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Our 90 year old mother with moderate demential refuses to eat in the dining room at her assisted living facility. She insists staff bring meals to her apartment at a cost of an extra 6$ per delivery. Staff have tried to encourage her but the ususal reply is she's "sick" or "hurting". She is more than happy to go if we visit and always seems to enjoy the company when in the dining room.We just can't get her to go. We brought her a wheelchair since her main excuse was she can't walk that far, but of course the escort has come and she refuses. She wears a nightgown and bathrobe all day and is now asking staff to bring her mail since she has been told she cannot walk around the facility in a bathrobe. She will not come out of her apartment and feels the visits from staff is all she needs in terms of socializing. I know they are frustrated with her too since she tries to keep them in her apartment as long as possible. One other thing, she doesn't want to bathe and uses the excuse that only one of the assistants knows how to do it right. What to do?

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Mom didn't want to go to lunch because of a disagreement with tablemates. I just rolled her in there. No choices. She was fine after that. Sometimes they need a boot in the butt.
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The assisted living at my the NH that my mother is in, wouldn't allow that. She would be down graded and have to be in the NH. Funny thing is, there you are required to go to the dining room. The patients are eager to get there and line up 30 minutes early, 3 times a day. Also, they have to dress and bath.

I was so surprised that my mother would do all that is required, but when the people that she has known for 80 years are all doing it, she conforms.
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Can Mom afford the extra $6,000+ per year to have her meals delivered? If she can, I would be tempted to allow her to eat in her room.

If that is a hardship and will make it less likely she can afford the facility the rest of her life, then I'd say to her what she probably said to you more than once (at least my parents said it to me!) "I know you'd like that, and I don't blame you, but we can't afford it." Since she has dementia this may not totally make sense to her, but I'd try it away.

If cost is part of the issue, would you consider a compromise? "Mom, it is very expensive to have all your meals delivered to your room. You can afford it 4 times a week. Which meals shall we schedule for delivery?"

Even if it is the socializing benefit and not the cost that is the concern, would you consider some meals in her room and some in the dining hall each week?

(I am very surprised that my mother is willing to eat all of her meals in the dining room. I never thought she would!)

Social activity, physical activity, and moderately stimulating experiences are thought to be good for persons with early dementia. Maybe going to the dining room would be good for her. So would doing appropriate exercises. So would watching a nature program on television. But none of us always do what is good for us (right?) and you have to pick your battles.

As for getting dressed, I have a bias toward thinking that is a good thing. I always insisted that my husband get dressed, even if he was just going to be at home all day. "Because when I see you in pajamas out of the bedroom it makes me think you are an invalid. You aren't. I am glad you aren't and I want to see you looking OK." When I have a day I don't feel like getting out of my jammies I remember that. I do feel more energetic when I'm dressed!

You have to pick your battles, and the battles worth fighting change over the course of the disease!
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It's hard. My mom is 94 and doesn't have Alzheimers, but does have major memory loss. She lives in Independent Living in a large facility. It's too far for her to walk to the dining room and she doesn't want to get dressed most days or have someone escort her to the dining room. So I bring her food (and get a credit on the bill). I think my mom is coming to the end of the line. But she's very happy. I help her shower once a week.

It seems like some folks just hit a place where they don't want to make the effort to socialize or dress. My mom is definitely there. Her memory is such that if she ate with people, she'd ask them the same questions or make the same comments every five minutes. I think she realizes that, so is embarrassed.

So I don't have great answers for you, but share your frustration.
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It is hard. I can understand that she would like an occasional tray, but 3 times a day? Mom's meals are all pre-paid as part of her living expenses and the tier she is in so in esseince it is costing 8.50 + an extra 6.00 per meal. We are already at 6100 hundred a month and have to watch her funds to make certain they will last.
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