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Was there a particular incident or realization that led to a final decision regarding Assisted Living?

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DKO, sounds like a typical abusive husband/boyfriend situation, be careful.... they promise change, but it only lasts a week - if that.
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Dko, be guided by what your mom's personality has always been like. And even then...my mother is by nature sweet and compliant except when she's paranoid and delusional. Strokes and tias often lead to vascular dementia. You ARE allowed to say that you need your mom to be cared for by professionals.
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Stroke damages part of the brain and each stroke takes a little more. If your mother has been negative and demanding I expect that would get worse as time goes on. My mother (87) has had a number of strokes over the years (also has Parkinsons & dementia). At this point I would say at least 75% of her brain is fried and she is either in bed or her wheelchair. She's been in a NH for 18 months now and stays in her room with the door closed dreaming up all sorts of ridiculous imaginings. A life long narcissist, her latest thing is that she can get into her wheelchair and go to the bathroom by herself so she won't use the call bell. Of course the minute she slithers out of bed, the bed alarm goes off and staff come running. She loves that - instant attention - as she's always complained bitterly that the staff don't attend to her first, come running the instant she snaps her fingers and so on. It's only a matter of time before she has another stroke or really bad fall.
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Keep in mind that you are responsible for your parents if you decide to have them move in with you. If anything happens to them you could be held responsible for not properly taking care of them. You can not leave them alone if they are not capable of taking care of them selves, it is a no win situation to say the least. There is an "adult protective services" just as there is a "child protective service", you must take this on with all of this in mind. Decide if you are capable of doing this very daunting job.
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Many thanks to everyone who has answered.
My personal predicament is that my mother lived with us for 5 months after a mini stroke. My mom's negativity and demanding nature made life horrible. She went back to the hospital in November after several falls. Rehab, then home. Refused to eat or dress & within 2 days, another TIA. Back to hospital, then rehab, then nursing facility. Right out of IsntEasy's play book. Now they feel she is ready to come home. Frankly, I'm afraid of repeat behavior, but I am the only child - in fact only living relative or friend. Guilt makes us second guess and against all odds I want to give her yet another chance. Gee, maybe if I am more patient, more understanding, more compassionate, things will be different (yeah, I don't believe that either). She is now partially incontinent and used to having someone help with pretty much everything. She has started saying sweetly, "I want to come home. I just want to come home." If it weren't for the extra support here, I'd probably just skip town ...(-: Lots of decisions to make ...
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Splitting up would have declined her faster but that happened soon after anyway from the split against my wishes in the NH so the point is I could have improved his quality of life had I let him stay home & taken him to visit her often. Although 20/20 hindsight is perfect.
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I had 2 or 3 times I attempted to facilitate my parents. The unsuccessful attempts were directly related to the cost of such facilities & what coverage they could qualify for or obtain & the business office at the facility's opinion of what they could qualify for. It was never related to the patient's desires of whether to be in one. The first try was when dad had a heart attack & qualified for 100 days of medicare. He went in & mom's dementia was not a problem if living with him since he didn't have dementia. But once he was in for care she was not okay. So I brought her home with me & that was fine but I wasn't sure I could care for both so I tried him in for 100 days with her private pay for a short while & medicaid pending. The home lied about the pending nature & they were dumped in my lap in 14 days. I was told the home was afraid they would not qualify clinically for medicaid & that they would not qualify financially although every legal firm said they would. Bottom line they had lied to get them in but not wanting medicaid. I took them to an ALF just in case that might work & they were too advanced for ALF. I found an all ages apt. near me that my grown son & exhusband lived in another building on the same grounds & rented the apt. in my name & theirs & moved in with them. I was able to leave for brief amounts of time since they were both in the apt. now. He was watching over her. But now from the heart attack he was a little off or lightly started the alz. Over the year I lived with them in that apt. it became more evident this would not work but I still had no 100 days. I still had no medicaid. I still had no money left of theirs (period) to do anything with. One night dad got explosive diarrhea turning into vomit. He would have died of dehydration. I called the ex to watch mom & took him to the ER. I sat in the ER while they tried to admit him but the hosp wouldn't so I begged & begged the ER doc to do something other than sending him back home. Took alot of begging. Really. I explained about mom being very advanced. still had no money for NH. He said that Healthsouth would work for the 3 midnights. Sent him there. Medicare really tried not to pay for the 100 days off a healthsouth 3 nights but we finally got it.
But dad was now in care & she was off her nut again because her emotional support was not present & she started biting the aides I would hire because he wasn't there. While he was in Healthsouth I got her in his room under the guise of her couple of past falls & needing to be trained to a walker or wheelchair so she wouldn't injure herself anymore. Remember again they had spent all their life's earnings knowing this was coming so there was no money for care. From healthsouth it wasn't easy because she wouldn't qualify at most NH's for PT which is the 100 days since she was so advanced but we had to go thru 3 medicaid firms before finding one that would work quickly rather than just taking the retainer & stalling so she was covered quicker. We managed since when they approved for medicaid - medicaid covered them retro-actively knowing she had not really qualified for the PT which would have paid for her bed. It all worked out but there was 1 other stint in a NH just for her when we had spent a night at the ER with her after she tried to walk out the door tripping her toes on the threshold as they were going on a walk landing face first on the doorstep. It was a bad night since her face was banged up & I had kept them spent down so when it was time I could do the app. Put her in. They loaded her up with pysches & sleep meds all in the first night w/o a wheelchair. Next AM she got up & pulled the tv over on herself having been injured. I took her home & continued the 1 year care having paid thousands of dollars out of my pocket for her 3 nights in the NH for her injuries. These institutionalizations sound nice & perfect but not all families or estates can provide or cover it so the only option is to move them in with you or move in with them. That is my answer. After seeing what I have seen I should have kept him at home with my assist on community spouse & put her in alone since they got split up once off 100 days out of money reasons at the home anyway. Would have been better for both & me. I would have split them up had I known what I know now.
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It took us 7 months of suggestions to get Mom to look at AL. Another two months of indecision and finally they talked her into a one month trial, no strings attached. She loves the place, the people and the staff. This will add years to her life, sitting home alone was slowly killing her. It was killing us too.
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We have not made the decision as of yet. Our show stopper will be when the need to lift my mother in law or she becomes bedridden. She is way beyond an assisted living level. We now see rapid deterioration. Though I have a friend who's father is bedridden still in AL. She had to hire extra daily care as his care was no longer assisted living but complete care.
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You don't necessarily have to wait for any accident to happen before you decide to move a love one to a long term care facility as discussed in infolongtermcare.org. When home care becomes insufficient for the needs of your loved ones, then you have the option to move them to an assisted living facility or other long term care facility that would suit their needs. Your loved ones may have some condition or chronic illness that would require advance medical supervision and home cannot provide that. Or if their current living situation suggest that they are no longer fit live alone, then you should make a decision.
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I hate waiting. In the middle of finding a place for grandma now. Having a social worker come by in a week to try to have her placed sooner.
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IsntEasy, I agree that this is usually the way things play out. Unfortunately, this is often the only way to "keep peace in the family". Rather than start a family feud, children wait until a higher authority, like the doctor or hospital social worker makes the call. That way, the ailing parent puts the blame on them, rather than on the child. In the case of my MIL, her daughter, my husband's sister, wanted her mother to stay in her home so that she would have a place to stay during her summer vacations. It took her years to get over being mad, but at least we could put the blame on the social worker.
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I see a common thread here that many "wait for catastrophe." That's something we see every day in the senior living biz. A family will come in, everyone in agreement that their parent is unsafe at home, but no one willing to force the move.

Here's how it plays out... Parent refuses to move. Kids yield to parent's wishes. Parent abuses kids (calling night and day, expecting them to drop everything to attend to their needs, etc...). Parent falls(or has other health crisis), winds up in hospital and at discharge, kids have 24 hours to find a place for parent to live.

So the parent, who could have chosen an independent living community for themselves and enjoyed companionship and social activity is now going to be transferred to a nursing home chosen by their children from whatever facilities happen to have a bed available.
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I too am waiting for the catastrophic event. Mom refuses to leave her house but she's so confused and forgetful that she shouldn't be living alone. She refuses AL so I found my angel of mercy, a wonderful caregiver, who will soon be helping out mom 32 hours a week in her own home. I do moms bills, do her grocery shopping and keep her appointments straight, and drive her everywhere. I needed some help and thank God I found some. But how long will this arrangement work with the caregiver until it's too much for her? I take things one day at a time, but I'm still waiting for something to happen that will force her out of her home. She's 83 and in mid stage Alzheimer's.
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Don't forget or worse not know about, smaller residential care facilities that give much better more compassionate care for a much cheaper price then any "assisted living" or "nursing home" can or is willing to do. Check all you options and you will find the right one for you. Check out every thing in you area and you will be shocked and surprised what great places you can find that give better, cheaper, and an over all more home like living arrangement along with great care for your parents in need.
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When she turned on the gas stovetop during a power failure and almost blew up the house, we knew it was time.
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My story is a combination of several of the above. Like Jaye, my mother lived in an independent apartment in a retirement community for four years after my dad died. During this time she needed to give up driving as her dementia progressed, so I was driving 200 miles round trip two or three times each month to grocery shop, set up pills, pay bills, etc. I could see that Assisted Living would be needed soon. Then, she fell and broke her ankle, had surgery and spent about two months in rehab. The medical people made the decision for us, saying that she needed a higher level of supervision. She has been in AL for almost three years.
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My dad had lived with me for 5 years and was having health issues related to his illnesses. One morning I went to work and when I came home all the lights were off, the newspaper was still folded on the table where my dad sat and the dog was whining. My dad had fallen and had laid there on the floor for hours. This was our "catastrophic event". He didn't injure himself but he was dehydrated and traumatized from laying on the floor for so long. He went to the hospital and they released him to a rehab facility (with a nursing home attached). After a little while the social worker approached me about keeping my dad there and I agreed. By the time we broke the news to my dad he was showing signs of hepatic encephalopathy (swelling of the brain related to end stage liver disease) and he took the news well. He was no longer functioning cognitively as well as he had been and that was a plus for us because it was kind of a buffer to the heartbreak of having to live in a nursing home. He just kind of accepted it.
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There are many health issues that dictate a move is necessary but it's usually a catastrophic event such as a bad fall or stroke that tips the scales. It's impossible to be a sole caregiver 24/7/365.
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A doctor made the decision for us. Both my husband and I worked full time, and Mom was left home alone all day. A doctor treating her for bursitis told me that she could no longer live at home. I called her visiting nurse, found the AL she recommended, and moved her in the next day. It was fast, and the best decision I ever made. There is a lot more to the story, but she lived with me for 25 years. It was time to give me a break.
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It is not an easy decision to make. My Mother was NOT doing well at home alone after my Father passed away. She was not eating she would lock herself out of the house repeatedly, she could not work the TV!!! Many many things that caused us to be running over to her house many times a day! The basic bottom line was she was lonely. WE moved her to Independent Senior Housing and she really likes it! She has a small but lovely two bedroom apartment with ALL her own things. She gets one meal a day and housekeeping in the dining room with other folks, she also gets housekeeping once a week. I set up her medicine and get her groceries. This has worked well for us. She does seem to really enjoy it. There are activities that she can participate in and yet if she wants to be by herself she can go into her apt and shut the door. Maybe you could find something like it in your area. take care...
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We had a catastrophic event which made the decision for us. That does not mean it gets any easier. We still get to hear how they want to go home. We still get to hear how things are no good, we are miserable, the food is terrible, etc. Now, we do not have to worry about finding them on the floor, or worse. The doctors are on call and on site. The dementia is being treated. The nurses and CNA's care. Family members can now visit because our loved one is being bathed and taken care of. It is a hard decision to make, but, once you make it, you will know that it is the right choice for their safety and well being. It is not easy emotionally and will not get easier, but, it is what is right most of the time. GOOD LUCK.
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When my mother was diagnosed early on with ALZ, he biggest fear was that she would be forced to leave her home. One exhausting night after an argument over nothing, she escaped all my preventative locks and alarms and started wandering the streets. It was January, snowing, she had no coat and was barefoot. I didn't know she was missing until a police officer found her and returned her. She was fine and in great spirits. A neighbor called because she had been trying to get into other people's houses, looking for home. She no longer knew her own home as home, so it no longer mattered. We got her into a ALZ place the next day.
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I decided this at least 6 months ago. Sadly, my 83 year old mother, with dementia, is refusing. I'm walking that very blurry line between respecting her wishes by taking over as much as I can, while trying not to enable. In the meantime, as harsh as it is to say, we're waiting for the catastrophic event which will leave her no choice.
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It would be a long story to tell, but in a nutshell, my mother developed terrible, crippling anxiety that prevented her from using services readily available to her that would have allowed her to stay in her suburban home. She realized after several bouts of extremely high blood pressure and what was the beginning of mild cognitive impairment that she should no longer drive, so I think anything that happened panicked her. If her bp went up, even a bit, it was a crisis. If she had a loose bm, it was a crisis. If we tried to arrange for a cab to take her somewhere, she was in a panic lest the driver get lost. My kind SIL arranged for a limo to take her to visit her sister and she describes the trip as "the worst day of my life" because she was convinced the man didn't know where he was going. We got her doctor to put her on anti anxiety meds, but they didn't really help; she became anxious that she was a "drug addict". We moved her to an AL where another family member had several elders living, but it was at once, too much and too little help. We ended up moving her to an IL facility where she was fairly happy (certainly happier than she had been at home). She was able to walk across the parking lot to her doctor appointments, the doctor gave her his cell phone number so she could reach him any time, there was a geriatric psychiatrist who was able to do a better job of medicating her for anxiety. It was mostly the realization that our having to rush to her side when she panicked was going to kill us long before it killed her.
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