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My 97-year-old mother entered assisted living five years ago. She has dementia and has been hospitalized twice in the last six months; once for COVID and once for a bowel blockage. She survived both, but not well. The problem is with her current AL. The AL is unable to keep a director for very long. Most leave after a year and one only stayed a month. They have also lost staff, like many of these facilities, and hire temporary workers to fill in the blanks. We currently have private care coming into the AL to help her at night due to staffing challenges and lack of leadership at the AL (the director recently left). I think she should be moved to a different, more stable assisted living community, or directly into memory care at another facility. My concern is that a move will drive her farther down hill. Have you done this, and has it completely destabilized your loved one or did they adjust after a while?

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Your mother needs Memory Care. An Assisted living is not enough. At 97 it may cause some decline but she is 97. I would move her.
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At 97 I way say she needs Memory Care. Recently moved my step-mother from one facility to another, both MC, after a few days she didn't know the difference.

Your mother at that age, there is no way of telling what would or would not affect her, she is very old.

I would bypass AL go direct to MC.
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I too believe memory care is what is best for her.
My mom lived in an assisted living facility until her decline was too much for the AL. Even though they did their best, it just wasn't enough for her needs and it was hard for them too. I moved her with me. I thought it was really going to impact the decline but I was surprised that she adjusted well. I was able to give her the care she needed. I understand it's not what everyone can do, which is why I think a memory care facility/unit would be best. I hope this helps.
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I moved my husband, who suffered from dementia, from a substandard MC facility to one that was excellently run. He didn't even seem to know the difference and it greatly improved his quality of life. They took good care of him until end of life, calling in Hospice toward the end. I will always be thankful for Avita of Newburyport, Massachusetts.
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It’s a little surprising to me that “the lack of leadership” may have allowed her to remain at a level of care and services which seemingly (according to your thinking)is really nt equipped to meet her increasing needs.

If her facility provides progressive (stepped up?) care, you may be able to request that she be evaluated and considered for memory care or skilled nursing, both of which represent significantly increased care than typical assisted living situations.

Unless you have already found a care site that has committed to offering a better set of circumstances to meet her needs, you might find her in a situation similar to what she’s already living in, then combined with a drastic and potentially disorienting change.

”Assisted Living”, however “stable” according to your comments, does not seem to realistically reflect her care needs at this stage in her life.
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horticulturist May 2023
The AL does have "stepped up" care levels, which we have requested and are paying for---but not getting. My concern, in addition to de-stabilizing Mother with a move, is that once the private care attendant leaves the AL will continue to accept payment for extra services but not provide any. I certainly don't think the MC section of her current AL will be any better. For example: we pay extra for two evenings of showering help. One evening this week the private care aid told me the AL staff showed up for shower duty complaining of hurting her hand and therefore being unable to lift anything. No one is in charge who can answer for these defects in service. I'm currently researching facilities in her area that are better run and can provide a better level of care.
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Move your mother to memory care.
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I did this with my dad. He did decline, but I feel it was because most of the residents in his MC are non verbal. He has no one to talk to, he is a friendly guy, OR was. Mid stage dementia. Caretakers can’t be there every second to talk. He does like them and converses when they are with him.
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My mom moved from a great AL to a not so great AL that told me she needed to be in MC or she needed to leave that day. I was distraught. No choice to move her MC where she shared a room and my mom started sleeping alot and I came in to find her in depends when she wasn't in them before. Someone was helping me because a week later the apartment next door from ours opened up...I moved her in ASAP and she is doing well with myself as her main caregiver, caregivers to relieve me and therapists coming and going. Watch the movie "Dad" and move her!
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My Mom had frequent trips to the bathroom at night and she kept falling down.
She was in AL but they did not have 24-hour staff (no one was there overnight).
I moved her into Memory Care at the same facility because the MC unit offered 24-hour attendants. She didn't like it in Memory Care because it was a locked unit. I plan on moving her to another facility in June when her lease is up on the Memory Care unit.
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Guessing Hospice or nursing facility would benefit her. Please call Adult Protective Services and have her evaluated for appropriate placement.
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Igloocar May 2023
I agree an evaluation is needed, but that's not normally the role of APS.
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horticułturist: Perhaps your mother requires a memory care facility.
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You need to move your Mom. All the staff changes is pretty upsetting to you and thus, her and probably does not allow your Mom to "heal" or bond.

As for AL vs MC, I would talk to the facility. Different facilities have different requirements/guidelines for MC and AL.

For MC, nearly all of them lock down the floors. What I found is that sometimes, MC is more economical than AL because of all the services that are considered part of MC which are not part of AL, like bathing and medication management. Supposedly, MC floors also have activities that stimulate the mind (e.g. swatting a balloon with a fly swatter) versus AL programs which might be more passive (e.g. watching a movie).

Forget worrying about destabilization. You need to find a facility that you believe in. Your Mom is looking to you for clues.
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I think all of the facilities are having issues with turnover of staff, so moving her to another facility may not fix your problem. If your mom is that far along with dementia, she may not realize that she has moved into the memory care part of the facility.

They transitioned my mom over a two week period. They took her to memory care and she spent the day there in the social room and with the other memory care residents during meal times. After she had a couple of weeks of doing that, I moved her things into a memory care room and then she never left. It was a smooth transition and she never knew the difference. Her room had all of her familiar things in it and she continued dining with the same folks she had been with for weeks.
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My moms AL has had 4 administrators in 2.5 years! One guy stayed about 2 months. Staff turnover and agency nursing staff filling in is a constant. Care remains just fine. That being said I moved her out of memory care 20 miles away into an AL {closer to me} that promised equal care. She hated being locked in the MC unit..she was the only truly verbal person. Here she walks around talking to people all day and can sit in the lobby. They also have an outside gazebo she frequents in warm weather. She never missed a beat. She was told I lived right down the street and she loved that idea. Good Luck.
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