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We recently moved my 66 year old uncle who has Parkinson's, depression, anxiety and partial blindness from his home to an assisted living residence. He is free to go in and out of the facility. Recently with the change in his medications it has caused him hallucinations and feelings of persecution. He recently wandered onto the streets in claiming he needed to buy something at the store but ended up falling and requiring stitches. Luckily staff from the assisted living received a call from the hospital and brought him back. Due to his fragile and fluctuating mental state (which most assisted living residents do not have), I am wondering what is the next step in our options for a cared living facility as he may no longer fit in an assisted living situation. Nursing home? Enclosed dementia home? Mental health community?

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Kayunsis, you should have the regular checkups and medications of your uncle. Apart from this, it will increase the responsibility. As your uncle is taking medicines from a long time and it has made some changes after the medications. Also, he is in assisted living so it will take time to adjust. I believe you are just having the doubt that he might not get fit in an assisted living situation.

Assisted Living has many benefits and one of the major benefit is they allow care for the family members which they mostly need. Also, Assisted Living provides quicker emergency responses and gives seniors their personal space.
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66 years of age is very young for an NH. Ask his geriatric physician. If he does not have one, obtain one for him.
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Generally every 6 months or so you will schedule a meeting with someone from staff to go over a care plan. You can also wait for the AL to contact you. My MIL has 4 children. To keep her costs down they would wait until the facility contacted them that it was time to move her to a place that had more care.
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I agree with the above posters. Most ALF's do have "step up" (or "step down", whatever makes the most sense in requiring more care) units within the ALF facility. My dear client was initially placed in a lovely ALF apartment with all the bells and whistles. As she progressed with her dementia, she was gently moved "upstairs" to a more secure unit and watched more closely. To her, it wasn't a horrible dragged out thing--she simply moved upstairs to a more "hospital" quality place. It was a lockdown, so no wandering was allowed. The facility was very expensive, but the family could afford it. I know she died in peace and lovingly cared for. Doesn't make watching the downward progression any easier to see, for the family, but the peace of knowing your loved one is cared for and safe..that's priceless. Just ask the ALF where you uncle is residing, I'm sure they'll answer all your questions and offer solutions.
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We are going through this now with my mother-in-law, she has sat back and when dementia kicks in she wonder aimlessly around the assisted living facility. A change in her meds has helped but she is going downhill fast.
The Assisted Living is wonderful, but they have informed my wife that if she becomes too much to handle they will send her to the nursing home which is part of the facility.
With people living much longer, it is often the children who now are much older and like I, retired. My wife is the POA and primary decision maker. She has a lot on her plate, dealing with her father's death, her mother mental illness, paying the bill and still working.
It is not like the days of old, I never knew my grandfathers or one of my grandmothers. My father died young at 65 and my mother live a healthy life except for the last two years, she passed away at 88. That was 5 years ago. My father-in-law lived to 93.5 years and my mother-in-law is 85 and suffering from dementia. She doesn't even know her husband has died.
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When the wife of a couple who made me their POA became incontinent and started to wander, I found a memory care apartment in an AL facility for them both. It's a locked floor, so wandering away was no longer an issue. When she became resistant to care and needed cleaning due to her incontinence, I took her to a geriatric-psych ward of a hospital where they found the right combination of anti-psychotic medications to calm her without doping her up. Hospice helped a great deal at the end, monitoring her blood chemistry to keep her comfortable until she passed. The facility I found took excellent care of my friends and the husband still resides there due to his lack of short-term memory and ability to care for himself. He thinks he is as sharp as ever, and he is intelligent, but without the memory part working he would be in tough shape on his own.
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If these changes are related to medication changes, your uncle may need to have his medications adjusted.
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Ask the facility to help with placement. Often they have sister facilities that will accept the patient without a lot of hassle.
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Many assisted livings have memory units. If he is otherwise physically able able to function a memory unit would be appropriate. However if he has a requirement for skilled care then you should consider a Nursing home. The facility that he lives in will be able to help determine what level of care is appropriate for his needs.
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