What's better for a person with mild dementia, home care or assisted living?
As some know I've been taking care of my grandmother and I haven't had a job or been in school for a while. We're getting closer to her release date in a couple of more weeks, and the PT, her PCP and her doctor overseeing her at the nursing home are agreeing that she needs assistant living due to her forgetfulness, her knee injury and her sudden confusion makes her a hazard to drive. The other thing is how she still thinks its 2002 even though she has a calender and watches tv and interact with other patients but she prefers to stay in her room. She gets very irrated easily when she get confused and no matter how you react she starts to accuse you. I have been talking to her daily at least 2 times a day and visits her when I can at least once or twice a week but she hasn't really gotten any better since 2 months ago. She has her good days but she's not as combative due to them putting her on anti-psychoatic drugs and two memory pills. She was open to live in one but now she is refusing to live there and she's telling her case worker and her nurse that I can take care of her when I can't. She went into the hospital 4 times over the same thing. She won't listen to me and refuses to eat and the littlest thing will set her off. I feel I should use some of her assets or the house value to be used for her long term care, but she refuses home care and insists and tells me I can take care of her. What should I do? I talked to her about this but she refusing to listen to me and keeps saying over and over again she can take care of herself and I can nurse her back to health. She still thinks she living somewhere else and will ask me what state I am. I know she worked hard for this house but I can't stay here without a job and I'm trying to enroll into school. I feel she should be in a facility for those with memory loss issues. Would that be a better plan?
She thinks it is 2002. She is wrong. She thinks you can take care of her. She is wrong. She has dementia. Her judgment is not good. She is lucky to have someone so caring to make decisions for her.
Make sure that her case worker knows in no uncertain terms that you cannot take care of her. You did that for years. You genuinely love your grandmother. You want what is best for her. Her impairments have expanded to a degree that you no longer can provide the best possible care that she deserves. You want to see her placed where she will get that level of care.
One of the hardest things is realizing someone you always knew to be reasonable and thoughtful isn't able to make good decisions for themselves anymore. As painful as it is, you must realize that your grandmother can't care for herself anymore, even if she says she can. Even though she doesn't realize it, she needs you to make the logical and informed decision of finding her an ALF so she will be safe and well cared for.
She believes you can nurse her back to health, but that's wishful thinking on her part. You know the truth: as her dementia increases, no one person is going to be able to manage all of her needs.
Know that she is very blessed to have a loving granddaughter like you to watch out for her best interests.
If she is still able to function on her own (feeding herself & the like) Assisted living is not a bad idea. It still gives them independence for the most part, but there are nurses around in case of emergencies and accidents. Some even offer transportation to take people to the grocery store or doctor appointments. So, that's not so bad either if she can't drive herself anywhere.
The longer you wait to find a good assisted living facility for her, and place her there, the harder it will become for her to adjust.
Keep things simple and tell her that you love her too much to let her become ill and have to be hospitalized again.
I learned a wonderful acronym from a good friend of mine who was an elder law attorney:
Don't do these things:
C - Don't Correct the confused person. Meet them where they are, in their reality, and reassure them that you love them.
A - Don't Argue. People with dementia/AD cannot reason the way they used to.
R - Don't Rationalize. Again, a long, complicated explanation of why she needs Assisted Living will only confuse her.
E - Don't Explain. Keep your sentences short and simple. No need to elaborate on who, what, when, where or why.
You have done everything that you can do to keep your grandmother safe and healthy. But her needs are too great now, and it's time to take the next step. Kindly and lovingly, find a good placement for her and reassure her that you will always look out for her. Now, though, there will be other caring people to help you do that.
Good luck!
It sounds like your mom is not safe living alone in independent living. I would have her assessed to see if she is at risk for leaving a facility. She certainly can't resist financial exploitation. For those reasons, I would try to place her somewhere safe. With your work schedule, you would have to have outside help come in while you are gone. Then when you are home, you wouldn't be able to leave her. I'd consider the options for Memory Care assisted living.