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Well, have scheduled my mom's move in date with the assisted living community for next Monday. We had to delay, her move in due to her fall 2 weeks ago, but she seems to be healing ok, and have follow up appt for the hand and facial fractures in a couple of days.


Her late day confusion has been worse since the fall, but her Neurologist seems to think that fairly normal with trauma and pain, so hopefully that will settle back to her previous baseline once she heals and adjust to the new living arrangements Her doctor prescribed Seroquel 12.5 mg to help with the extra confusion. She's taken it for a couple of days now, and the extra emotional distress and anxiety seem to be way down, but the confusion ( her husband alive(dead 14 years), looking for her child, wanting to make sure her mom(dead 35 years) know where she is ) that has remained. She seems more mad now, tonight she wanted me to help her call "somebody", but kept namin people who were dead, then getting mad at me when I couldn't call them. Then she called an old friend, all smiles on the phone.


Ok , now my question!


She has a little confusion upon waking, but not bad, as as she will need someone to help her get dressed in the morning untill her cast comes off, should be ok. She's ok morning and early afternoon. And once in bed, usually is down for the night. There are a few nights a week, that she has a weird dream, and wakes me up, looking for a child or saying there are people in her room, but that was a lot worse when she first came to live with me in September, much better now.


But I am worried about the time period after dinner and before bed. That's when she is the most confused and upset. I plan to stay the first couple of nights with her. But after should I employ a caregiver? Ask them to do what? She wouldnt like people she doesnt know hanging out in her apartment, maybe just knock and check every hour?
Ask her if she needs or wants the if she wants them to. I dont really know what to ask for. I really want this to work out.

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From my experience with my mom and MC, the staff know what to do! Every resident was different and the staff there were on top of it.

As far as staying away in the beginning, that was not anything the MC staff asked us to do and I think each situation is different. I know in my case, I would not have been able to stay away. Regardless of what my mother knew or didn't know, I wanted to know how she was and I didn't want her to ever feel that I had abandoned her. We visited daily in the beginning and over time, whittled it down to every other day in order to get her to settle in. We felt she needed to see familiar faces in the beginning. I can see, in certain cases, how staying away could be beneficial, however.

Good luck. This is a hard and terrible journey and no way out of it until it's over. I wish you and your mom the best.
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I was thinking the same as Barb, what does staff advise? Often facilities want loved ones to stay away for awhile so that the elder will come to rely on staff, not family. The adjustment could intensify if you were to stay the night for awhile, then leave. If it makes you more comfortable, hire an outside caregiver for a bit, check facility policy first.

Also it sounds like mom has had quite a decline as a result of that fall. She may need memory care from the sounds of it. Check with the facility another needs assessment sounds warranted. And be honest with them about everything it will help them better plan the care of your mom.
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I would seek the AL professional staff input on this.

Mmost ALs request that you stay away for a bit to let the patient get adjusted. Find out what they advise. Talk to the social worker before mom moves in about her sundowning. They need to know that it has intensified since their initial assessment.

Was it determined that AL is the right level of support for her? Is this a tiered facility, where she can get extra help if she needs it (at additional cost)?
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Gracie61 Feb 2020
I did talk to Assisted Living director of nursing yesterday. He want to reassess after her move in on Monday. I did get a list of their preferred providers if I wanted a caregiver.

This facility does have levels of care, ind. Living, Asssisted living and Memory Care. Prior to fall she was assessed at their lowest level Assisted Living. They said that they assess periodically, to determine if levels of care change, based on ADL needs. Obviously she needs a little more help at this time.

I wanted to give her a chance to heal and adjust before declaring that this is her new normal, and just going memory care. It was a big victory to get her to even agree to to try assisted living. When I first broached the subject, and we went to visit, she refused to get out of the car and go inside.

Im hoping in her apartment, with her things, and a more consistent schedule, it will be better.
I've only dealt with caregivers one other time, while my aunt was in a inpatient hospice a few years ago. I or my mom stayed with her during the day, and we had caregivers stay with her at night from 8 PM to 7 am so that we could sleep and recharge.
I'm just not sure what I want them to do , how to approach with my mom, or if it is even necessary. I guess I will see how things are next week, and what the caregivers on her floor recommend once we get settled
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