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When is the right time to move into a nursing home? I think I know that you can't predict exactly how a patient will progress but I want to know which stage we're dealing with. My mom had to move out of the AL because of combativeness, refusing meds, pushing attendants, etc. She's now in memory care, after a recent visit to a mental health facility to adjust her meds. She's getting more combative. Won't take her meds, curses and hits at the attendants. Throwing dishes in the dining room.

Physically, she does pretty well. Her blood pressure is under control. She has congestive heart failure, but she's been dealing with that for decades.

The MC nurse wants me to change doctors because her doctor is not being responsive, wants to discontinue waking her for night time bathroom visits and let her sleep late in the morning due to combativeness. She may wake up wet, but they'll add extra pull ups. They also want to increase her meds.

I want to keep her out of a nursing home as long a possible, because of quality and costs. So, I'm agreeable to their requests. She's in a really nice place that's clean and most of the time she seems happy.

When she had to move out of the AL, I knew it was coming, but I evidently, didn't really because I thought we'd have another year or more. My expectations a non-clinical caregiver seem to be very different from reality.

When we switch to this new doctor I would like to get him to tell me which stage she is in and what to expect as far as progression. I know medicine is an art as well as a science, but is this too much to expect?

So, what is the best what to handle this request with the doctor? Other physicians have not been helpful with this issue.

Also, is keeping her out of a nursing home a good idea. When she was in AL I did everything I could to keep her from moving to memory care. But, after experiencing it, I wished I had moved her sooner.

Have you had regrets of moving someone from memory care into NH? Did you wait too long or wish you had never moved them?

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Dont know about stages. But if you need help regarding Alzheimer disease, talking to your family doctor could be best option for that.
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It is possible that doctors have not been helpful on this topic because the honest answer is "we don't know." There are more than 50 types of progressive dementia, and it is difficult to even say with certainty what type of dementia a person has. And a person may have more than one type at the same time.

Roughly 60% of persons with dementia have Alzheimer's Disease. That has been studied longest and has found to progress in "stages." But not all persons with AD follow that pattern predictably. And the other types of dementia may not even have recognizable stages.

If you could be told exactly what stage your poor mom is in, you still wouldn't know how long she would be in it or how long the next stage would last.

I understand how desperately you'd like a road map. We all would! We have to do the best we can with the information we have.

Do ask the new doctor what he or she thinks the prognosis is for your mother, but don't be too exasperated if you don't get a very satisfying answer.

And, oh my goodness, DO NOT let them wake her up for night time bathroom visits. She needs her uninterrupted sleep far more than she needs to stay dry.

I'd say give memory care a little more time, and see what the new doctor has to recommend. See how it plays out there.

I can't think of any particular reason (other than cost) to avoid a nursing home. Start the search now so if that need arises you won't be scrambling. But it is also possible that with a new care plan and medication modifications your mother will do better where she is.

My heart truly goes out to you. Please keep in touch here and let us know how this develops for you.
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Everyone talks about stages:; I still don't know exactly what stages there are. Books if you like to read. Mom used to be able to say my anme, then she clled me her sister's name, which I finally accepted-a little too late. Now she doesn't talk......

Life goes on...
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OK: You are in the right blog, read a lot, filter through what best fits your situation.
HOSPICE.
Crush her meds and give it to her in applesauce, milkshake, etc.
Social services.
Aricept and Namenda were taken off the list as mom is too far gone. Namenda was too expensive anyway and didn't see any improvements.
Time: Give time to your mom to adjust. She has lost her control of her life, which someone else has.......She needs to adjust to her new surroundings. Give TIME....
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You are on the emotional rollercoaster. Hang on tight, it's a rough ride. NOTHING is right or wrong. Everyone is different. Mom has had ALZ for longer than I want to even acknoweldge. So, with that being said: ALZ has many effects. I don't even know what memory czre is. I moved her from home to a 6 pack. It is a one story family home with 2 caretakers and 6 residents. Mom went from bad to worse. She only sleeps, and they took her off sleep meds, guess it is getting close to the end for her.
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Have you had regrets of moving someone from memory care into NH? Did you wait too long or wish you had never moved them?
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