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My mom has lived with me for over a year now, she moved from another state to live with me due to Dementia. The disease has progressed over the last couple of months and it has caused my husband and I to consider Assisted Living - Memory Care. I am a little hesitate to bring up the conversation with her as I know she does not want to move from our home, but the time has come for her to get the professional help she needs with Dementia. I am, also, just mentally, emotionally, and physically exhausted now and feel I have taken her as far as I can. I hope I am not being selfish but I really would like to have my life back. I'm not sure how to let her know that moving to an assisted living memory care community is the next step, or how to handle it if she refuses?

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I am glad that my cousin has had excellent care in her Secure Memory Care unit. It's privately owned and has low staff turnover. The staff are quite responsive to the residents and to my inquiries. There are laws and regulations regarding the standard of care in these facilities and in NC, it appears they are doing an excellent job in ensuring that they are upheld.
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Jclint
Glad you're using the term assisted living memory care as I moved my mom into one after a hospital stay following a fall with little to no time to make a decision and I feel like it was the wrong decision for her - after 5 months and tens of thousands of dollars spent I don't know whether to leave her put or try to move her elsewhere

How difficult can your mother get to handle ? Has her doctor prescribed anything for her agitation ? My mom was not on any meds for memory loss or agitation prior to memory care but I understand that certain drugs actually increase aggression - my mom is now on a tiny dose of seroquel that said if I knew 5 months ago what I know now:

Visit the facility without your mom on more than visit - the folks doing the tour are salesmen and it's too much to take in - yes activities are good but are folks really participating or are they just in their wheelchairs around a table or is there just too much noise and commotion ?

My moms facility has a good reputation but it used to be a boutique operation with 30 residents and has recently expanded to 62 - imho it is overwhelming now, understaffed especially at night and on the weekends when most families visit can be a circus.

In the 5 months she has been there, she's had numerous UTIs a very bad fall and countless others have had bad falls - we pay $450 extra mnth for incontinance care but countless times I walk in she doesn't even have a diaper on

vast majority of residents are way younger than my mom - she's nearly 93 - and vast majority are on anti-psychotic drugs - the men can get violent and so can the women - since I work long hours I tend to visit her at night 8:30 pm - 11:00 pm- some evenings the place is calm enough but others all hell is breaking lose and staff is limited -

my mom is scared - men even come into her room and one grabbed her so fortunately my private caregiver was there to intervene - yes on top of the $315 a day for the facility I'm now also paying $20/hour for 12 hrs a day for private caregivers - at $17,000 a month we can't continue as is for long

Questions you should ask/consider
1. Ratio of caregivers to resident (day/night )
2'. Private or shared room - mom's first roommate screamed in a foreign language all night - ultimately not having a private room may be the deciding factor to move for us
3. How many residents are on anti-psychotics - frankly there is no such thing as loving memory care there is medication
4. How many residents have personal caregivers - even staff tell my caregivers they're overwhelmed
5. How many dogs/cats are there - in addition to two house dogs , residents have pets - staff cannot attend to residents let alone dogs that pee and poop in the dining room - bad enough when residents do that - ugh
6. Housekeeping - initially I let them do mom's laundry but after losing too many things - yes they were labeled - I'm now doing her laundry - her things still go missing even her personal full size sheets
7. Medical care - will you still be taking her outside to doctor app or switch to their visiting doctor ?

I don't mean to paint an overly bleak picture - as long as your eyes are wide open and expectations are realistic for your mom's level of care - if she's fairly mobile and doesn't need much hands on help then she'll be better off than most
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Yes I have checked into the activities and all that the communities offer and the one we are thinking about choosing has many activities and things going on in the memory care community. She's had a very outgoing personality all her life so I believe she would enjoy and benefit from being able to participate in something like this. She's never been a person to just be by herself so that was the first thing I checked into. We have scheduled a time to go for lunch at one of the facilities we're thinking about to see exactly what a typical day would be like. I'm hoping she will like what she sees.
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I would also add that you might look at the activities the facility has for the residents. In my state, there are required activities for those in Memory Care. Do you think your mom would benefit from them? They are geared to those with substantial memory issues. They also attend to their grooming, hygiene, medication and nutrition. Knowing this might help your brother adjust to the idea.
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Thank you for your candid responses. I really appreciate it.
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I don't put much stock into the opinions of family members who don't have to actually care for a person with advanced dementia. They often have no idea what it's like, what is involved and how demanding it is on you physically and mentally. IF your brother is opposed to your idea, you might suggest that he take mother for a week or even a weekend and see how he feels about it.

But, since you are the designated person in charge, I would make the decision based on what you think is best. I'd do my research, tour the places, get legal advice about the finances, consult with doctor, make the decision for her best interest and find peace with it. Sometimes caretakers who are under so much stress and responsibility that they develop an odd sense of guilt. Even when it's not well based. I'd work on that, since it doesn't serve you well.

It sounds like your mom is no longer remembering things. In that case, there is nothing you can do to make that happen. Reminding her that you already talked about it, might just make her angry. Sometimes, it's a process that you have to work on to get her there. You may not be able to have her understand, accept and agree. Sometimes, it's not easy, but since she's developed to this point, she is no longer able to process things. Sometimes, it's a matter of explaining you are getting her some place that will help her and then going.

You are likely to get responses from other people as to how they got their loved on into a facility on this site. I hope it will give you some ideas and encouragement.
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Thank you both for your responses. Yes I do have Durable POA and Health POA for her. Some things she remembers, some things she doesn't? The issue I struggle with is sometimes it seems like she's managing the dementia (if that makes sense) not having to many outburst and talking to me coherently, and other days she's off the charts not able to do anything (very agitated/argumentative, difficult to deal with, doesn't know how to use the bathroom/pees on the floor, can't form a sentence, can't use the phone, takes her clothes off in public restrooms, or just refuses to put her clothes on etc.) At her last neurologist appointment the doctor explained to me that the dementia had progressed to her frontal lobe area based on the things she is now starting to exhibit. So it's really confusing to me sometimes since I don't know a whole lot about this disease. I'm not sure but I think she might somewhat remember something like talking about moving to an assisted living facility even if for a short period of time. We talked about the "possibility" of being moved to an assisted living facility a few months ago and after that conversation she was in her room as she says getting ready to move (although all she was doing was taking stuff out of one nightstand like papers and napkins and putting them in little bags in the corner, taking her clothes off the hangers and then "trying" to put them back on the hangers which she struggles with). She said we were kicking her out which i tried to explain wasn't the case. Now she acts like we've never discussed it asking when were going to move to a new home (me, her, and my husband). I explained to my mother before she moved with me that when the time came that we felt we could not longer provide her with the type of care she required, and we felt that we had taken her as far as we could mentally, emotionally and physically, we would sit down and talk about the next steps for her. I know that was said a while ago during a time when the dementia wasn't as bad so I'm sure she doesn't remember any of that conversation now. I'm no expert in dementia so I don't know what stage she's in but I know she's changed since she first moved with me over a year ago. one of my siblings has tried to make me feel bad for wanting to move her to an assisted living memory care facility and I must admit he has succeeded. he is not capable of helping her but he doesn't want her to be moved into an assisted living community. I feel guilty for discussing assisted living with her but honestly I'm just tired and want to go back to just being her daughter not her caregiver. I hope that doesn't sound bad or heartless because i truly love my mother and don't mean it that way but it's the truth.
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You might discuss the issue with the facility that you want to place her in. They may be able to explain what they need in writing.

I agree that much of how it might be handled depends on how advanced her dementia is. How much will she recall tomorrow if you discuss it today? Can you discuss it in advance with her doctor? Sometimes, the person has less to get upset with if they told shortly before they leave. Because, even if you explain days in advance, she would not remember it.

Does she have need for any types of physical therapy? With my cousin, her primary told her that she needed assistance with taking her meds, nutrition, as well as physical therapy to help with her balance and strengthen her legs. I added that she would get help with her memory in this AL facility. At that time she knew her memory was very poor. I called it Rehab. The doctor insisted she go, but gave her a little time to accept it. At the time, she had enough memory to recall what the doctor said the day before. She did agree to go after a couple of days and I got her in the car with only a small bag to have her admitted. Later, I picked up her other things. She thought it was temporary, so agreed so she could get better.

Do you have Durable Power of Attorney and Healthcare POA? If so, the facility may work with you, but I would make sure you have the doctor on board so he can fill out forms for her admission. I think that the facilities had to have a form completed by the doctor as to what her needs were. And when she began to wander, her doctor said she had to have Secure Memory Care. I'd speak with the facility to see what Memory Care admission requires in your state.

It sounds like you placing her needs first. It's a difficult thing to do, but may be the best option for her.
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Oh good heavens, you are not be selfish. In fact, pat yourself on your back for knowing that your Mom now needs a HIGHER level of care, something a lot of us are not trained to do, and/or have the emotion/energy.

As for telling your Mom, it all depends on the level of her dementia. Would she remember you telling her an hour later, or a day later?

One thing that might help is to tell Mom that she will need to spend some time in this health facility so that she can get stronger with the help of a lot of professionals.... elders like the idea of getting stronger :)

Then hopefully once she is there she will bond with the Staff and the other residents. Where my Dad lives, I see the women are usually together like everyone is each others best friend.
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