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Hi! My mom has been in AL for 2 years now with moderate dementia. Per the staff there, she is okay since she is used to her routines and has adapted well. I'm her long-distance caregiver daughter with DMPOA. She needs to attend a few dental appointments soon for crowns (necessary not optional) and I'm not sure how she'll react. Routine cleanings are fine. I can't afford to fly out to help her with these appointments.


I'm considering hiring a home health aide that can, amongst other things, escort her to the appointments. Minimum time is 16 hrs per week.


Has anyone done something similar? How did it work out?

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Works well with a person she is comfortable with. If someone she recognizes and trusts can introduce her to the caregiver it helps.
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Reply to AnnetteDe
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I've been proving care / management for over 16 years, in addition to caring for my friend of 18 years for the last 6 years of his life. In my work, I initially started by offering caregiving and massage (I am certified).

I'd suggest: With dementia, it is best to ease someone in to get to know her vs just having someone pick her up for an appt. You do not know how she will react.

You can ask AL management about ind caregivers/providers and call / interview. I presume most care facilities have ind caregivers working with residents and could refer you to someone.
- If you call people, create a list of questions and ask the person the same questions. Of major concern is their experience working with people inflicted with dementia - and how they handle situations / work with a person.
- You could hire an ind medical social worker to manage care on your behalf. That person could hire a caregiver / driver. If it were my mother with mild dementia, I would want that care provider to check in for 1-2 hours a couple times a week 'before' the appts so your mom will (hopefully) remember them and get to know them.

Oh, I see you are asking how it works out -
- it depends on the person providing the caregiving: their experience and reliability.
- As a care mgmt myself, I would either offer these services or hire others to do.
- You could also contact an agency although they usually have a four hour minimum per day. Some will drive/some may not.
- If hiring directly: You should
- ask for references
- experience
- how they handle situations
- reliability (they will say they are, of course). Ask if they have kids in school - as some may need to cancel appts to attend to their children (in emergencies).
Hiring can be a revolving door. It would be best of you could find a care manager to manager all the care / service needs in your absence.

Is there a possibility of moving your mom closer to where you live?
Is she all alone in the facility - no family close by?

Gena / Touch Matters
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Reply to TouchMatters
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I found that most care agencies usually could only find caregivers that would work for a minimum of a 4 hour shift. The charge for 2 hours was more but agencies I talked to said it was pretty difficult to find someone who was able to take such a short shift (after all, most caregivers are looking for a steady 40 hours or more a week--which is frequency divided between multiple clients.) That said, there may be outside caregivers who already have other clients in your parent's building that may be willing/able to add a short shift with your mom before or after. Does your mom's facility have a staff social worker? I would start by asking that person for suggestions.
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Reply to JTQJOTSM
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Mom is in advanced dementia in MC. Her teeth are terrible. Many missing on top, one is broken. I was able to find a “travelling” geriatric dentist to clean her teeth and provide recommendations. This dentist suggested pulling all top teeth and making a denture for top. Bottom teeth needed work as well. After some push back from me, we agreed to wait until she has issues to decide on treatment. At some point, you will decide the outside dr trips are too much and not worth it.
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Reply to BenchmarkKid
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I hired a driver to take me and my mom to important doctors visits together in the hospital relating to her heart. When they have moderate Dementia, why torcher them with unnecessary visits to dentists etc.? My mom was able to eat without teeth. Once my mom was placed in Hospice Care, there were no more trips to appointments. Honestly, Dementia can cause extra unnecessary stress on your mom going to doctors visits. Sometimes the constant environmental changes can be detrimental.
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Reply to Onlychild2024
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I am also a long-distance DPOA to my older brother with mod dementia and mobility issues. (And personality issues, but that's another story.) I went the route of hiring a Geriatric Care Manager and was lucky enough to find someone I can trust and who has been a great support. Not the cheapest option, but worked out well for us.
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Reply to Questor
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My relative lost independance for appointments quite a while ago. Requies transport but also to arrange payment & for communication support - to listen to instructions regarding treatment or medication.

Having an aide to accompany has been fantastic. There became a regular one & they have a wonderful bond. It did take some family members time to get over having 'strangers' brought in to help - they had that 'family must help' mindset. But it's common sense really. One daughter, sister (brother whoever) just can't do everything all the time. If you don't live together, just impractical. Having a paid person makes sense.

For dental surgery, it was arranged to have the aide for the entire day. Get ready, transport, support in the waiting room., rhe whole duration. It worked very well.

I hope you can find a good agency, or individual to help.
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Reply to Beatty
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Snooze, or Sedation Dentistry may be a consideration in the mix.
My husband did well with that although as you will be warned, and as you probably already know, sedating older people especially with dementia has it's risks.
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Reply to MicheleDL
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That sounds very reasonable but I think I would hire her for some time before as well so she becomes quite trusted, and make it clear what this is all about. I would also discuss mild sedation with her dentist. Good luck.
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Reply to AlvaDeer
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Can you ask the AL if any of their aides would be willing to go with her and you would pay them for their time.

Why is it felt she needs crowns? Has she broken teeth?

This is a long process. The tooth has to be drilled to a point. Then a mold taken of the area for the permanent crown. The mold is made by piping the stuff into the area. I have almost choked on it. Then she has to sit there waiting for it to set. A temporary is put in place. The permanent appt is shorter. Its taking out the temp and putting in the permamnent.

Are you sure, with Dementia, Mom will be able to go thru this?
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Reply to JoAnn29
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Scbluheron Apr 23, 2025
That's my concern-I'm not sure if she can.

One of the teeth that needs a crown anchors her dental partial. If that tooth bites the dust she looses her partial and then worse choices will need to be made.
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Are you sure your mom needs a "home health" aid?
What you're describing sounds more like a "home care" aid. There's a difference.

Home health is used when there are medical needs and therefore much more expensive.

Home care is used for non-medical needs such as companionship and assistance with ADLs.

This article explains more:
https://www.agingcare.com/articles/difference-between-home-health-and-non-medical-home-care-services-426685.htm

My mom uses a home care aid in AL. She started with one a few days a week and now has one daily. It's been a godsend, and has enabled her to stay in AL longer as opposed to moving to memory care. She didn't like them at first but now has bonded with them.
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Reply to Dogwood63
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Scbluheron Apr 23, 2025
Thanks for clarifying. I wasn't sure of the correct title either and partly why I asked. I think you're correct.
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I’ve seen the aides working at AL places do work like this for additional pay on their days off. There may be someone mom is familiar with on staff who’d be interested in helping. Call the director where she lives and inquire
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Reply to Daughterof1930
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It should work out fine if you introduce the aide well before the dental appointments. If she doesn’t trust the aide beforehand, the appointments might not go well, Hire the aide, instruct her to take mom out for recreation, and if mom can take directions from the aide, then slip in the dental appointments. Make sure the dental office knows mom has dementia, and good luck.
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Reply to Fawnby
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Scbluheron Apr 23, 2025
Thanks. This dental office is aware of her dementia. She has seen them regularly since she moved to the AL for cleanings and cavities. They have not raised any concerns with me about behavior issues during appointments. They all like her and tell me how nice she is.
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I see outside paid caregivers at the facilities in our town. My boyfriend gets customers that live in the facility down the road that are driven to his workplace by paid caregivers to get their watch batteries and hearing aid batteries changed.

it is very common in my town.
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Reply to brandee
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