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She went from memory care to hospital (fell and broke her hip) to rehab to nursing home. She couldn't participate in rehab because of Alzheimer's. The nursing home is costing $11,000 a month. I think they are taking good care of her. She is only a 5 minute drive away from me. If I move her to a memory care facility that says they will take her and have the same equipment and level of care ( two person assist with a lift to get her from bed to recliner to wheelchair and back, feeding, bathing, everything) I could save her $3,000 a month, but it would be 30 minutes away from me. I can't imagine her going back home with the amount of care she needs, but I think that's where she would be happiest. Home would probably cost even more than nursing home. She would qualify for Hospice, so I think they would provide equipment at home. I would have to find caregivers who would change her, bathe her, shop, cook, etc. I went through all that management of caregivers years ago and lived with her for 4 years. I can't do it again. What worries me about her care now is that, as she has become more alert over the last week, she is lonely. They tell me that they talk to her and do not simply take care of her physical needs, but in all the time I've visited (at least once a day at different times) I have never observed them offering her company. I work, so can't stay there all the time. I hate thinking about her just sitting there waiting for nothing to happen, but I doubt moving her to memory care would bring her more human contact. It would just save money. It's her money and my feeling is that she's better off close to me. Does this seem reasonable?

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When my Mother pictured being 'home' I think she pictured pottering around in her own space. Not the reality of a commode, wheelchair, aides for shower assist.

When I volunteered at a facility, there were some who were very sad that family hardly visited them. One gent had an attendance book signed by his many family popping in over the week, I saw him on the phone with them & being visited myself. He'd forget & deny they ever came. Such was his reality 😔

Some told me they didn't ever go to any activities or see other people, were 'shut ins' - but I saw them at bingo, singing with the music group, in the garden etc.

Others told me their Mum or siblings were there yesterday (but actually long deceased). One was never lonely coz she talked to the ghosts 😆👻

I don't know the answer to your situation. I just gave some examples. Not just the location or money but the way people connect or don't connect varies so much.

I also feel there is no wrong answer.
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Reply to Beatty
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I hate to be the one to break it to you, but moving her to memory care will not give her more human contact or more of anything else.
If it's possible for you mom to remain in skilled care in the part of the nursing home she's in, leave her there. It's five minutes away from you as you've said and it's best for her.
Memory Care is the new trendy name for what used to be called a locked dementia unit of a nursing home. Memory Care sounds nicer. Don't let the name fool you.
Facilities are not in the business of keeping someone "company". That's the family's job. This is not what the staff is for. These workers have plenty of work to get done in a shift. They can't sit with someone because they're lonely or bored. Care facilities have activities going on during the day for their residents. If a resident doesn't want to take part, no one makes them.
You're being totally reasonable to want to keep her in the facility closest to you where she's also getting decent care.
As for the money, it's going to go one way or the other. Whether it's to the nursing home, the memory care, or to homecare.
Do what's best for both of you and keep her where she is.
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Reply to BurntCaregiver
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ArtistDaughter Jul 28, 2021
My mom's memory care experience was very different from the nursing home she is in now, but that is partly due to her current inability to get herself where she wants to be. And the staff at memory care did spend a lot of time visiting with her. Perhaps it was an exceptional place. I am feeling more comfortable over the last few days that the nursing home is okay and being able to go over there in five minutes is the best for me because if she is asleep I can go home and return later. Her most awake time is when I'm teaching, so to find the right time is hard. She can't answer or call on the phone now either, so that communication with her is not possible. This is a huge change for her and for me, but I at least know why there was a change. She's just lost in a muddle of confusion.
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ArtistDaughter, based on my experience, it's absolutely reasonable for you to keep your mom in the nursing home close to you and that you know has the staff and equipment to provide the care she needs.  I think your mom's fortunate to have you looking out for what's best for her.
 
Following is my experience. Before I moved my dad to the best memory care facility I could find within a quick bicycle ride from my home, four of my siblings thought I should instead move him to a facility hundreds of miles away that would save him $3,000 to $4,000 per month and their second choice was a less well-staffed facility in my town that would save him $1,000 to $2,000 per month. Over the objections of those siblings, as my dad's legal guardian and with no regrets, I chose the higher priced facility that was best for him and that was easy for me to visit him at least daily.  Unfortunately, when my dad's care needs increased near his end of life, that memory care facility decided his care needs exceeded their staffing level, so I was told I had to move him. This was despite prior assurance that he could stay there if he qualified for hospice, which he did, but even with hospice help the memory care staff still couldn't meet both his needs and those of the other residents. I found another place for him close to me, but he died before I could move him there.
 
Kudos to you for the care you've provided your mom over the years and best wishes for this new chapter in your lives.
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ArtistDaughter Jul 26, 2021
This is a very good question about whether or not she could stay at memory care. There's something about a degree of infection where they can't stay at memory care. On one hand I can see that in memory care her cognitive needs would be met better, but at nursing care her physical needs will be taken care of best and for no matter how much care she needs.
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It sounds like your more comfortable with your mom being closer, even though the cost is more than MC. You seem to be satisfied with the level of her care, except for the idleness. If she doesn't need the higher level of care the nursing home offers, her level of care in MC would probably be comparable to the nursing home, so would the lack of activity. So with her in the nursing home she's spending more but you have a shorter drive. In MC she's spending less, but you'd have a longer drive. If you feel the care would be the same in either facility, choose the one you are more comfortable with and go ahead and apply for hospice care. Either way, you you'll be doing the right thing for your mom.
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ArtistDaughter Jul 26, 2021
Makes sense. Thank you.
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I’m not sure I understand -
Does the current nursing home not get her up and out of bed into a wheelchair and bring her to the activity rooms and such?
When you say you have visited and she is lonely - where is she? Do they leave her in her room?
When my mom was in skilled nursing rehab - it was half skilled and half nursing home and those who could get around themselves did so - but those who couldn’t (Physically or mentally) were always bathed - dressed - and the aides got them in their chairs and brought out into the main areas with others every day (even when some didn’t want to they really did encourage them out of bed and their rooms).
I cannot tell you I was impressed by the way they lined up the ones with more needs at the nurses station (as I felt they should have had the more advanced stages grouped together attempting to engage them) but my mom also did not have ALZ so I thought at least they have interaction with all the people coming and going etc
. I think maybe some others here that have more experience of a loved ones stages with ALZ can give you help on what type of things they should be encouraging and including your mom in.
I would think they would try to group those at the same levels together and have planned activities.
See what others say and then I would then ask for a care meeting and stress that you want mom to be encouraged more and others to engage her more until she gets a little more comfortable. Make a list of things your mom likes to do or things of interest to her - even a little bio on her and ask that it be places in her file and maybe even post it in her room?
It may help anyone interacting with her engage in conversation and allow her to become more comfortable with them. Her nickname - names of her kids or grandchildren - her hobbies - her favorite foods - things that make her smile.
When my mom was recovering from her stroke - I made and posted things in her room like this for her and for others to know about her 💕
Its always great to have them close by so maybe just some ideas here will allow you to have a case meeting to request mom be engaged more and if you do see her outgrowing the place she is in now and don’t feel like they can bring her a better quality of life then I would start considering the benefits of the memory care 🙏🏼 But maybe she just needs a little more time and encouragement from the staff 🌷
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Reply to Momheal1
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ArtistDaughter Jul 26, 2021
Thank you. I did give them a lot of information on her and have hints around her room: telephone company awards, photos of family, animal books, etc. I'll do more of that. Yes, they get her up and dressed and use a lift for her into a wheelchair to go to the dining area for meals if she wants to and she usually does. They use a lift to get her in a reclining chair in her room after meals. I talked to the nurse last night about her care plan and asked if there should be changes now that she's more alert. She said no. But she told me that my mom was taken out to the garden area in the evening as the weather cooled. I, of course, cannot ask my mom what goes on because she won't remember and she can no longer talk very well. One day when I entered the floor where she is, they were taking her upstairs for some music. I went along. It was an amazing situation. The entire audience, except the care teams and I, was in wheelchairs. Most people were moving arms and legs and heads to the music. My mom slept through the entire performance, but was tapping her fingers on my arm. It's all so new to me that she can't get up and go do what she wants to do, has to depend on others. She doesn't know how to push the call button.
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The absolute best advice I was given when looking for assisted living for my dad was "Pick the best place that is closest to your home." and I have passed that advice along to other friends who later told me it was the best advice they got. In my case my dad is 5 minutes away. I can run over and drop something off without it being a big trip. I can stop by and say hi for a half-hour and not spend an hour on the road. If she can afford the place near to you, keep her there.
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Reply to jkm999
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I am grateful that my mother’s facility is close enough for me to get there in 5 minutes.

Sometimes, she needs an item.

Other times, it’s just for a visit.

Recently, she has had issues that have required me to get there QUICKLY. There’s a good possibility that it will begin to happen more often. We live in a high traffic area. If I needed to get there fast during rush hour, that wouldn’t be possible.

If it start to happen in the middle of the night, I will be grateful that she isn’t further away.
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Reply to cxmoody
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I have always been grateful to be close enough to my LOs that I can get to them in 5 minutes DURING A BLIZZARD! (AND I’ve done that!)

Having been through the broken hip, rehab, and nursing home, the chance that she presently has actual memories of her “home” are pretty slim.

It would also require yet another adjustment period, and those are always difficult at best for our elderly.

As near as possible would definitely be my choice, and I think it’s an excellent choice for you and your mother as well.
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ArtistDaughter Jul 25, 2021
Thank you. Her assisted living and memory care were like homes. This is a facility with a very different feeling about it, hospital like, with hundreds of people. This is the first she cannot go out to the common room by herself, can't just decide to do something and go off to do it. And the common room is not very inviting anyway. No, she has not remembered her house for years, but I just keep thinking how much of a pretty, comfortable, and quiet home it is. But maybe filled with all the equipment for her care it would no longer feel that way.
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