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Mom is 93, lives in assisted living, has had dementia for very many years. Assisted Living staff do what they can but it is not true nursing care 24/7. Mom is getting worse. Paranoid, sundowning, refuses most care, isolates herself in her room, talks badly of the staff, is generally miserable. Having falls, incontinent issues, refuses all meds, safety issues. She is on the waitlist for Long Term Care. She has only select few family members that have been willing to help her age. She has not been kind to her family over the years and that is putting it mildly. The few remaining are now having medical issues of their own and cannot be at her beck and call as she is demanding. Till recently, we've been able to manage, but now are unable. She will not want to go. It will be a battle. As much as she hates where she lives now (she hates everything and everyone), she will back-pedal when it comes time and say she lives in the best place ever. We are open to ideas on the best approach when the time comes. Should we be mentally preparing her now or just drop the bomb when we get the call from LTC?

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I moved my mom, a 92 yr old, at the drop of a hat..By day 2 in LTC she had forgotten where she used to live! Lots of worry for nothing. She tells me she likes where she lives and has lots of friends.. Year 6 of Lewy Body dementia.
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Reply to Sadinroanokeva
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You can’t mentally prepare her . She’s beyond being reasonable. She can’t process it because of her broken brain which is also in her default mean , miserable mode . This won’t change. A calming med may help to a degree . My own mother refused meds .

Don’t tell her ahead of time . Then Tell her that her room has to be painted and she has to stay somewhere else. Or if you don’t think the paint story will fly , I like the idea below of having the staff tell Mom they can no longer provide the care she needs .

Either way , hire medical transport to take her . They will take her right in the new building rather than you dealing with drama and her refusing to get out of your car. Best money you’ll ever spend . Use Mom’s money for the transport if possible , or perhaps split the cost with siblings . It’s well worth it to decrease your own stress level over the move. This is how I got Mom into care from the hospital to assisted living .

Good Luck
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Reply to waytomisery
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A medication check?
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Reply to JPFlam
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JPFlam: Perhaps a medication check is in order.
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Reply to Llamalover47
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JP,
Just some thoughts. It seems this move is necessary due to mom not taking meds.
If Advanced Dementia is the problem, she won’t remember the conversation the next day. If it’s mental illness she will never forget is my not a doctor experience.

Of course since she has always been difficult she most likely has both mental illness and dementia.

1) I might try telling her she will move if she doesn’t take the meds, with full intentions of moving her anyway. This to see how much of a difference it will make in her behavior to take the meds. Once you get her calmed she “might” be more reasonable.

2) If that doesn’t work, then I think I would try to get an all out focus on getting her on the meds by trying to get her in a psych hospital now. No need to wait.

I have a loved one who is mentally ill and will not take meds until it looks like she can’t escape a situation she deems worse than taking the meds.

Then on the meds she is at so much peace and so are others around her who have to deal with her. Problem for her, she’s in her 50s and out and about and soon decides she doesn’t need the meds or takes them wrong or any number of things. Your mom being in a more controlled environment might have a chance of staying in a calm state.

Try to talk to her primary about sending her for a few days to give her a chance to live her life with less agitation.

If she has to go as she is, she may be kicked out of LTC for her behavior and then what will you do? We see posters on here often with that problem.

Might be worth a conversation. If she can get on the right cocktail of drugs she might be able to manage her life in ALF a little longer and LTC when she arrives.
The mentally ill can be very difficult to help. Not intending to say all mentally ill are.

I wish you luck.
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Reply to 97yroldmom
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JPFlam Jul 25, 2025
Thank you for that reply.
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Maybe the doctor can prescribe a strong sedative, and it can be crushed and put into a spoonful of apple sauce. Or mixed into a small amount of apple sauce.

I am so sorry that she ruled with such an iron fist! You all deserved much better. Just remember, that she probably learned it from her parents. Try to break the cycle.

I would just get her where she needs to be, and continue to have short visits. That way you will not have the guilt of not visiting at all. Maybe she can’t help her behavior??? Maybe she can???

work on healing yourselves. Best of luck to you all. 🍀
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Reply to Tiger8
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JPFlam Jul 25, 2025
The doc has prescribed meds, but she refuses. A few have suggested this, but it is not as easy as it is being made out to be. Thank you for the reply.
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I don't think, from what you've said that there's any point in preparing your mum for the move. It seems that would just give you a longer battle that nobody can win.

Your mum is going to be unhappy wherever she is - you can't change that. It's unlikely you would be able to reconcile her to the necessary move, so there's no point in trying. It would mean your mum has longer to fight you on this and you would have a headache trying to get her round to something that she will never accept.

Explain when the time comes and endure her temper then. There's no point in prolonging it.
Good luck!
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Reply to MiaMoor
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JPFlam Jul 25, 2025
Thank you for the reply. I fear you are correct.
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Sounds like Mom should have moved years ago. She can't make appropriate decisions for her self care. She won't cooperate. She is mean and demanding. She is manipulative and abusive. Have we got the idea? Don't ask her anything. Don't tell her anything.

I don't know how you will move her when the time comes. If she is capable of physically fighting that might happen. Ask the people who will be taking over her care how they have handled people like this in the past. let them do it. Try to stay away from her during the move and for at least a few weeks afterwards.

Your job is not to make her happy or please her in any way. You just need her someplace safe where they will know how to care for her.

If Mom refuses to take medication that has been prescribed for her, feel free to tell her that you won't stay around and be bullied unless she does. She either takes her meds or you leave. Then go. Mom won't change, but you can. Wave goodbye and walk out.

Since Mom is 93, you are not so young yourself. Put your self-care first. You still have a life. Go live it.

P.S. - It is an amazing feeling to walk away from someone who has manipulated and abused you.
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Reply to DrBenshir
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SID2020 Jul 23, 2025
Thank you so much for your reply, so helpful, needed to hear this.
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No one with dementia 'likes' where they are, which is the nature of having dementia. Of course she won't want to go.

Dementia means brain cells have died / are dying.
The person inflicted is confused, scared, doesn't know the 'what or why or how' anything is happening.

You never expect a person with dementia - and who has had it for many years to agree to ... anything (why would you?)

You tell them ONLY AND ALWAYS what will keep them as calm as possible and then you do what is necessary.

You need to understand how their brain is working - or no longer working. The person with dementia will not be able to make their own decisions.

No, you don't 'mentally prepare' a person with dementia for anything.
You are talking as if they have the ability to understand and reason as 'you do,' meaning a person with their cognitive / brain functioning abilities.
She doesn't. She can't.

And, NO you DO NOT drop any bomb. You tell her you are taking her out for a nice lunch and then move her to the new place. She may or may not know it is a different environment. If she raises a fuss, which she likely will, you tell her ... whatever will appease her ...
- that you are visiting a friend there and will be back soon.
- her room is getting ready soon.
- divert her attention.

Bottom line: you need to understand that you cannot reason with her at all and you do what you have to do - and you expect her to always be angry / upset, etc., as she cannot help it. She is scared and confused.

You would benefit greatly to educate yourself by viewng: Teepa Snow's website (or call her office), watch her webinars and You Tubes and buy her books

You are re-acting in ways that will continue to frustrate you until you understand what dementia is and how to communicate with a person inflicted with it.
You cannot be afraid of their responses. This is what dementia does to a person. Although everyone is different, of course.

Your job is to keep her as calm as possible.

Gena / Touch Matters
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Reply to TouchMatters
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JPFlam Jul 25, 2025
I am very familiar with Teepa Snow. Thanks for the reply.
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Start by calling her doctor. She is having extreme anxiety and agitation. She needs medications to help her be compliant with her care needs. Then, she will be more easily transitioned.
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TouchMatters Jul 22, 2025
Good advice. Thank you.
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You don’t even drop the bomb. When the time comes, you take her out for a full day of activities and you wear her out and then you simply bring her home to the LTC facility that someone decorated while you were out.
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Reply to Bulldog54321
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Tell her on a need to know basis. Telling her prematurely that she will be moving will only cause her to stress, spiral and worry. She has dementia and cannot make decisions about this so why even bring it up sooner than you have to.
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Reply to Hothouseflower
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My mother is 94 with Alzheimer's and dementia. She becomes extremely stressed out at the thought of moving anywhere. When we moved her to another facility last year, I asked my family not to tell her in advance, which, of course, my angry sisters did anyway. Fortunately, with her memory loss, in 24 hours Mom forgot they told her. I chose not to tell her myself that she was moving until we actually came and packed her up the day of the move. All plans were made in advance, and everyone was notified and prepared ahead of time, except for Mom. I pretended to let Mom "help" decide what she needed to take and that we would have fun traveling together and eating lunch along the way, etc. The move went very well ... her adjustment to her new place ... well, that was another story, but she's doing better now.
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Reply to Lee188
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JPFlam Jul 25, 2025
Oh my, you've made it sound like it could go so smoothly. I can only hope and cross every finger and toe that I have. Thank you for responding.
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She has Dementia. There is no reasoning with her. When a bed becomes open at the LTC facility you get her there one way or another. She has no say. She cannot make informed decisions. Its now not what she wants, but what she needs.
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Reply to JoAnn29
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She has dementia. You do the move when you are ready to do the move. You may need to do it with medical transport ambulance or other. She may be unwilling so it will need to be out of her hands with the POA or next of kin acting for her.
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Reply to AlvaDeer
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Even if mom didn't have dementia, if nothing ever makes (or made) her happy, why put yourself through the misery of telling her beforehand that she has to move? And depending on how far advanced her dementia is, there's a good possibility she won't recall being told anyway, so you would have to have "the conversation" over and over again. To what point and purpose?

Fight the battle when it needs to be fought, not before. I say tell her if and when the time comes that you have to move her - the "ripping off the band-aid" theory.
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Reply to notgoodenough
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JPFlam Jul 18, 2025
Yes, I guess we're still trying to placate her as much as possible and give her some degree of autonomy to choose - it's hard to get out of that mindset. She has been a very controlling, manipulative and abusive person to her children through the years and there is some degree of needing to be praised/accepted/rewarded by her. Even after all of these years, she still rules with an iron fist. Sadly.
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Does the place where she is now have Memory Care? If so can "they" discover a problem (a leak, need repair of electric, need to paint or change floor) and while repairs are made she moves to a room in MC where she will remain.
Moving within the same facility will be easier on her. She will probably still see some of the same staff and residents so it will be more comfortable.
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Reply to Grandma1954
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JPFlam Jul 18, 2025
Sadly, it does not, and she has already maxed out on the type(s) of nursing care she can receive where she is at - even though she outright refuses it. The battle with her to allow staff to wash her once a week went on for months even. Debating getting the current staff "in" on the conversation as they may be able to help with "we can't provide anything else for you here". Your idea though, is brilliant. We may be able to put a twist/spin on that somehow. There will be no move whatsoever that will be easy on her. She is not comfortable with any of the current staff. I cannot tell you how many private nursing companies she fired when she was living in her home. The move to AL took probably 3 years to accomplish. Thank you for replying.
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