My mom is 93 years old, with dementia. (My dad died last December 2015.) In the last 4 months she fell, broke 4 ribs, hit her head which caused a brain bleed, several days in ICU/hospital then skilled nursing. She improved, did well, they discharged her to go back to her home. We hired a CNA to visit with her 2 separate hours per day and help with cooking, showering, etc. (My sister and I live near her so we too would visit everyday for a few hours.) First week she was fine, second week she stopped moving, showering, eating. She refused to talk to the CNA, said she was watching TV and did not want to talk to her. She kept telling us she did not need anyone coming to her house and while she was in HER house she did as she pleased. Third week continued same behaviors. By end of the third week she fell again, broke her hip, broke more ribs, another brain bleed. Back to ICU/hospital, skilled nursing. This time they strongly recommended she go to assisted living. However, in the 2 months she has been in assisted living, she has made a remarkable improvement. With home health care and visual/verbal stimulation she is stronger, walks very well with her walker and her brain is sharper. She now calls me several times a day asking to please take her back home. She says she can't stand being around all these "old people" they are driving her crazy. (all the patients are demented and are very passive, quiet and don't bother her at all.) But she keeps insisting she is well enough to take care of herself at home and wants to be in her home. I am afraid if we take her back home with some home health care she will revert to where she was when she last fell and broke her hip. (We are afraid she won't let the CNAs help her, will ask them to leave, will stop moving, showering and eating.) She could fall again and break even more bones, or not. We cannot afford 24 hour care in her home, so the care would be sporadic, two hours here, two hours there throughout the day. What should we do? Is there a professional type person that does evaluations of demented patients to determine whether or not they are capable of being at home on their own? Could use your advice and counsel on this issue.
I would try to adjust to the fact that mom may not agree or get on board with the decision. But, she may move past that and even forget about it.
She is now in an environment where she is thriving. Why would you consider putting her in an environment of high risk?
But she may be correct that she is more alert and lively than the others in her facility. I take it she is in a memory care unit? My friend's father had the same complaint when he was in a memory care unit and he managed to convince his doctor that he didn't need to be. He moved to the "regular" assisted living unit at the same facility and did very well.
If your mother has improved enough to want to interact with others perhaps she should try a facility with more residents at her level of interaction. In most assisted living facilities and nursing homes more than half of the residents have dementia, but they don't need the extra level of care provided in a dementia unit. Unless your mother is a wandering risk, you might consider a move for her -- but not, certainly, a move back to living on her own.
You are right, your Mom will fall again, have another brain bleed, and find herself probably in long-term-care. That is what happened to my Mom because she was too stubborn to want caregivers, or to even use a walker [that was for old people... she was 98, so I guess that meant at 108 she would finally use one].
You could ask your Mom's doctor to give you a script for Occupational Therapy to come over and preview your Mom's home, give suggestions, and hopefully tell you that Mom needs a higher level of care.