I am trying to decide if it is time to move my mother into Assisted Living.

Currently, my mom is living in independent living, where they offer 3 meals a day, transportation and some activities, but no medical. If a resident needs a home health aide, they can contract with the company that is management-sanctioned (they have an office in the building).

I'm hearing conflicting reports about her capabilities, also muddied by my own observations.

I've asked my mom's doctor what she thinks, and she says mom is fine where she's at, but needs a little help with medications and housekeeping. (That sounds like entry level assisted living to me.)

The management where she lives treats her as completely incapable and my mother constantly asks me to call them for her requests because they won't listen to her. They have all but forced her to give up her cat due to her not managing the litter box. She is very upset to lose her friend. (On this I agree with the management and wish I could thank them, at least for the cat's sake.) The management is supposed to provide light housekeeping, clean towels and linens. Due to COVID they are not housekeeping at all. They drop off sheets and towels every week,and then they are appalled at her lack of housekeeping (she has never been one of those spotless types) and said pre-COVID that they can't clean because she has too much stuff. So, she has her own vacuum cleaner and mops the tile areas, cleans the bathroom as best as she can. They charge to bring meals up when residents are sick, after the first three meals. This place is way too expensive to have to pay for someone to walk up one flight of stairs and hang a bag on a doorknob. I wish they would credit us for the unperformed housekeeping, and all the breakfasts she has never eaten.

In their defense, having lived with her all my life, I confirm that she can be challenging. What annoys me is their supposedly hands-off-independent-living-we-don't-mess-with-anything approach while still managing to meddle in an epically unprofessional scale.

Okay. Rant over. Point is that although they haven't said anything, it's obvious that they think she is overly needy in terms of their offerings.

My own observations... I think she could use a more structured environment where there are people looking in on her daily and helping out where needed. (housekeeping and the like). She is a social person, so I would like her to be able to make friends and to live somewhere where the staff is supportive and treats her with respect. You know, like an adult with a mind of her own.

A couple other things:

-My mother has asked for the home health aides to set up her pills every week. (leading me to believe that she is unsure in this area).
-She is incontinent. (I point this out from a housekeeping standpoint.)
-She does have some trouble with short term memory and I expect that will only get worse over time.
-My mother is really good at pulling the wool over strangers' eyes when it comes to her capabilities. Hence why I think the doc thinks she's good.

I have broached the topic with her, more as a threat than a reality, but I plan to bring it up again in the near future. Currently I am running the numbers, and doing the research to find places that will eventually take Medicaid.

Anyway. Do I go with my gut on this?


Independent living is just that. You need no help.

I agree, time for AL. If she could not care for her cat, then she no longer can fully care for herself.
Helpful Answer (9)
Reply to JoAnn29

It sounds REALLY clear to me that your Mom needs a higher level of care. Actually she should almost certainly be given her meds now, which puts her a bump up from the first care level in my experience. Each place is different, but in my brother's place the medications nurse need bumps you to level 2. I believe your Mom needs to be in assisted living. Another poster today makes it clear that brief visits to doctors people often confabulate so well that the doctor cannot imagine what is really going on. Your post makes crystal clear what is going on and I can't really imagine not moving up to Assisted Living now, from my own read of it. Wishing you good luck.
Helpful Answer (7)
Reply to AlvaDeer

You say, "I've asked my mom's doctor what she thinks, and she says mom is fine where she's at, but needs a little help with medications and housekeeping." That is a conflicting statement! She's not 'fine where she is' if she needs help with meds and housekeeping, neither of which is offered where she's at.

It's time for Assisted Living. A person does not need to be totally incapacitated to require Assisted Living. Being incontinent, having a poor memory and the inability to administer her own medications is MORE than enough to qualify her!

Good luck!
Helpful Answer (6)
Reply to lealonnie1

I think you already know the answer.
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Reply to LoopyLoo

Incontinent and unable to handle meds screams a need for AL to me.
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Reply to ZippyZee

I just this week moved my 91 year old father into AL after 51 years in his house. He sounds very much like your mother but he has bad mobility issues too. The complex also has independent living (his lady friend of 15 years lives in IL) so he will have company, but he is getting cared for. They will take care of his meds, make is bed and tidy up every day with full housekeeping once a week. He gets 3 meals a day and snacks, but does have a kitchen so he can have food at other times. I am adjusting too because it's a change for both of us. But, I can worry less about him (he has fallen or gotten "stuck" and can't move well 3 times in the 2 weeks). I worried so much about the days he was alone in his house that it was depressing me. It sounds like it's something she needs, but it will also be for you. This way you know she's better cared for and you can worry less. I'm still working on not worrying (my daughter says I'm just a chronic worrier) but I know it's the best thing for everyone. I would say "Do it."
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Reply to Sharon40az

She would be perfect for an assisted living situation. My dad is in assisted living - 1 bedroom apartment including full kitchen. He gets 3 meals a day, weekly housekeeping (cleaning/linens), personal laundry, activities, a call button to wear so that any where on-site they can locate him if he pushes it, etc. A nurse is available 24 hours a day. In addition, he also has medication management, his doctor makes on-site visits, someone checks on him a couple of times a day. He is completely independent with personal care but should he need more assistance, either with ADLs, or housekeeping, etc I can just bump up his level of care. Should he need more full-time assistance I can bring in home health aids that I contract for separately. Sounds like your mom needs at least medication management (in my dad's place that's level one care) and maybe an additional level for help and additional cleaning/laundry due to her incontinence.
Helpful Answer (2)
Reply to jkm999

Move in with her for a couple of days even if you have to sleep on the sofa. Then you will know for sure. Tell her work is being done on your house and you need a place to sleep for a couple of nights.
Helpful Answer (1)
Reply to careinhome
chillinwithscb Oct 4, 2020
I don't see any reason to lie. But staying with her nonstop for a couple days is a good plan. I did that with my father when the senior center staff told me me he was declining. I had stayed away due to covid and thought he was still ok. But after 3 days and nights in his apartment I knew exactly how he was. I knew better than his doctors or the senior center staff; better than my dad knew himself. It was time for me to care for him: to make choices he no longer could make for himself.

I hope you find that your mother is still able to care for herself. But be prepared to step in.
It’s sounds like it’s assisted living time. The assisted living will also send someone out to evaluate her (usually) to make sure she’s appropriate. With proper medication management you may see some improvement, but a decline will likely continue. When you talk to the assisted living factor in additional fees for medication management, bathing and dressing. For instance there is a basic fee for my mother’s AL that includes laundry, cleaning, paper goods, meals, activities, transportation to stores. We pay extra for medication management (nurse administers all medications), bathing, dressing, etc. Her fee structure just went up because she is declining. I didn’t worry about Medicaid for AL because her next step will need to be LTC if she continues her decline and outlives her resources. Go with your gut. Things are not going to improve. And I found in my research that the AL was cheaper than hiring in outside help at her independent living apartment. The AL that my mother is at also has a visiting doctor, mail order Rx service, and mail order incontinence products that they manage and tack on to the bill. I found this very helpful in that I have basically two main bills, the AL and the pharmacy that lists all costs for her care. This makes it very easy to track ALL her expenses for Medicaid in the future. Good luck - this isn’t easy. I can only say that when I second guessed myself I was wrong!!!
Helpful Answer (1)
Reply to Mepowers

Imho, your mother may require a higher level of care going forward. Prayers sent.
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Reply to Llamalover47

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