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Ugh, I know, I have talked about this before. I'm so sorry to be a broken record. I put in an application at the best place in my area for her to move in there, most likely into MC.



I'm feeling so conflicted. I am so done with her living with me. But I know she is going to be HURT and PISSED.



I thought there was a waiting list and now the admissions lady says we can get this thing going right away. I feel like mom is still in a weird state of ability vs her level of dementia. I would feel kind of horrible for her to be one of the highest functioning people in MC. That just sounds hellacious. She'd be in a 24 bed locked unit and if most of the people have much more advanced dementia than she does, seems like it would be so boring and awkward for her.



I also don't know how to get her to go there for an evaluation where they make sure of the level of placement most appropriate for her. It'll be horrible for me to bring her back home after doing that. She's already pulled the crying act when I've mentioned her needing more care.



I just don't see how she could navigate AL.



I keep waiting for that big something to happen that would make this transition simple. So far, nothing has happened for years. If she falls, I'm calling 911 (she weighs over 200 lbs.) and will have them take her in for evaluation and then I'll push for placement. But of course when you wish for something to happen, it's not going to.



I have just increased her caregivers from 3 to 5 days a week.



We went to our camper with her this past weekend and it was just horrible. A small confined area and one little bathroom and she had a bout of diarrhea - NOT fun. Never happening again. Came home early and canceled our plans to go back this coming weekend.

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Is there any way to arrange for the admissions evaluation to be done in your home? I’d be begging someone to come do that. I know it’s done in some cases where I live. I’m sorry for your anguish in this, so hard…
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againx100 Sep 2022
Hmm, interesting idea. I don't have high hopes but it's always worth asking. Thanks for your response.
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The Director of nursing at my Mom’s place came out and did the evaluation.

We fibbed about the reason the nurse was there. We said that it was for insurance, or something like that.

They want your money. It’s EXPENSIVE. They should be happy to come to her.
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againx100 Sep 2022
Thanks. Good point.
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What is the phenomenal lifestyle mom is living at your house, exactly? That you're so afraid she's going to be lacking at in the ALF? Do you realize she'll have activities, others to mingle with and complain to? Movies, outings, 3 hot meals a day, doctors coming in to see her all the time, caregivers waiting on her 24/7, changing her soiled briefs, washing her clothing, dressing/undressing her, showering her, rubbing lotion on her body afterward............? The list is endless. My mother had 'her girls' waiting on her hand & foot, literally, every day of the week. Plus she had me and DH visiting her, showering her with gifts and snacks and pretty tops with matching jewelry so she could always look spiffy. The 'locked doors' so they can't get out they're not even AWARE of, g/f. In the activity room of mom's MC, the door to exit had a mural of library books covering it. The residents all thought it was a wall of books, not an exit door at all.

Nothing will make the 'transition simple' or make your guilt any less. You have no reason TO feel guilty, of course, b/c you've done enough for mom and now she needs a level of care you're no longer equipped to provide for her. You're just looking for 'reasons' to allow yourself to DO it. And you don't need any reasons. The one reason is, she has dementia and needs that exceed your scope of abilities, and it's time NOW she go into managed care. In fact, it's BEEN time for a long while already, you're just holding back for some reason.

Tell the admissions director you need a nurse to come out to YOUR HOUSE to do the evaluation. And that you'd prefer mom to go into the highest functioning group in the MC, at least at first.

You're expecting the worst b/c you've conjured up all sorts of horrible images in your mind of how bad life will be for the Poor Soul in Memory Care. I can tell you my mother quite liked being the Queen of Sheba over there, getting dressed up and comparing her rings with the other ladies' rings. Who's got a nicer top on today and who's eating more lunch than whom? It's a big day camp for seniors, Memory Care, and they do all sorts of fun and silly things, like have walker decorating contests and pretzel rod decorating contests. No lie. They have FUN. And they do more together in that activity room than they will EVER do alone in our homes in the kitchen, that's a FACT.

Stop over thinking this and just move forward. It's time now, my friend. You're tired and mom's ready.
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againx100 Sep 2022
Dearest Lea - your answers are ALWAYS the best. Thank you so much.

You're right that her lifestyle at my house is not phenomenal - I know that's not how you said but it IS true.

I guess my hangup is mostly around the 2 times that we've touched upon her moving out, it has NOT gone well. Cry, cry, cry. It makes me crazy.

I need to ask them to come here to evaluate her and I just can't have them do it there. Will just make things impossible.

I know you're right that it's time and I just need to do it.

I'm going to ask how they deal with the different levels of dementia there. It's a kind of small facility - I think it's 24 beds.
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TALK to the people running the place you're considering. Don't make assumptions, but get concrete information from them.

First, it's likely they'd send someone to her to evaluate her, not the other way around. My mom was in a SNF 40 miles from the MC I was moving her to, and their admitting nurse came all that way to evaluate Mom without thinking twice. It's what they do.

Also, Memory Care is always going to have people with varying degrees of dementia and needs, and the place should have programs in place to handle that. Mom's MCs had three distinct areas -- one for folks who were completely independent and could do things like watch TV on their own, make their own coffee with a Keurig and read books and magazines, one for organized activities like bingo, crafts, trivia games, and exercise games with the mid-range-ability group (the majority of the residents), and a third area for those with the lowest cognition. Those folks had the assistance of multiple caregivers for their activities, which was mostly things like sing-alongs and manipulatives like giant Legos.

Ask, ask, ask questions until you're satisfied.
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againx100 Sep 2022
Thank you so much for your response.

They asked me to bring her in for an eval. I just emailed to see if they'll come here. I think that's much more reasonable. IF they can do it in a vague way that in no way mentions her going to MC. I also asked about how they handle the activities needed for various levels. More info will make me happier.
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Oh boy I really feel for you.

After ( another ) stroke, Mom could no longer live independently. She had to be moved to MC, but ,she was high energy and would have been the higher level functioning in MC so Assisted Living was also a temporary option…but just barely due to her memory…she would have ended up in MC sooner or later anyway. I talked a lot to the admin, doctor, care folks, etc..anyone who knew her well and asked for their opinion. Even they were throwing up their hands. I opted for MC and said, “ please tell me if you have any other opinions or better ideas. “ It was awful feeling like I was cooping up my mother - this was truly a case of choosing the least bad of the bad options.

I’d say definitely get an eval , at the least for some peace of mind with decision making. Most likely if your mom is like mine, no matter what she’s going to be super peeved with everything…just prepare for that…sigh….feeling like I was ‘jailing’ my mother was horrible, I could really sympathize. I needed to be told the truth , which was , she was getting the best help possible for the situation. So I pass that message on to you!

I also did something unusual for MC - I stuffed her room to minor excess with lots and lots of pictures and personal Knick knacks . Because she was highish functioning I wanted to give her as much control as possible , and have a big project from the get-go, namely choosing her own things to keep or to move out. This might have helped a little. Usually MC spaces should be more zen but I wanted mom to use her energy for her own purposes.

Fyi she’s now gone way downhill, this MC was the right choice, and she’s MUCH more comfortable and in a clean safe space with lots of attention. It’s the beginning that’s really rough.

You are taking great care of your mom. I am sending you a huge hug and a bringing over a big glass of wine! ( If that’s your thing ) Good luck and here’s another hug
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PatsyN Sep 2022
Maybe make it an entire case? 😻.
It's the only thing getting me through.
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I decided early on that it would be a matter of SAFETY for me to make that decision.
If it became unsafe for ME to care for him at home I would have to place him.
If it became unsafe for HIM for me to care for him at home I would have to place him.
Safety can mean :
Physical safety
Mental safety
Emotional safety.
Luckily I never had to make the choice. I have a house that was built accessible
I got all the equipment that I needed to care for him safely from Hospice
I got the mental, emotional support from friends and Hospice.
He was never aggressive or violent so physical safety from violence was not a problem.

YOU decide what you can and can not do. YOU decide what your "line in the sand" is.
Making a choice to place someone in a facility either Memory Care or Skilled Nursing is not a failure it is accepting that the level of care required to keep this person or yourself safe is more than what can be done at home by 1 or 2 people.
Hiring more caregivers is an option but often more daunting and sometimes more expensive than placing in MC or SNF.
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cinzim281 Sep 2022
Well said, Grandma1954!❤️👍🏼
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❤. My mom has 24/7 in-home aides. Stroke 10 years ago. Dad was providing much of her care till he died from COVID 2 years ago before there was a vax. (An aide brought it in.) The aides we have now through a local agency are adequate at best. Not a lot of options--really no other options--where she lives.
This spring my sister and I started applying to nursing homes. What a s***show. One wanted all her bank account numbers just to apply. Nope. Then it took her doctor's office--now part of big medical outfit--3 months to release her records to NH #2. Never once did doctor's "call center" call to let me know they "needed more information"--bullshit forms/releases they'd never told me about. It was always me following up.
Finally got the DSS in-home eval NH #2 requires.
Again, I had to follow up, this time with NH#2. Oh sure, Admissions says, riffling through her desk, we have a bed. Tomorrow too soon? My head almost exploded. Yes, one day's notice is too soon.
We'd expected mom to have declined more by now. We'd also expected her to have burned through more of her money. So we told NH #2 no. But she's in better shape than we'd anticipated. What we have is still working. To their credit, NH #2 was very understanding.
Now I get a message from aides yesterday that suddenly, mom's having trouble with weakness in her legs. ( She can't walk, but can "help" getting in/out of bed/car/onto commode.)
I'm headed there there now, just a typical Sunday, a 6-hour round trip. Hopefully, it was just a super-busy Friday with a doctor's visit, lunch out. But WTH? Did we mess up by not saying yes to NH? I know there are no "right" answers but...
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GAinPA Sep 2022
No “right” answers. You just have to make a choice and step forward to the next change in circumstance. I had a choice between two SKN after my mom’s hip surgery (at age 99) Took the one 1/2 block from our house. Had to show up the next day with 1/2 month payment to save the bed. Was it adequate? Barely. But I could be there every day.
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I had the same concerns. We did an evaluation and I placed my mom in MC but after a week, the staff and I felt like the ALF side was a better fit. I was concerned that it would cause her to decline faster in MC. She has been in the ALF 4 months. The hardest thing I have ever done. The first month was not easy. Now, due to her condition, she has forgotten my home completely and thinks she has been living in the ALF for a long time, I guess you can say, , in this instance, the memory issues have been a blessing. I still have concerns and I am still working through some adjustments. I visit daily and my time with her is precious. Not as much task oriented as it is more “together” time.

It is the hardest thing you will ever do but if you can get through transition, it will be better for your mom and for you. I know my stress level and health is much better.

You will be in my prayers.
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againx100 Sep 2022
Thank you for responding. Interesting - she moved from MC to AL. Was it a hassle and difficult for her? Or just as difficult as any of this is for them??
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I think it’s a blessing that they have a space available for her. If she needs care 5 days per week, then it seems like a placement is needed.

How much longer can you do this?
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againx100 Sep 2022
Thanks. I don't want to do it anymore. I can do it for a few more months but there are things coming up in my life starting in March next year that will make it impossible for her to still be living here.
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You aren't read and she probably isn't either if you can foretell the writing on the wall.....in my opinion. I would not be able to place her with so much angst on your part and knowing she would still realize the huge change. Change can put her mental status into a downward spiral quicker.

Until she is completely out of touch with reality, why not keep her at home and hire help for your own respite. Take some weekend camper trips and leave her in her own regular surroundings with someone providing 24-7 care.
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againx100 Sep 2022
Thanks for your input. I am 50% in this reality that you speak of. And 50% in the wishing for my life back.
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The "Big Something" that happens may come at a time that you are unable to find a satisfactory placement for your mom. Your mom reads you like a book. She knows you are uncomfortable about placing her, so she throws a tantrum.

My son and I visited seven facilities before my husband "chose" his favorite continuing care facility. When we began our search, I told my husband what we were doing. I promised him that when we narrowed the list down to the top two, he would choose which facility he moved to. After many tours on the same day of the week at the same time of day, we decided on our top two. I took my husband to lunch at both facilities. Both facilities had excellent staff to resident ratios, lovely suites, delicious food, beautiful grounds, 24-hour RN, on and off-campus activities, etc. Guess what--My husband chose the facility with the friendliest residents, something neither my son nor I considered.

I, too, thought my husband qualified for MC until the facility's counselor performed her assessment in our home. She recommended Level 3, Assisted Living. As time passes, he will move up to MC. Now, my husband has what he calls his "gang." They play games together, they eat together, they go to the movies together, they go shopping together, they exercise together. His best bud reminds my husband when it is time to "dine" in the opulent dining room. He has gained four pounds in the three months. He has a social life, friends, nursing care, mental and physical stimulation, nutritious meals, laundry and housekeeping service. My husband leads a more active social life, eats healthier, sleeps more soundly, plays harder than I do. I am in our house sitting in front of my computer typing this reply to your quandary while my husband is listening to an entertainer in the Rec Room with all his friends and will go to lunch with his friends in an hour and a half.
Note: We have been married 57 years.
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ConnieCaretaker Sep 2022
Thanks for this reply.............I am searching for a gang for my husband to meet: he loves to visit and chat. He has a neighborhood gang, but it has become just a memory since the passing of our precious princess doggie last year. She dragged him all around the neighborhood until he got to know his people. One neighbor built him a bench near the street where he and our girl could rest (we didn't know she had cancer, we thought she needed to rest because she had a bad hip). So, yes, we're looking for Assisted Living with gangs! lol
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Please seek a remedy and make her an appointment with a Gastroenterologist and a Geriatric Psychiatrist who can help with placement and medication. You can seek out a therapist for yourself to work through this complex and tortuous relationship with this woman you call, "Mom."

You might want to put mom in respite care to give you a break and get mom acquainted with her reality: accepting change takes courage.
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againx100 Sep 2022
Thanks. She does go to my sister's once a month for 4 or 5 days. Verrry helpful. But frankly, once she's home, it's like she never left. So the time off is great appreciated and enjoyed but doesn't make a difference when she's back. Oh well.

Love this : accepting change takes courage!
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Tell her doctor and he will help you place her in a caring home..
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My mom went “early” to the memory unit where the other 12 residents were in varying degrees of dementia. Most of the time she was either sleeping or watching her tv and playing Solitaire in her room. She occasionally participated in activities.
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againx100 Sep 2022
Thanks for responding. Why did she go early?
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againx100: Perhaps you could ask yourself if this opportunity for the facility will come up soon again. Who really knows if it will? Maybe you should accept this chance. You need to convince yourself that you've been a STELLAR caregiver and now your mother's dementia possibly needs the care of many medical professionals, not just one solo individual trying to jump through hoops. Best of luck, againx100.
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againx100 Sep 2022
That's a good point. Who knows when another opening will come up?? I am waiting for a return email re an at home eval vs taking her there for it.
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Memory care is for those with advanced dementia. Please take her in for evaluation by a neurologist and physical therapy. Let them know you are looking for advice on appropriate placement.
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againx100 Sep 2022
Thanks for responding.

Her dementia has been evaluated and is mild/moderate, depending on the moment. She's had PT and doesn't ever keep up with it cuz she just doesn't want to do it. Her caregivers get her to do it but complains when I used to try to work with her. So I'm done!
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Most sick and weak people are terrified of being placed in the care of strangers. They won't admit this to themselves or to you. Keep this in mind when you get the anger and refusals. You are not a bad person; you are just bringing them news they don't want to hear. Tell yourself and the person what you can manage, and what you decided is best for yourself and for them. Keep aware that there is a lot of terror behind their tantrums and accusations. Don't expect reason right away, just hope it comes with time. It does if the place is less scary than their fears, and it probably will be. Stay in touch, stay reassuring, but stay firm, with yourself as well.
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againx100 Sep 2022
Thanks.

Excellent points. Certainly fear of the unknown can be playing a big part in her reluctance. I'm sure she can't really figure out what it will really be like so that's probably overwhelming, etc.
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I too was experiencing the same. Although, he hasn’t gotten that bad yet. He was with me months before their was an opening he could afford. He’s been in a facility for about 4 months. He’s been ok. He says sometimes he will be looking for another place but it’s his mind talking. I felt guilty like you but it was affecting me mentally, emotionally and physically since it’s only me providing for him out of 6 children. I had to do it or mentally I wouldn’t be able to function. I felt I was so overwhelmed and stressed that I was about to have a nervous breakdown since he’s been there I am not as stressed and I can rest but I still have to be sure their doing what their supposed to. I’m the contact for his daycare and anything he needs it’s my responsibility on top of I’m the only Provider on my home. So o understand your frustration. Unless your professionally trained to deal with Dementia you have to do what’s best for you. Pray and give it to GOD. He will tell you what you should. Don’t feel guilty for doing what’s best for her. Best of Luck to you. Live your life
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Msblcb Sep 2022
What wonderful advice. I have also had my mom in for 4 months. Your message made me realize that what I am experiencing is not so abnormal. God bless! Psalms 57:1.
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Your mom is likely to be mad at you anyhow.

Take the opportunity if placement is available and if you have all your ducks in a row . Don’t wait for the situation to be perfect because when your are really ready you may not be able to find placement. I speak from experience.

Do you have POA? Is there a trust? Get out all these documents and see if they give you the power to act now. Your mom may not have a choice.

it’s so hard to place our loved ones (regardless of what they think, it’s not our dreams to lock them up) but eventually it happens to most of our families. We are not meant to care for disabled adults alone. The physical, financial, emotional load Is to much for just a single person or family.

When we place our loved ones it does not mean we don’t care, it just means we need a bigger team with appropriate staff and equipment.

Good luck.
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Thanks for responding.

You're so right that the perfect situation does not exist.

I have POA and it's activated. I can place her without her permission if I want to.

Good advice.
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Hi againx100…I moved my mom from the MC to the ALF only one week after placing her so the transition was pretty smooth. She had not stayed long enough to get adjusted. Most of the residents in the MC were nonverbal which was just not the right fit. So, the transition was simple. Had I waited weeks to make the decision I suspect it would have been much harder.

it is not an easy decision, my mom is not as sharp has some of the other folks in the ALF but can carry a conversation. I think she is the middle somewhere between the two cognitive levels. So, I think, for now, it was the best decision. The fit is very important.

I am in the beginning of the 5th month and she is still adjusting. Hope this helps.
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