My 88-year-old mother has been declining mentally and physically for about a year. It is no longer safe for her to live at home on her own. We have found a senior facility that we really like. But, do we place her in assisted living or place her in the memory care unit? The facility did an assessment and told us she is right on the verge of needing memory care. Although she has dementia, she can still carry on conversation and enjoys talking to people. I fear that if she is placed in memory care there will be little stimulation, as most of the residents appear significantly less mentally aware. However, if we start her out in assisted living, we may be faced with needing to move her to memory care within a few months. Have any of you faced this type of decision?
I KNOW my mother would have found the entrance and walked out, although she never wandered from her own place (YB disagreed with MC.) Within 9 mo of moving in, she was asking to get dropped off at her mother's (gone 40+ years) and was going to walk to her place, my place, her previous home, etc. She may have been asking staff about it prior to that (never asked me to bring her back to her condo, she saved that for YB thankfully!) but no way to know.
By the time they realize someone has wandered, it might be too late...
It should be based more on the current capability and how good the short term memory is - mom would never have been able to get from A to B without help. One has to anticipate AND understand progression happens at different rates for different people (just like any baby's progression from rolling over to crawling to walking, etc - it varies a lot and there are no real warnings!)
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......
My suggestion was to visit the MC area again, preferably at meal time. You would see a much better representation of all the residents. At other times the only ones you might observe in the "common" area might be those who are more challenged, physically and/or mentally, who require more care. Others may not be present, so you don't get the full picture.
Mom's place (and her residence) just started year 4. Those who moved in at the same time and similar level are gone. Others have moved in/out. There is always a mix of capability present in her place, and various activities geared to the resident's interest/ability.
Always go several times at different times of the day to get a better idea what ANY facility offers.
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.
Not in the facility our mother is in! It is IL/AL/MC and to get to MC one has to enter where everyone else does - I meet and chat with various residents from all levels. There was one AL gentleman who is actually older than my mother, no walker, or other assistance, sharp as a tack! Most I have met are just fine mentally. Age and physical ability are the more important deciding factors in choosing IL vs AL. While someone in the early stages of dementia might do fine in AL, initially, it can be hard to make the move when it is needed. My YB and I didn't agree on where mom should go, but staff said NO to AL after assessment and meeting her. Outwardly she could seem fine, and could function "fairly" well at that point, but it doesn't improve...
good luck. ❤️
In mom's MC, several who moved in about the same time and about the same level are already gone (they progressed beyond most capability and either had to move to NH or passed away.) Others who have come later, some younger than ME, have progressed and/or moved on more than our mother. Our mother is declining, but slowly. She just started year 4. The first year she had a step down in memory at about 9 months (started asking about HER mother and forgetting her condo, but remembering a previous home from over 25 yrs ago.) She was still walking unassisted and doing most ADLs and continued to do so. It took 2 years before she asked for a rollator, but still mostly cared for herself. About 4-5 months ago she developed fear of standing/walking, so now she's in a wheelchair.
Memories are still slowly regressing, so she is living in about 40+ years ago, but given the progressions seen in others vs hers, MC isn't the cause.... She still know who I am and while communication is hard due to nearly non-existent hearing and the dementia, she still gets along great with staff! She's 96 now.
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.
As for "... join in appropriate activities sessions in the ALF..." I'm glad you wrote this! When mom first moved in, she was the first and only resident (several were to move in at the same time, newly opened MC, but were delayed), so there were many times I would find her upstairs with an aide and AL residents. They also often bring those who are capable to various activities (with staff to watch over them) to some of the AL functions/activities.
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.
Problem with dementia is you don't know if/when this might happen. They haven't been a risk until they were...
My YB had arguments for AL vs MC, which were silly actually. "Oh, she won't want to be in with a bunch of old farts." Not everyone in AL is an old fart and not everyone in MC is either - dementia knows no age. There have been several residents in mom's MC who weren't even early retirement age!!! AL vs MC with walkers, canes, rollators, wheelchairs is about even. When I mentioned that there was no control at the door to AL, she could walk out at any time, he responded with 'She doesn't do that now.' No, HOWEVER that was her own place and she was self-isolating. Here she won't know where she's at and can walk out the door looking for home. Staff who were there said no, MC.
Although she had never wandered prior to the move (that we are aware of anyway), based on what I saw/heard myself, she WOULD have left the facility... looking for her mother's place, my place, her home previous to the condo she was in last, etc. She would often ask where her room was, easiest one to find right at the corner of the common area. She WOULD have been a serious flight risk if we let her move into AL!
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.
On the other hand, it could be depressing to her, so you may be the better one to judge this depending on her personality.
The one I enjoyed was 99 when she moved in and was much more "with it" than my mother!! She loved jigsaw puzzles, which I like too, so we'd work on them together, getting mom to participate (which was surprising to me, she was never one to do this!) I gave her one for her 100th birthday! She almost made it to 101, but a serious fall hastened her demise. I miss her a lot!
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
Wishing you the best of luck.
My concern would be more to ask about the other residents. Are they only seeing those who are visible at the time of visit, those who require more care or are not mobile, while the more "with it" residents are elsewhere?
Our mother was the first to move into the newly opened MC (entire IL/AL/MC was rebuilt) section. The other residents vary in capability and progression. Generally in the 3+ years she has been there, the mix has been varied between those who are more capable vs those who need help (or move on, either to another facility or pass.)
ANY MC facility should have activities and socialization to keep the residents active. I would either find another MC facility, or find out if they are only seeing those residents who are less capable (visiting at different times might be more revealing, esp at mealtimes.)