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Mom has been in a very nice memory care facility just over a year, in Texas. I am the only caregiver, and I live with my family in Maryland. She was adamant about not moving up here; I cannot move down there. Even if living with me was an option, her care requires 24 hour professionals now, which I obviously cannot give. She is pretty mobile still, but her anger, which she has always had, is now "unleashed" with her advanced dementia. She has been on a number of medications, mood stabilizers, anti depressants and anti anxiety meds, none of which have a lasting effect (Risperdole previously and Depakote now). She spent 2 weeks last month in a psychiatric/senior behavior unit to see what they could do with her, which is why she is now on Depakote (she also had a dementia-related seizure while there - Depakote is a mood stabilizer and anti-seizure med)
Staff is concerned for the safety of the other residents at this point. I have no idea what kind of facility would take her, and if I have to move here, I don't want to do it again! She also has a dnr, and is currently admitted to Hospice/Palliative Care, because her quality of life is diminishing so quickly.
What kind of facility can I move her to without fear of her having to move again? She's not quite ready for the immobile life of a skilled nursing home. (this is the worst part of Alzheimers - the mind is gone, but the feet and fists still work). My dad was caring for her until his stroke last year, which is when I had to move her into the facility. Dad died in October. I have a brother, also living in a nursing home with brain damage in Texas. I am all mom has left. No other relatives to help.

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Thanks for your input vstefans. My mom has always swung and thrown things - she just had more control over it before dementia set in, so it's not related to UTI's or anything physical. Still, she is regularly seen by a physician, and various physical issues are addressed. The facility where she has been is really top notch - they just are not able to handle aggression issues. It was suggested that a "smaller, less stimulating environment" would be helpful. Mom is an attention seeker (not new with her) and she is will get more one on one attention at a home with less residents. Doing the paperwork today. And yes, it's still heartwrenching. I'll be down in a couple of weeks to visit.
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Usually someone else already posts this, but another thing to do is a medical checkup for UTI or other infection or even just fluid and electrolytes out of whack. My mom would swing a purse at people and was not really strong or mobile enough to be dangerous, but any time she was like that it was actually medical. At one point right after getting out of rehab she did not like a facility and rather than get used to it I think (in retrospect) she stressed out and had an MI; I was blessed that I had been able to move her and was right there and could make sure she went to an ER for a medical eval, where they knew her and I knew they would treat her right, instead of a geropsych unit. Turned out she'd had a second MI. You did a good job not letting yourself get beat up emotionally on here too, BTW. I still feel guilt at times that I did not move/uproot my family, etc. but did the long-distance caregiver thing for nearly 3 years, but who knows how that would have turned out if I had, or whether Mom would have lived longer or better or not. My mom was important to me and yet was not the only person or thing that was, and the decisionmaking was heartwrenching and the traveling and scheduling stressful and demanding...its good you found some good help! Hope it all goes well.
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To all, except "perseverance," your answers have been at least encouraging, and helpful, too. I spoke with the executive staff where she is and they knew of a company that operates several group homes in the area. I was a little skeptical, but I reviewed their website (and I grew up in the area, so I knew where they were). These folks work quickly, and came out today to assess my mom. They realized if mom hits another resident, the State must be called and that will make putting her in a place where I want much more difficult. They specialize in aggression issues and were very compassionate. I asked, "Is there any behavior my mom can do that will cause her to have to leave?" She said, "No, this is what we do." I am reviewing all the paperwork tonight and will make a decision after I sleep on it. Thanks, all. And perseverance, sounds like you have some sibling issues to work out. You should stay off forums for folks who need encouragement, not judgment. Yes, you really ticked me off at a time when I needed help. I hope you get more support from your family.
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SSwaim, are your sure your mother is not ready for a skilled nursing facility? Dementia with physical violent tendencies requires a type of facilty that can handle that kind of condition. There are nursing skilled facilities that work with Hospice/Palliative Care. You owe no explanations for your choices in this situation. Whatever you choose it will be right for you and your mom's safety. Good luck!
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Agree with isnteasy. She is not in a condition to be moved and likely it won't matter at this stage of the game. Don't inflict more trauma on her or yourself. I would consult with director or social worker where she is now and get their perspective, this isn't unexpected behavior and they have expertise to compassionately deal with the behavior hopefully. If she is a risk to staff or other residents and they have exhausted all resources, typically there is one or two special facilities that are equipped to handle violent elders. Some are good and some we cringe at but you should start the discussion with present facility so you will have peace of mind and be knowledgeable for the "what ifs". NC has two such facilities.

I can appreciate perserverancs' perspective but she doesn't walk in your shoes. My mom is adamant that she wants to go to a care facility in her hometown if forced, but I prefer her to be near me. At this point, that will require a medical transport at considerable expense. I will do it for my convenience not because it is what she wants. Then what happens when you relocate a loved one and your job gets transferred another state? Or you decide to move near your children and grandchildren...

I say put yourself and your family first. Don't let anyone make you feel guilty for your choices.
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Whoa, "perseverance"! You're reading an awful lot into sswaim's post! Sound to me like she has some pretty compelling and practical reasons to keep mom right where she is and, given her own family situation (which should be everyone's priority!), she has already gone above and beyond for a mom who has made it very difficult.
Sswaim – Considering all the practical concerns and your mom's current status, I think I'd leave her in Texas, too. With her behavior issues, it sounds like a skilled nursing facility is the best place. Don't worry about the sedentary lifestyle of the nursing home. The 'feisty' residents find each other and it will be the best thing for her to be in a place where behaviors like hers are something that's commonly dealt with, not cause for being kicked out. She just might make some real friends there, where she won't be the thought of as a cantankerous outcast.
I feel for you trying to manage all this on your own and at a distance. Remember to find something to laugh about every day.
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If she has been admitted to palliative care, then hospice will certainly have recommendations in Texas.
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"She also has a dnr, and is currently admitted to Hospice/Palliative Care, because her quality of life is diminishing so quickly...She's not quite ready for the immobile life of a skilled nursing home"

I don't quite understand how she can be admitted to palliative care but not ready for a nursing home, but anyway, given that she must stay in Texas, the task is to hunt high & low for a suitable facility - whatever type or category it may be. Have a frank discussion with them about her needs (they will have heard it all before), including the part about this needing to be the last move, and then make the best choice you can given the circumstances. Good luck.
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15 years ago she was in a different state of mind and need. I don't mean to ruffle your feathers. These are important questions. Visiting 5 times a year, and calling is not the same as being there for your Mom. Sorry.

Your Mom could be medicated and you can travel with her on the plane. People do this all the time. I think what I am hearing is that you don't want to really be bothered on a day to day basis with your mom's growing needs.

A bit about me: I am the youngest sibling in my family and the one in the vicinity to care for my Mom. Other siblings, even if they call and visit are NOT caretakers for my Mom - how can you really be living in another state? It is a different ball game having your parent near you when you care for them.. Your mom needs you and you've left here in the care of strangers... Sorry, but it is true.
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Perseverance - Brother is a state-paid patient and cannot be moved, as another state will refuse to take on more expenses. I tried for 15 years to move mom here and she refused. And yes, she has friends visit her almost weekly. She doesn't know who they are anymore, though. Moving her now would be complicated - can you imagine someone with violent tendencies on a plane? And continence/bowel issues for all day travel? And it is a lot more expensive up here. I am in contact with all her staff on a weekly basis. Not sure what you mean by "more involved" but if that's more time at the facility (besides my 5 trips a year to see her), I'd likely lose my job. My husband is unemployed and I have 1 kid in college and one more next year. And, she has already bought and paid for her funeral in Texas. So I move her up here, she runs out of money, and dies. How do you suggest I get her back to Texas for burial? I stated "many reasons" for not moving her. There you go. What I need is practical help for my situation.
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SSwaim...I don't understand your decision to keep her in Texas in a facility with no family nearby... That mystifies me, especially given your Mom's dementia. I recommend pulling her out and moving her to a facility near you, where you and your family can be more involved. Essentially, your mother is surrounded by strangers (and I suspect her friends don't visit) day in and day out. I'd be depressed too.

You sound like you a have much on your plate between your brother and your mom. Perhaps both can be moved to Maryland?
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