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Does my mom "have" to go to memory care?

We recently moved our 90 year old mom to assisted living (AL) after two places agreed she only needed assistance with medications. Less than two months of moving in, they are wanting to move her to memory care because she is confused and comes to the front desk unsure whether she lives there. She thought the move was temporary, or just a hotel. We didn't correct her when she referred to it as a hotel because it seemed to make the transition smoother. She can dress, bath and eat without assistance, but she puts her room key and emergency necklace just anywhere when she gets undressed, and then can't find it. (We can easily find it with a "Tile") She is definitely often unaware of time or day, year, etc., but she hasn't needed to know these for years since she has lived alone for almost 30 years. She has always had different hours, sleeping out of boredom and eating whenever she was hungry, gives her a different "norm" than other residents and the AL. They say she is a wanderer or sun downer, but she is not agitated, and she doesn't leave the building. She just goes down to the front desk, walks to the dining room and goes back to her room. (Sometimes several times.) She can easily forget why she was heading in a direction. She was diagnosed with mild cognative impairment, but after the AL director said she was sundowning, they are now labeling her with dementia or alzheimers and she has not been tested for either. (She only scored a 15 out of 30 on the intake exam, but I didn't know what a resident should score) She is completely aware of people around her and their mental state. We don't believe Memory Care would be a good fit for her. We think it will cause her to decline rapidly, as there is no privacy and residents with extreme mental impairments. When we went over the "points" for additional personal needs, "constant cueing" for mental impairment was 30 points. They want to charge 100 points for security checks every two hours, when all she does is watch tv in her room and isn't a danger. (We had them unplug the microwave and stove. Our choices were to pay for security checks, move to a shared unit in Memory Care or hire an outside service for companion care, which is what we are doing. But, the question is also, will we have to move her in the near future, and how detrimental is it to keep moving her?
Status: Open    Apr 28, 2016 - 08:20 AM

Dementia, Senior Living Communities

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May 01, 2016 - 07:59 AM

If the facility wants to move her to memory care, you may not have much choice. Read the contract that was signed. It is usually a month to month lease. If the facility feels she cannot be cared for in the present situation, they may make her leave altogether. The people at the facility are seeing her 24 hours a day, you are not, so they may be seeing things differently than you. Please look at other facilities and their memory care. Get A Place for Mom to help.You may find a better one. My mom has a room to herself--no roommate. When my mom moved to memory care it was actually better for her. In the assisted living they had activities, but the resident had to decide to go to them and then show up. My mom was not going to anything. In memory care they take you to the activity, but of course you can always leave at any time. She enjoys the activities. My mom has made a few painting that are pretty good! What a surprise, since she never did anything like this before. Has a doctor evaluated her current condition? You mention the 15 out of 30 score. I am assuming this is the mini mental status exam. You can look this up online and see what the questions are. Based on the complexity of your writing, I would say you would score 30/30. I am sorry but your mom clearly has more than a mild cognitive impairment. By the way, this exam does not measure things like judgement, planning, predicting the result of an action, etc. You mention that she does not keep a schedule. This is fine for a person such as yourself. When a person has cognitive impairment, it is important to keep a schedule. It actually helps the person be more oriented. Actually everyone benefits from a regular sleep schedule. Everyone had a decline in their thinking ability as it gets close to their bedtime, so don't try to balance your checkbook at 11PM!. This decline is greater and therefore more noticable in people with dementia.
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By lisamcfong on Jun 10, 2016 - 05:44 PM | Like (0)  |  Report

Thank you for your thought provoking response. I appreciate the feedback.

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May 01, 2016 - 06:28 PM

My mom is still at home but much of what you talk about with your mom sounds very familiar. My mom is worse in the evening and often forgets where she is headed (Any time of the day). She has my dad and brother in the house with her and I come visit from 500 miles away. I also take both parents to my home for 4-6 weeks at a time. My mom needs supervision almost all the time. We have put childproof locks high up on the doors for the times she decides to walk "home". I think your Mom either needs the memory care unit or evening and night time care. It only gets worse. Soon there won't be a choice and the assisted living place will tell you she has to go. I read a really good book a few years ago. You might find it helpful. It's called A Bittersweet Season by Jane Gross. She was a writer for the New York Times and started a blog called The New Old Age. She really knows a lot about Eldercare and the choices in care as parents age and their needs increase. Best wishes. It's a stressful situation and a heartbreak.
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By lisamcfong on Jun 10, 2016 - 05:46 PM | Like (0)  |  Report

Thank you for the response. I have thought about whether she could move back in with us again, but knowing she can burn things and that I cannot shut of my stove and microwave and oven, etc, childproof locks are not enough. I will look up that book! Thanks very much.

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May 07, 2016 - 03:44 PM

The problem here is dementia is a progressive disease. You mom sounds a lot like my mother. One year ago, I was convinced that my mom could live in assited living. She could do a lot of things for herself. Today, one year later, she definately needs memory care. She has declined a lot.

My mom is 93 and has alzheimers. She has lived with me a year and a half and believes she is only visiting. I had her assesed recently at an Assisted Living facility and staff said she definatley needs memory care. She is very mobile and a bit compative since she doesn't believe she needs any help and would be a risk for wandering (since she thinks she is fine, and believes she goes to work every day at the Adult Day center she attends) The problem with assisted living is that they can walk out the door at anytime. Her wandering downstairs may progress to going outside.

I know its difficult and more expensive but you also have to look ahead at how she will be in a month, or six months.

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By lisamcfong on Jun 10, 2016 - 05:49 PM | Like (0)  |  Report

Thank you! I must agree, there is a significant difference in the short time she has been there. Or, we as a family, are just getting to clearly experience it. I believe we are heading in that direction, but trying to wait as long as possible. And yet, I'm told that, similarly to making the move to assisted living, moving to memory care is better when they are still more cognitive, which has been my greatest concern. But I've been told she will enjoy more of the activities that they lead her to. I don't know though. Will be praying heavily for God's guidance.

By doreenc4 on Jun 11, 2016 - 05:48 AM | Like (0)  |  Report

Have you already decided on a facility? If not, in the interim; I would suggest visiting places and decide where you want to place her. It took some time, but I finally found a place that I am confident is the right choice. Also many of these facilities do not have openings - so I would suggest putting her on a waiting list. You can always decline if you are not ready and stay next in line on the waiting list.

I put a deposit down in January 2016 - I was not ready to place her. I am definitely ready now but there are no private rooms available. Due to new construction - new memory care units will be available in September. But that is another thing to consider, you may be on the waiting list awhile.

Also, as I have experienced first hand. You never know what will happen in your life. I just had back surgery (never planned on that happening) and my recovery has been slower than expected. This whole experience was a wake up call. Something may happen in your life, where you may not be able to care for you mom. So all things considered, get on a waiting list you can always decline if you are not ready.

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