Did we move Mom into memory care too soon? - AgingCare.com

Did we move Mom into memory care too soon?

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My 67 year old mother has Dementia (undiagnosed but all signs point to it and she is on medication for it). Recently we moved her into assisted living after she asked for us to. She loved the facility and the apartment she was at, was doing fairly well, and was most importantly happy. After a couple months of being there the staff noticed she would wander the halls (my mother has always loved walking) and had a lot of trouble getting dressed, and was starting to show signs of incontinence. Based on these signs they recommended she be moved into their memory care unit. They took her over for several lunches before the move to get her used to it. When we finally told her we wanted to move her there she was all for it. Now after being there for week she hates it!! She notices the other residents are all in great cognitive decline (she is the highest functioning person there) and feels like she has no one to talk to besides the staff. She feels trapped because there is not nearly enough room to walk like she used to. All in all she is miserable and wants to go back to her old room and see her old friends. Did we move her too soon? If after a few months she still hates it, should I move her back? I want her to be safe but I almost feel like her happiness is more important.

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I personally feel that being around people that are further along on their decline could be very bad for her. PLEASE move her back where she can be with her friends. As far as incontinence she can wear pull-ups. I'm 68 years old and lucky that I'm still healthy and very active, when the time comes that I need help I hope my children won't put me in a place where I won't be challenged to live my life as fully as I'm able. Get her back with her friends please.
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You wrote: "My 67 year old mother has Dementia (undiagnosed but all signs point to it and she is on medication for it)." The "undiagnosed" part bothers me. Before you make further decisions, my suggestion would be to take your mother to a physician who has no ties to the care facility and who has extensive experience with geriatric patients. I would ask the physician to perform a detailed physical examination, an evaluation of her medication, plus examinations that will determine the degree of cognitive decline your mother is experiencing.
I know of a woman whose family had these things done for her so they knew exactly what they were dealing with when locating an appropriate facility for her.
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Talk to the staff and see who is the next highest functioning resident. See if you can set up a coffee meeting or a card game with those two individuals. You may need to be present to help the conversation get started. If you can create a friendship with this two, you could be enriching TWO lives instead of just one.
I had to do this with my father in law in the standard nursing home. He wouldn't leave his room, so I joined him at lunch for a few days and "I" struck up the conversation with the table mate. I would ask a question -- Hey, Jim -- I heard you like to so and so -- My father in law here - Dale -- also likes to so and so -- Dale, tell him about the time you -- etc. And I got them talking. Now, they have lunch together every day!
Good Luck!
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I disagree. Walking and wandering are not the same thing. I often see people moved to memory care way too soon. Has she gotten confused and couldn't find her way back to her apartment? That would be wandering and a reason for memory care. I love to walk and will walk around in my own home if the weather is bad does that mean I need memory care?
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I had the same issue with my 63-yr-old cousin who went into assisted living 2 ½ years ago after being diagnosed with dementia. A year ago she became completely incontinent and unable to dress herself properly. It was clear she would need more hands-on care and we felt she would get more of what she needed 24/7 in the memory care unit. She was happy about it at first – probably because it was something new and different – but after a short time, she became agitated, belligerent, and started throwing things and cursing – all of which was completely out of character for her. She even struck several assistants and another resident. In turn they medicated her which turned her into a mindless zombie. The memory care unit was very small compared to where she was before, where she was used to walking the halls and seeing other people and it turns out that she felt very constrained in memory care and simply needed freedom to walk around. Fortunately a room came available close to where she had lived before, and we moved her back out in that area. Since then, she has not had one episode of violence or cursing. She gets the care she needs regarding dressing and hygiene, and things have calmed down considerably. Happiness is relative when one has dementia, but I would have to say that she is definitely happier or at least more content being back where she is now, which is out and around and able to walk the halls and talk to other residents.
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Karen- You have a right to move her if you do not feel she is being appropriately placed. often these large communities put a lot of pressure on the staff to fill up the beds regardless of whether the placement is appropriate or not. I know because I worked at one and now work with many of these communities. You are your mom's advocate! Do not let them push you around.
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My mother lived in a conventional assisted living facility, a "memory care" assisted living facility, and a nursing home. Here is my advice, for what it's worth. I would definitely consider moving your mom back into the conventional assisted living side of the facility--for now. It sounds as if she is truly "walking" around, not "wandering" (i.e., getting lost or trying to leave the facility). And I bet she really is one of the highest-functioning people in the memory care side. My only concern is the incontinence. Someone above said that incontinence care should be a standard part of assisted living--but it's not. It depends on what kind of license the facility has. When my mother had another small stroke in her conventional assisted living facility, and became incontinent overnight, the assisted living facility was unable, legally, to assist her with changing her Depends or changing her clothes. They could only stand there and coach her verbally, but she needed a bit more help than that. They could also only shower her twice a week. I had to hire private aides to come in and make sure that my mother was clean and dry--hiring them for several hours a day. It was more expensive to do that than to pay for the higher cost of memory care. However, if your mother loves the assisted living side of her facility, it might be worth it to discuss the option of moving her back as long as she has extra help from private aides to deal with the incontinence and keeping her clean. Also, even with private aides, your mom may need more help than that. My mom, for example, was left in a wet bed in the conventional assisted living facility (she pulled off her Depends), and was found like that in the morning by a private aide. That moved me to quickly move her into an excellent memory care facility across town, where she enjoyed nearly 3 years with a loving staff and dementia-specific activities (until she ran out of savings and had to move to a nursing home on Medicaid--also a pretty good place, fortunately). Your role here as her advocate is very important, and she's lucky to have you looking out for her. Some other advice is to a) make sure the incontinence is not caused by something fixable, like an infection, b) talk to a counselor at your county's office for the aging to see what their advice might be, and c) consider hiring a geriatric care manager (expensive at $50-$100 an hour, but well worth the investment) so they can assess your mother's situation and give you some solid advice. I wish you and your mom all the best.
--author, "Inside the Dementia Epidemic: A Daughter's Memoir"
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No don't move her back, but talk to the staff there about activities for her. If she is wandering, she will wander off the AL premises, a very unsafe prospect. Staff can connect her to others at her functional level, and that can change as her decline will continue. Her other friends will be joining her soon.
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Check with your pharmacist about the incontinence patch. Most incontinence medications, and many others for that matter, are anticholinergic. In and of themselves, they can actually induce dementia, so taking them when someone has dementia is ill-advised.

Please refer to a book by Grace Jackson MD, Drug Induced Dementia - A Perfect Crime. Your mom should be evaluated by a neuropsychiatrist before she is given any dimension drugs. It certainly isn't enough to have her primary care doctor guessing at her condition.

To download a list of medications and what is called the Anti-Cholinergic Burden (I can't post it here directly because it is a.com), please search google for "prescribersletter.therapeuticresearch anticholinergic" exactly as written and the first choice it comes up will be the PDF file. This is an industry list to pharmacists, yet I have personally delivered the list 25 different pharmacist who knew nothing about it! This list gives non-anticholinergic alternative to anticholinergic drugs.

I learned of the anticholinergic effects of drugs from a neuropsychiatrist. Don't presume any doctor automatically knows about this. There is another list called the Beers Critetia for Potentially Inappropriate Drugs for the Elderly.

Comparing these 2 lists side by side will give you more knowledge to ask intelligent questions of the doctors treating your elderly patient. If the doctors are unaware and are not interested, guess what? Probably with the wrong doctor!
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There is a major difference between wandering the halls and not finding her room and the dangerous wandering outside. Not sure, but I think that the people that wander away from the facility are trying to get away and go back home. If your Mom is happy there and has not talked about going back home(often meaning their childhood home), and you don't think she would wander away from the AL facility, then you might want to move her back. My Mom's cognitive ability declined very rapidly after she started wandering the halls, but if we had moved her to memory care when her other functioning was so much higher than the others in memory care we would have questioned whether her rapid decline was caused by the move.

Also, trouble getting dressed and incontinence seem like normal things for AL and not a reason for memory care.
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