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I have two relatives recently placed in two different secured Memory Cares - 75 and 78. Both are the highest functioning in the MC and neither can even find someone that can carry on a conversation. Did their relatives act too fast in placement there and should they consider moving them to an assisted living community?

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I've observed some residents at mom's memory care who could easily get along at an alf - they don't wander and they don't have behavior issues

They would certainly have better food activities and be exposed to less mayhem- it is sad and there's really nothing to fill their time - some seem very depressed as a result
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My dads friend kept pushing to move him into a MC facility. He had problems but memory loss wasnt a huge issue for him. We looked at a few places. He asked my opinion. I told him I thought they were nice (beautiful!) and would support whatever decision he made but thought he seemed a lot sharper than anyone else there. My concern was that the lack of stimulation might accelerate his condition. He ended up moving out of my house and back to his own apartment with 24/7 care. He has seemed pretty happy to be the king of the castle again. For us it was the right move.
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There is an all in one facility for Dementia patients in Beachwood Oh (suburb of Cleveland). It is set up so the resident never leaves and can pass away there.
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I believe that Dad was one of the highest functioning in his MC when he first moved in. But, he couldn't qualify for ALF, & really was prob more a candidate for a SNF. But the MC I found was new and beautiful, and he was the 3rd resident to move in. He got lots more attention there and was able to afford a spacious private room and bath, whereas that wouldn't have been the case in a SNF. I felt like it was the best that I could find for what he could afford. I visited every day, sometimes 2-3 times a day, & sometimes for hours, & I believe the staff there were some of the best around. He had good rapport with several of them a few of the residents too. His dementia accelerated with a vengeance toward the end, and he was only there for almost 8 months before he passed.
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Shay,

Our family had a similar experience with Mom. When my father passed away, Mom refused to move in with any of us. She wanted to stay at home and have caregivers come in; however, that idea proved to be too expensive since she really needed 24-hour care. Her neurologist recommended MC. The MC unit we chose performed their own assessment and accepted her. At first it seemed like Mom was the highest functioning person there, and she probably was. She complained of having "no one to talk to" and felt like the organized activities were "stupid" and rarely participated. I made a point of staying overnight a couple of nights, which Mom's MC facility allows and made a point of mingling with some of the residents who proved to be very near the same progression of dementia as Mom. I thought many of the activities were delightful, and it still puzzles me why Mom, now 1 year in residence, still refuses to participate.

It finally occurred to that someone has to be the "smartest kid in class," and Mom was it. But now that Mom's dementia has progressed from the early to mid stages and new residents have joined the community, I can now see that there are several there who are very close in dementia progression as Mom. Sadly, she doesn't see it and has progressed to the point that she no longer recognizes her own deficits, anyway. Almost all the residents there don't think they belong in MC. It's part of the disease.

Mom has made friends, though she makes a point of denying this. When I arrive at MC unannounced, she'll be talking and laughing with residents with similar staging. Mom is a complainer and a drama queen with highly narcissistic characteristics. She likes to play the victim with an abundance of "woe is me" stories; the staff are stealing from her, she's bored, etc. The family are in agreement: moving Mom to some other MC facility would create a whole new (but similar) dynamic of things to complain about with the added stress of having to acclimate to a new environment. And we agree: having her moved to MC while she still had a little short term memory made it easier in the long run, to adjust. We did the right thing, and I suspect you did too!
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My parents are among the higher functioning at their memory care but they would not be able to navigate a phone or call a doctor. They don't wander (or weren't when I moved them in there).

They do not have good judgement, they don't have a good sense of where they are in time, lost the ability to really do any multistep tasks, their short term memory is just about gone. However they are not one of those who wander around mumbling to themselves and they can have conversations and can participate in some activities.

Having said that tho, I did look at many assisted living and didn't find any that were locked or secured, I could tell that they would be lost and not be able to make it to the dining room back to their apartment.. it would have been a disaster for them.

I don't think they would have been accepted socially there either.. I watched them struggle at their independent living environment. When you have dementia and think it is 1970 .. its hard to carry on much of a conversation with their non dementia neighbors.

I chose the MC they are in now for several reasons.. but one is there are at least 1/4 of the residents who are around their level.. or maybe even a bit higher.

Still .. its hard for me to see my parents with some of the very low functioning residents..even tho there are some others there for them to make friends with.

Sadly.. at some point they will be the low functioning ones.. I hate to think about it.
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That's interesting Upstream, it has always been my understanding that Memory Care is generally geared toward those who have cognitive impairments but don't need the level of assistance required in a nursing home. Once again it seems the definition varies from region to region or even facility to facility, it sure must make it hard for families to understand what they are signing up for.
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Someone has to be the highest functioning, but if the gap to the second-highest is large, that can be very detrimental to that someone.

In my local support group, a father was placed in Memory Care. After a few weeks he called his doctor and said he did not belong there and that there was no one he could converse with. The clinic was amazed and impressed he'd been able to navigate the phone menu and actually get to speak to the doctor. He was moved to the ALF floor and did fine.

I've read that about 60% of the residents in ALF or NH have dementia. If those facilities can handle people with dementia, why do some need to be in Memory Care? One primary reason is security. More than half of ALZ patients wander. The number varies for other kinds of dementia. Those people in regular ALF settings? They either are in the 40% ALZ that don't wander, haven't hit the wandering stage, are wheel-chair bound, or have some other type of dementia that doesn't include wandering.

Another need for MC is disruptive behavior. When my mother couldn't sleep through the night and was shouting and keeping others awake, the NH considered moving her to the MC floor. She settled down at night and stayed in NH.

My daughter works at a well-regarded ALF that also has a MC unit in the same complex. Recently a resident of the ALF started wandering. They reluctantly moved her to MC, for the security. But she had friends in ALF and liked ALF activities. They arranged for her to eat with her ALF friends and participate in some of the activities.

Some people with dementia simply need to be in Memory Care -- no discussion needed. Many others can fit well into the mainstream care centers. I believe that those who can do mainstream should, as long as they can. One of the benefits of care centers is socialization opportunity, which is greatly diminished in MC.

If I were your relative, I would ask at a care meeting why my high-functioning loved one was in Memory Care, and if they might fit in OK in mainstream. If the loved one really needed MC, I would then work with the staff to see how to compensate for the lack of social stimulation.

[I truly hope this is never a factor, but facilities do get more money for their MC units, and sometimes they have empty MC units but the regular side is full. Just something to know.]
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I placed my dad into memory care about 9 months ago. It became very apparent that he was the highest functioning resident in the building and it was sad. We spoke to staff and they agreed to move him to the next-door building which is a secured ALF. The residents there are higher functioning but a lot of them are also cognitively-challenged. My dad receives assistance with daily tasks but has some conversation and some choices in things like meals and activities such as Bingo.  He can't keep up with the game but staff helps him and he really enjoys it!  In the memory care unit, most of the residents were physically inactive also, so I could really see the situation was bringing down my dad, who is ambulatory (with a cane).
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Google "showtiming". Dementia patients can put on one heck of a show for a visitor or a doctor's appointment...just long enough to make everyone look at the person making the decisions on their behalf look like a fool.

My mom always told folks that she was the "best" in whatever facility she was in; she had a drive to be an "A" student, always.

Be aware that you don't get into Memory Care when you could still live successfully at AL.
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Shay, no the families did the right thing. One has to realize that most of the people who are already in Memory Care were once the highest functioning when they first came in.

It is much better to place a love one while that love one can learn their way around the facility, learn the Staff, and eventually make friends. If the family waited, then the love one would be really confused.

My Dad moved to a facility that had Independent Living, Assisted Living, and Memory Care, so as he progressed with his dementia and mobility issues he could still stay in the community. You'd be surprised how quickly one's dementia can progress. Before I knew it, my Dad was dealing with Sundowning, then the Staff said Dad was beginning to wander, so it was time to move him over to Memory Care where Dad would be secure thus no worry about him leaving the building at night.

My Dad would appear to be pretty smart, but there were time when he would fade back into the 1940's. His next door neighbor at the facility had the same thing. I use to wonder if they would be introducing themselves daily like they never had met before.
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