When does a person in assisted living need to go to a nursing home?

It's time for you to meet with the Director of the ALF and tell them what is happening with your mom's roommate so they can discuss next steps with the family. Or, perhaps you already have a relationship with the family and you can speak to them first and then go to the director. Either way, communication is essential. At the end of the day, you understand the needs of your Mom and what may have a negative impact.

The natural progress of the elderly is disheartening.

Have you asked your mom what she would like to do in the situation?
Perhaps she would want to stay and be a comfort to the other woman.
Sometimes just the presence of someone we know, even if they can't
communicate, can be a comfort.....for both.

How can you truly know how to proceed in a situation such as this? It is such a fine line. On the one hand, your mom could be a great contributor to the other lady, "nursing" her along, so to speak. My aunt had a deteriorating roommate and it gave her great pleasure to try to assist her "friend". However, the administrator of the memory care home my aunt was living in felt that the roommate was probably not going to survive and, in her experience, when a close bond had formed, the death of the other person was a traumatic and depressing to the one left behind, in this case my aunt. What what's this I did was to move this other lady, who was part of hospice and not going to go to the hospital, to a different way in a different room and just tell my aunt that they had to take lady to the hospital for a while. My aunt accepted this, and do to her dementia, after a few days, forgot about her roommate and could even walk by her room and the other win without recognizing her. Wisely, the administrator waited about 3 weeks before introducing a new roommate. My aunt was happy all over again with a new friend she could "help out".

Thank you for your answers; they are very helpful. Two weeks ago my mother fell and broke her wrist in two places. She had a plate and two screws put in and is now in rehab. She is also starting to show signs of dementia, so it looks like both ladies are on the decline. :-(. I'm going to take it day by day after Mom gets back to her assisted living place, because it now looks like it may be a matter of time for Mom as well.

T Y butters ... I appreciate your update, I'm sure we all do.

I'm so sorry to hear that your mom fell and hurt herself and that she seems to be declining. You've got the right attitude: day by day is the only way you CAN take it.