing home. Again I would say that more than half of the residents have dementia, in most cases in addition to other chronic conditions such as diabetes, COPD, vision impairment, etc. There is a much higher level of skilled care in a nursing home, of course. My mom is wheel-chair bound, needs 2 people and a lift device to transfer to toilet or bed, and has dementia. This facility also has a floor for "memory care" but my mom is not a candidate for it, since she cannot wander and she has a very pleasant personality. Her facility also has an assisted living building, but my mom spend her "assisted living" period living with a daughter. When she got beyond that she needed nursing home care.

So there are several possibilities to consider and explore for your mom. When the time comes for a care center, are you considered one near you? Or does she have strong ties to her present community?

How is the 8-hours on in-home care working out? Is that 7 days a week? How is she the other 16 hours, alone?

It is very rare for a person with dementia to be able to live alone much beyond the earliest stages. This can be extended somewhat with daily in-home care and relatives checking in daily, etc. But with you living 40 minutes away, I think your choices will soon be 24 hour in-home care (could she afford that?) or a care center. You are wise to explore the options now.

As Windyridge, someone from the care centers you are interested in can help determine what level of care is needed. Keep in mind that will likely increase as the dementia progresses.

I am so sorry that you are facing these hard decisions on your mother's behalf.
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I'm a Type I diabetic, so I really feel for her. Maintaining proper blood sugar control with Type I can be very challenging. It's a delicate balance of counting carbs, calculating proper insulin doses and multiple blood sugar tests throughout the day.

I think that in my state, Assisted Living staff do blood sticks and inject insulin, but I'm not positive. I know they handle Type II residents.

I would not delay getting her assistance, since she could forget and take too much insulin. She should be supervised with this pending her placement. You might consider getting her a continuous glucose monitoring system that will alarm if your blood sugar does too high or too low, though, it may require some training to operate it. And that might not be something that she is up to doing right now.
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Call a few ALs near you and ask. They all have policies and will clearly answer your inquiry. If you are moving her anyway, I'd urge you to get her closer to your home.

The memory care my Mom was in had type 1 diabetic residents. They all have their own approach. Cal and visit.
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Many facilities have services from AL to memory care. Visit some near you and ask them to come visit your Mom for an assessment. They can tell you what level of care is needed.
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