My mom, 85, has dementia. We managed to get her on meds and into a really nice AL facility (a bit of a miracle with a dementia diagnosis) but she is really chafing at the restrictions on her freedom - she wants to walk to grocery store on her own, resents the multiple daily checks, etc , but the policy for the AL faculty is (rightly so) that she cannot leave on her own and must be checked every couple of hours. I think she has anosognosia, and has always been stubborn. She won't give up trying to get more freedom and we are worried she'll end up in memory care sooner than she really needs it. Also I'd like her not to be so frustrated and angry and make the most of her time in AL, hopefully avoiding MC as long as she can. But I just don't know how to talk to her about this.she's so convinced there's nothing wrong with her beyond normal old age. Any advice? BTW I live in another country. My sister is nearer and has POA - and is often, unfairly, the scapegoat for my mom's anger.
If mother can abide by the rules (happy or UNhappy) you can let her remain n ALF. If not she will require an upgrade. Some places now have a sort of in-between facility that is more like ALF in terms of staffing and care levels, but that does have locked cottages. That would be ideal. If not, mother may have to move to MC which as you understand, may be nearly double ALF fees.
Assisted living is for people who need extra help but don't need complete care. When someone wanders unsafely, they need complete care with others making the decisions.
It's really difficult because there may be other ways in which your mum is still herself and still "with it". However, there are few places that offer a medium way, and safety has to be the paramount concern for the AL facility. So, if they can't keep your mum safe, they probably won't be able to continue to provide what she needs.
I'm sorry it's got to this point. There's no point in trying to reason with your mum - it's an impossible task - and there's no point in your sister enduring your mother's abuse.
It's time to step back and just make sure that your mum has appropriate care and safety, without making yourselves Mum's emotional punching bag, or worrying about whether she's in memory care or has the semblance of independence in AL.
Moms AL had a key paid and I needed to know the code. I also learned who was allowed out and who was not. But not all visitors do, and may let Mom out. ALs are really for people who can come and go. MCs are lock down units.
Mom can be as angry as she likes, but that won't change anything. The rules now need to be the rules. It is worth discussion with her MD as to whether a low dose antidepressant may help. Often they do.
Good luck!
You are projecting your hopes and wishes upon your Mom, who is no longer able to get her mind into a place of acceptance and contentment due to her *progressing* dementia.
Maybe her meds need to be adjusted to address the agitation and anxiety. She is clearly an "elopement" risk. My 90+ yr old Uncle managed to leave AL on his own the first and last time: he fell while trying to cross a busy road but luckily was helped and EMTs came and took him to the hospital, then back to the facility where he went into MC — an appropriate level of care for him going forward. He eventually adjusted to it as best as someone with dementia and memory impairment can.
If your Mom hasn't been in the facility for long, she needs a time to adjust and often it is recommended that visits are cut back until she does. Your sister should only call or visit her in the mornings to avoid Sundowning behaviors. She doesn't need to talk to her more than once a day and when she scapegoats her, your sister needs to redirect the conversation and if that doesn't work she needs to just end the call or discussion by telling her she has another important call coming in and that she'll talk to her tomorrow. Then she lets all further calls for that day go to voicemail so she can review them for any real urgency.
I'm so sorry for this distressing situation but it probably won't always be like this. You are doing the right thing, and everything about dementia is hard. Blessings to you and your sister. Hang in there!