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My mother has been living in AL for two years and has been just great about transitioning out of her own home. She actually seems more engaged and calm in this setting. She has cognitive issues, however, and does get things mixed up, or even imagines things happen that don't happen. Recently, a staff member Mother was very fond of left the facility for another job. Since then, Mother has told a very detailed story to me about the staff member leaving because of "something about money" and being escorted off the property by three police and put into a police car! I spoke directly to the Wellness Director of the facility (because my sister and I have doubted Mother before, and she sometimes turns out to be right). The Wellness Director was shocked and said the former staff left on good terms, but for a better job. Mother also tells about fights at the dinner table with another resident, which no one has seen. Mother doesn't seem to tell anyone at the AL about this, but we are worried. She does everything for herself (bathe, dress, feed herself) except for taking her meds. Are we looking at transitioning to a memory care facility? Do we need a neurological assessment?

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The director told you the police escort didn't happen, but that is often how any stealing ends, with escort out. Theft is serious at ALF and reported to police and licensing agencies, but can be scary for residents so is often kept under the covers a bit to the community so as not to cause fear. It does happen, unfortunately. I would tend to think Director wouldn't lie to you. But who knows. Elders become quite paranoid about money and their "stuff".
Arguments at table? I don't know arrangements at your Mom's ALF but at my bro's they live in cottages, with rooms arranged around dining room; meals are served, and then servers are gone and many elders sit and visit at table after, some engaging in games such as scrabble, etc. The stories I hear about "engagements" from my quite rational brother are entertaining, and I often tease that he is in the latter life version of a "commune" where all get into tifts and have to have community meetings about issues.
He is quite rational and is at the point where he is aware of the deficits from his "early Lewys" diagnosis. Will describe how it can be difficult to spell common words; how he sees things peripherally "all wrong". And then there are some few times that he is just dead on "wrong" about something that happened. He is one of the more "with it" in his facility, and only 2 more as mentally competent as he in his cottage. Some have quite serious deficits.
All ALF vary, but cost to move to memory goes from 5,000 to 10,000 a month average, and unless there are complaints from the facility I think I would not do anything abruptly now, but just "keep a eye peeled" for changes. Sometimes things move very slowly and sometimes not.
Memory care is locked. She would lose the relationships she has formed now. And often rooms are shared. It can be a difficult transition.
You are clearly very in tune with what is going on. Changes can come and go. Just stay watchful as you are now.
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So, your mom has been diagnosed with dementia/cognitive issues yes? By a neurologist?

Would a further cognitive assessment give you useful information? Or would simply asking the staff at AL to be upfront with you about when Memory Care might be needed be sufficient?

Has she been tested for a UTI?
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horticulturist Oct 2019
Thank you for these answers. Barb, Mother has not been officially diagnosed by a neurologist, but it is something we are considering. She hasn't been tested for a UTI, but the next time we see her primary care physician I will ask about that. She certainly doesn't drink enough water. She doesn't complain about discomfort, however.
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