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Dear SSSepe,

I know its always hard to come to an agreement with a sibling. I would try to compromise. Or even take a video with your phone of some of the places and take pictures to show your aunt and see what she says. Its always a good idea to include your aunt in the decision making process, but I also know its hard if she has memory issues.
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Do not bring the elder on any tour of an AL. What should happen is the LO'S family member takes tours of these facilities; then he or she makes the determination what is best for the elder, including a contract.
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Would she do better in a smaller board and care home, if a suitable one is available?
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With evaluating any facility, I recommend showing up unannounced/no appt. Why? Seeing is believing. Ask the receptionist for a tour and as she
scurries for the Director use all your senses to size-up the environment.
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Ferris--I beg to disagree. A person with dementia may not be able to "voice" that they are unhappy--but they certainly HAVE feelings. Plus, I would hate to see someone I loved in a substandard place just b/c "well, they have dementia, they don't notice". I've been constantly surprised by how much my elderly friends who are considered "long gone" with dementia remember and can call forth in conversation. People I haven't see in years have been able to talk to me by name and I have a VERY unusual first name. We're not living in their minds, we don't know what they suffer or don't.
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I really do think it depends on whether she recognizes that she has memory issues or not. And, also, whether her memory issues have made her be kind or belligerent. My mother has anosognosia and thinks she is perfectly fine and, unfortunately, she is pretty belligerent. I took her on a tour of the place that I'd already chosen (without telling her) and she was annoyed that it took so long and was pretty rude about it. I've been told that my mother is in early stages, but she barely remembered the place when I moved her in. So...should you take your aunt on the tour...I've recently realized that sometimes my inclination to keep my mother informed and included only backfires on me. More stress for her and for me.
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To add to my post above.... for my Dad, I found him a senior living facility that reminded him of a resort we all use to go to that was a Victorian type resort.   Thus he was happy when we drove up to the place and commented that it had reminded him of that place.

The inside had a very large living room, numerous sun rooms with wicker furniture, and the halls were more like a hotel.   Behind the building was a nice area with picnic tables, benches, and very nice landscaping.   Also a library, and a TV room for when the guys wanted to watch football.   Plus a common dining room with table cloths and menus.  Yes, the place was expensive but Dad had saved of such a "rainy day".

Thus, finding a place that would remind your Aunt of a place she had enjoyed in the past.
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I agree. No. It is only agitate her and what difference does it make? One looks about the same as the other, the prices only change. People with dementia do not care what a place looks like.
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Maybe use the approach of looking at these places before she needs it. If she thinks she has no problem now, go with it. Tell her she needs to decide before she gets a problem. That way you'll know her wishes while she can still decide. She may fall for it. It certainly won't hurt to try.
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I sought out 15 different AL facilities. I took pictures to show mom what they looked like. The doctor said she could no longer live alone. I took her on different days to 4 of them. I saved the best one for last. She loved it! We had lunch there and a tour of the facility. It took her 2 months to finally say she was ready to move. She couldn't take care of her house anymore or herself. Once she was in AL, she told me to stop coming every day because she was just fine. They filled her days with exercising, bingo, puzzles and lots of other activities. They kept her busy and even though her mind was going fast, she liked going to different activities throughout the day.
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This may help: For example at our ALF (group home) we offer adult daycare. Some people suggest to their family member that they'll be less isolated and have things to do, if they come to be with us in the daytime, and they need not make the leap all at once. First they come in the daytime, and get a chance to settle in gradually, seeing it's a nice place and the caregivers are attentive, there are activities and so on. They have help and need not feel anxious alone while family members work.
Down the line, there will be an opening. It helps all involved, as the better places (smaller is better for several reasons) won't always have openings for residential care. Rather than place her in a large place (remember, just because someone drove a car last year, they did Not live in a hotel or hospital) People live in Houses, largely or in apartments. Some have already downsized from a large home to a small apartment as widow(er)s. Others live with family, and guess what, None of those places is Big, with a lot of unfamiliar hallways and people always in the common areas, that they don't know.
This can Cause more memory issues, as the new resident of the large ALF is feeling lost and anxious. What do they typically do? Give them sedatives, and even anti-psychotic medications. In the Small group home setting, you'll be consulted more and you can meet their doctor, who comes to our home once a month. I went through a few, until finding one who's on my page with Natural treatments, supplements when possible and not drugs with side effects. You can learn as well, as the small place has time to help you encourage your loved ones to eat healthier and to be calmer and happier with the move.
I hope you find just the right place.
Doreen from Angel House in south Florida
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When you say your aunt is in denial about her memory issues... is she resisting moving to AL altogether, or is she happy with the idea in principle but doesn't agree that she particularly needs help?

Either way, I agree with everyone else that you and your sister need to do the initial reconnoitring. Apart from anything else, you don't want your aunt freaked out by a facility that turns out to be absolutely vile - reeks of urine, or has semi-naked residents bent on escape round every corner, or trolleys with uneaten pureed meals left standing in the lobby.

But in terms of involving your aunt in the choice as far as possible, I'm with your sister. Narrow it down to three; take your aunt on a leisurely tour of each one, preferably having lunch there, and take notes; then a further visit of the preferred option to confirm that she's happy with it.

Wouldn't you want a say in where you're going to live? Being cognitively impaired doesn't mean you can't have an opinion.
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We thought my mother was in denial about her memory issues, but it turns out she has anasognosia, meaning that the part of her brain that allows her to see her deficits has been impacted by the same disease that affects her memory. It helped me understand her seeming unwillingness to see things as they were was actually not under her control. She still thinks she's right as rain and will be able to again drive a car, live independently, get a job, etc. I agree with others here--find a quality place or two that you really like and know will meet her needs, and then bring her. But she probably doesn't see the need to move someplace so it might still be an uphill battle.
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Agree with Cwillie. Researching and finding a good AL place is overwhelming and exhausing. Lots of research is necessary and the person(s) responsible for your Aunt must go there first and interview - ask loads of questions - look at the staff - ask to meet the aides - what type of living will your Aunt qualify for? You write 'memory issues'.. if she was officially diagnosed with Dementia, then some places accept a resident in their AL area and some, depending on how good (or bad) she is, possibly might need a facility that only offers Memory Care. I would do all the leg work and pick 2-3 places your Aunt can choose from so she is in on the decision. Good luck! :-)
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SSS, you can also make it like a pre-view luncheon date.   Most Assisted Living facilities will offer you and your Aunt a free lunch if you make an appointment to see the place.

Depending on the size of the resident's room, your Aunt may balk at the size of the room, unless the rooms are more like an apartment.   Maybe your Aunt could start out in Independent Living if the facility has those, and if she can be assessed to live there.   My Dad was more than happy to move into a really nice 2 bedroom apartment that had a full size kitchen, and large living room.   It made the downsizing easier.   He was tired of trying to keep up all the maintenance on his own home... he was ready to pack and move smaller.

Another thing that may bother your Aunt is seeing other residents with walkers and wheelchairs, especially if she is in denial.
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I think you can do this in two stages, you and sister can pre-approve two or three and then allow auntie make the final choice.
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