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Once Covid is done (could be months) we will have to make some decisions about my dad. This seems to be happening pretty quickly. Last fall he had a 24 MMSE and now he had one 20 and one 22 this week. He's 92 and his memory still comes back sometimes briefly. Anyway, I'm sure every facility is different but I was just wondering if there is a direct relationship between this score and when someone has to be in memory care versus assisted living versus some other residential care sort of set up? He is frail and can't walk far either. Or is it one of those "it depends"things... I know wandering will do it but is just getting lost around the facility considered wandering? He likes this one particular facility but they don't have memory care... just assisted living cottages, residential care, and skilled nursing. I'm thinking that maybe that's not a good idea because it surely means we'll have to move him for memory care. But maybe by the time a person needs memory care they don't know the difference?


I am so incredibly sad. I live far and can't see him often. I seriously want to move there and get a place so I can see him every day... (which my brother and sister in law... not to mention my husband..would hate)

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thank you... I have dad here this week with me (my brother drove 3 hours and we drove 3 hours to bring him to us. I'm spending time talking to him and trying to figure out what he wants... one minute he wants to live near my brother, but the more he sees where I live, he sometimes says here. I would love to have him here until Covid is over but I really think he'd be happier and we'd be happier in some assisted living place nearby. Anyway, mostly he wants to live where my brother is: the weather is nicer and it's within an hour of his "girlfriend" (he's 92!). He seems resolved to moving to assisted living so that's good...
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Mary, when we initially moved out of her home of 60+ years, we thought it was SO important to keep her close to her friends.

Not one of her friends visited in the 2 years she was there. She made good connections at the IL.

But when she had a stroke, and it took each of us over an hour to reach the hospital, we realized we needed to pick one sibling for her to be within close physical proximity.
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1. If he is going to move is it possible to move him closer to you?
2. If there is any chance at all that he would wander away from the facility then he should be placed in Memory Care. Memory Care typically has locked units where Assisted Living does not.
Memory Care also takes the residents out for lunches and other outings so they are not "locked up", there are activities and many have a kitchen area where residents can help them selves to snacks, drinks (if there are no dietary restrictions) and the Memory Care is geared for a variety of levels of care.
If he can not be moved closer to you tour a few near where he lives so you get an idea as to what each one is like. Pick the best 2 and take him for a visit.
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If you can find one, an MC like the one my father was in would work well. Dad has vascular dementia and needed MC care, but he also had serious heart problems and eventually died from CHF. Basically, the facility position was they would try to keep an elder in MC as long as the resident didn't need medical support on a continuing basis. They did require an additional half or whole "aid" (with additional cost of course) at times. When Dad came back from a hospital stay, he had a whole aid for 2 days to help with readjustment and evaluation. When Dad had the flu or other times with his CHF, he needed a half aid for a few days too. Be careful to find an MC that doesn't want to push residents out to NH as soon as their physical health declines. It's harder on elders with cognitive issues to move, especially in that last year or so of life. There does come a point in ALZ and some other dementia types where the elder cannot eat and needs a feeding tube and no longer participates in group activities or visits where it's appropriate to move them to NH for the higher care level required; at that point, the move is no longer really an adjustment issue for the resident.
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marydys, yes...the majority of people on this site are or have been where you are now. It is sad. You're not alone. I'm so sorry for you and your family.

I agree whole-heartedly with moving him close to you. I moved my MIL from 15 miles away to 2.5 and even that made a difference. I have 2 very senior aunts in FL and I'm in MN. They currently are receiving agency care in-home, supported by help from relatives. When one of them passes, I will bring the other up here to be close to me.

Also, please choose a facility that has the full continuum of care: LTC to MC to hospice. Same admin/staff, less paperwork, less stress. You don't want to have to go through a search at a distressing time for him and your family, plus there can be waiting lists. May you have peace in your heart and lots of support and help in settling your father.
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The differences between assisted living, memory care and nursing homes is very fluid and varies not only from region to region but from facility to facility, the intake people at any facility should be able to tell you if they are willing and able to handle his care needs. Pay attention to staffing levels (especially over night and weekends) and the extra costs of added services, keeping in mind that people with higher needs can not be adequately cared for without many available hands.
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Getting lost is one thing. Trying to elope from a facility is something else.

Your best bet is to have an independent assessment done, either by the local Area Agency on Aging or have on ordered by his doctor. It's based on more than a single test score and includes an assessment of his health and his ability to do activities of daily living (eating, hygiene, toileting) as well as the ability to plan for these (cooking, changing clothing, etc).

Also, why not look at facilities close to where YOU live?
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