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My 92 yr. old Mom has been living with me for over 8 years and the time has come for her to move to an assisted living facility. She wants to move to Las Vegas or Florida where she has friends. I live in the Northeast and think she should be closer to me. She doesn't value the help and care I have given her so it makes sense that she is willing to move away. Although, it would be less expensive to have her move to either of these places and easier for me, I do feel conflicted because I know better. She, however, is very stubborn and says that I am not her Boss. Any thoughts on this matter is appreciated!

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Might be off topic in this situation, but I read these looking for help in my own situation, don't we all apply things to ourselves? It MAY apply - if moving from NJ to FL, could the reason be because of prolonged time stuck indoors because of snow and cold weather? That is what I am facing with my LO. I am not her guardian, but live in CA and my LO lives with a guardian in NJ. She is longing to leave. Won't go into more detail, but don't you think that should be included in the conversation? Unless one is in such a situation that it doesn't matter. We have little enough money that my LO spends long periods of time with no one around but her caregiver and little to do. Heartbreaking for me. Sending you all love and compassion.
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Here's the deal. If your mom moves away, she will need to hire a Geriatric Care Manager to do the stuff you would be doing if she was in an AL or MC near you.

This is not optional. When she falls in AL and is transported to the ER, she will be there alone until the GCM gets there.

When she needs new clothes, toiletries, snacks, thr GCM will be doing those tasks.

When there are questions about her insurance, when she needs to see a specialist, the GCM will see to it.

In dementia, logic often flies out the window. In your mom's case, I would give her the choice of where she wants to be, but with a GCM if it's not near you.
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gladimhere Jun 2021
My thoughts exactly!
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Imho, for all intents and purposes, YOU are the one in control in this matter/the decision should be your's.
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So, her argument is that you aren’t her BOSS. You can claim the same argument for yourself. She isn’t YOUR boss and ‘seniority’ means absolutely nothing in her favor.

My mom recently died in a hospice house with end stage Parkinson’s disease and mild dementia. I can’t imagine my mom not having been nearby.

This is your decision to make. Having your mom near you is not only for your benefit but also for your mom. Not to be disrespectful of your mom, but she needs your help more than you need her to be happy with your decision. You can live with her being dissatisfied, as unpleasant as it may be.

You are the one who will be called upon for decisions to be made. Her ‘friends’ don’t have any say in her care. For all you know, they won’t even visit her.

I hope things will work out as smoothly as they possibly can. Best wishes to you and your mom.
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You will be the one to pick up all the pieces from all the messes that your mother creates when she moves into Assisted Living in another state and can't figure out what to do b/c she has moderate dementia along with Parkinson's disease, let's face it. She really belongs in Memory Care where there are no decisions to make and where you, as her POA, get to make all the decisions there are TO make. They call you first b/c mom has dementia. She has no ability to make rational decisions and so, you will be facilitating her next move and the ones after that if the right decision isn't made the first time, as I said to 'bevthegreat' who doesn't understand it's ALWAYS our problem with a demented parent to care for. Right?

Your mother doesn't have to value the care you've given her over the years or appreciate one single thing you've done for her in order for you to help her make the right decision now. Her 'friends' in Las Vegas or Florida won't do anything to help her once she moves there, and once again, YOU will be the 'go-to' girl for everything, except you'll be far away. Making everything harder and more expensive for you to handle. It makes no sense at all for her to be so far away from you. My mother is 94 and lives in Memory Care AL 4 miles away. I'll give you ONE example of ONE crisis I had to deal with recently. She had swollen feet and legs so the new shoes she insisted she needed wound up not fitting. First of all, I had to go buy them for her and drive them over to the MC to begin with. 2 weeks later when the nurse called to say they didn't fit, I had to drive over to Wal Mart to buy her 6 pair of MEN'S shoes in various sizes to see which ones would fit her swollen feet, wait while the nurse tried them on her feet, then bring back the extras to Wal Mart for a refund. Then I had to go home and order diabetic socks from Amazon b/c she refused to wear regular socks b/c they were hurting her ankles. That is one small story about how I had to run myself ragged on her behalf. What would have happened if I was 1000 miles away?

With dementia, you as POA get to make the decision about which ALF mother gets to live in. If she thinks that's bossy, so be it. Sorry mom, but I am still going to have a million things to do for you while you're in AL (and that is the God's honest truth) so you need to be close by. Period. Anyone suggesting you tell your mother to 'manage on her own' just doesn't get it. The facility will be calling you constantly b/c they cannot make decisions for demented elders; AL is for fairly independent elders who don't need a ton of assistance, in reality.

Wishing you the best of luck doing what's best for YOU and for your mother. There are TWO lives involved here, not just one, in reality. I've been 100% involved with my mother's life since my parents moved back here in 2011 when dad couldn't drive anymore. I am an only 'child' and I'm IT; the go-to gal for everything. "Stubborn" parents have no problem picking up the phone and asking us to do a ton for them when they need something.........that's really the truth!
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Clearly anyone anywhere is going to be happier or happiest making their own decisions especially such important ones. IF at a distance you might still become ensnared if her behavior or health becomes problematic, and you being next of kin get the phone call(s)....But I'd say have a nice trip and just realize I can't afford to run to help and you will have to manage on your own....
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Let her decide where she wants to live. Of it doesn't work out, she can change to one closer by you
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lealonnie1 Jun 2021
And who's going to facilitate that move? The OP of course, which puts her out and creates a big mess for her after having cared for her mother in-house for the past 8 years.
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We kept my mom (she was 88) in an IL close to where she had lived for 50+ years..

Not one of her close friends ever visited her there.

When she had a stroke, it took my brother 2 hours and me several more hours to get to the hospital. By that time, several really critical errors had been made. (My mom nodded "yes" to everything, ie, do you have diabetes? Have you ever tried to dc insulin? It is really hard).

If your mom is competent and cognizent, she needs to understand that going to an AL NOT near you is a bad idea. If she chooses that, I wouldn't make any of HER emwrgencies YOUR emergencies.
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So when was the last time she was in person around these friends in NV or FL for an extended period of time? Like for weeks not weekend. Are they Christmas card friends or speak in depth regularly friends?

Do you know any of their kids? If so, I’d call them, ostensibly asking about health care and doctors that mom might could go to as she’s planning a move nearby their folks. It could be quite enlightening.

At 92 whatever health issues she has are only going to get worse. Unless she moves into a CCRC with full range of tiered services, that is included in her $$$$ buy-in, she’s going to need others to help her find new doctors, get a pharmacy set up, get her kitchen set up. I’m assuming that mom cannot use any apps so she not ever going Instacart route for groceries, or can use Venmo or Prime.

Make a list of all the things you do for her right now & what services she’s on. Who is gonna do all these in NV or FL?
She needs a reality check. The issue will be that she probably has the beginnings of dementia & can’t …. Im guessing she still appears very competent and cognitive but it’s there lurking. The move to a new place will be a huge stress to her system and only exacerbate her dementia. The world she thought she was moving to happened back in the 1980’s, maybe 1970’s. If something goes amiss, can you immediately drop everything and go to NV or FL to band-aid the problem?

Out of curiosity, does she dislike most people or is it that she flat dislikes you? If so, is there anyone she would listen to as to why it’s best for her to stay in a new place in the NE rather than move states away?
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smartbutton Jun 2021
Agree totally
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Well it is true being an adult that your not her boss. That’s not meant as an insult, it’s the truth unless she’s on conservatorship she can choose where she wants to go. I’m sorry this is difficult for you do you have a therapist you can talk to help you through this new phase in both of your lives?
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disgustedtoo Jun 2021
OP knows she isn't the boss... however... given mom's age (92), and medical conditions (Parkinson's and mild to moderate dementia), moving 1000s of miles away is going to be an unmitigated disaster.

WHO will be moving everything and setting it all up?
WHO will be moving it all back when it doesn't work out?
How old are these "friends", when were the last together and what are their conditions?
If, or rather WHEN, mom has serious medical issues, OP won't be there to assist.
Typically ANY move is hard on elders, and especially difficult for those with dementia.

Sure, mom WANTS to move to where she thinks her friends are. They could be active or they could be in serious decline just like she is. That's not a good recipe.

Sometimes we have to curtail what they want and consider what they NEED. OP isn't saying mom needs to stay more local because she'd be devastated if mom moved away. OP doesn't need a therapist to work out her "issues." This new "phase" isn't like your child going off to college and leaving you with empty nest syndrome. This is an elderly frail woman who will have needs that only OP can address and will need oversight. OP's the one thinking rationally.
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My first impulse was to say to let her go live where her friends are. Then I saw it was across the country from where you are and where she’s been living for 8 years. If she moves away, it will be very hard on you and very hard on her bc she won’t have a local advocate.
I bought a house across the street from my mom (about 7 years ago.) My brother lived 2 blocks away. She was in her late 80s then and had a neighborhood community of support. But she wanted to sell her house to get her money out of it instead of leaving it to “the heirs”, my brother and me. So she sold her house, bought a mobile home in a park (the monthly expenses which were more than she paid in her home) and the heirs wound up having to drive 20 minutes when she couldn’t operate her tv or thermostat or just to visit. The move was a mistake. And the heirs suffered the consequences. Part of the justification for the move was also the social life she could have at the mobile community. It didn’t happen. She could no longer see well enough to play bingo, and the spry 70s did not want to take on an old lady (my opinion). She did not go to the clubhouse or pool across the street from her home. She was too disabled by then bc of macular degeneration to venture out. So instead she sat home alone waiting for the heirs to visit.
My point is that my mom’s expectations of her abilities—and my expectations—did not match her reality. We are often slow to recognize our limitations. I fear this is the case for your mom, too, and her memories of life with her friends will not match the reality.
One wonders why she didn’t move closer to the friends earlier if this is what she wanted. Do you think any of this is a passive aggressive way of punishing you, who she has lived with these past 8 years? Seems to me that likely she’s feeling hurt about the move to an ALF (where my mom now lives, by the way, tho this is new for us), and is striking out to hurt you by letting you know she doesn’t need you, either. She’ll be fine with her friends. Maybe a conversation about how much you’d miss her if she moved away instead of how hard it would be to navigate the distance would restore her feelings of worth.
Wishing you both love in working out these complications. (Note: my mom is in a Florida ALF, with my brother nearby, after a year of living with me. I am in MS. Tho I am enjoying my break and the chance to sort things out in my own life which were on hold while she was with me, it’s too far. I wish I lived close by so I could visit, take her out, enjoy her. I am going to have to figure this out.)
Wishing us both clarity, peace and quality time with our loved ones.
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Let her decide based on her preferences. If she is not happy, it will have been her choice — and not your fault if something is less than desirable.
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disgustedtoo Jun 2021
So, OP lets mom have it her way, has to arrange the move, set up and everything else to get her there (never mind the prep work of finding a place.)

And... if things don't pan out? Who gets to undo all that and move her back? Who will be there to provide support (AL doesn't substitute for family) or pick up things she needs?

It IS a lot harder to maintain things for our LOs when they aren't local. If she has a serious medical issue, how soon can OP get there?

There are a lot of unknowns, but given age and medical issues, this isn't a simple "let mom do what she wants." Dementia alone clouds a person's ability to make rational decisions. Memory loss can make the old "stomping grounds" or being with "old friends" seem like paradise.

This isn't a child on the cusp of adulthood, who we should let fly to make or break. This is a vulnerable old woman.
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Why not let her live with her friends for now? First off, she might want to start calling those people and chatting regularly. 8 years can change people - her friends may not even be capable of getting around or holding a conversation anymore. Do some of them live at AL facilities that she is interested in? If yes, let her go. Do rental furniture or minimal personal item moving. Worst case scenario, she finds she doesn't really have any more friends there than she does where you live...and returns. Assuming she has money for AL, so a few trips would not be out of the question.

Shoot! Tell her to call her friends and find out when she can go there for a visit. Make sure they understand her physical limits and can handle her for a few weeks - maybe a month! Maybe all she really needs is a vacation with the old gang.
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Research places online in all of those states. Visit the top choices to narrow mom's options down to the top 3 and let her choose from those. You probably already understand that she will most likely NOT be visited by "friends" in Las Vegas or Florida. If she lives a distance from you, it will be hard to visit her in her new home or when she is hospitalized for problems with her PD.
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disgustedtoo Jun 2021
" You probably already understand that she will most likely NOT be visited by "friends" in Las Vegas or Florida. If she lives a distance from you, it will be hard to visit her in her new home or when she is hospitalized for problems with her PD."

Then why would OP be encouraged to facilitate this move? It's not like she'd be moving around the corner, the hassles of finding a place (which is best done IN PERSON), packing and getting all her things moved, getting her there is bad enough. Finding new doctors, dentists, etc, arranging transport to appts, shopping, etc will need to be handled. Medical emergencies will be a total nightmare. If she had "needs" beyond what AL provides and/or decides this "utopia" she dreamed of isn't up to snuff, who gets to deal with it and/or undo it all and bring her and her possessions back, just to mollify her?

If she were moderately capable physically AND capable cognitively, she could arrange all this herself. She isn't and she's 92. This shouldn't be all about her wants, but rather her needs.
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JoAnn has given you the best answer. Don't argue. Move her NOW because she's no longer suitable in your home. Use compassionate fibbing to tell her that you're looking into LV & FL, but never do it. However, you should have her evaluated, and if she is appropriate for AL (she MAY already be ready for MC), please DO move her to a place that also has transitional MC.
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If she has not been declared incompetent then she can make her own decision on where she wants to move to.
Work with the Social Worker in helping your mom find a Care Manager that can navigate doctor visits and other "problems" that might arise. The cost of a care manager varies.
Does either the Florida or Las Vegas location have a "sister" company in your area? If so you could ask if she can "try on" a community and see if it is to her liking. It would also be important to actually determine how often she spends time with friends. Does she know people that would actually spend time with her and would she be active?
It might also be easier to transfer her from the Florida or Las Vegas facility to one close to you if they have another residence in your area.
I would say...let her make the move at least at this point she is active and wants to do things. You never know what will happen in 6 months, 12, or.....
Yes it might make things more difficult for you IF you try to do everything for her. If there is a crisis you will be contacted, decisions can be made over the phone and if needed you can be on a plane in a matter of hours.
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my2cents Jun 2021
I like this answer. As long as she is aware of things in her life - let her make decisions. May not be best decision for everyone else - but then, how many of our own choices have we made that may not have been best for others. Give her what is left of her personal freedom - for a little while, at least.
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How many friends does she really have? Are they well and do not have Alzheimer’s disease and/or dementia, or other medical problems? I assume you have POA. You need to decide what’s best for both of you; and particularly your mother. How about getting mom to visit and stay a weekend at the local ALF. These facilities usually offer a free week or weekend trial.
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I have a 90 year old mother with Parkinson’s who lives 3 minutes away in Assisted Living. It is $ 7,010.00 a month-private pay. Her short term memory isn’t great, but she manages. She bathes herself, gets dressed herself, gets downstairs for meals herself…I run and get what she needs, have her over for dinner, dry clean her clothes, etc. The reason I write this narrative is because it shows why you will need to have her close to you, as she will need additional supports beyond what her retirement community can provide.
Bottom line-elder care isn’t perfect. It helps to have those supports in place. I am that extra set of eyes to make sure her pills are given to her on time, her bed linens are washed, her apartment is clean and she is okay. New doctors at 92? It makes sense that she is near you. Moving across the country at 92 won’t work. The change alone in scenery and routine will be very hard on her and her memory might (will) get worse—not better.

Best wishes to you!
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Be clear with her that at such distance you will not be able to help her as you do now. But, there is an alternative, she could hire a care manager that would check in on her on a schedule that is decided at time of contract.

If you get that far to have her accept this is a viable option. Interview a couple, ask about their hourly rate. At around $100.00/hour that may be the end of the discussion.
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gladimhere Jun 2021
I am certain that I typed "geriatric" care manager. Would admins remove the geriatric word?

https://www.aginglifecare.org/

https://www.nia.nih.gov/health/what-geriatric-care-manager
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You aren't her boss. However, I wonder how many of her friends still are able to be friendly. I am 77 and have lost many of those close to me. You might let her call them; I suspect she may find things have changed. Poor thing, like all of us, she wants to go back to the (happy parts) of the past. However, if the place is decent that she wants, and she is adamant after exploring, let her go. Is it a permanent commitment? Zoom calls are a terrific idea; I don't use it. Let her see her friends (if they are still there), and if not available, let her think about that. Let her call them and see what happens. Let her contact the facilities. And, indeed, make it clear how often, if at all, you can reasonably visit. another pandemic, a hurricane? Closer would be better, and easier for you to reach, and less expensive, indeed. My moderately demented mother in law often wanted to return to her old apartment, long gone, and her old friends, long dead. Heck, let her call the place and see what she can arrange. I suspect it will be discouraging. A little practice of managing things without you might be impressive. Let her call her friends and talk to them. IN my mother in law's case, these were passing moods.
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Sorry. RE thought.
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If she's capable of making this decision and can move to a facility with her friends, let her do it. If you live in the Northeast, try to pursuade her to move to Florida. It's a much easier commute (shorter flight, same time zone, cheaper fare) than to Las Vegas. When my mother was deciding where to move after my father passed away, I told her that if she didn't move near me I wouldn't be able to visit her more than twice a year. I was working at the time. Explain to her that if she has emergencies, you won't be able to quickly come to her to help. She'll have to depend on the facility's staff to make arrangements.
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You are not her boss - she says it and if she has mental capacity to make the decision then she should be allowed to make it even if you think you know better. As long as she realises you will not be going to see her more than once a month or whatever then let her make the decision, she can always move back to somewhere closer if she prefers after a while.
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disgustedtoo Jun 2021
Who is going to facilitate all this moving around and "visiting"? If mom is 92, OP isn't some spring chicken - does she want to be flying to FL or NV once/month? Who's the boss??? BTW, the title clearly states mild to moderate dementia. Generally at that point it is a "paradise" of the mind she's going to live in, not reality.

Mom has mild to moderate dementia and Parkinson's. It's not like she's a recently retired gadfly who wants to flit off to greener pastures. She's 92 and has lived with OP 8 years. Who are these "friends"? Will they take her into the "group" and facilitate her needs? Or will they leave her behind because she can't keep up? With PD she likely needs some help getting around and isn't likely driving - are these also 90+ old ladies going to be hauling her butt around and waiting on her? I doubt it.
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Absolutely, let her decide. She has few years left...
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disgustedtoo Jun 2021
She could have more than a few years left. Just because she's 92 doesn't mean she's on death's door (and if she was, all the more reason to squash that idea of moving 1-2000 miles away, to be with "friends" she may not have even seen in almost a decade, who may not even "hang" with her or live long themselves!) Who is going to facilitate scoping out a place, packing and moving her things AND getting her there? It's not exactly around the corner. After all that, when she decides these aren't her friends and she doesn't like it there, who gets to repeat all that work to get her back?

With dementia and POA, it is up to us to ensure they get what they NEED, not always what they WANT.

My mother's dementia wasn't even all that bad, but it was NOT safe for her to be living in her own place, alone. I tried bringing in aides, 1 hr/day, to get her used to them, have "eyes" on her and check she took her meds from the locked dispenser (she was about 1.5 hours away - with hearing loss and forgetting to change hearing aid battery, misplacing the hearing aid or best of all, turning the vol off on the phone by accident, I needed "eyes" on her every day.) The plan was to increase time and duty as needed, but she refused to let them in. Plan B was MC. She wanted nothing to do with moving, esp not to AL even though that had been in her own plans before dementia.

THAT was the brief prelude. Just prior to the planned move to MC, she injured her leg and developed cellulitis. Thankfully she mentioned the "bruise" to her neighbor, who called and told me. She was still mobile and self caring, so who would be inspecting her all the time? That could have killed her before my next trip there. It required several rounds of antibiotics and took a long time to heal.

So, she was about 92, like OP's mom. She lived several months beyond her 97th birthday, but in MC, closer to where I live, so I could monitor, visit, provide necessities and gifts, etc. It was a wonderful place. Most of mom's friends were either too old or gone, all in her generation on both sides had passed years before and she was beginning to self-isolate. The move to MC local to me was best. I have 2 brothers and both suggested taking her in (AFTER they found out how much MC costs, and would want that paid to them!) Although I said I wouldn't stand in the way, I suggested they get better informed about what it takes to care for someone with dementia. Neither was EVER going to work and thankfully it was dropped. YB is more local, but working full time, no room in GF's condo and is, quite honestly, rather scatterbrained. OB is NOT local (2 day drive) AND is abusive. I had reservations about the distance, because we would not be able to provide help.

With dementia, we can't always let them drive the bus...
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You are POA, she has been DX with dementia. So in SOME ways, "You are the Boss of Her." Caregiving is hard enough, don't make it harder by giving in to her desire to be near friends of her age - how much time do any of them have.

I say it's like the old Rolling Stones song:

"You can't always get what you want
But if you try sometimes, well, you might find
You get what you need"

And don't forget: "The grass is always greener ..."

You job is to do what is in her best interest - not necessarily what she wants - though it would be nice if the stars aligned that way more often than they do.

I agree get her into AL in your "neighborhood" and tell her you will check into moving to her desired location - without actually scoping them out. Do some pro forma looks on the internet into the properties and print off some of the pictures. Give her a chance to get acclimated to her new home. Let's face it she may never be happy in the property you pick out for her - or for that matter the one her friends live at. Maybe you can let her choose between 2 properties in your area, while "You look" for her property of choice.

BTW, I WOULDN'T actually answer with "I AM the boss of you." It sounds good in our head - but will just make mom more stubborn and entrenched in her view if it comes out of your mouth. LOL. Best of luck.
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disgustedtoo Jun 2021
"And don't forget: "The grass is always greener ...""

ESPECIALLY when viewed through the rose colored dementia glasses.

Good answer regarding the "check into moving to the desired location." With dementia, there are so many ways to play that tune, if and when the question comes up.

Never NEVER try to play boss in front of them! We have to work harder to make whatever decision is made seem like it is THEIR idea!
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Nope, not her decsion unless you don't have power of attorney and she hasn't been diagnosed as incompetent.

Trust me, I speak from experience when I say you need to place her where she'll get the best care but is closest to you. The friends aren't an issue because they won't be visiting one another any more than they do now, and if Mom has dementia, those friends will quietly drop away very quickly. Set up Zoom calls if necessary, but Mom doesn't get to move based on friends who have no obligation to her.

Do what makes your life easiest, and that means having her close by.
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Just a thought. Remember that Mom probably can't understand anymore that Fla is at least 1000 miles away Vegas 2000. She can't comprehend what she needs to do to get there. Pack up all her belongings, find a place to live, get plane tickets. She may think its a short ride on the bus. You may want to tell her, Mom you can go if you can get yourself there.
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disgustedtoo Jun 2021
"You may want to tell her, Mom you can go if you can get yourself there." Add to that "Meanwhile, you can move to this transitional place. They can make arrangements for you and have everything shipped..."
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No she has dementia and is not capable of making this decision. She should live near you. Assisted living dies not sound reasonable since she has dementia and parkinsons. Plus she's 92 most of her friends are probably around her age so they are all on borrowed time at this point.
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bethny58 Jun 2021
Very true about her friends! Everything is great until something happens! She is probably between AL and MC. Thank You!
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My mom is 2 miles away in Memory Care. She has moderately severe dementia.

NO WAY is my mom capable of making decisions in her best interest.

I need to run over there at least once a week to keep my eye on how she is. The staff is wonderful, but they don’t catch everything.

Today, I had to bring her a new watch. Hers broke. She doesn’t remember for even one minute what time it is, but she REALLY likes looking to see what the watch says.

Last week, I restocked her toiletries.

Doing all of this from halfway across the country would be soooo much more difficult.

My mother does not remember her friends at this point. I wonder if your Mom REALLY understands how old she is, end what her friends can and can’t do, if they are her same age.

Best wishes.
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bethny58 Jun 2021
You speak from experience! Thank you!
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NOTHING counts once the dementia diagnosis, written by an trained expert with geriatric experience, is in your hand.

Pull together a list of LOCAL ALs WITH connections to a Memory Care Unit, write that list out, and give it to Mom.

Invite and encourage her to choose from the list she’s been offered, using whatever points that seem reasonable TO YOU - less expensive, better building facilities, more activities and social connections available, better medical staff, whatever you can come up with.

If you think it’s worth it, sling in the emotional- “I’d MISS you terribly if you were so far away.”

Then back away a little and say you need to be in touch with the one she chooses
“….to get the sign in benefits….”.

If she won’t choose tell her she’s on her own to choose and arrange for her placement elsewhere.

It sounds as though you may be in the gray area on your POA. Probably a good time to clarify what rights you have on her behalf.
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bethny58 Jun 2021
Excellent advice! Thank you!
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