I'm contemplating hiring a live in caregiver. Is it feasible or better for mom to stay at memory care?

Have you discussed this with your friend who would be doing the caregiving? Is she very experienced in caring for people with dementia? Since Mom is also a fall risk, your friend would need to be extra vigilant. Would she be on 24/7 duty or would you also need an aide during the night, since many dementia patients wander and can leave their home. Your friend has experience, yes, but even professional caregivers with lots of experience can get burned out. If Mom can be difficult, this would increase the possibility.

To be honest, since Mom is doing so well at the facility, I would hesitate to uproot her. Even though the care ratio is 1-6 ( which truthfully isn’t that bad), there is staff on duty all the time. Moving from place to place, even back to a familiar home, can be confusing and upsetting.

I don't think any of us would opt for a facility but finding reliable 24/7 home care is nearly impossible

mom has been in memory care for 3 1/2 years - she is no longer mobile and while I would prefer she be comfortable at home, I know it isn't possible
wheelchair wouldn't fit
no way to shower her
caregivers get sick, have their own family emergencies etc

with dementia, things only get worse, so you will need a plan beyond just the near term especially around mobility and incontinance

6 to 1 is a very good ratio
i have private caregivers with mom in the facility
if mom has funds, maybe you can find someone to spend some time with her at the facility and provide those extra touches that staff can't

Since it sounds like mom is doing very well where she is, leave her be. Every move for those with dementia causes further decline.

Live-in would become mom's employee. Taxes, Medicare, disability, all deductions would need to be paid for caregiver by mom. You would need a caregiver agreement prepared by an elder law attorney. You would need an accountant or payroll service to take care of salary. There is also consideration needed to labor law. Will caregiver be 24/7 or will there be three shifts of caregivers to provide breaks for the live-in?

If you were to use an agency, that would require three shifts of caregivers, 40 hours a week times three, 120 hours at $20.00 an hour or more. $2,400.00 a week plus expense of being in home with utilities, etc? Excess of $12,000.00 a month, easily.

Then a friendship that could be lost. Never hire a friend. She will not, necessarily, do things the way you want, then what? Or mom, with dementia, could decide she hates this woman. Leave mom where she is. 6:1 ratio is very good.

The idea is to make the best decision for your mother, not to be concerned what your siblings think. If she is doing well where she is at, then, leave her there, her needs will continue to increase and eventually she will have to go back to MC anyway. As for hiring a friend, I think that is a very very bad idea, your friendship will be under too much pressure and most likely be broken. If the worst thing that is happening where she is, not having her teeth in, I would say they are doing a pretty good job, 6 to 1, is a good ratio, and if she cannot even put her teeth in by herself, that might be a sign that she needs to stay where she is.

Is the house she would be returning to set up properly?
* No stairs
* Large bathroom for a wheelchair or other equipment? NO lip on the shower that she would have to step over or that you could not roll a shower chair into?
* No carpeting?
*No thresholds to get over going between rooms?
* Wide halls and wide doorways?
Just a few things to consider there are plenty others.

Are you ready to loose a friend?
How long will she work?
Who will care for your Mom when she is off? You can not expect someone to work 24/7/365 with no break.
You do not say how old your Mom is nor any other physical problems but this could go on for 5, 8, 10 years is your friend ready to commit to that? And are you willing to maintain the house for that length of time as well.
You will still have property taxes as well as all the household expenses (include added insurance for your friend in case she is injured, because she will get injured).

Personally I would leave her in Memory Care. She is with staff that is trained, she is in a facility that is set up for proper care.
If your friend wants to do something for you, and get paid, have her run all the errands you would have to do, bring Mom to the Dr, get any shopping done that she needs stop in for a visit on a few days you can't make it in.

I'm with the other responders.....since she is doing well there I wouldn't rock the boat. I have been after my parents for years to consider IL.....and now that mom has dementia (exact stage to be determined soon), AL would be preferable. Mom is extremely stubborn, difficult and demanding (always has been) and my dad is beginning to show signs of burnout. I wish she would be more cooperative for both their sake.
Moving your mom back home is an unknown.....and to depend on 24/7 permanent private care is precarious at best. Also, with dementia being progressive, you would most probably need to move her back at some point. As MsMadge suggested.....hire a companion to visit with her a few days a week to ease whatever loneliness you think she might be experiencing. If that doesn't work, then nothing is lost....whereas a move would be an upheaval and could impact her dementia. Decisions concerning our LO's is not for the faint of heart.....best of luck with this one.

I would keep her at the memory care facility. She likes it there and that says something about the place. I would look into hiring a reliable person to sit with her for 3-4 hours a day. Visit your mother at different times so you know she is getting best possible care . This seems like the best option for all of you. What if the caregiver friend is no longer able to care for your mother, you would need a back up plan. Are you and your sibling willing to take care of your mother until other arrangements can be made in case of an emergency? Do not stress too much on the teeth, that is a minor thing ,but changing her is definitely a priority and I would talk to the nurse in charge of the unit about it. I would make sure staff walks with your mother, she is fortunate she did not fracture her hip. She is a fall risk and staff should all be aware and take the necessary precautions to keep your mother safe. We all would like to be in our own home in the last stages of our lives but sometimes it is not possible. This is a difficult decision that both you and your sibling have to make. It is a difficult journey ahead and you will need all the help you can get. Pray about it and God will direct you in this decision.

Everyone has given excellent advice and I concur. Mom will continue to decline and it would be more labor intensive and emotionally draining on your mom to take her out of memory care and try to return her if the situation did not work out. Ask the friend to drop by to see mom more often, and other friends and family should drop in more often, trying to do little things to help your mom. Being in a facility is sometimes the best for everyone involved, and it will help the family members to be more loving if no one is burdened and burned out by full time care in the home.

Leave her where she is. It sounds like you have been very blessed with this facility.

Please do not project your issues onto mom, nor your siblings preferences. This is about mom and her wellbeing, which sounds like she is being taken care of pretty good.

I would find out how her skin is doing if you believe they are leaving her in wet briefs. That can't be denied, our skin speaks for itself. Could it be a situation that she has gone after they changed her? Ask the DON to help you understand what the process is for dealing with wet ones.

Roseformom, I also vote for keeping your Mom at Memory Care. She has had time to learn the new faces of the Staff.... learned about the food.... learned the routine.... and she is able to keep herself busy.

There comes a time when it will take a village to care for a person, and with memory issues, that time will come quicker than you know it. Keep Mom where she is comfortable.

My Dad had around the clock caregivers, 3-full time shifts each day, that way each caregiver could have a good rest until her next day shift. But the cost was expensive, as in my area it was costing my Dad $20k per month. Eventually it was his decision to move to senior living and he was happy as a clam being there :)

You say she can't socialize at the MC, but who would she be socializing with when living at home? At least in a facility she can watch the comings and goings, interact with the staff, and I'm sure there must be entertainment of some kind.

You also have the benefit of the burden of care being spread out among many caregivers, in a good facility that means they are policing each other and picking up the slack when someone else is having a bad day or is ill, with a live in caregiver you place everything into a single pair of hands.

Then there is the whole headache of finding and keeping a good person, setting up contracts, withholding taxes, arranging alternate care for the caregiver's days off, vacations and sick days, as well as managing all the medical appointments, home maintenance, grocery shopping etc etc.

I guess you can already tell which would be my choice, leaving her where she is and working to improve any deficits you've identified would be a far better use of your time and resources.

I would say leave her in Memory Care. Especially if she is adjusting well. Yes, she will get worse hopefully by that time she will feel MC is her home. When Mom was in the AL a man came to live there. All he wanted to was escape. He could not sit. I heard one one of the aides say "they brought him too late" I understood what they meant. They had kept him home too long. Now it was hard for him to adjust to a new place.

Memory care? What is your definition of "memory" care. Mom has dementia so her "memory" has started leaving never to return. That is a fact that is very hard to accept. Is she really in a nursing home using "memory care" as a label?
I have to agree with your siblings. My 1 sibling lived with our Mom/stepfather for 10+ yrs. Even though I told her I'd help pay for respite help and some other things she would tell me Mom doesn't want strangers in her house. I was looking into in-home care even though my ugly step-sister took over without consulting me and expecting Mom to pay for it, the owner of the company FINALLY backed out and told ugly step-sister that in-home care CANNOT help with medications nor can they do anything but clean, take to appointments etc and are VERY WELL PAID BABYSITTERS.
Your friend CANNOT LEGALLY administer ANY MEDICATIONS EVEN ASPIRIN SPELLS LAW SUIT! IN-HOME-CARE CANNOT ADMINISTER EITHER.
My Mom/stepfather are in an assisted living group home. It was very very hard for about 2-3 months because they wanted to go home. We, the family and the caregivers tell my stepfather that Mom is very sick and the doctor will not let her go home yet. He says Oh that's right, I forgot. They now "call their suite home". Mom will tell a caregiver she's done eating (when she talks) she wants to go home, gets her walker, turns toward the hallway and goes "home". My stepfather has begun asking me if I'm his oldest daughter (UGH!) when I visit every month now.
This group home has Tuesday bingo day, a musician come from the manager's church for singing day, celebrate holidays, birthdays or just so something to surprise the residents. There is a resident who isn't there for mental issues, she's by her choice because she has to use a wheelchair, has fallen and her children live out of State like I do. The owner has 3 group homes, he as well has all of his employees are Romanian who fled Romania due to their Faith (Pentecostal, this is great as we were raised Pentecostal). They treat every resident as a family member. I asked why they took such great care of everyone, the answer OUR TRADITION WITH FAMILY IS YOU TAKE CARE OF YOUR FAMILY AS THEY AGE. It is the job of the YOUNGEST sibling to live with the parents EVEN AFTER THEY MARRY and take care of the grandparents/parents. The youngest receives the home as thanks for taking care of the grandparents/parents. The older siblings understand this are never angry about what the youngest receives for this family duty.
I never worry about Mom/stepfather being there. Mom's Alzheimers has become more aggressive in this past year and stepfather's Alzheimers/dementia is becoming worse also. Mom fell about 4 months ago, she got up from bed without pressing the button for help, so no one knew or how long she had been on the floor. She was fine after taking her to hospital and neither she nor stepfather remember it.
You can walk into this group home and EVERYONE is happy. There isn't that OMG hold your nose smell. What you do smell is delicious home cooking going on. The caregiver's parents come to US on a visa, Momma does the cooking, Pappa takes care of the property while they're visiting their children!! This is Romanian tradition at work.
I'm happy when I get a smile from Mom, a look on her face that I know she recognizes who I am or my favorite "what the hell are you doing here"? She tells me she loves me after I tell her I love her.
Memory Care is just an oxymoron.
No one can ever care for their memory, it's gone when it's gone and WE as their children have to accept it no matter how hard that is to do.
My Mom is just sleeping more and more now. Not as in needing hospice, just something that happens with Alzheimers which is different with every single person. Like snow flakes, no 2 are alike.
I hope this helps you and something to help discuss with your siblings too.

What happens if the potential live in carer changes their mind three months after moving in? I would leave her were she is but maybe I'm pessimistic as to possible problems and her likelihood of deterioration.

I'd recommend leaving her in MC. Her needs will only increase over time and one caregiver in the home will not be sufficient since they cannot work 24 hrs a day. They will need days off and vacation and will get sick. This is too much of a burden, and hiring the 2-3 people needed will likely be too costly. Your mom sounds like she is doing fine right where she is. Not sure why you'd want to move her.

It would be an unnecessary temporary situation to take her home. If she is incontinent now, the end is not far away, maybe six months. My mom walked until the last few days of her life and only stopped eating and drinking the last week or so. Leave her in memory care where she has the interaction with others and some activities that she can still participate in.

I would rather my mom in her own home. Wouldn't you rather be in your own home, if possible. Some of these places care are terrible. If you can trust your friend, I would go for it. It's your mother's life & not everyone needs to be social able. If she is happy & keeping busy that is wonderful. Sometimes, people being around is exhausting. You might want to curl up with a good book! Too many cooks spoil the broth!

Hi. These are some of the hardest choices we as live ones have to make
My siblings and I followed our mom’s wishes. Several years, before being diagnosed with
dementia, she told us that she does not want us to take care of her in our homes. She knew it’s hard on marriages and family (she took care of grandma). Years forward, when the doctor/psychiatrist told us mom had dementia we put her in an assistant living facility with memory care. She complained but eventually adjusted in the Assistant Living side. The caregivers were marvelous. She made friends and enjoyed the outings. Mom has passed on. Not from the dementia but pancreatic cancer (we caught it to late).

Now I’m helping my husband with his parents. MIL has been-diagnosed with Alzheimer’s (2 years now). My FIL (1 year). We researched Assisted living facilities in our area but couldn’t put her in because my MIL was aggressive/combative with all who tried to help. She refused all medications. The Al facility told us they would accept them with a private caregiver for her. Way to expensive. We then researched home care. We now have 24/7 care for them. They hated it the first year but adjusting now. They wanted to know why there are people in their house, We just tell them Kaiser (their health insurance) said so or they have to be in a hospital. They accept care because “Kaiser” said.
I hope my experiences help you.
Stillhere1

My mother lives in a Memory Care facility with 24 other residents and about 10-12 caregivers. There is plenty of help, and she gets her needs taken care of as quickly as humanly possible, as opposed to Assisted Living where an hour wait was not unheard of. The cost is $6375 per month in Colorado. She has a hotel suite type of room with a large bathroom with shower; it's very high end looking & luxe. I would NEVER have her living in my home because it's just too much to handle. She's incontinent, and that ALONE is a full time job! She's fallen over 3 DOZEN times in the past couple of years, and I could never lift her up by myself, I have a terrible back and a prosthetic hip at 62 years old. She had a stroke this past October, making it harder for her to swallow, so she came down with pneumonia in May *which may or may not have been aspiration pneumonia* and needed a week in the hospital and 21 days in rehab* As her cognitive skills continue to decline, she's in the right place; everything, and I mean everything, is geared towards dementia issues in this Memory Care facility. They don't even use menus, but present two meals on red plates (to stimulate appetite) and ask the resident to choose one. No decisions, no confusion. The games they play, the activities they pursue, all geared towards the dementia; the staff are ALL trained specifically to assist these residents with their individual needs. I am simply NOT equipped to handle this at home, nor would I be willing to, to be perfectly honest. Mom just has TOO MANY issues that I'm unable to deal with. As it is my involvement with her, in the Memory Care, is almost a full time job withOUT her living with me!!! And that's the God's honest truth.

What would an in home caregiver, one person, be able to offer your mother on a day to day basis, by comparison, and what would the cost be? When my cousin hired an in home caregiver for her father so he could stay in his own home, she wound up filling up suitcases with all of the valuables in his home and having a truck pull up front to load it all up. I'm sure that's not a standard story, but one of many nevertheless. I'm sure there are horror stories out there with facilities as well, so be sure to make your choice based on informed decisions. In my experience, I 100% believe that my mother is still alive at 92 BECAUSE she's been in Assisted Living and Memory Care vs. at home with me. The ALF caught her first bout of pneumonia immediately, had the in house doc prescribe antibiotics right away, and saved us a hospital trip and possible death from the #1 killer of the elderly. We've had many such instances where the ALF or the MC stepped in to ward off disaster.

Best of luck!

First of all: if your mom's memory care home has a ratio of one aide to six residents, that's better than many places--although still not adequate. I'm one of the few people who believes that a communal setting can be better for the elderly than remaining at home, unless they are still very 'with it' and independent and remain socially engaged in their community. Better to hire someone to visit your mom a few times a week for a few hours. Be sure it's someone who will engage with your mom and not just sit on their cell phone. Maybe a senior citizen who'd like a little extra income and who will pay some attention to your mom, take her for walks, etc.

There is Much to Think about, Yes. If you Move her, And the Money is immense in her accounts, The Facility will Use it all to pay her way so she can Get Medicaid. Unless it is protected.
Talk to the Social worker over there. If there is one. Or get one. I agree mom is maaybe better off there right now, But there is alot Riding on her Finacial deal and there is much to consider. Dad is staying Home, My sister helps him and is His POA. He would have had to do a Spend time down the line to get Medicaid and didn't want to do this, Thank God he is doing okay.
God bless you and See what is Best, I agee though, She is probably bet left There for Better care.

Same situation here . My mom needs someone around . She fired one person that was coming by several times a week . She was lonely , couldn’t keep up with her medicines, her nutrition , her finances . I moved her to an AL close to me . It is very nice but not home and she had hated it . Going on 4 mo now and she is doing better , participates in many activities, had made some great friends , getting PT for her balance and looks better than ever . She’ll probably never understand or forgive me but I truly feel , under all the circumstances , it was my best choice . She does have memory issues which I had been taking her to drs the past two years . She can’t hardly remember her home now .

Roseformom, looking back through earlier events, I wonder if you're coming under pressure from your brother and it's undermining your confidence in your own judgement. I'm very glad that he and you have been working together pretty well, but it sounds as though you're both being tempted to take a big risk for uncertain gain.

Lots of people got there before me: hire this close friend to supplement the care your mother receives in the facility; but *don't* take her away from the safe, fully-staffed, fully-equipped environment she's doing so well in.

Even if you took your mother home and everything worked out well with the friend for the time being - and the friend has endless stamina, never needs a break and is in perfect health - you know that the time will come when one person cannot meet your mother's needs and you will have to get her readmitted to a facility. By that time your mother will not be functioning well enough to adjust, and it will mean another big change just as she's become completely unable to cope with it. And that is if everything goes *well*.

What's your brother's main reasoning? Is it financial, social, a bit of both?

Keep her there. My mom spent 5 years in memory care. The mix of residents changed over time with respect to abilities. Nice blend. I always liked to see some early stage dementia as they brightened the place and they were provided engaging activities.

Someone else suggested hiring the friend to tend to her at the facility. Great idea. You already identified a need at the facility based on staffing ratios - and trust me there will be many days in a facility where the ratio is much greater than what you think. Figure out a flexible schedule where the friend is at the facility with your mom throughout the week. Actually an unpredictable schedule works out better in order to see what is really going on in these places.

A live in caretaker will probably not be able to hold up to 24/7 duties, so you're not going to be able to do it with only one person. Family members get strapped with 24/7 and accept what they can't do anything about, but a friend is not the same. You're going to need back up caregivers to allow for days off, vacations, illness, personal time away from the house. The other thing is, if this friend moves in and gives up her own residence and things don't work out, she's going to be looking for another home within a, possibly, short period of time. Not worth having issues destroy a friendship.

Dear Roseformom..I am in the same boat w my mom..I lament over her being in memory care, bringing her home w a 24/7 Aide/nurse, etc..

No situation is perfect, but in memory care, your Mom has the best care, access to staff, activities, drs come to see her(no getting in /out of the car!), PT, OT, etc..

With my Mom’s moderate/severe dementia, we know additional care will be on the horizon..We will bring in a part time private CNA, in due time..

Your love, & providing the best for Mom, is a Blessing..She “senses” that, even if her communicative skills decline..Prayers for you, Mom & the family🙏🏻❤️

Our

Memory care has socialization and activities your mother won’t get at home. If she’s highly functional, other than the normal routine and meds, does she need a lot of help? Studies have proven that socialization and keeping active helps slow the dementia process. My mother is also considered to be more functional than many but she actually has worked that to her advantage as she likes to be the boss lol. It seems to me birds of a feather kind of flock together, at her facility they put like abilities and interests together for dining so they are more likely to become friends. My mother sat and watched tv pretty much 24/7 at home and rarely saw anyone but us. She was bored and depressed. She would never admit it since she lives to complain but she likes her ALF and considers it home.

Why would you want to move her since dementia only worsens? Bringing her back home is going to require a highly-skilled medical professional, not just a caregiver. I wouldn't advocate to make a change that drastic.

It's good that you are assessing the situation. Memory care is usually reserved for seniors who are at risk for wandering, or are uncooperative. It is more expensive, so not sure why she is in that wing.

I agree with commenters who say staying at home with 1 person is a sterile environment. Unless your friend has prior experience, she may be shocked at how boring care taking can be.

Unless your friend has a medical certification, she can't (or shouldn't) be administering any medications to her, even pills. Does she even have any first aid training? What if she's not as good as you thought...then you're going to ruin a friendship letting her go. What happens when your friend is sick or goes on vacation? Who will tend to your mom then?

If I were you I'd have your mom in long term care where there are many eyeballs on her and they are trained and there are things they can do with her socially. I also agree with hiring a companion to hang out with her for a few hours on a few days per week. But it begs the question: if your mom doesn't remember that she was visited, is it of any benefit to spend the extra money and hire someone for this? Is it really for your own guilt? I've had this dilemma with my MIL. No short term memory. We visit her because we love her but she forgets we were ever there 5 minutes later and gets no other benefit from our visit..

Make sure the facility she is in also has hospice care so that she won't need to be moved when "that" time comes.

Good luck!

Memory care is assisted living for those with dementia that do not need nursing home care yet. Higher level of care than straight assisted living.