My parents are moving to AL and say Mom needs the memory unit. My parents and I don't agree. Are there DOH standards?

Quick note to CarolLynn: I have been bitten by the need for editing in posting in this and similar mechanisms in other venues (who hasn't?) - the downside of real time typing. If your comment is longer than the small view window, your best bet is to compose it using Notepad, Word, or something similar. Do your editing there, then copy/paste it into the window.

Don't give up on AgingCare! This is a great site and you are needed to help make it great!! :)

This is common knowledge among those who work in senior living...the caregiver often dies first, particularly when advanced dementia is part of the picture. They carry the stress not only of the caregiving (which is overwhelming in and of itself), but also of maintaining the facade for the adult children. No matter how much those kids think they know about their parent's dementia, they really only know the tip of the iceberg of what their caregiving parent deals with all day, every day.

Depends upon your state, but regardless of how tight or loose the definition of who can live in AL, in the fuzzy area (like where your Mom's condition has her now), it's a judgement call by the community. They may decide strictly based upon an intake evaluation (which is a pretty comprehensive review of a person's care needs) or depending upon their staffing and staff skill set. Some communities work harder to keep a couple together.

If you aren't fully committed to this particular AL and you have several to choose from, look at a couple of others and explain your situation. See what solutions they offer. One I can think of is to have them live together in a single apartment, but add an additional care level for your mom – much less expensive than a separate apartment for her.

That said, you have to prepare for her to need a 'locked unit' at some point in the near or not-so-near future, so you shouldn't move them in to a place where their finances won't survive if one of them needs much more expensive care.

Is there a reason your parents couldn't live together within the memory care unit? Your father with full facility privileges and lower levels of care, your mother with more care but being evaluated in real time and real circumstances to see how she manages.

If your heart is set on this facility, you might want to have a conversation with the director to learn exactly what deficits they observed in your mom that would preclude her from the general population?

I was within earshot during the evaluations done by that facility as well as the one we eventually chose. Listening to her evasive answers was heartbreaking:
Q: "Can you tell me today's date?"
A: "I can't keep track of the dates now that I don't get a newspaper."
Q: "Can you tell me the President's name?"
A: "I stopped paying attention to politicians a long time ago because they're all the same."
Q: "How old are you?"
A: "You don't even want to know that. I'm ancient."
And so forth. I stayed just outside the doorway. Close enough to hear, but out of her line of vision so she couldn't look to me for help.
Those interviews shocked me. I knew she'd had losses but had no idea how far she'd slid, especially since she still recognizes everyone (vascular dementia, not Alzheimer's).

Your suspicion that facilities can be motivated by money and space available may be well founded. When searching for AL for my mother we saw several facilities. One didn't offer memory care, and was really pushing us to move her in there. We resisted because it was obvious to us that Mom's cognitive skills would have put her at the lowest level of the residents we saw during the tour. At her rate of decline we would have had to move her again in six months or less. They had a hefty move-in fee, which would have been squandered, not to mention the considerable disruption to Mom.

We continued to search and found the perfect place for her. It's less convenient for me to visit because it's farther away and off my own beaten path, but is much better for her. I hope you find someplace that will accommodate your family's needs.

Your profile doesn't indicate where you are. That may make a difference and what answers you receive, a skate setting any of their own rules.

Generally speaking, each level of care, from residential to assisted living, or from memory care to nursing home, has its own guidelines. There are limits to what kind of patient each type of facility is allowed to administer.

It sounds like you're in a tiered facility, where the patients can be moved to different levels depending on their needs.

You might want to try interviewing some other facilities for their opinions.

Different states have different rules about what kind of care can be given in what sort of facility. In NY, for example, if you are a two person transfer, that can only be done in a NH, while in nearby Connecticut, it's okay in AL. Have you called your state department of health?

We have a similar issue here, but turned 180 degrees. Clearly my Mom needs memory care, a secure facility, and I expect it may be a nursing home. However sibs think Mom would be just fine sharing an apartment with her husband. They are looking onlynat cost, not what would be best for both of them. He needs assisted living, mom memory care. So the cost will be in the area of 10k a month, on the low end for both of them. My mom's behaviors while she is still at home are difficult to manage and her hubby is relieved when I take care of this dirty work. He willingly admits he would not be able to do it himself. Does not make sibs happy in the least they have their eyes on the prizebat the end of the rainbow.

In my area we are beginning to get what they are calling memory care transition programs in assisted living/memory care facilities. They allow a couple to share a unit at a reduced price for double occupany. Then the one with dementia participates in a day program, at additional charge, to give time to the caregiving spouse. It will be interesting to see reports on how this method actually works. My Mom as it is is up and down all night long. If she were in a new place sharing space with her hubby, he would never get any rest not good for him. Expensive, yes but it is their money for their care.

This is such an interesting question. Probably as Pam mentioned, it all depends on your state laws. I hope the OP will re-post updates as her situ gets resolved (sounds like an ongoing fluid situ). On a side note, I did have a grandparent couple, one had ALZ, they survived about 18 mos at home with 18 hr paid caregivers. Then moved to adjoining rooms in NH and one spouse died 2 wks later, we all say they were so incredibly worn out from having been in the presence of their ALZ spouse. IE they would have lived much longer if their ALZ had been placed in NH, earlier, so the wife could finally get a break from all that craziness. Its incredibly stressful just to be around. And if my spouse and I were in AL, someday, and the couple next door had ALZ, boy I would be moving in a flash (if it were disruptive). Those who do not have ALZ shouldn't be forced to be continually exposed to it, especially if they are paying a lot of money for a nice AL, it changes the dynamics of the AL.

Yes, it was so hard for gramma to just be around her husband--they even had live in caregiver and more, but it was so stressful (live in CG would quit too, it was so hard). So he only way gramma could "quit" was, once her hubby was in ALZ care. Then she could relax and go to Heaven for some respite!
But I also feel (maybe too strongly) that A.L. residents do reasonably expect their homes, hallways, dining room and common areas should be free from disruptive behaviors....even if that is from another resident's spouse. After all this is why people are moved to memory care or dementia wing, because their behavior needs are too great to be met by just their spouse or by themselves. Its a nice way of saying, these individuals do not "fit" in with healthier people--its no good for the sick folks, but it also isn't any good for the healthy ones. Very rough time for a couple, I hope doesn't happen to me, but I have written in my Health Care Directive that I don't want to be residing with family or spouse if I should develop ALZ or similar. Because it's too hard on THEM.

Another thought: since most AL's are month-to-month rentals, the facilities may observe that a couple no longer "fits" with their community and ask them to leave. I have at least one friend whose parent is on their 3rd facility this way. Most people imagine they are going to move to AL and that's where they'll be forever, but not always the case.