We are finally at a point of moving my mother into a senior living facility. Should we place her in assisted living or memory care?

My mother started out in Assisted Living & had to move to the Memory Care annex after 5 years. It's true that the MC is a bit less stimulating and the residents aren't as sharp as our mothers may be, so that's the dilemma. If it were me, I'd place my mother in the Assisted Living section UNLESS she has serious memory issues or you feel that she'd be unsafe using a microwave, or unable to function properly with the independence that's offered in such an environment. Only you can answer that question. My feeling is to put off Memory Care as long as possible, because she'll wind up there until the end of her life, more than likely. So what's the rush? My mother always says she wants to go back to the Assisted Living section, but last night, for instance, she called me at 8:15 pm asking why I hadn't called her. I did call her, 2 hours prior, and we'd had a 10 minute phone conversation. She'd completely forgotten it. Plus, she was insisting it was Tuesday even though she has an Alzheimer's clock in her room displaying the fact it was Saturday.

Wishing you the best of luck.

My step mother and her husband are in AL, when he dies she will be moved to MC. Right now he is able to keep track of her. I would start out in AL and go from there, the facility will guide you.

Defintely place her in the Assisted Living situation. If this is a good facility, such as the one my bro is in, they will let you know when there is progression that needs more care for her own safety along with the locked unit and better staffing. Do know that even in Memory Care people often adjust and socialize with one another quite well. She will need to go up in care, that is need more attention on level of care in Assisted Living, but where my bro is, people can maintain Assisted Living quite well with a bit of help for a long time. The costs will be so much more in Memory care, so that can be a factor as well. I see people at my brother's assisted living, and the assisted living facility itself struggle with just exactly "when" is the right time. But they will help to guide you. I am so thankful to the Assisted Living where my brother is. The people are absolutely MARVELOUS and I cannot say enough good about them.

Hello,

You may request from her Physicians to get her assigned to a Nurse Case Manager, these Case Managers usually have local resources at their fingertips. Be prepared to answer alot of questions about finances, etc. to also help determine what type of facility for her short- and long- term care.

Side Note: Regarding mental stimulation, also ask about Adult Day Care Centers as an outing.

Determine if she may also be eligible for Dual Health Coverage, meaning Medicare and State Medicaid, as per finances/liquid assets/etc... If you believe she qualifies for Government assistance besides Medicare, go to the local Social Security office and get a determination decision. Bring financial paperwork, POA to this meeting.

What's medically necessary for her short- and long- term care are the types of questions to start asking her Physicians.

Once, it gets narrowed down to a facility, please do what you can to learn if they have any complaints of abuse or neglect of Residents.

During the process, I strongly recommend you keep a special notebook to take down names, numbers, dates/times, instructions you will be given ....

Maybe see if there are any local CareGiver support groups for Dementia that you could go to? Sometimes, that could give you some golden nuggets from others in your circumstance that, either is or, has experienced on a personal level.

I hope this helps some, and I certainly hope all the best during the transition.

Kind regards,
Delene

My mother was also right on the line between both types of units. We weren’t sure what to do. Facility thought she might not engage with people in AL and because there is less staff, she might just stay in room. We also did not want to move her to MC if she declined. We put her in MC and for her, it was awful. She was too high functioning for MC and she had no one to interact with. When we would take her back there, she would get off the elevator and basically run to her room. I still feel bad about it. We moved her to a different facility and she is much happier. I would put your mom in the AL unit and not worry too much about moving her if you need to later.

There was a woman who was in the MC unit at the facility we had our mom in. You wondered why in the world she was even there! She seemed normal! She was in the very beginning stages of dementia but you'd never know it. She loved being there and helped out with the other residents. We loved having her there since she also made my mother happy because she was someone my mother could sort of talk with, when my mother was having a good day. So many of the other residents couldn't carry on a conversation with anyone, but this woman could. So depending on how your mom is, she may do better in MC, even if she is between the lines at this point. It could give her some purpose if she thinks she is "helping" the other residents.

On the other hand, it could be depressing to her, so you may be the better one to judge this depending on her personality.

Or she may thrive with proper nutrition, social stimulation and proper med management.

I would place her in AL and see how she does. MC is not for someone that can function at all from what I have seen.

My dad improved tremendously by getting the above.

In my mom's case, when in AL, they assisted with everything. All she really had to remember was to go to the dining room for meals - and, believe me, they do! If someone didn't go to meals, an aide would go to their room and check on them. Also, other residents help. Someone would say, "Where's my room?" and others would say, " go that way". They get A LOT of help in AL. Nurse brings meds, aides bathe them on a schedule, someone does laundry, etc.

ASSISTED LIVING BY ALL MEANS.
Unless she is a flight risk.
My father was in assisted living until he recently passed, and there are statistics that when they are placed in memory care, they decline much faster.

Most assisted Living facilities are so crowded now, that they put ankle bracelets on their ankles so if they are not locked in, the door beeps loud if they leave.

I know all my clients that had Dementia and or Alzheimer's or many other issues, the children would not put them in memory care. One son was a fireman, and he said he could tell the difference just by going to the different floors.

The dividing line really shouldn't be so very stark as all that. Why is there so little stimulation provided in the memory care unit? It's a bit of a chicken-and-egg, of course - no activities because the residents aren't up to it, versus the residents are vegetating because there is so little mental stimulus - but that's the point I'd question with the staff. There shouldn't be such an impermeable boundary.

For example: could your mother (with other more able MCU residents) join in appropriate activities sessions in the ALF? Or the other way about - what would stop them bringing ALF residents to pet therapy in the MCU, as another example?

If this facility prides itself on continuing care, there should *be* a continuum. Challenge them on it.

I am going through the exact same thing. Mom is only 77 and is declining with her dementia . She is high functioning with everything except for her memory . They put her in the memory care section where she does not belong and is getting worse . I am afraid if we put her in assisted living she will flee .

Does the memory care offer anything for residents that are more mentally aware. My moms place has something called terrace Club. It’s a program she was part of when she was in the ALF. They meet twice a day in their own beautiful area and play games. Do trips etc. they still will come and get some of the better residents from memory care and bring them up to terrace club. It’s a hard decision because if she gets used to AlF she won’t want to move. My mom has the worst time transitioning. Her problem was mostly being a fall risk

good luck. ❤️

It the facility has a memory care unit that has so little stimulation, I'm not sure that their assisted living will be all that great. Because they should be providing stimulation in their memory care unit as well! Furthermore, now the aim is to allow for residents to 'age in place,' even in these long-term care communities. While it's true that your mom might decline soon, if she is in a good place that stresses engagement with residents she may well thrive. And let's be honest, most people living in assisted living (rather than independent senior homes) probably have some degree of cognitive loss going on.

Are you sure there is no better place available, one that is more person-centered? For-profit long-term care communities are notorious for finding some basis on which to raise a resident's rate of payment: "She needs more care now." "His memory is failing." I hope you can find a better place, one that isn't waiting for your mom to need more care, but to give her the kind of care that helps her thrive rather than decline. Best of luck.

I faced this exact same dilemma a few years ago. At the time, I couldn't imagine my mother being happy in the memory care section of the assisted living facility. It was going to be a huge change for her to even move into assisted living from her home so we opted to hold off on memory care until her dementia was further along. At the time she was not a wanderer, sundowning was minimal and she could easily carry on a conversation. At first she enjoyed the many activities but after about a year and a half, she was much more confused and quite frankly wasn't interested in crafts, movies or happy hour parties. Eventually, the staff said she tried to wander on "field trips", she rarely talked with the other residents and she needed much more prompting for daily life activities. She seemed ready for memory care, so we moved her to that section and even that was easier because by then and we just told her she was going to a new room that was better for her. Within a day or two she was settled in and in all honesty felt safer with more care. I was glad she had enjoyed that time in assisted living. It probably took more work to move her twice but she just wasn't ready. If your mother is not at risk of trying to leave or feel confused by the freedom of assisted living, I would encourage you to place her there and then move her to memory care when needed.

Both my MIL and FIL have dementia early stages pf Alzheimer's. They are in assisted living presently, started off in independent living one year ago. Just the other day at their one year anniversary review we asked how are they on reference to being moved to memory care. What do they look for? At our facility besides the obvious cognitive decline they look for "wandering ". When this happens in assisted living they will make recommendations to the family to be moved to memory care.

It seems that a lot of folks fall between AL and MC.

My LO fell between the two and continues to do so after a year and 9 months of residential care.

It was VERY TOUGH for me to accept the recommendation of the center that she needed the locked MC placement, but they proved to be absolutely right.

There is PLENTY TO DO in her MC unit, and higher functioning residents can go to religious services, concerts, the beauty salon on site, and MANY other activities with the higher functioning AL folks.

Socialization and boredom are NEVER concerns in her residence. Look for good programs before you choose......

We put my dad in assisted living and he has really thrived with the socialization and participates in some of the activities. We have a buy-up plan for med management, shower assist, etc. I'm afraid that memory care would not be enough stimulation for him although I believe in the next year or so, we may move him. He is forgetting more and more lately. When I was visiting different facilities, several of the memory care places asked me why I was considering those. They all asked me the same thing: does he wander? does he get lost? Memory care is a lockup. He is definitely not ready for that. And they agreed. But do consider a buy-up plan for assisted living if the base plan isn't enough care.

In my experience it is not just wandering that is a signal for memory care. My mother does not wander but she needs prompting for personal care, eating, getting out of bed. She sleeps most of the day and night. Also, the ratio of aides to patients on the memory care unit is 2 staff for 14 residents. And I supplement her care with 1 hour in the morning every day.

My mom at first was not at the same level as the other residents, and she basically stayed in her room watched tv and played cards. Within this last year, she stopped playing cards and at this time is basically nonverbal so she is at the same level as the other residents and actually takes herself to breakfast and stays a bit before going back to sleep in her room.

Memory care was right for her.

I would put off memory care. My 94 year old mom moved into ALF October 1 with minor cognitive impairment after living alone until the last year where we had a 24/7 caregiver. She has actually improved with the addition of socialization and activities and now manages without any assistance and takes her own meds. She definitely has short term memory problems, but she remembers the important things, but does sometimes call me, especially after a nap, asking what day and time it is, despite two dementia clocks. When she moved in, the staff told me she is confused and they see her in memory care in a year. Now they say she is doing great.

Hi! We just placed my gramma in MC even though she is very high functioning. There is definitely a noticeable difference in the functional level between her and most of the patients in her cottage, but after much discussion with the facility, we are very comfortable with her placement. We did have the option of changing her to the personal care facility next door, but the extra attention they provide in the MC makes us feel more secure. One thing the facility admin discussed with us is that the independence of the residents in the personal care cottage leads to much LESS interaction due to the residents going into their own rooms more often to watch TV, etc.; and although she's pretty high functioning, she'd be on the lower end of functionality if she were in the PC cottage.

One thing that our facility is doing to beef up her socializing is including her on a regular basis in the activities in the PC cottages. I think that's been working really well. So as long as she's able, we'll continue to do that. This is a progressive condition, so the stimulation may help to keep her from turning the corner as quickly, but her condition will deteriorate, so I'd rather minimize the amount of change we have to subject her to.

Good luck!

We moved my dad to Memory Care, and I think that he suffered because there wasn't the social stimulation that he was accustomed to previously; however, he needed the safety measures provided by the Memory Care home. I was in denial for so long that once he was approved for Medicaid we didn't have sufficient time to start in assisted living and move later. Daddy was put on waiting lists and it just didn't work out. There are some facilities (and I hate that word!) that have both kinds of care and it seems that the transition may be easier.

I'd leave her in AL and let her enjoy the company.

I'm not sure it needs to be a choice between AL and memory care. In my community, there are two AL facilities specializing in dementia. My mother is in one of them. Best of both worlds! We get the safety measures and understanding of dementia, along with an abundance of planned activities. Some of the residents are lower functioning than my mother, but she finds the ones on her level to socialize with. Before you make the choice you think you have to, make sure you are aware of all the options in your area.

I have found the facilities with inhouse memory care units were kind of one size fits all. Mom lived in assisted living for 7 years but when it was time to move her to memory care, I looked at both stand alone units to compare to the graduate unit where she was living and several others.
We had many signs it was time to move to memory care, a long list I won't go into, but the final huge sign was that she was no longer safe due to wandering. We ended up going with a memory care unit divided into 2 separate living areas based on functionality of the resident. Mom is really happy and thrives there. She is well cared for, safe, eats much better and is kept busy with activities all day long. She is out with the other residents most of the day and has a beautiful atrium patio to enjoy. Any need is taken care of with visiting dr's, physical and occupational therapy as needed and emergent needs addressed promptly. It hasn't been perfect but is a wonderful place for her to spend the rest of her life. If and when her dementia progresses she will move to a room on the other side with those less functional. Not looking forward to that day, but am glad in the mean time she is with people like her. It's not depressing for her or her family to visit and participate in the many activities and parties offered because she resides with people who still enjoy much of life.
So I guess, short story long, depending on her functionality, I would do assisted living as long as she's safe and well cared for AND allow the flexibility of looking at stand alone memory care facilities rather than just moving her into the memory care unit of her senior facility.

I agree with finding a facility that has both AL and MC in same facility, if possible. If she has to be moved, it's easier that way. Who did the assessment saying that she was close to MC? I ask because, I know that someone with dementia can progress really quickly to need MC AND they can really struggle in an AL if their needs are great. That happened with my LO and it was not only hard on her, but, very stressful for me. I didn't know that much about MC when I placed her into AL. They did assessment and thought she was fine for that level of care, but, her needs changed quickly.

Due to the level of care she needed, I got daily, sometimes more, phone calls from the AL. There were so many things that she needed help with. She went to a wheelchair and bladder incontinent. Plus, the resistance to care....AL staff are not just trained to manage the care of someone with dementia, like MC are. They will remind residents, but, if the resident has short term memory loss, they forget soon after the reminder. And, they need lots of prompting to bathe, bush teeth, change clothes, eat, etc. Based on my experience, someone with significant dementia, even if they are verbal, are not going to be fine in a regular AL.

When I moved my LO to MC, she immediately relaxed and was able to get the one on one attention that she needed. And, they allowed her to go to the regular AL section for visits, special occasions, holiday parties, etc. In her case, it worked out. Each person is different.

Parents moved to AL 6 months before Dad passed away. Dad was on Medicare hospice status during that time, so hospice RNs, CNAs and social workers came in multiple times a week to check up on him, bathe him, make determinations as to need for oxygen, hospital bed, etc. AL staff was there to check in and help if there were an emergency, like a fall, or a bathroom accident and to get them to meals. We kids were also there almost daily to check in, change the beds, do the laundry, shop for groceries for the apartment (Dad hated the food there and meal times were ridiculously early.)

Mom has dementia. Her short term memory is totally gone. She repeats the same statements/questions multiple times a minute, all day long. She could not help Dad in any way, and actually caused him a great deal of irritation at the end.

Once he passed, the AL staff told us she would need MC immediately. She was assessed as being at a 6 year old level of functioning at the time, less now. While the AL area had good programs and there were lifelong friends living there, Mom became confused and somewhat agitated in any group setting, even family. She could take one or two at a time but not more. She gets more agitated later in the afternoon. She cannot remember to change her clothes, bathe or shower, go to meals, take her medications, go to bed. She does not remember that dad is gone and does not remember that she doesn't live in the family home (sold) any longer. She constantly packs "to go home." Constantly asks where Dad is.

Her MC area is locked, but they have all day program of activities that she can participate in. There are occasional "excursions" to the AL area for programs. We can also take her out for lunches and MD appointments, but she's resistant to that. We are told she enjoys the "crafts" projects but hates "bingo" since it involves groups of people talking at the same time. She has her favorites among the residents and some less favorites but she is not one to rock the boat. It is a great relief to family that she has 24/7 oversight, since that's what she needs. She seems pretty settled and content there.

From my experience with a relative, even though moves are traumatic, I would suggest going with the option that is most like home. My relative's main problem is that her short term memory is almost non-existent. Her doctors told her that she should not cook, not drive, and not try to navigate stairs. They also stated that a communal residential situation would be best for her. But, she doesn't require any assistance with daily living tasks except for med management and food prep. Even so, doctors, friends and other relatives all thought she needed assisted living. We tried that for two years. The AL residents who could carry on conversations were not all that mobile; the ones that were mobile were lower functioning. I felt like my relative was isolated, plus the facility's staff changed monthly and they kept raising the rates. So...we moved my relative to independent living with a home health agency providing med management. She has an actual apartment that is more like home; three hot meals each day; lots of quality activities; outings; entertainment; on-site physical therapy options. She looks and seems healthier. And we're saving $1600/month over assisted living. There is less daily "supervision," but even if we need to add more home health services, it's still less expensive than AL or Memory Care. The facility we found also has an AL section when the time comes for that. It's almost impossible to compare "apples to apples" when researching IL, AL, and Memory Care facilities. If your relative enjoys the company of others, is mobile enough to get to the dining room, is not a flight risk and can still learn new routines, I suggest you look into independent living options with some add-on services. It may allow whatever money your relative has to last longer, and despite the potential trauma of another move when the functional/cognitive abilities decline, the immediate benefits, at least in our case, have been remarkable.

Just wondering, you said your mom can no longer live safely at home, have you considered in home companions and adult day centers? Dorthy had it right, IF possible,(may not be possible), but really is no place like home.

You know your mother better than anyone. Even so, the progression with dementia varies from one person to another. We get no warning signals for the next step. The most serious one would be wandering. Others have said this would be the sign that a move is needed, but if she wanders off, the first time could be the last (read BeeKee's post.)

Our mother could also do ADLs, and carry on a conversation, but also tended to repeat statements/questions. While searching/waiting for a place to open we tried hiring aides 1 hr/day to check on her. We installed cameras, more to watch who came/went, but to check on her as we weren't local. Over time I saw her wearing the same clothes (she had enough clothing to open a store), initially 2 days in a row, and eventually 6 days in a row! Sometimes they would be soiled with food droppings. Once we took the car away, I had to take her shopping and realized although she was buying fresh fruit, veggies and meat, she was eating frozen dinners and boxed crap. Had no way to tell if she was bathing. Found evidence of "accidents" when we finally got to clearing, cleaning and fixing condo for sale. She also started this odd OCD behavior just before bed - initially a day here and there, a few times, but it became 1 - 1.5 hour marathon checking the door lock, sidelights, dishwasher and LR, over and over! Most likely her "version" of sun-downing, although it was later in the evening.

To others, she might seem fairly functional, but clearly she wasn't. In her mind she was fine, independent and could cook. She wasn't and couldn't. She refused to let the aides in after less than 2 months. She wanted no part of ANY AL or moving anywhere (AL had been part of her plan before dementia) and wanted nothing to do with Meals on Wheels.

She didn't (that we're aware of) wander from her place, but again, there's no warning sign for this! Her "circle" of travel was slowly becoming smaller, so clearly she would've easily gotten lost. She was in self-isolating mode, making excuses or ignoring the other seniors who would all go to the Senior Center functions/special meals together. YB was adamant she would prefer AL, but there was nothing to stop her from leaving the building. She would, at this point, get lost in a "new" place, and would likely go out, looking for her "place." I said no. Staff who did assessment and met her said no. I do think MC was the best choice for her.

The first 9 months, she begged YB to take her home. Then she asked me to drop her at her mother's on my way home, or did I have a key to their previous home, sold >25 years ago! I know she asked staff many times to call her mother, gave them that old address and often said she was going to walk to her mother's, my place or her place. She, IMO, would have walked out of the place with no warning. In MC, fairly independent 2+ years, no walker before that, ADLs were done by her. It's only recently she won't stand/walk, so needs more help (into yr 4.)

In other responses I suggest going to visit the MC at other times, specifically meal times, when more residents are together. You might be seeing only those who are less mobile or more needy of supervision. Others could be elsewhere. IF all the residents are together and all appear to be minimally functional, could you try any other facilities? Mom's place is a mix and being there 3+ years now, I see residents come and go, some progress rapidly, others not so much. If there at certain times, it can appear that not many are very functional, but other times there are activities, meal times are fairly busy, residents are as active as they can be. Often they have outings for those who can participate, and other times they join the AL residents for special activities/occasions.

Not all facilities are alike, and must be checked thoroughly. Go at different times to get a better sense of the residents. Ask what their plan is for your mom if she's more aware.

Right now, living alone, there is little activity to keep those skills going. With the stimulation and activities of assisted living, she could easily improve and thrive. I would place her in assisted living. Give her the benefit of the doubt; don't hasten her decline. Think positively!