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For background: I'm an only child dealing with a 77 y.o. mother who has mid-late stage diagnosed dementia. I've had to turn her into the DMV, so she no longer drives. I've been bringing her groceries weekly as well as filling her weekly pillboxes. She's fully dependent on me to call her daily to remind her to take meds and eat. I walk her through how to make simple food in the microwave. I had to take her modem and unplug her stove on Christmas eve (she's burnt SO many pans). When we arrived she told me that she was on the computer talking to someone who passed away years ago. She has yet to mention either of these changes, ironically.


Utimately though, my question is HOW can I move her into a memory care facility? I have a care coordinator helping me locate a good location for her (safe, good staff to patient ratios, etc) and I'm in the process of selecting and touring facilites. But she is fully unwilling to move. I've tried reasoning with her and explaining that I feel I can't even go away for the weekend in case something happens to her (she's locked herself out MANY times), walked to McDonald's in the dark, etc. She has no concept of any of the things that I do for her and I'm reaching maximum caregiver burnout.


She has a follow up appointment with neurology in February. Is there any way that they can help force her to move? I know if she ends up in the ER they often will not release a patient with dementia back to live alone at home. But do I need to wait for her to hurt herself in order for this to happen? She has the financial means to move, she just doesn't want to. And there is NO way I would have her move in with me. I know that may sound mean, but I need to have my own life that is not inclusive of being a full time caregiver. Any advice is welcome as she really shouldn't be living alone, but short of tricking her in some way, I can't think of a way to get her out of her house.

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In my case, it was my husband (Lewy Body Dementia). One day his doctor suggested he take a "respite," to get away and do something a little different. He liked the idea, and after some research and visitations - with him - we chose a very nice Memory Care facility where one can stay for a week, two weeks, a month every so often, whatever was the best fit.
We had NO idea how this would work. The night after our tour, he was sitting on the bed at home and I was helping him with his pajamas. He looked at me and said, "I want you to know something...I'm going to go live in a very nice place."
It was an odd comment, and I reassured him that it was just a short "vacation" for him, but he seemed to know something that even I was not aware of.
After his first week, before we went to pick him up, the staff called to say that he was upset, crying, and did not want to come home yet. So he stayed another week, at the end of which this behavior repeated (wanted to stay), and then again...
He was there for nine months, until he passed away this past November.
I visited every day, except those days when i knew that his mother or sister would be visiting.
I realize that this may not work for everyone, and we certainly did not expect this from him. But there were some residents there who stayed a month, went home for a few months, came back again for a month, giving their caregivers a much needed break. I think that's what we were planning, but it seemed like somewhere deep inside his clouded cognitive function, he knew that this was a safe place, and he was ready to be protected and cared for by a loving staff.
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People have posted that there are facilities offering 1-2 wk accommodations so caregivers can take a vacation/time out. May be a way to test the waters or transition.
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Yesterday, I put my Mom into a memory care unit, doing what our entire immediate family said we would not do. She did not go willingly and it was not her choice. She has been stubborn all of her life, however, she wouldn't have gotten to where she was in her professional life if she did not possess the qualities that she had. I no longer had it in me to rationally care for her.

Previous posts have brought up some very important points. First, does she have a will, a trust, a Power of Attorney and a medical directive? If not, you should do that immediately. You will need the POA and medical directive and a POLST, if you want to get her into a care facility. If you do not have these things, get it done because soon she will not be able to mentally make the decisions needed to perform those items, especially if it this is the first time she is making these decisions.

While that is getting done, get a real inventory of all of her financial assets, her bank accounts, her real estate holdings and stocks owned, any life insurance, etc. You will need these things because you need to know how much she is able to pay and what options would be available (e.g. day time at a senior center?) Should she pass away, it will make it easier to distribute her assets, pay bills and pay tax, etc.

Also, I highly, highly, highly, suggest that you get in-house caregiving for her. If she is truly mid-late stage, she cannot follow directions consistently, nor can she be expected to make those rational decisions that you and I take for granted. Just based on the description of your post, I do not think she is in mid-late stage, however, more like early to mid. Get her professionally diagnosed, look for a geriatric doctor. The official diagnosis might be a shock to you.

For you, I suggest that you try to find for yourself, a therapist who deals in caregiving of elders. It is worth your time and money to get the right therapist, who can guide you through the methods and pitfalls of dealing with your mother. There might even be a non-profit in your area that can provide therapy for free or group therapy. Memory Loss shows up differently in different people and you need someone to help you personalize your interactions with your Mom with minimal emotional upheaval for both you and your Mom.

Don't wait for a life-changing event that you have to react to. Take control and start scripting your future and your Mom's future.
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PeggySue2020 Jan 2022
LoveConquersAll, your reply won the Internet for me today. I wish I had extra likes!

Many ALs around me roll out the carpet when it comes to respite care as they want to make sure the senior chooses them. Three chef-prepared meals a day, drivers to take you shopping or the doctors, often beautiful gardens one doesn't have to maintain, daily exercise classes, seminars about everything from flower arranging to football.

I wish seniors would see respite as choosing between various hotels. The ones that are more accepting of that from the get-go are ironically the ones that will be invited back home, because it's respite.
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What a frustrating situation for you. My first question would be - does your mother have the legal paperwork that would name you as POA in a situation? Meaning, if her doctor declared her unable and incompetent to take care of herself and make sound decisions about her wellbeing and financial affairs, then that sets up things so that you become the POA. At which point you are legally entitled to make her decisions for her.

Which then, brings you to how to get her moved. If she isn't willing to be moved, which I am guessing she isn't since this is what I had to deal with my own mother, you have two choices - leave her where she is, where her abilities are compromised and she could be a danger to herself and others, or get her moved. But it isn't going to be pleasant or easy.

You could contact her doctor and speak to them about enlisting their help (they could contact social services/adult protective services). Or you could. Because then the only other way is yes, you would have to wait for her to cause harm to herself and end up in the ER where they won't let her go back to living alone. This as what happened to my 95 yo mother who refused, continually refused to even consider moving the AL. Even though I showed up weekly with groceries, laid out her meds in the pill boxes, picked up her rx, took her to doc appts, etc...she got to the point where she wasn't eating right (cookies, candy and ice cream), not sleeping because her dementia was causing her to hallucinate (and yes, the local police were summoned on several occasions because of 'someone out there trying to break in'--- not), etc. I couldn't be with her 24/7 and would get phone calls at all hours of day and night (she even had 4 news anchors from CNN in her living room one night having a discussion about world affairs .....yuup, sure they were..sigh).

Things finally changed when she fell trying to get out of her recliner and fell, breaking her femur by the hip...off to ER and no more going home- ever. But the fall resulted in her passing 8 weeks later. But she admitted that she shouldn't have been so stubborn and 'should' have moved to AL a 'few years' earlier to that 'nice place' we toured and had lunch at. Too late.

I tried. I tried oh so hard and for oh so long. But I couldn't never change her or how she was or thought. I 'should' have just forced the move and then dealt with her anger but at least she would have been in a safer environment. Hindsight.
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I have had considerable success moving clients into memory care.
My recommendations: First and probably most important: Stop talking about moving or trying to convince mom. Research without including her. You want to find two or three facilities that meet your criteria (staffing and special dementia training, etc) - After the "glamour tour" with the marketing person, get permission to visit by yourself. Spend an hour or more in memory care simply observing (fly-on-the-wall) and imagining yourself in Mom's shoes - Once you've made your decision, rent her room/apartment and furnish it, so it’s ready for her move - later. Bring Mom there for lunch at "this new cafe you like" - Arrange with staff to have you and mom seated with a couple of their outgoing residents. - Come back the following week and the next, progressively . 

During these visits help Mom converse with your table mates. Unless she brings it up, retrain from talking about her move. - Be patient! - Gently steer the conversations to daily life, activities, and friendships. Extend your visits to participating in afternoon activities. 
When you sense that Mom has connected with the other residents and is starting to feel at home, ask her if she’d like to spend more time there. It’s a very slow “dance” to get to the point where the move feels that it’s her decision. 

Impossible? No. The average time to get to that point is two months. I’ve actually had clients beg me to stay. To reinforce this, I’ll usually tell them that “this is a very popular and sought after place to live, but I’ll check and lo and behold, she’s incredibly lucky that they have a vacancy. We’d better take it before someone else does.”

Good luck.
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Geaton777 Jan 2022
What about having the LEGAL ability to get her in? Who is legally able to sign the intake paperwork or pay for it? THe mom doesn't sound like a candidate for AL but rather MC. Would any facility accept the signature of someone entering as an MC resident? I'm asking because I don't know anyone who's done this successfully or if it is legally possible.
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I went through the same thing with my mother. I had POA for my mom and a letter from her physician stating that she can no longer manage her own affairs. This made things legally easier.

I visited a few facilities and found one I liked. Once I found one I consulted with the lead nurse. She advised me to pack up a few things for her and drop them off ahead of time. Then the next day, my brother told her he was taking her to a doctor's appointment. The facility is in a rural setting so she started to wonder where he was taking her but he pushed on. Once they arrived at the facility (I was already there) the nurses chit chatted with her for a few minutes and loosened her up. When she felt comfortable they took inside and that was it. I called to check on her and they advised me to give her a few days to calm down. Since then she's been settled in. She doesn't even ask about going home anymore.

It was one of the most emotionally draining days of my entire life. The anxiety I had leading up to that day made me physically ill.
However now she's there, she's safe and she's taken care of. And as her disease has progressed, I know we did the right thing.
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From what I understand, bolstered by the many touching stories on this forum, you cannot 'reason' with a person afflicted with Dementia; you cannot 'explain' things to them; you simply have to get mom's affairs in order, locate the best possible placement, and take her there with whatever pretext needed (lunch out, a little vacation, etc.) These facilities know how to do intakes and help transition a new resident. Lean on all the appropriate agencies, social workers, aging assistance available in your area. Wishing you all the support you need for the best outcome for you and your mom.
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I am confused if two doctors and you say she needs placement, and you her family member agree, what is the problem? She may not be agreeable. She may not be too bad; she may be very difficult. But she will be in a place that knows how to handle the situation. Will they send someone to evaluate her and help you plan? IF she is too rambunctious about it, call 911 and ask them to take her to the hospital. Then on with the plan. Tell the situation to the hospital, refused to take her home, and give them the name of the facility which should be waiting for her. She is not cognitively able to picture what the change will be like and digest the possibilities. But if the place is nice, and used to helping such patients, it may go reasonably well. in any case, they have much more experience handling the situation than you do. Asking a seriously demented patient to agree is a bit like asking a two year old to agree to being hospitalized and describing her appendectomy. Pick a place with your consultant, make a plan, and do it. Go away for the weekend afterwards. Then, there are companies that will do all the preparation for cleaning, getting rid of stuff, and selling the house. See if there is one near you and get on with getting recovered yourself.
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I don't know if this would help you, but when my dad needed to move into memory care, we told him that we had to go and take care of another relative who was very ill and lived in a different town. We told him his stay at the facility was temporary and he had to do this for us because we could not help him for two weeks. We made it sound like a hotel with services. He really didn't want to, but he did it. Getting them in the door is the biggest hurdle. It sounds like you have a plan to do that. I knew I'd have guilt doing that, but when I weighed that against the guilt I would have suffered if something terrible happened to him that could have been avoided if I'd acted sooner, it made it an easier decision. You are not doing this for you, you are doing this out of love for your mom.

It's also a very good point that it's better to do things now while you have a choice of where she can go rather than being forced into a situation where her choices are more limited on placement because of things that may have happened (falls, injuries, etc). That happened with my father in law. We waited too long and then he was in the hospital and we were forced to find a place in 2 days. The places he could have gone to earlier had no vacancies and we were left with a choice that wasn't as great but we had to act on last minute notice. That was a terrible experience.

You are doing the right thing for your mom. You really are.
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I could have written this same letter except it was my MIL and my husband was the only child. We had to “trick “ my MIL. We set up the transfer, hired movers for some furniture, and between my husband and I, we took her to the Assisted Living and then said that this is where she would be living. She was upset but within a few days she LOVED it.
If you are waiting for your Mom to agree to the move, you will always be waiting and your Mom could be injured or worse. Get things lined up and moved her ASAP!
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