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My mother fell and broke her ankle. She has early stage Alzheimer's, is becoming delusional and is confined to a wheelchair while the ankle heals. She is in a rehab facility for 30 days. The family is divided over whether Mom goes back home after the 30 days or after the 30 days go right to an assisted living. Is it better to return to her own home, with 24 hour care, or to transition directly into assisted living? Any advice?

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My mom is 94 and has dementia. She fell in her home and fractured a couple of ribs. She spent 2 weeks in rehab and now I have moved her to a facility near me that has a memory care unit. It is a wonderful little apartment and all of her precious things are in it. She has been in it for 2 weeks and constantly begs to go home. Cries and pleads all the time. She is extremely hard of hearing and her eyesight is failing, so she isn't really enjoying the opportunities to make new friends of do some of the activities. Should we let her go home with the VNA checking in on her often? She was secure and happy in her own home. Now she is horribly depressed.
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I wish I had moved Dad when he was just beginning his dementia. Then he would have been accustomed and comfortable, "knowing" it was his home. He would have made friends and participated in activities that he might have remembered, now. If at all financially possible do it now. If it doesn't work out the house is still available.
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Wow I hear the hostility, confusion, and every bodies emotions in these messages. There has been good information shared also. The primary care doctor might have some suggestions, but you need to visit each facility to see what they have to offer, what the food is like, the friendliness of staff. Are other siblings in the area to help with the search? What is her/their financial situation? Remember the money our parents have is to take care of them before it is shared with us- their children.
There is a difference between a Retirement Community and an Assisted Living facility - which do they need.? You want to find out if there are levels of care so if more is needed over the years you won't have to move them from the facility, but maybe to a different floor because then they are still familiar with their surroundings and staff.
I started visiting various facilities and would e-mail the siblings information that they could look up on line. After visiting 9 facilities it was definitely time to make a decision for a "Memory Care" facility. I was lucky that one had an opening and the siblings agreed with my recommendations so the transition was fairly easy to move her in. Downsizing was now the concern - what to keep, what to send to siblings, what to trash, what to donate. So my spare bedroom is cluttered now, but that too will be taken care of when I rest after adjusting to this new adventure I am on with Mom.
After moving Mom I furnished it with her favorite chair and the bookshelf Dad had made that she kept family pictures on. This way there would be some familiarity in the room. Yes, she thought she was only staying for a short time, she was waiting for her sister from Denver to visit, she asked the staff to check on her airplane reservations, and she had a nice visit with friends (all deceased) when she went on her imaginary train ride.
I still take her to Doctor appointments and sometimes to lunch before returning her to her new home. We have the same conversation over and over again, but you just have to laugh it off and try to divert it to a different topic. Remember the good times by going through photo albums and telling stories. BUT don't get upset when they start to argue or contradict something that you have said. Walkout of the room and take a deep breathe, shake it off and then return with a smile on your face as if nothing had happened.
There are many agencies out there to help - check Senior Services, ElderCare, or whatever is available in your community. Join a n Alzheimer's support group or attend a Caregiver's workshop Put on a Happy Face and remember the good times.
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This is a difficult question because it depends on a number of factors. First, delusions are not typical in early Alzheimer's. How functional is your mother. If you talk to PT/OT they can give you a professional opinion of the type of assistance she will need. How long and what is the expected recovery time? If there are people committed or have reliable care it may be feasible at home. Sometimes they do better in familiar environments. It does sound like she will need ongoing therapy for some time. Another option is try àssisted living through recovery if you dont think it would be too traumatic and go from there. Good luck!
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You don't say how old she is, but if she's elderly and might qualify, I would recommend getting her home with hospice. The dementia might get worse if there are no familiar touchstones for her, as in a nursing home. She has the best chance for recovery and slowing the progression of her mental slide at home.
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Wow Seabiscuit that is such a sad and awful story. Couldn't you contact someorganization that deals with elder abuse and see if they can offer you any suggestions on how to help your poor Mom out? There are also reputable caring lawyers whose primary interests are helping the elderly get a fair shake in life, I think they are even called elder care attorneys. I know after your extremely horrible experience with that lawyer and others you feel suspicious of everyone, but there are people you can contact. I feel terrible for your Mom, what a nightmare and so bad for you too. Please do some research and find the help your Mom needs, even call any local senior citizen centers and ask for their recommendations on what you should do.
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Why not discuss what would be best for your Mom with her primary doctor? And you need to Google the place ( s ) you plan on putting her and look if any complaints are lodged against the place. You might want to also look up whichever agency rates and makes surprise visits to a/l and nursing homes and see what they write about the place ( I have no idea what agency does that, I hope there is an agency like that, you know like a BBB or consumer affairs group, but one that rates only assisted living places and nursing homes on staff to patient ratio, cleanliness of the place, attentiveness to patients by the staff, activities for patients, medical mishaps, dr's expertise, on and on. Some people just put their parents into a place without really thoroughly checking out the facility they put them and the end results can be disastrous.
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I recommend looking into home care assisted living and keep her in her home. I put mom in assisted living. they were at an all time low occupancy. believe it or not, they over-ruled a 30 day vacate insisting mom had begged them to keep her there, a total lie to keep her rent money. nothing could have been further from the truth. In the end, the evil thieving children wanted mom's money, the managers (now fired for lying) wanted mom's rent money, the judge wanted and got mom's money, seized her properties and her pensions, doled out lavish salaries to his appointed investigators (2), lawyers (3) court reporters (2) medical experts (5, all of whom unanimously agreed mom was competent and capable of making her own decisions, the judged over-ruled and declared her incompetent so he could steal her money) and she was kidnapped, held hostage for her assets. with mom a "ward of the state" now and fodder for the county taxpayer head count in yuma, arizona; a public fiduciary, a guardian and 3 hospice workers were assigned to mom at county taxpayer expense, so you see how they run an entire economy/industry around the elderly, it's like the burning times when they used to burn witches in order to seize property during the inquisition only now in modern day they have replaced the word witch with elderly. The judge is a lawless crook and mom cries for her home and her son every day. the evil sisters and the grandson who were jealous now have their lawyers charging to mom's estate, necessitating the sale of her beloved 500,000 dollar ocean view home we were desperately trying to get back to so she could file bankruptcy in California and keep the home as primary, but her grandson and daughter wouldn't move out of it after she let them live there for 7 years rent free. It was in my name and the judge forced me to sign it over back to mom. each lawyer charged 50,000 dollars for 2 months of work (they did absolutely nothing, idiots and total crooks all) the evil daughters got nothing, it all went to their lawyers, the grandson is being evicted by the lawyers in order to liquidate the asset and put it in their pockets. So you see how evil evil can be? Beware authorities of any kind. What was suppose to be a house of justice for all, the rule of law in favor of mom's competency was over-ruled by a lawless judge to fill his jurisdiction's crooks pockets. I was told the same thing the lady above tells you "do it now before it gets worse." Oh, it can get worse all right. You need help. Just bring it into the home. Keep the rest of the world out. The only thing good that came out of this was the help from a 3rd party CNA assisted living company "Vital Wellness" in Yuma who are the only ones who ever show up at all, and take care of mom now, the rest are all no shows and mom doesn't get a 10th of the care she got with me. Vital Wellness could have been brought into mom's home, but once I put her in assisted living, the investigators lied in court under oath saying her home was "unsuitable." It's a 275,000 dollar home in Yuma which she had a reversed mortgage on and it was in perfect condition. They said "oh it has ceramic tile she might fall down." It as a total set-up. My mother was robbed blind in broad daylight and it broke her heart to lose her home in California to a bunch of public officials and thieves in Yuma. The judge was David Haw. He's an evil lying bastard.
Beware! Beware! Assisted living in home, would have solved everything and mom would have had her 6000 a month pension and her homes before she was robbed because I put her in assisted living temporarily. It has ruined mine and my mother's lives for the the rest of our lives. We are devastated. We had dreamt of going home to Clambeach, California for over 20 years and bitter, jealous, covetous, envious, conniving, cunning evil thieving children who she had helped all of their lives, dragged her into court on her 88th birthday, blocked her from going back to her own home, so they could keep it rent free, on the grounds that I was exploiting her money which the courts never proved not a one of their false allegations. The judge purposely dragged out what was originally an unlawfully scheduled hearing by my evil sister, for 8 months, hoping mom would go senile and every month put her through a rigorous 2 hour competency test with 2 separate neurologists and 2 separate psychologists and 2 separate primary doctors, also a head nurse a vital wellness and they all confirmed she is competent. My sister should have been made to pay for her lies, she lied through her teeth under oath, absurd lies: "he dog-naps my mother's dog and extorts money from her, withholds my mother's prescriptions from her, black mails her, bribes her, tortures her dog in front of her to manipulate her. Funny, mom said i'm the only person in the world she trusts 100%, the dog worships me, scott would never hurt me, i want those daughters disowned and the judge to kick my grandson out of my home. that was the last thing she said in court. None of the 3 have ever called her since, except the grandson (37, never had a job, illiterate, has 3 kids from 3 women and never has given a penny to any of them in the way of child support or for the unmarried women, in 11 years!) he's still living in the house rent free, growing pot 8 months later! The daughter stole 150,000 in cash from her mother, ran up 70,000 in credit cards as did her son, the same amount, before they hired lawyers and used the money against their matriarch to get rid of me. it worked but it backfired on them, they get no more. They stole everything they could and lied in court to steal it, and the judge stole the rest. A house of justice was merely a house of commerce. Beware!
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Like I have poster earlier I would go with the assisted living I have experience in this matter. We took my mother in-law in to take care of her, and after several years it has become a bad situation for all involved. My wife's mother turned against her and now treats her like a slave instead of a daughter. Nothing my wife does for her is good enough. Definitely go with the assisted living it is better for al involved. GOOD LUCK TO YOU !!!!!
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The first thing I suggest as I do in my book - is find a reputable and compassionate elder attorney for your MOTHER. He or she will have invaluable information and resources for you.
Also, contact Adult Protective Services thru DSS in your area. They are bound by law to intercede and help. In my case, the case worker was wonderful.
I am sharing a blog I wrote - as I was asked by my mother's doctor if mom could come live with us? She could no longer live alone either. I did know, that if I took mom into our home it would not only affect her but it would not be fair to MY family either. I was already Mom's caregiver and every extra minute I had available was spent taking care of her and her business.

Please read my blog that I posted on my internet site. I post blogs that relate to my past experiences in hopes of helping other caregivers. I feel for you - and understand exactly how you feel. I hope this helps. If you would like a d/load of my book - please let me know....it will help you - your feelings, frustration, rage, and whirlwind of emotions. They are real, I have been there. I am a survivor.
alzheimersandflower/2014/04/15/can-your-mother-come-live-with-you/comment-page-1/#comment-52
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As a registered nurse my fee for 24/7 hour care would be well over $150,000 a year. Maybe I should start charging but as demented as my Mother is she actually expects me to pay rent! She has no idea about money anymore or how much it is costing me to put my life on hold - so I say take the assisted living option NOW - do not make the same mistake that I did because now I feel stuck.
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This is the perfect opportunity to place her in assisted living. Three yrs. ago my then 87- yo MIL had surgery and spent 2 weeks in the skilled nursing unit of a continuing care community in which she placed a deposit. She was diagnosed with mild to moderate dementia at the time, and from there, on the advice of her dr. and hospital social worker, went right into AL. She hated it at first but after several months has adjusted and now likes her room, the activities and the staff. She is eating a healthy diet and has gained weight. Also, they have physical therapy on the premises which was very convenient. I might add that at the time we looked into 24 hr. home care for her and found that was more expensive than the $4300/mo she is paying now! She does have long-term care insurance which made our decision easier.
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With a diagnosis of dementia, you know things will only get worse. But, nursing home care is expensive and if she can stay in her home with 24 hr. help that might be better if the family can agree. Decide whether you want her in professional care now or in the future based on your own needs and her/yours financial situation.
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Or you could do what I did. Have her live with you 24/7 and regret that you did not get her into assisted living while there was an opportunity. I am now my mothers assisted living director, medical assistant, personal assistant and all around scapegoat - my life is boring and tedious taking care of a 91 y/o and I really wish I had just put her in assisted living. Too late now.....she is too demented.
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Grab the opportunity now while you can because this is going to happen again. The next time she may not be suitable for assisted living-so if she is now go for it. IMO it will save you a lot of heartache down the road.
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If u can afford it, move her to AL. The physical strain on u will hurt..Can she get in the shower? Does she wear diapers? Will she eat or drink? Can she comb her hair? Brush her teeth? Clean herself after a bm?Clip her own nails? Dress herself? Make her bed? Sweep? Dust? Does she read? Can she work the tv remote? How do u transfer her to and from the wheelchair?
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At home by herself and whoever is assigned to take care of her is not a social environment she needs for her condition. Let her join others and you'd be surprised of some improvements.
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An option that you might want to consider is having your mother moved to a respite care option at an assisted living facility. That way you don't have to do any major moving (which can be expensive). She and your family would get a chance to see how she does in the setting, and it would give you some breathing space while everyone adjusts to the changes.

I wish I had done that with my mother after she broke her femur. She was in rehab for eight weeks, and then we moved her to assisted living, which she ended up hating. It was my brother's idea to move her to assisted living. He lives 1500 miles away, so it was easy for him to see that as an option. Since I live close by, all the issues concerning moving and care fell on me. My dad was still living in their apartment, and he missed her very much. We ended up moving her back, which was an additional expense. The bottom line now is she is very, very resistent to trying assisted living again, even though she really needs it.
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I would heavily suggest the assisted living for the loved what starts out as a act of love will end up with you being the caregiver. that is where the real problems start your siblings promise that they will help but after it starts will always find a reason why they are to busy or any other reason they do not have to help. I speak from several decades of experience on this issue. I would suggest talking to the assisted living people to see if they had individuals you could talk to that you can 2 different perspectives GOOD LUCK
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Another thing to consider; if she's only in rehab for 30 days (not sure why that might be, the bone will take 6 weeks to heal and then she's going to need PT to get walking again), she will need PT for sure for a while, better provided in an AL facility connected to a rehab place than at home. Good PT requires equipment (ramps, step ups, various other implements) that are not easily transported. Also, Mom will need to exercise on her own to practise the moves the PT teaches her; at-home caregivers and not likely to want to "annoy" her with suggestions that she do things she doesn't want to, whereas AL staff can cajole more effectively, also better opportunities for group exercise. Also, is her home handicap-accessible--ramps, bathroom with grab bars, door wide enough for a wheelchair, accessible shower, raised toilet seat? There is a myriad of things that will have to be done just to bring her in the front door. Also, I'm curious about how she fell in the first place, was it related to the possibly unsafe conditions in her home? Just some food for thought.
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Assisted Living if the funds are available. The sooner the better. That way maybe you can enjoy being a daughter instead of the "caregiver" before she forgets who you are.
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A couple of things to consider...how will 24 hour care be paid for? Does she has funds to do this long term? AL is ultimately going to be more affordable long term and will provide your mom with activities and distractions so important in the early stages of dementia. As Blannie points out, more transitions are hard. Also, unless the family members who think she should go back home are going to do the caretaking, I wouldn't listen to them.
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With her Alzheimers, I'd use this as the perfect opportunity to get her into a facility that can move her from Assisted Living into a Memory Care unit when the time is right. Moving her back home only to need to move her again (unless one of you is living with her and wants to continue that) would be more stressful the farther into dementia she is, in my opinion. She'll have been away from home for a month and used to "outside care", which is a good time to make the change.
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