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Mom has moderate alzheimers and we moved her to an independent community a week ago. She is so confused and wanders at night. I have had to stay with her every night. How long shall I give her to adjust before moving her into assisted living? She has become much more confused and angry. She would really hate assisted. Any ideas how I can get a break from staying with her at night? I have a family at home

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My mom, 87, doesn't have Altzheimer's but is in the early stage of dementia. She lived by herself in a gated senior citizen community and attended an adult senior day care facility for 3 days a week. The day came when her anxiety of being alone caused panic attacks that made my sister and I have to go to her house to calm her and put her to bed. When I checked into ALF's, I picked 2 that were close by so that we could visit mom frequently and bring her to our houses for visits and occasional dinners. The one that mom now lives in allowed her to try it out for up to 30 days. (We had to pay the daily rate but we didn't have to pay the entry fee). After about 10 days, mom said that she wanted to live there. Her ALF has many individual houses with about 16 residents per house. Everyone in mom's house have dementia of one kind or another, with varying degrees. There are more houses in another section for people with more advanced dementia, where they can't roam off b/c of a wrought iron fence around the property. Finally, there is an Altzheimer's residence for those needing much more supervision.
Mom's room is very pretty and cheerful and she has a private bathroom. An aide gives her a shower twice a week, she goes to their hair dresser once a week,
and she gets to go on many outings with the staff and her "new" friends! I have her house for sale and mom will sometimes say in a wistful voice that maybe she can move home if the house doesn't sell but I gently remind her of the reason that she chose to move out of her house.
If it ever comes to the problem of "wandering", it's not a problem b/c the doors to her house have to be opened and closed with a code. The residents that have brought their pets with them can walk their dogs if they stay nearby. Whenever the resident can't walk his dog b/c of bad weather or other reasons, the staff does it.
This house is probably more expensive than the average ALF ($233/day + RX's +special supplies like DEPENDS, wipes, Ensure, etc.) They have agreed to keep mom when she runs out of money if she can self-pay for 2-3 years, which mom can do, if her house sells!!
From what you've said about your mom, she would probably be better off in an ALF than independent living. Mom gets all of her RX's and I don't have to worry about her taking the wrong RX's. (She once took a suppository by mouth for her
constipation!
Good Luck in whatever decision you make. God Bless You.
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Dear Jangirl,
An independent living community is not set up for people with Alz. She wanders because she is looking for her house or something familiar. If Assisted is within the same community, move her right away. She is in a time of transition right now and it is not fair to her to have her finally adjust and then move her again. It has taken Daddy 5 months to adjust and he still doesn't like it but is less angry. If you need to, you can hire an outside source PA who will sit with your Mom at night and calm her and remind her where she is. We did that for both Mother & Daddy for their 1st month. Then we weaned them so they would accept the facility's personnel and schedule. I guess what I am trying to say is there are no time-lines. Transition is very hard on everyone. It only gets worse. This has been my experience that minimizing the actual transition is best as they can 'get on with it'.
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My mom has moderate alzheimers - i live with her and really, she couldn't be left alone for any amount of time, due to loss of relativity about time (an hour seems like hours) and at night - some nights she sleeps all night, others she wanders, so we need someone with her 24/7. Before another move for your mom - to assisted living - you may want to consider instead, having an overnight caregiver come in. Also, I know that my mom would't be able to live in assisted living because they don't offer enough around the clock care. Our only option right now is in-home caregivers. Medicaid waivers will give you many paid for hours, and possibly over night. I'd suggest checking with the Aging Services in your community. It's a challenging situation - my best to you.
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From what I've seen, a lot of assisted living facilities are as nice aesthetically as the independent living ones but will provde a lot more guidance and support. There are some communities out there that will provide any degree of care from independent to assisted to skilled nursing. If it helps any, even a lot of skilled nursing facilities are trying to capture some of the look and feel of assisted living with nice communal dining and sitting areas and allowing a lot more personalization in patient rooms, though typically you can do a little more furnishing in an ALF just because they are more like apartments and space is less limited. Try an assisted living locator service for your state and see what you can find that Mom would like best. I found out the hard way that the "atmosphere" had to be what Mom liked and found most comfortable, not what looked comfy and homey to me! She strongly preferred a brighter-lit, more modern and to me more sterile and spread out facility and adjusted well to it within a couple weeks. The one I liked made her anxious to the point of having a second small heart attack - unfortuantely she didn't manage to tell us what was wrong until *after* the trip to the ER and back to the hospital. She had moved before, and it had always seemed to help that I took pictures when I toured and showed them to her, then she'd say OK, that looks nice" and then I helped set up her room with favorite familiar things. She lost some vision ability with her last CVA and it was too much effort for her to even look at the pictures, so she just told me to pick one, and I picked wrong.
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You might check into smaller, more "homey" assisted living facilities for your Mom. My mother was in one for a while (only 20 residents) before she moved in with me and we all liked it better than a larger, more "institutional" facility. We have to remember to tell ourselves also that as much as we want our Moms to have what they would like, they are not in a good position with dementia or alzheimers to be making these important decisions for themselves. You have to do what will work best for her condition. Good luck and God Bless!
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Hi Jangirl,
When a person has dementia any move will be confusing due to their memory loss. They have lost the previous "clues" that they are dependent on to orientate themselves. If mom has moderate dementia as much as we like the independent living facility the reality is that it doesn't have the structure and staff to help redirect them and give them the feeling of safety that they need.
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Moving seems to speed up the process of dementia in my experience. If you put your mom in assisted living she may be angry for awhile but she will be safe. And if she wanders a lot in assisted living they will not want to keep her as it is a real liability issue for them. Wanderers need a special place but I haven't been able to find one. We ended up putting my mom in an Alzheimer's facility. She can get to enclosed and secure outside areas but she is not free to just wander off. I don't have to worry and more about the police being called in to find her as happened last fall in assisted living. Good luck to you. Remember that you have to make decisions on what you know now and you can't look back and second guess yourself. This will be a difficult enough journey without you beating up on yourself.
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People with Alzheimer's rarely do well with change. However, if the assisted living center has an Alzheimer's unit, they will be able to take better care of her than her independent living folks can.
You shouldn't have to be spending the night away from your family. She will take a few weeks to adjust, and her doctor needs to be aware of what is happening. Work with the professionals to get her to a place where she is safe. You'll have to cope with her anger and confusion no matter what you do, so most likely the quicker the change is made the better. Please check with her doctor for suggestions.
Take care of yourself, too.
Carol
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