Are there any care facilities (in California) for higher functioning vascular dementia patients who need considerable help with ADLs but a much higher level of intellectual and emotional interaction than is typical in memory care facilities? In-home care costs are so high here ($20K/month) that facilities are more affordable in the long term, but typical memory care facility residents are not her peers. I am aware of Belmont Village "Circle of Friends" level of care, also not a fit.
Mom's usual demand to leave when we were not there (so they reported to me) was often in the evening, adamant with coat and purse in hand that she was going to leave and walk to her mother's. I was just there tonight for a bit (I usually do not go in the evening as this is when sundowners typically hits - there was at least one, possibly two residents who were worked up about something or other - these same residents are okay mostly during the day (maybe not initially, but more recent times they have been fine when I was visiting.) Funny too, about the time she regressed a bit and started asking about going to her mother's or a previous residence, about 9-10 months after moving in, my daughter and I joined her for lunch one day. After lunch we went to see her room. She says to my daughter "this isn't bad and it is FREE!" (we pushed the idea that the VA would cover the cost, even though it won't and we have not been approved for the survivor benefit yet, but she is not aware that she/we are paying for it, which works fine!)
I am NOT a big fan of medication, but I know they requested one soon after the move in (Lorazepam aka Ativan, which is used sometimes to manage anxiety.) She was never doped up and there was no repeat in the order as I manage all her Rx orders. Perhaps a little something to help bridge the transition? Moving again could trigger even more trouble with her, and as the condition progresses and she becomes more "needy", it seems that handling care-givers remotely might become difficult and even more expensive?
If it is a nice, affordable (hah) place with good staff, I would give it some more time - it can take months to adjust. Sometimes even after you think they have adjusted, there can be flare ups, but a good staff knows how to handle it.
As for MC facilities - the best you can do is check out those in your area. There really is no way to determine what level residents might be at in any facility. The causes and progression rates vary from person to person, so even if you found a place with all higher-functioning residents, 6 months later that could change drastically!
The place we chose was recently rebuilt (includes IL, AL and MC) and mom was actually the first to move in to the MC unit. A woman who came in shortly after seemed to be about the same level at that time. Within months, the other woman has progressed to the point that she likes to talk to us, but it is all gibberish. Our mother on the other hand made a step down after about 9 months to remembering a previous residence (sold 23 years ago) and asking about visiting her mother or how she is doing (gone almost 40 years!)
There are no rules about how or when regression takes place. Our mom needs no real assistance with personal care or walking, but is not safe to be left alone or in a non-supervised place (AL.) Another woman there is 6 years older (just turned 100!!!) and is more "with it" than our mother. Now that the unit is filled up, there are so many levels of cognizance that can be observed.
There may be several reasons why the places you have looked into only have low functioning residents:
- others have not chosen to put loved ones there or keep them home
- once higher functioning residents have regressed
- remote possibility it is just a lousy place and maybe cheaper for those who need it
Do check out more facilities, even if it means moving further away from you.
Do check these places at different times
Do inquire about activities, etc
One other note: after some meals or specific activity, some residents go back to their room or for a walk around the loop - mom will note that it seems like everyone has "gone home." So, if residents have retired to their rooms or are joining in activity outside the main area (mom's place does take residents to other areas and even outside the facility, if they can manage it and want to go), you might only be seeing those who cannot join in those activities.
You might also want to look at places that will accept Medicaid in the future, even if mom has enough to pay privately for a time. I've gotten countless calls from family members in a panic because their loved one has outlived their money, and they're in a private-pay only facility and have been asked to move...then they can't find another facility that will take their loved one straight on Medicaid. Very sad, but it happens every day.
Larger facilities do have some added benefits but I found the cost far to much for the benefits.
Best of luck finding a solution. Finding a place is such a challenge.
My mother had vascular dementia and my grandmother had Alzheimers...i found they were very different.
My mother was so aware of her situaton even towards the end. Our dementia care in Oz is PATHETIC and in my opinion its starts at the top...Geriatricians...i wont get started...we looked after my mother at home...not easy..but for me very rewarding...she was and still is the most wonderful person ever!
It would be best to find a facility that offers all three "steps"... Independent Living, Assisted Living, Nursing Home. That way the patient is familiar with the buildings, with the Staff, with the meals, etc.