Did we move Mom into memory care too soon?

When to move to a memory unit assisted living: Quality of Life is the question for a person with declining memory loss. The goal is not longevity, it's quality. Would the person consider their life quality now if they could be reflective? Is the person doing unsafe things? Is the person unhappy? Is the person roaming outdoors and getting lost? Is the person high functioning enough, and safe enough, enjoys at least one person in traditional assisted/independent living, is sensitive to more declined residents, enjoys their own company, is not a joiner, is open to hiring a private aide for short check ins during the week if needed. There's a lot to consider when uprooting someone. Metrowest Eldercare Management

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There are memory care facilities with space to let residents wander to their hearts content. My husband "wanders" to the piano room to listen to live entertainment, or to the soda shop for a root beer float, or to the movie theater where classic movies are showing. They have men's coffee, ladies teas, gardening, crafts, cards, games, Tai Chi, you name it. I could go on and on and on. Often, residents go "nap" in the wrong room. Everyone understands. Memory care is not the same as a nursing home. Keep searching until you find the right fit. Try googling "Silverado Memory Care."
They have an excellent memory care facility. I'm sure there are others, too. Good luck and don't give up.

I am so interested to read all these answers as we wade through the deep waters of what to do with our parents and their growing memory issues! Most of you say to wait and put it off until no other choice, which I so appreciate!!

My alarm bells went off as I read, "they recommended she be moved into their memory care unit" because the memory care unit is undoubtedly much more expensive....It is extremely rare for there to be an opening in the memory care unit, and the facility probably was looking for someone (is your mom self-pay, or on Medicaid?) who could fill that bed, and pay more for it.
Sorry if this sounds harsh, but I speak from experience, with several GP/aunts/parent in different facilities, most facilities are going to work very hard to fill their more expensive beds first.
In fact, when you visit these places, they will encourage you to sign up on their waiting list (and perhaps charge you a few grand for it). What does this accomplish? It helps the facility to fill open beds, sooner. But does it help you, find a place, at the time when **you** need a bed? No.

MsTaylor that is spot on!

Thanks for the update. Your doing all you can! I often find that after I leave my Mom and feel bad, she forgets her complaints to me and moves on. I am some times left worrying needlessly.

Thank you so much for the update, asherry - wish more people did that!

You are right again. It could be 1. that she was more ready for the memory unit than you'd realised or 2. that her meds, the stress, the lack of stimulation and everyday company or some other factor (possibly correctible, though I don't want to get too excited for you) is at play.

Good to hear the memory care people are being helpful and co-operative, at least. Best of luck with further explorations, please do keep us in touch x

That's great that she has friends in the asst. living area and they are willing to take her to activities and accompany her back. That in it self is great stimulation for her.

Just to let everyone where we are at now. I met with the health director yesterday. We discussed all of the reasons they felt my mother was ready for memory care. She was in fact getting lost on the way to and from her room and starting to "hang out" right by the front doors. There were several other reasons but those alarmed them the most. They also did another mental evaluation that was the exact same one she took 2 months ago. She scored significantly worse on it. They do think that stress may have affected that and are going to retest her in a few weeks but they don't expect too much improvement. I did arrange so that she can do activities in assisted living with her friends so long as they take her and bring her back. So far she seems happy with that arrangement. She has recently told me she is starting to hear my dad (her ex-husband) talking to her even though he has not been to see her at all. Her memory was also noticeably worse yesterday and she seems paranoid. Unfortunately I think she was more ready for memory care than I thought. Whether we keep her at this facility is another issue. I want to make sure she gets as much stimulation as possible. I am still planning to take her to a doctor and have re-evaluated. We will see from there...

Ferris, you are so smart. You amaze me.

Brilliant, Asherry, don't see how you could do more. Very best of luck finding the ideal setting for her from here. x

That is another option. Keeping her in memory care but just at another facility with more opportunities. I feel like they do not have enough activities at this place. Every time I go, usually at different times of the day, everyone is just sitting around. Whenever we ask if someone can walk my mother around they say they can't because they are understaffed. So it seems like my mom is getting very little stimulation. If after an evaluation we find that memory care is the best fit than I will find a more suitable arrangement. If however it seems like she was put in too early and we can move her back to AL than that is what we will do.

Remember, we are here to support. Whatever Asherry chooses to do will be the right thing for her family. Blannie, nice answer.

No easy answer to this one. I agree with pstegman and InWyoo. Having an evaluation by a geriatric doctor or a neurologist specializing in dementia can be very helpful. While medications can make a big difference in functioning, many of the traits listed by responders above can also be part of the dementia journey. My husband willingly moved into a memory care until at age 63, 2 years after diagnosis. Fortunately, this facility has built in many activities and freedom for its residents, even though they are locked in. He is the highest functioning resident, yet still has wandering issues and as the day goes along, many times agitation issues. Each individual and care home are different. Is there another facility near-by that would give your mother the supervision she needs along with more freedom and activity? Is she at a point that any change can be disturbing to her? Her reasoning ability is probably not what it has been in the past. With dementia, you may find that safety outweighs happiness. My husband is much happier using a chain saw than being in the memory care unit. However, it is no longer safe for him to use a chain saw. (Yes, an extreme but true example.) Best to you as you move forward with your mom.

My mom is the highest functioning resident in her unit. She needs to be there because she forgets she isn't strong or steady enough to tend to herself. The caregivers take her to the front for all the activities and to get her hair done. Can they do something similar with her?

One does not need to be seen by a neurologist for admittance to Asst. living or Memory care. Your family Dr. just needs to review the request and send medical records with recommendations for what care is required. Most asst. living places have a range of care provided to almost no help to asst. in almost everything. And you pay accordingly. My Dad after being hospitalized entered at a level 6 out of 7. He needed assistance to get up, shower and get dressed etc. He was not able to stand on his own etc. Now he is at level 2 which means they only oversee meds and weigh and check bp daily.

YES!

A person must search the answers to these type of questions within themselves because only that person knows all of the circumstances involved in their decision. asherry, we all make mistakes going through this process but only you know what is truly right for you and your mom. Good Luck! Caring thoughts...

Thanks again everyone. Definitely lots to consider and I will listen to my own gut. We did do MRI's and bloodwork not long ago. Her doctor did start her on b-12 injections but even with getting them on a regular basis and making adjustments to the dosage we did not see any improvements. Again I definitely want to take her to a new doctor and/or neurologist to follow up and get more answers. The place she is at now accepted her into assisted living because she asked to be placed there, they also got a note from her doctor and they did their own in house evaluation. Based off all of that they deemed her qualified for assisted living. I go in Monday to speak to the director in the memory care unit to see what our options are. I will keep you all posted.

Asherry you've gotten a lot of good advice. One thing I'd say is to listen to your own gut. You know your mom better than anyone else - doctors, staffers, etc. Gather all of the information you can and then decide. If you do move mom back to assisted living, it's not cast in concrete. If she needs to go back to memory care, I'm sure they'll find room for her. So do what makes the most sense for your mom. And also get your mom a full physical exam with blood work to rule out things like vitamin B12 deficiencies and other deficiencies that are easy to fix. And check her meds for possible side effects. Good luck and please keep us posted, as we all learn from each other.

I want to revise what I said earlier in that without a diagnosis of "dementia" how do you know for sure unless she has had an MRI, EEG, a long psychometric exam, etc.? Another illness that mimics dementia is a B-12 deficiency which can be solved with B-12 injections. How did she get into this assisted living facility without a diagnosis from a qualified neurologist? I need more answers, but I am glad to hear the facility is letting her friends visit from the other unit.

I respectfully suggest that you have your mom seen by a geriatric specialist who can professionally evaluate her mental and physical condition. She may have a urinary tract infection that could be causing her incontinence and affecting her general health. Also, if appropriate, her doctor can prescribe anti-depression medicines that do not turn her into a "zombie." Her physician can also give you advice on which facility is the best fit for her present needs. I wish you the best in all your efforts to care for your mother.

If the memory care place is like the one my Mom is in she is there too soon. Further more she may decline faster without the cognitive stimulation of the other environment. She would be out of place where my Mom is. No one remembers anyone there except their beloved family members or even where their rooms are etc. Was she wandering away outdoors and getting lost? That is the only reason I would consider having her in a memory care place this early. My Dad is now in asst. living and while he is mentally capable many of the residents are there because they are in the early stages of dementia. And a lot of them need help dressing etc. for a variety of health reasons. Move her back the sooner the better.

Chicago 1954 brings up a good point have her checked for a UTI urinary tract infection. My mother would be out of her head and I would panic only to find out it was an infection. To keep cost down I kept several sterile specimen bottles on hand and would run a sample to her doctors office to have them check. I can't stress how important I believe it is to develop a rapport with her doctor or his/her nurse. I didn't do anything without his approval. He still called the shots while she was in AL and made my life easier. So happy you made the call to see about her continuing to interact with her friends.

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!

My mother's doctor is aware of her being in assisted living, but he's not aware yet of the recent move to memory care. He's the original doctor who prescribed her the meds. We've run several test and gone to a neurologist and while they say she displays symptoms of dementia no one has ever given me a definitive this type or this stage or anything of that nature. Even before all this happened I was in the process of looking for a new doctor just to have her re-evaluated. From what I've seen in the memory care it does not appear to be stimulating enough to me. So if we do not have the option of moving back I would be open to looking into other facilities.

I think I would talk to the staff about whether they would be willing to "cope" with the newer problems. I believe it is our duty to help them be happy if we can. She has been cooperative thus far about placing her in a home, maybe she had made some friends there and she misses that too.

Asherry, going back a bit someone else mentioned this too: I'm still puzzling over who prescribed medication for your mother without going to the trouble of properly diagnosing and assessing her dementia. Apart from anything else, how can you tell if the medication is helping or not? I really don't like the sound of it.

Such a difficult position for you to be in, I feel for you, especially the point about balancing your mother's safety and her happiness. I suppose we tend to think 1. Safety 2. Physical comfort 3. Happiness in terms of deciding priorities; but of course they blur and overlap. No joy in keeping somebody 100% safe if in the process you make them 99.9% miserable.

It's in the memory care unit's favour that they are prepared to carry on discussing options, and presumably, then, will keep considering different options. Having said that, how do you feel about the range of activities and enrichment they offer in the memory care unit? Letting her friends visit doesn't quite cut the mustard, even assuming her friends will want to set foot in the place (they might regard it as similar to prison visiting): what else do they suggest? What about a caregiver accompanying her to visit her friends?

I also sympathise with your mother's feelings of claustrophobia, as I'm sure you do. The trouble is, that's not an issue anybody - not you, not the staff - will be happy to take any risks with. Terribly difficult to judge the exact point at which wandering within the home will suddenly become some misguided person holding the front door open for her and… doesn't bear thinking about. On the other hand, best practice should dictate that the whole facility is laid out to aid orientation for the residents: colour coding on different floors, clear signage, that sort of thing. Is this one up to the mark on that, do you feel?

On the question of your doctor, would he/does he have a good track record with your mother's care? I'm surprised that he isn't up to date on her anyway, if he still regards her as his patient. But if you're generally happy that he (or she, of course) is doing a good job with your mother, then yes by all means discuss decisions and get advice.

Finally, there's the question of what alternatives you have. If you could find a better facility not too far away, would you consider moving her? What is provision like near you? Before you even thought about it, of course, you would need to be very sure that another place was so much better that its advantages would outweigh the drawbacks of a move, which are considerable; but that doesn't have to mean that it can't be done.

So much to think about. Meanwhile, try not to get upset yourself about how upset your mother is. I don't mean be unsympathetic to her, of course, just don't get yourself into a state worrying about it - it won't help you reach clear, well-founded decisions. Comfort yourself by remembering you are working hard to find the best quality of life possible for her. That in itself makes you a good, caring daughter - well done you. x