When is it time for nursing care in lieu of memory care?

You pay for extra help for 7 hours every day and yet he was still dehydrated and lacking strength from not eating enough? What are the helpers actually doing there?? What is the facility staff doing?? I realize one cannot force a person to drink or eat but this should have been reported by *someone* there: the helpers to the agency and then to you -- or the admins of the facility... if they were properly trained.

The doctor is just guessing at why he collapsed. At his age, it could be all sorts of reasons. Has your husband been eating better since he was released? Was he checked for a UTI? Vitamin deficiency? His eating and fluid intake is the first thing I would monitor closely.

Your original question is "When is it time for nursing care in lieu of memory care?". I take it you mean LTC? This needs to be medically assessed by his doctor. If he is recommended for this, then Medicaid can help pay for this care if he also qualifiies financially.

He doesn't seem to be getting the help he needs despite paying for extra care, plus he is no longer interested or able to participate in the activities designed for those with dementia - I'd say the time for the extra care available at a nursing home is now.

I would interview some Nursing Homes. I would also interview other Memory Care units that are willing to take care of people until death. Give them your situation and find out what they say.

If it is like what I found with Memory Care, what different facilities will do and take, is very different from one home to the next. Is he a candidate for the Rehab Hospital because of the fall? How bad is his memory?

As for the extra 7 hours of help, what is it that they do? Can you hire from another agency to care for him or must you use their help?

I'm not sure I'd want to stay in that MC unit. The fact that they warned you that they might not be able to care for him, tells me that they are telling you that whatever care they provide, could be subpar of what you are expecting.

I'm sorry, I think it is time to leave.

However, I wouldn't rule out another MC unit so do your research.

...and dehydration and not eating enough? Does the MC ensure that your husband eats? For a MC unit, I would think that how much a resident eats (as well as whether they are pooping or not), is something they have to do to maintain their license. This is because lack of eating is one of signs of end-of-life. Did your husband lose a lot of weight prior to the collapse?

I don't know whether the doctor is trying to pull a fast one over you or whether you have your husband in a borderline quality MC center.

Either way, I think it is time to move on. You might also want to use the services of a placement center to find another home for him.

It depends a lot on the level of care and facilities at the memory care home. My mother is in one, recently broke her hip, and is now in a wheelchair. This home can handle her needs but some others could not. Is the current home recommending a move? Is the doctor recommending a move? If yes to either, you should consider moving him and he is lucky to have you looking out for him so keep your chin up.

Likely when 24/7 care is needed.
Agree. 7 hours a day is not enough.

Are you his POA?
Is he considered medical competent or incompetent?

See if medications need adjusting.

Lack of eating could be from depression, medication, pain.
I am concerned with the dehydration as someone(s) need to insure that he is drinking enough liquid / water - and that he can (no issues with swallowing).

You want to do whatever will provide him the most care as well as keeping him as calm as possible. And, take care of yourself, too, which is very important. This is a time to cry as you are sad - for him - and losing him as you've known him, it is a sad time for you. This is not easy and my heart goes out to you.

Gena / Touch Matters

Nursing homes have decreased staff …only slightly better than a memory care …be sure to ask resident to staff ratios! Also look it up on your State website..ps: falls will happen wherever they are…no one can watch them 24/7.

Side comment here..
If the collapse was due to dehydration and not eating enough I am surprised that the hospital did not report this as neglect. And if they didn't maybe you should. Due to HIPAA laws you have no idea how many other residents are also dehydrated and malnourished.

similar happened to my brother. Check to see if it could be meds related. Dehydration is also a big factor. We are still keeping my brother at home but it’s a monumental task. Sorry you are experiencing this.

My mother was in memory care when she fell, and had to go to rehab. Memory care assessed her at the time of discharge from the rehab and determined they could not meet her needs. The path opened to have my mom admitted to long-term care. Although it was difficult, it seemed the best answer for her and for us.
I would imagine your case is similar. If memory care does not believe they can safely continue with your husband’s s care, he should be moved to LTC. He would need the support of his lphysician in making this decision. His physician may want to see if your husband has a UTI.l
You are obviously very committed to your husband and his care. There are no perfect answers but he is very fortunate to have you to watch over him . God bless.

Have you considered Hospice? After my husband fell three times while in memory care and wound up in Rehab for a month due to a T-12 compression fracture, I met with the memory care coordinator. We agreed that it was time for hospice. Now an RN visits him every week, CNA's take care of bathing and hygienic needs twice a week, provided an oxygenator, and all my husband's continence products. My husband gets to stay in familiar surroundings and the facility's caregivers aren't overwhelmed with the care of my husband. Hospice is wonderful. Medical care comes to him.

My husband's memory care is a "to the end of life" facility. It is my husband's home, and the staff are supportive as well as knowledgeable. Because my husband forgets that he can't get up without assistance, he falls. When he falls now, the hospice nurse visits him within a few minutes. If she/he believes that my husband has to go to the hospital, she/he calls an ambulance. If not, the nurse tends to any superficial scratches and my husband gets to go back to sleeping in his own bed.