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My 72 year old mom has suffered with bipolar her whole life and started having some memory issues a few years ago but was living by herself with a caregiver until she broke her hip this last August. After that she developed delerium which lead to what the doctors says is dementia/Alzheimers, not sure of the difference. She is on Medicaid so it was really hard to find a place that had an opening for her and my sister and I were unsure of exactly where to place her. Some doctors said a skilled nursing home and others said a memory care home. She was living with me the youngest daughter for a couple weeks but it was way to hard for me to take care ofher. She has some memory deficit but is still "with it". Well my sister found an Alzheimers facility after the doctors at the hospital after her hip said that was what she had. They changed her meds and added Haldol to the other two mood stabilizers. To me it cured the delirium but it has made her seem more out of it and slower. My older sister says it is fine and we shouldn't rock the boat by changing meds. She found an Alzheimers Memory Care home near her and they accepted her as a resident. The home is divided into 3 "neighborhoods" and they each have one roommate. I have visiited and am bothered because although my mom has some memory issues she is the most high functioning one there and I see her becoming lonely because most of the other residents are worse off than her. I feel really guilty about it but my older sister says she is just fine and safe. The place doesn't seem bad it's just I am worried she will get worse by not having alot of stimulating conversations except with the staff. They do have activities and my sister takes her to lunch once a week as she lives only ten minutes away. I am now two hours away but for the last year and 1/2 she lived by me and I was the caregiver. I guess my question is am I worrying too much about it all? My mom has always had depression and bipolar and has tried to commit suicide 4 times , two times in the last two years. But now the memory problem seems to have taken over the bipolar symptoms. It was always hard to try to find a place for her because before none of the facilities wantd to accept her because of the mental illness so now my sister says our prayers were answered wtih the memory care accepting her? I am not as convinced as she is. She has also become very incontinent since being in the facility.

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Each person is different. I can't imagine going into a facility in less than 2 years. I recently turned 70 a few weeks ago, but for her it may be a good fit. I have 61 year old SIL who is getting ready to contract with a Retirement Community.
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I, too, have questioned whether placing my 86-year-old mother in assisted living six months ago was the right timing because she, too, seems high-functioning, although her short-term memory is pretty shot. However, taking her on a four-day trip to visit family over Christmas answered my doubts: She was disoriented and somewhat anxious, confused, and had two temper outbursts and one incontinence episodes. I realized that her high functioning was precisely because of the stability, routine, and limited environment of the assisted living facility. She has a daily newspaper, news magazines, and daily activities to engage her interest at the facility, and I take her out to "blow the joint" (as we joke) once a week.
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So much painful truth in your response Blackhole. Thank you.
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No, it's not too soon. They all go downhill. And the full spectrum of care is not for amateurs.

Here's what gets lost in translation: a significant potrion of the "downhill" slide is actually a zig-zag. As we (adult children) witness this, we are conflicted. And frazzled. And sometimes doubt ourselves. Or we have a Greek chorus of family and friends supplying the doubt.

So when Mom has a good day or a good hour or is showtiming her azz off, we tend to latch onto that behavior as "the norm." Sadly, it isn't.

It's wiser to make your assessments and decisions based on the bad days. And the sh*t you don't see but see the aftermath of. Unfortunately, it's heartbreaking. And strips away the cushion of denial.

I lost my mom a year ago. With the buffer of time, I've been revisiting my old perceptions. So much of the nonsense that I attributed to Mom "just" getting weirder and more intractable (lifelong traits) with age.....were manifestations of dementia.

In hindsight, I see how poorly-served Mom was by her precious (and so-called) independence.
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Dear gaylabarton, I understand your feelings completely and agree with others that your Mom may be right where she needs to be. I know how much it can tear you up inside. My Mom was a very difficult placement too due to medical issues in addition to her dementia. I'm so grateful that I found a dementia facility that could handle her complex needs and is taking wonderful care of her. Like you, I tried for as long as I could but it got too hard. Other more patient people are now doing the bathing, dressing, grooming, laundry, cleaning, cooking, supervising, changing, entertaining, etc. I notice that the higher functioning residents have a sense of pride and purpose. They redirect others, encourage them to eat, push wheelchairs, orient new residents, etc. I pray that my Mom will be able to stay right where she is for as long as possible. I hope you can find peace knowing your Mom is safe and not alone.
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I am surprised the continued use of Haldol has not been questioned by anyone . This is an antipsychotic medication often use to control patients with continued use. I would question this. I would also request, if not already done, an assessment of her degree of dementia. We placed my mother, stage 6 Alzheimer's, in a nursing home, for a couple weeks, while my wife had surgery and was recuperating. Mother was bored to tears because, at 91, she was one of the oldest people there, but the most active and mobile. We found a memory care respite ALF where she interacts with residents and staff alike and absolutely loves it. Yes it is pricey, $175 a day, but it is only a temporary convenience while we take a break a way for a week or so a couple times a year. She is re-assessed before every stay and they love having her there. You may ask about an ALF as an alternative at least until her dementia progresses, as long as she is mobile enough and is able to do basic functions for herself. Just a suggestion.
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Has the facilities social worker/case worker contacted your sister or you regarding a meeting to discuss her "care and make a care plan"? This is something that is done at the home my mom is in. In fact, the 2nd such meeting is this next Wednesday. In 12 1/2 months, this is the 3rd one. You might check into that. She seems cognizant at times but can do a about face in seconds. It has really gotten bad the past 2 to 3 months and is in a memory care unit and wears an alarm. They also had to put one on her window. And the code to open the door to her ward has had to be changed since she has watched them type it in (it's on the wall at eye level), and she had memorized it. I warned them once that she knew it. It seems she is in a good place. Unfortunately, we let quilt eat away at us even when we cannot change what will be. I wish you and your mom the best.
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My 92 year old mother with dementia was hospitalized for A ministroke and rapid afib. While in the hospital she completely decompensated. She was paranoid, demented and agitated. Many elderly people respond that way . It was so scary. She was put on an anti-anxiety drug. I asked them to discontinue it as soon as was possible. She spent a month in rehab and came home physically and mentally frail. We wondered if she would need extensive services. What we found was after a month in her familiar surroundings, she is coming back to her baseline.
I hope your mom adjusts to her new environment. We do know that stimulation is important.
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Even at assisted living, patients seem closer to their aides than they are other residents. My sister in a group home is the same way, always seeking staff attention. Nursing home, same scenario.
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Gayla

I went through this also. Unfortunately there is no perfect scenario. The place I picked was the best I could find with the finances I had to work with. When admitted, mom was higher functioning than most. When she lived with me and attended a day facility - she had friends or associates in that familiar environment. That changed when I moved her to assisted living. Mom would socialize with the staff more than the residents.

I asked if she could do activities with the more higher functioning people. Sometimes she goes over to the assisted living side and participates in activities. Maybe you can request something similar. Express your concerns.

Five months later, mom's dementia and health are worsening. They have had quite a change in residents and there are more higher functioning people; but my mom tends to stay in her room since she is not feeling well.

Unfortunately we do the best we can with the resources we
have to work with. I think due to her history of mental illness, you did the right thing. It is never easy.
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I remember when the complex said it was time for my Dad to move from Independent Living over to Assisted Living. Say what? Not my Dad.

Even Dad's private part-time caregivers were telling me he was having memory issues. No, that can't be right because when I visit him he is fine.... well, I guess Dad was "showboating" and I didn't realize it. Everyone was right !!

Dad didn't mind moving to much smaller quarters, and he still had his wits about him to learn his way around that floor. He knew right where the dining room was. And his tablemates were 2 other gentlemen. It was the right move.
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gaylabarton, I felt the same way when we placed mom in a memory care facility just a few short months ago.
She seemed much "better" than all the other residents.
Well, she already has progressed deeper into dementia and osteoporosis.

I'm so glad mommy enjoyed her time at memory care because after this last hospitalization, she will be needing skilled nursing. She loved the activities, her sweet caregivers, new friends, and the delicious food.
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My 87 year old mom went to rehab after a hip replacement. It was a grim place full of very old out of it, hopeless cases. I thought, oh crap! She's not gonna stay here! Mom is still quite with it and very quickly became the queen bee, so to speak. She has always suffered from depression but kinda realized how well off she was compared to those around her. It wasn't fun for her but she got busy, did her rehab and went home.

I know your case is different but maybe appeal to your moms ego a little by taking the queen bee approach. Who knows.....
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Thank you so much everyone who answered me. Just listening to your reassurance helps. You are all very wise and it is exactly what I needed to hear. You are "angels"
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I have found that most of us believe that our loved one may not be as effected by dementia as other patients or residents. I suppose that it's a normal reaction, however, I don't think that the medical professionals nor facility would agree to her admittance, if it was not proper. I know it's a tough call.

I would consider what your other options are if you attempt to place her somewhere for a higher functioning resident. How has it worked before? Granted, if she is too much for a family member to manage, it might be similarly challenging for a regular AL. Keep in mind that there may be moments that someone is "with it," but there may be many moments after that in which the person is agitated, confused, deluded, confused or manic.

Residents in a special care unit may fluctuate. Since my cousin first entered one, I have observed residents from very high functioning to very low. They all eventually progress. Quite a few of them have passed away that live in her unit. She has also declined in her abilities.

If you continue to feel conflicted, I'd arrange to meet with the special unit director and ask questions that might help you work through this.
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At only 72, I imagine your mom is also one of the youngest residents

It sounds like a good thing that there are three levels of care in your mom's facility as my mom's memory care facility mixes everyone together which can be difficult when behavior issues arise

My mom is over 93 and is one of the more conversant ones but no one there really has any friends - she hangs out with the nurse in the evening and I have a private caregiver with her 4 hours a day to give her one on one attention

The caregiving staff is usually overworked and when they do take a break they stay among themselves and don't interact with the residents

If you're mom can engage then hopefully she can enjoy an outing or help set tables for dinner or arrange flowers

Sadly there is no expert memory care - they largely leave them alone and medicate to control behavior- haldol was like an elephant tranquilizer on my mom and we're using another med to calm her down without overly sedating her
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Gayla I feel for you I really do. You have tried to do the best by your Mum and it isn't easy to say 'I can't do this any more'. But knowing when you can do no more is the making of a good caregiver.

Care homes by their very nature are significantly different from familial homes so first off you will notice that. However as her dementia progresses she will not have to bear the challenges that come from being moved out of familiar surroundings so think your timing is probably spot on.

She would have become incontinent anyway my angel - for that can be (but isn't always for everyone) part of the process.

Dementia and particularly Alzheimers progresses at different rates for everyone - there is no EXACT pattern or order although there are similarities. So if you think of a list of perhaps 40 symptoms in each of the stages then your Mum might only have 5 from one stage but she might have 15 from another. People will tell you this will happen next - there is no 'this WILL happen next' - it MIGHT happen - it might not. Dementia is so complex and so 'unknown' in terms of prognosis that there is no defined route - the only thing you can be sure of is that there is A route.

If you have concerns, quietly monitor and jot down your concerns to talk over with your sister and perhaps with the care home. I suspect (and hope) that, long term, you will realise she is in the best place. xx
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With our elders, it's always a balancing act between what's best for them versus what is available and affordable. Your mom has hit that intersection of those things in a way that may seem bad for her right now but it's available and affordable. If she's safe and in a place that will serve her for the long run, then I think she's where she needs to be. It's unfortunate that she seems to be more mentally capable than the other people around her, maybe she can help, like Barb suggests.

Can you call her frequently, since you're too far away to visit? Are there any other friends or relatives who can visit her? You can send her cards and letters. Would she be a candidate for something like an iPad, to keep her "plugged in" to the world for as long as possible? Or a handheld game device or radio?
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I think your mom is in the right place if her dementia has advanced to the point of incontinence. If she can chat with staff, perhaps there are ways they can allow her to "help out"?
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