Where to place mom who needs high level of care but mind is intact?

What you describe is advanced dementia. No, the brain is not good if it can't get the right commands to the body. She is well past Assisted Living and would need skilled nursing care. If she is high functioning and social, the nurses will adore her.

I don't see how you can conclude she has dementia. Just because her body isn't working right doesn't mean her intellectual processes aren't intact. A stroke could affect motor functions without affecting the mind's sharpness.

My mother was the same way, competent in mind, but her body was failing. It seems your Mom needs 24/7 care for ADLs. Not "all" nursing homes are full of dementia patients... that is a myth perpetuated by the uninformed. According to the alzheimers association, ONLY 1 out of 8 people over 65 and less than 1/2 (45%) of people over 85 ever develop dementia or alzheimers. Wish more people knew these stats..Just because a person is old or frail, does NOT mean they have these diseases. Some NHs have a separate unit for alzheimers patients, (at my old NH, they were mixed with the general population), others dont. Mu suggestion is to just do some research, reviews and pre-admission visits and find a good place for mom. Best wishes at this difficult time ...

I'm not sure what a "board and care"home is...I'm thinking you don't live in US...am I right? My dad is in assisted living and there are people there who need assistance at all different levels for daily living skills as you mentioned. Some minds are fine and others may have some slight dementia but if it's advanced then they are in memory care. I have to agree that you need to visit different places and interview and ask the right questions based on her needs and your concerns. Best to you.

Carolion, you have a situation that is frustrating for many. As was mentioned in this thread, just because a person is elderly and has physical issues doesn't mean the dementia is present.

Yet most care facilities have a majority of people who aren't sharp mentally. This makes it hard for the person with good cognitive skills but poor physical health to find a good place. You'll find nursing homes with people who are in their 50s and are there because of MS and other diseases. They struggle with the same issue. If you are lucky, you may find a home with a few people who are cognitively sharp.

You have to do what must be done, so get her the physical care that she needs. Then keep her supplied with social and mental simulation and work with the social worker to make good things happen.
Take care,
Carol

I'm not sure where your located.. but in the U.S. finding the "right fit" takes some researching. I've had the same issues with my Mom, who does have Alzheimer's, but she physically was still able to do ADL's independently. She lived in a facility that was Independent Living WITH add on services. It worked out well for her, as she only had and paid for the services she needed when she was newly diagnosed, which was only for about a year. Now, fast forward 1 year, and she is in need of Skilled Nursing Care (NH). Her Alzheimer's has progressed to the mid stage, she cannot walk without a caregiver nearby and her walker, some days, she can't walk at all. She needs help with all ADL's now, and is beginning to have wandering behaviors, as well as hallucinations. In hindsight, I wished I'd moved her to a facility that offered independent living, assisted living, and nursing care all at the same place. Multiple moves are very difficult for the elderly and especially those suffering from Alzheimer's. Good luck to you in your search, my best advice is to do your research and look ahead as well as where your loved one is today.

I see that you posted an earlier question asking about funding - is money the key issue here? Is it that she is being required to move from her current ALF because she can no longer afford the supplementary, intensive support she needs to stay there?

Whoa. "What you describe is advanced dementia." Not necessarily. As others have stated, just because someone can't do ADLs (activities of daily living) does NOT mean they have dementia. MS is just one example. Mind is fine. A friend of mine was involved in a car accident and became a quadriplegic at age 25. His mind was as sharp as the day is long. Unfortunately, he could no longer speak but used alternative communication devices to communicate with family and staff. He lasted this way for 25 years and succumbed finally to pneumonia at age 50.

To this day, I struggle to understand how he maintained a good disposition. If I was in his position, I would have begged to "end it all." He was completely dependent on staff, family for ALL of his needs. Again, his sharp and excellent mind was trapped in a body that no longer functioned. It would have been the ultimate torment for me. I admired his courage and strength. He was a stellar example of making the most of a horrible situation. He was my hero.

That said, try to find the best facility for your Mom's needs. One that has an active "activities" program to keep her engaged. Yes, there are facilities will elderly and middle-aged people mingled. I would consult an elder care manager, a geriatric psychiatrist/psychologist, caregiver support groups. Elders in your Mom's situation can become easily depressed with thoughts of their situation which can spiral out of control and cause even more complications.

You mention board and care homes so I'm assuming you do not live in the United States. Therefore, it's hard to give advice when most of us are answering from our knowledge of care in the United States. Do you have a gov't entity in your country that deals with the aging population? Start there.

In my mom's nursing home, many if not most of the residents are mentally intact. It may be that because this nh has a separate memory care/nh floor, the more severely mentally impaired patients are not mixed with the general population. I would seek a ltc facility that does lots of rehab work. They tend to have younger, healthier patients. Good luck!

Unfortunately, some residents of nursing homes have sharp minds but may be so hard of hearing that communication is difficult. However, where my mother is, there are some younger residents with sharp minds and good hearing, and a few older ones with these faculties as well. As Pam mentioned, if she is pleasant and sociable, the nursing staff will respond in kind (I see this with my mother)--but you'll have to overlook their patronizing "Sweetie"!

My friend's mother has a room in a beautiful old house nearby, here in NY State. it is called a board and care. It's like an old-fashioned rooming house for the elderly who need a little help, but who are still sharp in their minds. Meals are provided and someone is always in the house in case of an emergency. But they don't provide any health services. Residents must not be bedridden or unable to walk. Most of the residents have a relative or health aide to come in and set up their pill box for the week, take them to appointments, help them with bathing and dressing, and throw their laundry into the washer and dryer in the house. It costs at least $1000 a month, my friends mother pays out of her social security and a small pension, and it has worked out well for a few years. Now, however, though she is still pretty sharp, she may need another level of assistance, which will require she get on Medicaid to go into assisted living, and eventually a nursing home.

carolion, my Dad is in a wonderful place called Sunrise, which is nationwide, and he's happy as a clam there. Dad's issues are age related decline, thus for him mobility problems, yet he can answer the questions on Jeopardy. Oh there are times where he will forget something, but at 94 who wouldn't. Everyone he has met that lives there has either very clear minds or very mild memory issues.

Dad has his own 2 bedroom apartment, with living room and full kitchen, in the Independent Living section and he has "options" that will give him another level of care and still remain in his apartment. Such as help daily with showers and dressing, and with twice a day pill maintenance. The rent of his apartment includes once a week housekeeping, laundry, cable TV [first time Dad ever had cable TV so he is like a kid with a new toy], one meal in the dining room, on call nurse/aides, activities, etc.

Dad still has some of his Caregivers who he had when he still lived in his house, but this time instead of 24-hour care, they are only there from breakfast to lunch. Then Dad is on his own, and he can get around with his walker to go to the main dining room for dinner. And he needs to wear Depends. The facility offers life alert type of pendant that Dad wears.

We live in a large metro area thus there are many Independent/Assisted living facilities to chose from :)

As others have mentioned finding the right fit can be time consuming. It would be a plus if you are in a larger city with more options available. I found my moms current facility first time out but it didn't take pets and my mom wanted to keep her cat. So for two months my brother and I looked for a good facility that would take pets - never did happen. However, other than that, the facility is the right one. Small-ish, about 35 residents, at least 1/3 of which are probably under 55 and sound mentally but have severe physical challenges. These types of facilities are out there but you might have to broaden your search area.

Why is it so hard to find these nice smallish facilities? Small home-like places? I was at my wits end trying to find one of these facilities, and all I was ever offered were assisted living/nursing homes (the BIG $$$ facilities) - all the nice little assisted living places had 2-3 year waiting lists, and didn't take Medicaid. ..... Well, time passed and mom went really downhill past assisted living and went into a nursing home. (But I must say keeping her 'at home' until we got her on Medicaid and put in a facility
nearly killed me.) I always feel so bad when I read about the pets. I know how important they are, and I always hope they find new homes and not taken to the SPCA or even worse dumped by the side of the road. It makes me cry and feel much much worse than even the plight of the elderly. Something will ALWAYS come along for poor old mom or dad. The poor pets left behind, that to me is tragic.

Thank you for all your answers to my question. I found a wonderful Board and Care 15 minutes from where I live. The caregivers are wonderful(4 very loving to 1 resident ratio...6 residents. Great food, beautifully presented. I am, finally, very satisfied with the care she will receive. One woman resident there is 100 and mind sharp and actually in good physical shape, mobile with cane, not incontinent, hears well, ex librarian, loves music (as my mom does). My mom is 96 with sharp mind. All are in their 90's. Wonderful place and reasonable priced. Very grateful.

SNH.

Help2day -- the United States DOES obviously have Board & Care facilities, but due to their small size (limit 6 residents) they are not heavily advertised like all of the national for-profit chains. They are typically a bit more than half the price of the chains, vary widely and are not suitable for all people.

Lassie - not to worry about my moms cat. My brother took "Kitty" to live with him, his wife, their dog and their four cats - two of which are Kitty's litter mates. The cats totally rule the roost in this home. And - my mother is so crazy about this cat there is an entire paragraph devoted to his care and comfort in my moms DPOA papers. My brother also brings Kitty to visit mom. But I'm with you about the poor pets that get displaced in these situations. From time to time I look at the local shelters on-line listings and nothing breaks my heart more than when I see a pic of an obviously older dog - then read their bio, 10yrs old, owner couldn't take care of them etc. The poor animal ends up like this after devoting their life to their human - they must be so confused and scared! Okay - I gotta stop or I'll end up in tears! But yeah, I know just how you feel, Lassie.