What is the best way to explain to my mom with dementia that I have to put her in a memory care facility?

Just tell her you need her to be safe, and this is the best way to ensure it. Assure her you'll be there daily and will be in touch with the staff all the time.

I wouldn't get too deep in the weeds with her since she has dementia.

rapidswimmer, it is ok to use what are called "therapeutic fibs" for such situations.

If your Mom understand what is her doctor, you can always say "doctor's orders until she feels/does better" or whatever you think Mom would believe.

If possible, try to set up Mom's bedroom furniture the same as she has it at home. I did that for my Dad and that helped him when he would awaken in the middle of the night, he would see his furniture placed the same so he wouldn't become scared. Also, use Mom's same bedspread.

Hope everything is a win-win :)

I just put my mom, 79, with dementia in to AL, with extra levels of care needed.

It kind of broke my mom's heart too. But she is adjusting.

So, do you have POA and are you working with the facility to set everything up? That's what I did. There would have been no way to involve my mom in the process. She would not have been on board and would have just been mad and upset. Would not have been helpful to anyone involved, most of all me.

I waited until 2 days before the move to let mom know. Any earlier and it would have just been too hard to deal with the repetition and the crying and the "you don't want me" accusations. With dementia, they don't need a lot of notice. You are going to handle everything so there is really nothing for her to do in advance.

I don't know how your mom is but my mom does not understand or accept that she has dementia and needs a lot of help. So I did not try to explain it in that fashion since she would probably have given me answers on how she doesn't need help, I can just leave her alone, etc. Instead of setting up that argument, I just used a fib telling her that we need to get the house ready to sell so we can downsize to get into a small retirement house. It's not a 100% fib cuz we do need to do it, it's just not going to be done in the immediate future.

So you can change that to needing to repaint the house. Or replace the flooring. Or that you have mold. Something that makes enough sense that you can say it over and over again.

Expect her to be upset and confused. It takes varying amounts of time to adjust.

Best of luck.

I am so glad you decided to do it (read your earlier post).

You have done SO MUCH for your mother. I hope those 2 brothers of yours who didn't want her in a MC also visit her! One is living in one of her properties. Is he paying rent?

Did you get any compensation for taking care of your mother? I think you should have gotten compensation for that. What did your brothers ever do?

One method often used, but controversial, is to just not tell her anything. Some facilities and mental health professionals recommend no visitors at all for the first two weeks after a loved one is placed in a nursing home. Especially for an Alzheimer's patient as explanations would probably be futile. They have to acclimate to their new situation, there is no choice.

I didn't tell my mom. I had taken her to visit the assisted living home and they had come to her house to talk with her. She refused to go. I had to go back to work and the caregiver couldn't work more hours, so I just made the appointment. Care giver and I took her and stayed with her for several hours, then took turns for the next few days to go stay with her and help her out. It's good we did because another woman moved in the same day and she was a huge problem, so the staff was too busy to comfort my mom. I told Mom I had to have surgery and so couldn't take care of her. She adjusted eventually. I actually think it was all harder on me than her because I understood she'd never return to her beautiful home. But she made up in her mind that the assisted living facility was the house she had decided to buy years ago and it had finally happened.

swimmer,

So glad that you reached this decision.

Perhaps tell her, once there, that this is where she'll be staying while you take care of some medical appointments and let her know that you'll visit as often as you can while you're taking care of the 'condition' you've had to put off taking care of for yourself because she's needed so much help.

One thing that seems to really strike home with my mom is telling her about my own medical needs, she becomes totally self-effacing and tells me not to worry about her, to take care of myself. Maybe you can appeal to her deep sense of love and caring for you and explain that you need this time to take care of yourself, please.

Mt mom is in a MC at 88 and has empathy for me that is over the top. We've all been dealing with respiratory flu here at home and I have to be careful what I say because she'll fret while she has recall of it. I'm up for hip replacement in a couple weeks and I'm very careful what I say to her about the difficulties I'm having with mobility. I don't know how long she actually remembers it now, but while talking, she is very empathetic.

You may have to feel your way through this. Just know that it will require at least 3-5 months adjustment for her and will likely cause a dip in her cognition. Do what you can to encourage relationships with the unit SW and Nursing Director, they're the primary go-to for a resident and will try to help her to adjust.

I wish you strength through this adjustment time.

Most people that I know didn't tell their loved one anything, other than they were taking them out to lunch. And the lunch just happened to be at the facility, and when lunch was over the aides just took the loved one for a walk to their new room, while the family just left.
Now of course the family already had the room all set up with familiar things for their loved one, like pictures, favorite chair and the like, to make the transition more smooth.
And yes, it is always recommended that family and friends DON'T visit for the first week or two to allow time for your loved one to get adjusted to their new surroundings and schedule.
You can call the facility and talk to the staff daily if it makes you feel better at first, but know that they will call you if and when there is an issue.
Please give your mom time to adjust as hard as it may be for you, or you will be doing her and yourself an injustice by not allowing her to get adjusted.
I'm wishing you well.

It might not break her heart as much as you think. My never-married BIL developed Alzheimers, which resulted in his driving around in his car for days and getting lost. So his brother and the doctor decided it was time for memory care. BIL had never lived with anyone but his mother, who lived to 100, and brother.

Everyone was so worried that he wouldn't adjust and would be overwhelmed. He went to a group home, 5 to 7 residents, and has been there 5 or 6 years. He fit in with the routine immediately. When he first got there he looked around and said, "Nice place!" The caregivers love him, and he's able bodied, so he likes to help with care for some of the others who can't get around. He forgot about his house, where he'd lived alone since mom died, and he thought his car was being repaired and forgot about it too. He's also forgotten family. But he smiles all the time and says how happy he is.

Find the right home for your LO. They're not all alike.

I took my step mother out to lunch, my brother moved her furniture from AL to MC, came back from lunch and explained that this was her new home, some adjustments as she liked to roam around outside, but she is fine now, she is part of the group walking gang.

Learned over explaining doesn't work.

Also visiting everyday in the beginning is not a good idea, they need to settle in, every home that I have worked with has been clear, stay away for a few weeks, let the person acclimate.

You are super imposing your feelings and concerns on her, she has dementia, she will forget about it all in a day or two. Her mind is broken, that is why she needs memory care.

My Mom was in her last Stages when I placed her in AL. Actually, I was looking for respite care to be able to go to nieces wedding out of state. When I went to ask about the respite care I was told there was a half price sale on room and board. Mom had enough money for a year and if the house sold, hopefully another year then Medicaid may take over. I told my Mom nothing until the day of, right before we left. I told her she was going to a new apartment where she would make new friends. Got her there, settled in and let the staff take over. Some MCs will ask that you don't visit for a while. This helps the resident adjust to having others care for them. Personally, I think this makes the person feel abandoned. I was lucky that the AL was 5 min away so I visited once a day for no more than a half hour. Just checking in and making sure all was well.

Actually, Mom trusted the staff more than me. She was wondering all over the place looking for a baby. I told her there were no babies because only adults lived there. She looked at the aide and said "I don't believe her but if you tell me there are no babies, I will believe you". Aide told her there were no babies and Mom said ok and walked away.

These replies sound like they come from a lot of good experience. My suggestion is to find a small group home. This is the best thing I have found for respite care for my mother. But, they are not easy to find. 5 or 6 residents in a home setting. These homes are in regular neighborhood settings and that made my mother feel like she was just going to a family’s house to stay instead of a big place that has constant events and chaos and lots of different people helping her. Also, the price per day was the same. I am not sure how much more memory care is but the smaller facilities are definitely worth looking into. I was lucky enough to meet one of the psychiatric nurses who visits these places, so he knows about the ones that are available. I also contacted a website that helps locate these types of facilities. If you are interested, contact me privately, and I will find the name of that website for you.
good luck and hang in there.

Thinking of how to tell my husband gave me such incredible angst. I had planned to tell him that he was going for advanced physical therapy and classes “to get better”. A few days before I was to take him, he was admitted to the hospital with pneumonia. I took him from the hospital to rehab to the AL/MC residence where he is in classes from 10-4 seven days a week. He thinks he is “at school”. The hospital visit sure eased the trauma of his move. I wish you peace and strength. It is heartbreaking for your mom and you.

Tell her with love.
Do not beat yourself up ( nor allow anyone else to) about this decision.
Since you share that she has dementia, remember that by this very dementia illness, she has limited cognition, limited ability to understand, make safe decisions and, she has short term memory challenges. Due to the short term memory challenges, she may or may not ( most likely will not) be able to remember what you tell her in it's entirety if at all. Hence you can frustrate yourself and build more anxiety by constantly repeating.
Be honest with short, loving responses, be present to her, acknowledge her grief ( if expressed, and if not expressed most likely is there). Acknowledge your own grief about this need. Be sure to seek spiritual, emotional support from your faith leaders and/ or facility Chaplain.

I was honest with my mom. She needed to be safe and that she needed more help than I could provide. I told her a week or so before the move. If I could do it again, I would have waited a little longer to tell her. I would have also transitioned her earlier, when she had more cognitive ability. I do think they transition better when they still have some ADL capability.

In my case the ALF was sold to another company in the first few weeks. It was a rocky transition. I did visit every day simply because the ALF struggled with the management change. I am glad I did visit! I contemplated moving her to a new facility but did not want additional trauma. She loved her room but it took about 6 weeks to get into a rhythm. She was an introvert and that made the transition a little more challenging.

It will be the hardest thing you ever do. That is a fact! But, the visits were wonderful. I was able to visit as a daughter and spend quality time rather than task time. When I left her each day, my home was a place of rest so that when I visited the next day, I was at 100%.

Take one day at a time. Expect some transitioning time. It is normal to second guess in the first weeks. My husband wanted to bring her home many days. Give it time.

I wish you blessing during this transition.

Nothing wrong with a little white lie. Like she's going there for rehab to get stronger because her doctor has ordered it.
Once she's there don't visit for a couple of weeks. The staff will probably advise you not to. This is so your mother can get acclimated to her new place. If family is there every day she never. It will just be one long and constant cry of 'I want to go home' and 'When can I go home?'. It's heart-breaking but you have to do it.
It's for her own good.

I know what you are feeling. We just went through this with my mom. She too is very attached to her family. It will be difficult for her and you. Change for seniors is difficult but with Dementia, i can't begin to tell you. We had my mom meet with her family doctor. He did soften the blow a bit by telling her she needs to make a change for her health and safety. We did not want to lie to her because she still has moments of clarity. Our state requires a visit from a social worker before we could move her to the memory care home. We had an open discussion with her then. If your mom has moments of clarity find the time to tell her. My mom has been there now just over two weeks and still struggles with the move. She has very good days and dark days. It will be stressful so prepare yourself. Move in items she recognizes including plenty of pictures. Take a family photo album so when she has dark days you can distract her or pull her out of it. We may have waited too long to make a decision. Looking back it was the right decision. She is now safe and in the hands of people who care for those with this terrible disease. You will feel guilty, don't. You are doing the right thing. I wish you the best of luck.

Just curious: Have you considered the cost of memory care? One staff can have up to 6-7 (at least) residents, so there is no 1-on-1 care. When your mom gets worse (and she will), the facility will expect you to hire a private caregiver to look after your mom, and that means even more cost for you. Once you are out of money, the facility will discharge your mom - unless the facility also accepts Medicaid. Medicaid-approved facilities are usually sub-par in terms of care. When you add up all the out-of-pocket expenses, it will be 2-3 times more expensive than home care with a private caregiver who will give your mom 1-1 attention.

As long as you plan to visit her everyday, you can create a personal plan to supplement her care and ease her into her new routine. And those days you can’t make it, those middle of the night emergencies staff be there 24/7.

Don’t let guilt cloud your objective: safe & reasonably clean with the advantage of your support. The best of all options.

You don't tell her that. Instead, you have to use Therapeutic Lying. You tell her that she is going to rehabilitation for some physical therapy. Then, remind her that you will see her there.

When she says, "I want to go home," you tell her she will go home when she is a bit stronger.

If there is a day that you cannot visit in person, be sure to make a phone call, or video (Duo, Facetime, Zoom, etc.) call.

This will be one of the hardest things you will ever have to do. I was also advised by social workers and a counselor to allow two weeks before visiting, but chose not to listen and visited most days. Both of my parents had Alzheimer’s/dementia at that point and having 24/7 in-home help at their assisted living community was not enough to keep them safe. Transitioning was brutal on everyone; maybe I should have heeded the advice.

It will be incredibly stressful and sad. I had tons of guilt. There is really no way to avoid that, no matter how many people tell you that you are doing all you can. My advice is to focus as much as you can on self care during this time and going forward. The stress can really take people down - it did for me. Listen to the advice of professionals along the way and try to focus on the fact that she is safe and being cared for.

Many of us go through these painful decisions that must be made.
My heart goes out to you. It is a difficult heart wrenching time.
When a person needs to be in memory care, talking logic and 'facts' = ('for your wellbeing, you need more care') do not compute. This is an emotional time, not a time for an intellectual discussion or facts.

As you say:
"I have a doctor appointment setup. He already called me to discuss that he will tell her she needs professional care for her sake as well as mine. I think this will help and this is when I plan to tell her the first time. I have always tried to be upfront and completely honest with her but I'm not sure she will remember.
I do question that your / her own doctor."

Why is her MD telling her she need professional care for her sake? The MD should know if she needs this level of care that she will not understand. I question this doctor and hope you question him too.

It is important to remember that you want to keep a person in this transitional situation as calm as possible, knowing that there will be moments of outbursts wanting what she wants / what she knows. She is confused and scared. YOU ADDRESS her fears and confusion. How?

1. Hold her hand.
2. Look her in her eyes.
3a. Tell her she's going to a hotel while the house is renovated (okay, she may not get this either ... )
3b. Key is getting her out of the house, in the car, in the most calming way as possible.
4, Is MD / facility going to put her on medication? Is she on meds now? Perhaps discuss w MD possibility to increase any anti-anxiety/depression meds during this transition.
TAKE CARE OF YOU.
1. When the guilt comes up, have a visualization in place of you caring for her when she was able to 'get it.' Replay this over and over again. You want to replace the feelings of guilt with a new tape until this behavior becomes automatic. Guilt is a waste of energy and time. What wouldn't I give to be able to take back words I said to my mom... my friend (89) now in a nursing home...

THIS IS A TIME FOR SELF-FORGIVENESS and SELF CARE.

I haven't been through this personally. In terms of whether to go 'cold. turkey' and not see her for two weeks . . . this is a tough call. I would recommend you visualize doing what you want to do - and then see yourself, and your mom, in 30 days (in your visualization) and see how things are. AND REMEMBER . . .

We do the best we can in any given moment. When decisions made with LOVING INTENTIONS, we need to acknowledge that we are human and doing the best we can.

DO ALLOW YOURSELF . . .
to grieve.
Cry.
Be with people / support
Take walks

It is a very difficult time and you need to get through it as best you can by being AWARE to be gentle with yourself and find beauty ... in nature ... birds singing ... wherever you find moments - even if fleeting - of inner peace / serenity. And, realize this is a process.

DON'T . . .
run from the painful feelings. Allow them in - on a red carpet - to process through them.

Trying to 'fight' grief, sad - it will get stuck and cause you more stress and pain. Be in the moment with EVERY feeling you have. Honor the process which is honoring both you and your mother.

Gena / Touch Matters

Hatd decision, and hopefully you have weighed all the pris and cons and in home care verses a facility.

If for sure going to a facility (well researched facility)...

I would go with expressing her safety. I would stay away from telling her she has dementia or has declined. They know their vulnerability. And in fact that is why they don't want to move. They would rather stay where they feel comfortable and with familiar surroundings not knowing it is no longer working, or worried they are going to a worse alternative.

So I would stress how being home is now unsafe: Let her know you worry about her safety when you are not there, her being alone. Bring up scenarios. Stress the good of her being in a secure facility. 24 hour help when she needs it like if she falls or better yet to make sure she doesn't fall. All meals made for her, Help at the push of a button, friendly faces, fun activities. A house cleaner. And you can visit mainly just to visit, so more time with her. And it will be very comfortable and familiar because you will bring all of her favorite things. And of course you will keep all her important papers, etc. Good luck and God bless!!!

Everybody is always talking about the 'heartbreak' of placing a loved one in Memory Care Assisted Living. The REAL heartbreak is the disease of dementia/Alzheimer's, not the need to cry Uncle and admit how impossible it is for ONE exhausted, worn out and burned out human to care for a demented elder 24/7 at home. THAT is the REAL heartbreak, let's face it.

Nobody asked for dementia. Nobody asked to have a husband or a wife or a mother or a father to care for with such a condition. It was thrust upon us through no fault of our own. So here is where we find ourselves: alone and scared, with TOO MUCH on our plates, trying to pretend we're Superwoman or Superman and sure, we can handle incontinence, and staying up all night wandering, and asking the same questions 1000x in an hour, and refusing to take medications, and screaming horrible insults at us 24/7, and stripping naked while smearing feces on the wall, and refusing to shower insisting they 'already did' when they didn't since last month. Nor did they change their stinking clothing which reeks to high heaven.

And on and on. Truth is, most of us mere mortals CANNOT handle this alone.

Yet here we are, talking about the 'heartbreak' of 'putting' them into their own room in a clean, well run Memory Care ALF where she'll be fed 3 hot meals a day, able to socialize with peers her own age in the SAME boat, have activities geared towards her ability levels, movies to watch, outings to go on in a mini bus that are SAFE, caregivers to change them, bathe them, dress them, attend to their every need 24/7......etc etc.

Let's change the thinking here from 'heartbreak' to 'gratitude such a thing exists' to HELP my loved one manage their condition properly. With a team of people.

It's the best of a bad situation, in reality, so once we acknowledge that, we move forward.

Let's ignore the guilt inducing/shaming comments that suggest we SHOULD be able to accomplish this impossible task alone at home, and what on earth is wrong with us for NOT being able to manage such a 'simple & easy' task? And let's move on with the placement knowing in our heart's it's the right thing to do. And that we'll visit daily if we'd like, erasing all doubt that the loved one is 'abandoned' and all that nonsense. And we'll call as needed too, making our presence known in the MC and advocate for our loved one ALL the time.

It's like taking a loved one to the hospital when they're sick. Are we so proud and ego driven to think "oh I'll just care for her at home all by myself"? Yeah, no. When it's time to call in the pro's, it's time to call in the pro's.

Here is a link to an article with 50 Tips on Transitioning a Loved One Into Memory Care:

https://www.seniorlink.com/blog/50-tips-on-transitioning-a-loved-one-to-memory-dementia-or-alzheimers-careyour-blog-post-title-here

Follow THESE suggestions for best results, but pick & choose what you feel works best for YOUR loved one.

I myself did not stay away for 2 weeks while mom 'adjusted' to MC; I visited her daily and called her as well, leaving her a landline in her room to call ME as needed. It worked out well.

Remember: nobody wants this, nobody asked for such a diagnosis, not you or your mom. You're making the best decision for BOTH of you at this juncture. Move forward with confidence & show that confidence TO your mom in your voice & your actions.

Wishing you the best of luck and a smooth transition for your mom.

Swimmer -- Just read your post of 12/16. Don't have much advice to give, but want to let you know that I feel like we're on the same journey. I feel and share your hurt. Sending lots of strength and hope and care and support your way.

My mom and I, too, are so close and she is headed in the same direction as yours. My dad died, too, during the summer, and deep-rooted hurtful conflict with my siblings is over the top horrible, which is making this way more challenging and complicated than it should ever have to be. I'm breaking.

I understand what folks say about "compassionate deceit" and "therapeutic fibbing", but underneath it all, I still believe it is lying, which makes this all the more agonizing to do for me. Mom is in a rehab place now, after a hospital procedure, and I've been trying to fib -- not not not easy. We've had many compassionate talks about her needs. While she has some moments of clarity, she doesn't really remember these talks or even when docs have told her . I feel hopeful sometimes afterward, and sometimes, overwhelmed. I guess I'm just holding on to some hope that one time it'll click, and she'll say, "OK, I'm ready to go." (Yep -- sadly, i know it's not going to work out that way.)

Lots to do everyday, like you -- finances, house stuff,insurance, medical care. It's a full time job.. Oh...and then there's me. Had to quit my job to do all of this. Rough road ahead. Wishing you all good things.

PS __ to message someone directly, just click on the link next to their name at the top of their post.

I am also on the same journey. My mom has Alzheimer’s and has moved in with me because she became combative with my niece who was trying to care for her in her own home. At my house she is much more docile and acts like a guest. Of course this means I must wait on her most of the time it it keeps things easier. I know she will go to memory care eventually. I’ve already learned how to handle it though. I will put her there for “rehab” due to her physical limitations and tell her it is for about 2-3 weeks. As she has no concept of time, she will not realize for a very long time, if ever, that she is living there permanently. She has been with me since October and thinks it has just been nearly 1 week. She asks when she is going home and I tell her “soon” but we still have some things to do like Dr. Appts and visiting old friends. (She used to live where I do but her home is 4 hours away. She accepts my answers and is happy.

Not knowing your mom and how she understands things, it is hard to answer you but I believe that giving information that is acceptable to them is more important than the truth at this point. Our elderly generation thing the “old folks home” is a 1970’s nursing home which, let’s face it, were pretty horrible. Todays memory care facilities are quite nice with lots of activities, good food and others in the same boat.

My siblings also tried to cause trouble and the stress of their involvement caused my auto immune disorders to flare but I finally pointed out that my mom and dad gave me POA almost 20 years ago for a reason and that shut them up. My brother demanded to see it and I advised him to speak to my mother’s attorney. He stopped bothering me after that. Neither of them wants any responsibility where our mother is concerned and haven’t even called her for several weeks (brother never, sister called twice in the first three weeks).

acj a few years ago, my mother worried about how I would deal with them. I told her “that’s why God gave me legs and a car and put an “off” button on my phone!”

rapidswimmer: Perhaps the real anguish is the disease itself. One can be grateful that such memory care facilities exist as a SUPERHUMAN caregiver does not.

Yeah, this one is dicey. However you owe it to your Mom to tell her before she is placed, if you think this will not become a combative situation.

I suspected, then it was proven, that the loss of memory does NOT mean that everything is not remembered. Most pieces are not remembered, however, some bits and pieces do stick and are revealed at different times. What she will remember one time, might be forgotten the next. So your message has to be consistent and the facts cannot waiver. I never knew what she would remember and when it would be remembered/forgotten. The outside caregivers were instructed to answer truthfully and if they were unsure of what to say, they were to say "I don't know the answer. Talk to your daughter about that".

After doing some research about how and what to say, I told my Mom that "I can no longer take care of you." Put the blame on you, the caregiver. If you anyway hint that the reason why she is going to Managed Care is because of her, she will think that if she promises to change, then the decision can be changed. If you put the "blame" on you, the caregiver, then she cannot affect the outcome of the decision because she is not the reason why she is going to Managed Care.

The first time you say it, it won't stick. As she asks questions, reinforce that it is you that can no longer give care. Correct her if necessary to make sure she understands that it is you, not her, that is to blame. My mother wanted to change caregiving agencies. I told her I was too tired to interview anyone else. She called my sister and my sister said that she could not uproot her family to give care to Mom.

I told my Mom that my brother and I had visited this facility before his death and that he approved of the facility. She was surprised as she was unaware he had been involved in the process. She asked me which facilities I had considered and visited. I listed them all and told her what I liked and disliked about each of them. She asked me if she could see the facility before she moved in. I said no, because she had already said no to all the ones I previously showed her (she didn't realize at the time that they were candidates.) She talked to my sister about what I had said. I had grilled my sister and told her that she had to use exactly the same words as I did when talking to Mom. Do not waiver from the script. My sister reinforced that I could no longer do the caregiving. All these conversations took place in pieces, at different times, and repeated, over a span of 3 weeks.

In my case, it cost less for my Mom to go to Memory Care than it did for her to stay at home, assuming that we rented out her home. I showed my Mom the numbers. I showed her the receipts for the caregivers. She added up the numbers manually to double check the math.

My sister came for a visit and by design, she helped my Mom get ready to go. She, her husband and I, moved my Mom. In retrospect, that was a smart decision, because we all worked together to move her therefore, she couldn't play one person against the other, which she had done for most of her life.

Granted my Mom was not happy that she was moving to Memory Care. However, when she did move in, her attitude was one of "I'm gong to make this work", rather than "I wanna get out."

Good luck to you.

I visit my Mom nearly every day and we do exercises or go run errands or go out to eat. Apparently I'm one of the few, if not the only one on my Mom's ward. One of my Mom biggest fears is being abandoned. Therefore, I make sure, I always have someone who I can call on, if I'm out of town. So far, our system has worked.

Why tell her anything? Simply explain that she is going to a nice place and you'll still be there to see to her needs. Why do we complicate things to make ourselves feel better? Once she's there, as long as you or other loved ones visit often, she'll be fine.