My 92 year old mother is healthy physically but she has a severe short term memory deficit. She still lives in her own apartment and we have made arrangements for someone to see her everyday. “We” includes my brother and his wife, their daughter and me. I wonder if for psychosocial benefits it would be best for her to be in an assisted living facility. She seems happy but her latest saying is, “Come often and stay long!” I believe she turns on a tv at 5:00 pm until around 9:00 but otherwise sits in her chair listening to talk radio. She no longer reads. Is that sufficient and reasonable to maintain what is best for her? Or are we kidding ourselves that it's ok. She is, in my opinion, incapable of knowing how someplace different might help. Or does it?
That allowed him to live a long time on his own. But the turning point was when he quit eating the meals we provided and slept all day. He was very frail when he moved here but is doing much better physically with a better diet.
We moved him here slowly, first a few days/week, then added days and finally told him we wanted him here permanently. I didn’t make it about his dementia, but that he was our family and we wanted more time with him and to help take care of him. We talked up big all the benefits of living here, lol. He grew attached to our dog and we told him the dog really missed him and their walks, that made the biggest difference in his saying yes (without a fight)
The visits may occur a few times a day. It sounds like she may also feel lonely.
I can only speak from my own experience!
After my Uncle passed, my Aunt (Alzheimer's) was unable to live alone. I witnessed her burning a rice bag in the microwave. She set the time for 20 mins instead of 2 mins. She also had the toaster on the highest setting and it caught on fire.
I was terrified of moving her into ALF!! And more terrified of leaving her alone!!
I will tell you that for my Aunt, ALF has been a Godsend!!
She is out socializing all day. They keep her busy! She is engaged and active!
I think in her case, if I had left her in her home, alone and isolated, she would have passed away by now.
It's a difficult situation!
Wishing you the best!!
She will be happier getting to stay right where she is unless she tells you otherwise.
Besides checking in on her once a day in person, you should also call her once a day.
You should set up cameras in the home so she can be watched 24 7 by cell phone or lap top.
She should also have the Home Button she can push in case of an emergency like a fall.
She should only cook by microwave.
Mom was about the same age and relatively healthy (hearing loss, treated for Mac Deg, on BP meds.) Clearly her short term memory was fading quickly. Once I realized this, I started learning about dementia (knew ZERO before that!) Of course during the early stages we have some options. AL is one. Bringing in aides is another. Safety enhancements when possible. Socialization is something highly recommended, but while this virus is still an issue, that is a problem. In mom's case, she was social before the dementia, but became increasingly self-isolated. She would make excuses not to join others for events at the Senior Center, etc. She would often plan or try to cancel appointments.
The more I learned, the more concerned I became. One brother isn't local, but even he was pig-headed and blind, esp when I tried to "inform" him. The other, right up to the actual move INSISTED mom should be in AL, not MC, despite what the assessment and staff were saying. Other than having more 'eyes on the prize', more services to help and more people around for socializing (not at the moment), AL is really no different than having your mom in her apartment with someone, whether you, brother, aides, coming in sometimes to visit and/or check on her.
When you don't actually live with someone, it's often hard to notice ALL the deficits. I missed the very earliest warning signs because she lived alone and I didn't snoop around to see how things were or even talk every day (multiple times per week.) Finances had to be taken over first - she was having difficulty, so I just made the decision to "activate" POA and take that on. Once we took the car away, then it became obvious she was no longer cooking. I could only provide so many home-cooked meals that could be frozen, but even then I'm not sure she knew what to do with them - frozen dinners and boxed crap was her go to, along with instant coffee (multiple cups would be found in the fridge, because she would even forget she made it and would make another, saving that for later!)
Once we moved her and I started working on clearing/cleaning/fixing the condo, MORE became evident. She was still mobile and able to keep herself clean and fed, but too much else was falling apart. Even though they can walk, talk and feed themselves, there is so much more to consider when they live alone.
I did note that you are pretty much on board with a change being needed, but brother isn't. Would it be possible for you to install some cameras? We had some, and they would record for a chosen set of seconds (mainly at front door and in the finished basement.) These only provided small glimpses into her daily routine (sat a lot reading, esp sale flyers and catalogs.) The big thing they revealed is that she began a nighttime OCD marathon, checking the door lock, sidelights, dishwasher and LR. It started out a few times/week, a few times those nights. It shortly became a nightly 1-1.5 HOUR trip, cycling through these over and over again! The camera couldn't see to the dishwasher, but I could count seconds, light on, light off, and same for LR, no camera, but pass-through window allowed the light to shine through. This was her version of sun-downing. Without the cameras, no one would have known!
If you can document her "doings" with the camera and show him, maybe you can convince him. Even better, or in concert with cameras, could you stay there for a few days and document what her days involve? Seeing is believing! If it's as bad as you think, get him to stay there a few days.
I would be checking the places you think are best, while waiting for virus resolution. You can still talk with them and get a feel for whether AL or MC is best. They will do assessment as well. Meanwhile, gather enough info to work on bro. They often just don't see the whole picture.
It's time to start investigating other options.
I would suggest a life alert button for her. Does she need help cooking and cleaning?
If possible, could the visitor join her for a meal? Lunch or dinner.
I cook a well balanced dinner, with plenty of extra to bring for Mom and share a meal.
Also, perhaps a schedule for a daily call. I call my Mom each evening around 7.
Hoping your Mom can stay in her apartment, especially during the pandemic.
Best wishes.
We added some "safety" features for mom, including a flashing light for the doorbell, a timed/locked dispenser for meds, and cameras. Her hearing wasn't great and she would often forget to replace the battery in it, leaving her mostly deaf. She misplaced the portable phone (there was a wall phone too) multiple times. She dismantled the flashing light. She would miss the alarms, etc on the dispenser. She switched the thermostat from Cool to Heat, mid-summer! The place was SO hot (the heat wasn't running, but with all windows closed, heat and humidity built up!) One brother put in a Nest thermo - he could monitor and control it through WiFi, she didn't know how to mess with it. He also put in a cipher lock on the door, also able to control it and set it to lock at night.
We tried bringing in aides, 1hr/day, to check on her and see that she took the meds. That didn't last 2 months (she refused to let them in.) If she had an alert button, that would have been misplaced as well. Too often she would put away "supplies" and then forget she had them, use other things (wrapping items in torn up plastic bags for freezing, despite having baggies, plastic wrap, tin foil, etc) and ask for me to pick up more.
I also made extra for some meals (lasagna, mac 'n cheese, chili) that I could freeze and bring to her. I did not live close enough to provide daily meals. No clue how far away OP is, but that isn't always an option. She flat out refused to even consider MOW. She forgot how to cook things, so she relied on frozen dinners and junk.
Sometimes it just isn't easy trying to keep them in their own place, esp when memory issues are the big concern. Without being there all the time, we have NO way to know what deficits there are, what danger they pose for themselves or what they are doing daily. Cameras can only show so much.
Learned LONG ago when watching The Electric Company with my kids:
IF.... is a very big word....
When you say someone sees her every day - do you mean a drop in 15 minute visit or a couple hours every day? If she is happy and physically doing well, is there a way she can live with one of you for now? Just thinking that if you trust her at home alone right now, she must be in fairly good physical shape and should not require that much work for a relative that she lives with. Being around others and engaging in conversations more often is good brain exercise. It won't make dementia go away, but some say mental activity slows it down.
Being that she is physically able to get around and manage on her own at this time, I would try to extend her time outside a facility until absolutely necessary. With covid, she probably won't get all of the social gatherings in a facility that used to take place and could be more alone than she is now. Most have to stay in their rooms away from the other patients.
You might also consider a few cameras in her house - living room, bedroom, and maybe one that can pick up a hallway, etc. You could peek in on her through out the day to have a better idea of what she does. Amazon alexa has a thing that you can have an audio and video call with someone - you could put a little note on it for her to say, "Alexa call SusieQ" to reach you.
I would vote to move her in with one of you so you can spend more quality time with her while there is still some long term memory and she is able to get around on her own. Maybe even split time between you and brother's house - however - there will come a time that moving her around won't work. It will create more confusion for her. --- This last paragraph just my own personal opinion based on she is becoming unsafe living alone but she is not quite ready for solitude of covid practices in facilities. Really just needs more eyes on her daily and while you all are familiar to you, enjoy this period of time ---
In OP's case, I don't think her mother is really AL material. If she was, then she could remain at home.
I agree , mom will be better, or you will be better knowing someone is around 24/7
The last sentence fits as well. Initially she was miffed, but she eventually was content. The place was great, mom was well cared for and SAFE. She had 3 good meals per day, with snacks and coffee between. There were plenty of others around for socializing and varied activities for the residents.
Please make a consultation appointment with a good elder care attorney to learn your options about protecting and/or utilizing her assets to best serve her. You should have a durable POA and health care proxy in place before you make any major changes. Any changes in memory should be documented with her primary care physician. Lastly, if she has sizable assets hire a local caretaker (besides family) to keep her company and take care of her household needs for a few hours a day. I think that would be a help to all of you and give you some time to make a good assessment before you decide on moving her to an AL facility. Best of luck to you!
Is it "safe" for her to stay in her home? That is the important question.
Will she wander out and not know ho to get back home? Could she leave the stove on? Is it gas or electric? If gas does it have an exposed pilot light that could catch a towel, garment or paper on fire? Is is possible that the pilot light could go out and fill the apartment with gas? Is there a working carbon monoxide alarm?
Is she taking medications? if so is she taking them properly? can she over dose or under dose? If someone sees her everyday if she fell after someone left would she know how to get help or would she remain on the floor until the next person scheduled to see her arrives? And what if the person scheduled to visit did not show up that day?
All this is speculation. Unless she has been declared incompetent you can not "force" her to move.
On the flip side..falls are bound to happen no matter where she is. Accidents happen, that is a fact of life. And another sobering fact is : no one gets out alive.
If she is safe, if there is no chance she would wander she would probably be much happier living in her home. The best solution would be to have someone live in with her if that is an option. then she can stay until it is physically impossible for her to remain.
All the safety concerns are valid, and there are likely more. If someone can't be there 24/7, anything can happen (can for us too, but when not able to make proper decisions, even simple issues can be deadly.)
Agreed also that while falls are a concern, they happen everywhere, no matter how well someone is monitored. It matters more that there is someone available to help if/when it happens.
Funny is that my idea for prompting the move wasn't implemented, but could have worked. YB had put in a Nest thermostat. He could monitor and control it from anywhere with WiFi access. The old one she managed to flip from Cool to Heat in the middle of the summer. The heat wasn't running, but it was like a sauna in her place! Anyway, I suggested he mess with it, making it too cool for her (it was already into early winter), then maybe too hot, etc. Instead, he used her leg injury/cellulitis to draw up a fake letter (how nice of her to provide this "solution" for us!) The funny part is that a few months later, while working on clearing and cleaning, I discovered the heating system died! So my idea wasn't even really a ruse, it was reality! Had that happened while she was still living there, she would have been in a dangerous situation.
The nurse the agency sent to assess her before we started aides had suggested this. It did help, however she would often miss the daily meds, either not seeing the blinking light or hearing the alert. The aides were mainly to check on her and see that she took the meds (they can't dispense, but they can look and remind.) We never got past 1hr/day as she refused to let them in less than 2 months later.
We tried bringing in aides, initially to check on her, but with plans to increase the time and care needed, so she could remain in her own place longer. She thwarted that by refusing to let them in. I started looking at places nearer to where I live, as it was not safe for her to remain there. Any mention of moving, whether to my brothers' places or AL were met with extreme refusal to even consider it. AL had been in her own plans before dementia, but dementia lies to the person, and they think they are just fine. The Elder Care attorney told me we could not force her to move and said we would have to consider guardianship. I don't think her condition was at that point where she would be deemed incapable, but it was enough that no way was she safe to stay home alone. Secondary issue is the facility I chose would not accept a committal. So, we had to come up with a plausible reason that she HAD to move. I suggested some ideas to the brothers, but she provided it herself by bruising her leg and developing cellulitis. One brother wrote a phony letter from 'Elder Services' at the hospital, stating she either moves to a place we choose or they would place her. Madder than a wet hen, but she went with my brothers. Even staff at her residence told me THEY can't force residents to do anything, they have to work around obstinance and refusals, even when it's necessary medical treatment or taking regular medications.
Just as with taking her car, WE have to weigh our options and go with the BEST solution. Is it my right to take her car away? Maybe not, but I wouldn't want to live with the results if I backed down. If she killed herself or someone else, I would have to live with that. Is it my right to say she has to move? According to attorney, no, but again, I have to live with the results. Would I go to see her, take her shopping or to an appointment and find her dead? Would she fall down the stairs? Would she wander off? Any number of what ifs were enough for me.
Legal or not, I stand by my decisions!
Try your best to "Come often and stay long!" Also, hire someone to provide companionship for her when you all can't be there.
When the pandemic blows over, then you can search for a good AL facility for her.
She needs to have a person helping her to keep her safe. Consider whether there are enough people: family members, friends, members from your community of faith, and/or paid help to have somebody with her most of the time in her home. My MIL has 2 women who care for her in her apartment. If finances are tight, consider if she needs to move in with a family member or into a residential facility.
I above idea only works if your Mom can budget for the cost. Cost vary from area to area. My Dad paying $5k per month, he got a special discount due to winter and the community was trying to fill their rooms.
Once covid-19 is totally under control, make an appointment to take Mom on a tour of a senior facility. the facility usually likes to have you and Mom come at a time where they can serve lunch so one can get an idea about the food. Just make up an excuse why you are taking Mom there. Who knows she make see someone she knows or really love the place, or wouldn't step foot back into the place.
If Mom loves the place, tell brother that Mom wants to move there.
If you decide that your mother does need more supervision, do not move in with her. Once that happens, it will be very difficult to remove yourself from that situation.
And what is her financial situation? Is there any chance that your brother wants her to stay in her home so that his inheritance isn't spent for a facility?
The real issue is coming to an agreement with my brother as to what is best for our Mom. And her money that currently enables her to go into a private facility.