Moving my mother to assisted living, I need your thoughts

[ErrorMargin]

I'm interested to hear your thoughts on this situation.

If you've been in a similar situation, tell me what you did and how it worked out.

My mother has dementia. She is 83.

My father is 86 and mentally fit.

They are currently living in their own home and have someone come to the house 5 days a week to help my mother (bathing, meals, etc.).

She has become more combative this year and it is time to move her into assisted living.

My mother was a nurse (RN) and 20 years ago managed the assisted living home that we are moving her into.

It is a very nice facility but she does not want to go.

She really does not want to go.

She suspects that we are working to move her in there. And with good reason...I took my mother there for lunch a few weeks ago. She said she liked it and the food was good but she does not want to go.

My sister and I have finished all the paperwork with the insurance and the facility and the move in date is April 8th (this coming Tuesday).

We have not yet told my mother that we are moving her in there.

I asked several of the staff members at the facility how we should go about telling my mother that we are moving her in there. They were all unanimous that we should not tell her. Their advice is to tell my mother that we are going there for another lunch, get her inside the secure area and then leave and let the staff help her adjust.

They further advised us to stay away for the first week to let her adjust.

One of the several concerns here is that if we tell her or she otherwise finds out that she really is going she could hurt herself, try to run away, and physically resist going to the facility.

The staff sees this kind of thing all the time and tell us that it is best to just tell her we are going there for lunch.

I don't like not telling her, even lying to her, at all. But I am inclined to do exactly that.

[Cajundaddy]

If your dad is in pretty good shape, consider keeping her in the home she knows and have a caregiver come in every day. Moving to an unfamiliar place is hard for them. Once they become combative or begin to wander off this no longer works.

My mom had progressive dementia and started seeing things and imagining things, becoming fearful at night. Living at home alone was no longer an option. We moved her into an elegant place with her own apartment and common dining for 3-4 years and that was a good transition. As she progressed she needed more personalized care and we found a home nearby with only 5-6 residents and she lived her final days there within easy visitation. We came to see her often and take her out to lunch or just for a drive at different times of the day. We got to know the staff on a personal level and they were good, but there are no perfect solutions. Dementia sucks.

Best wishes finding a place that she is comfortable with where she gets quality care.

[cabmandone]

Man that's a tough one. The dementia aspect makes things that much more difficult. I'm not sure I'd lie to my parent. One of the things I promised my parents when they made me POA for medical and financial was that I'd never lie to them and never do anything that went against their stated wishes. Can you get your dad to help with the sell? Maybe if he appears excited about it, it might help your mom be more open to it.
Thankfully my dad went willingly into an assisted living facility. I went daily to see him just because I spent so much time around him normally with my handling of his finances. I thought it helped maintain some level of normalcy for him while he adjusted to being in a new environment. The facility my dad was in had a monthly calendar of events that I'd spend time going over with him to find things he might enjoy. I wouldn't attend those events other than the weekly happy hour where the facility brought in live music, served snacks and a couple drinks.
I wish you the best in this. I'm sure it's not easy.

[Baz]

Sorry you and your family are going through this.

My opinion....if you think she's combative now.....just wait until you force her to go live somewhere she doesn't want to.

Also, I wouldn't do that to my mother.

I realize I'm only going by what you have posted, so I could be completely wrong.

But you asked for my thoughts.

This subject has been discussed in this forum many times and I have complied an Index for those looking for advice, help, and input:

https://forums.pelicanparts.com/off-topic-discussions/1130825-elderly-parent-care-index-thread.html

My best to you and your Mom!

[oldE]

Recognizing there are many ways dementia can affect people, it would be helpful to know exactly what you mean by combative. If she is reasonably rational and aware, I would make every effort to keep her in her home. However if her behavior is aggressive and irrational, she and those around her are not safe.
I know the decision is hard.

Best
Les

[ErrorMargin]

Originally Posted by Baz

Sorry you and your family are going through this.

My opinion....if you think she's combative now.....just wait until you force her to go live somewhere she doesn't want to.

Also, I wouldn't do that to my mother.

I hear you there.

Originally Posted by Baz

I realize I'm only going by what you have posted, so I could be completely wrong.

But you asked for my thoughts.

This subject has been discussed in this forum many times and I have complied an Index for those looking for advice, help, and input:

https://forums.pelicanparts.com/off-topic-discussions/1130825-elderly-parent-care-index-thread.html

My best to you and your Mom!

That is super helpful, thanks!!

[ErrorMargin]

Originally Posted by oldE

Recognizing there are many ways dementia can affect people, it would be helpful to know exactly what you mean by combative. If she is reasonably rational and aware, I would make every effort to keep her in her home. However if her behavior is aggressive and irrational, she and those around her are not safe.
I know the decision is hard.

Best
Les

Yeah, she is more the irrational and slightly aggressive (more passive aggressive) type right now. But she is prone to wander off and be very difficult.

Plus she needs help 24x7.

Thanks Les!

[ErrorMargin]

Originally Posted by cabmandone

I'm not sure I'd lie to my parent. One of the things I promised my parents when they made me POA for medical and financial was that I'd never lie to them and never do anything that went against their stated wishes.

I'm right there with you and I thought I never would until now. Then came dementia.

She now needs 24x7 care, she needs to be in a locked facility so she does not wander off and she absolutely does not want to go.

Originally Posted by cabmandone

Can you get your dad to help with the sell? Maybe if he appears excited about it, it might help your mom be more open to it.

Yes, that is a good point.

He has told her several times that he sincerely wants to go to that facility in the building next where my mom will be that is low security, private studios, just meals, cleaning, check ins and activities. My dad does not yet qualify for the insurance to pay for this.

Originally Posted by cabmandone

I wish you the best in this. I'm sure it's not easy.

I appreciate it.

[ErrorMargin]

Originally Posted by Cajundaddy

If your dad is in pretty good shape, consider keeping her in the home she knows and have a caregiver come in every day.

It is to the point where my dad + the helper cannot manager her.

This is my dad's call and while I could probably influence him to keep her there longer, I agree with him that she needs full time care.

Originally Posted by Cajundaddy

Once they become combative or begin to wander off this no longer works.

Yep, this is where we are on both counts.

Originally Posted by Cajundaddy

Best wishes finding a place that she is comfortable with where she gets quality care.

Thanks, I appreciate it.

[RANDY P]

We sent my dad to a care home (Dementia). For the first few weeks he tried to get out, etc. etc. Not a serious attempt but kept asking how do I get home, all that. After about 2 weeks or so, he settled in and figured this is where he belonged (Forgot).

Remember keeping mom at home is a risk to her since she will get into stuff- dad liked to forget he showered- multiple showers per day (with baby shampoo) Getting up all hours of the night losing track of time (thought it was AM), turning things on at full volume in the middle of the night, wandering out and then getting lost.

I've gotten calls from strangers who found him on the street-he got out from my brother's while they were away in WA state visiting him

Why we did it. At least in a care home they will have FT staff to keep them out of trouble. The biggest thing is to make sure they are keeping her clean and maintained. We went several times a week to give him extra washes to ensure no problems.

Good luck, it's tough but for both of your benefit..

rjp

[wdfifteen]

Originally Posted by ErrorMargin

I asked several of the staff members at the facility how we should go about telling my mother that we are moving her in there. They were all unanimous that we should not tell her. Their advice is to tell my mother that we are going there for another lunch, get her inside the secure area and then leave and let the staff help her adjust.

In my experience, this would be the best option. Folks with serious illnesses, especially dementia, are hardest on the people who care about them the most. Your mother is more likely to accept living there from the staff than from you. Especially since she worked there, they could "give her an apartment if she would help them out." My dad was OK moving to an "apartment" in the dementia home since my mother was such a harpy to him. I think it felt liberating for him.

[Arizona_928]

I asked several of the staff members at the facility how we should go about telling my mother that we are moving her in there. They were all unanimous that we should not tell her. Their advice is to tell my mother that we are going there for another lunch, get her inside the secure area and then leave and let the staff help her adjust.

I would be livid…

I’ll take my luger, a bottle of Bruichladdich Black Art 29Y and my diesel in the forest.

[ErrorMargin]

Originally Posted by Arizona_928

I would be livid…

I am certain she will be as well.

I have to balance this against my deep concern that she will harm herself or someone else or be harmed by physically resisting if I tell her before we go.

Originally Posted by Arizona_928

...a bottle of Bruichladdich Black Art 29Y...

I'm going to have to try that one.

I may need it Tuesday night...

[Dixie]

Listen to the staff. They're giving you spot on advice. (My momma had alzheimers.)

[Cdnone1]

I had to put my mom in a LTC.
Prepare yourself. There is no easy way for either your mom, dad or you.
This is going to suck and you just need to remind yourself and dad that you are just trying to keep here safe.
Sorry you are going through this

[group911@aol.co]

Ask anybody in their right mind if they'd like to forced to go into a jail for old folks and you won't get a single yes for an answer yet we think Ma should just go without a problem just so we can keep them safe so they can live a long time. No thanks.

Everybody wants to be in control of their own lives. Try making her feel like she is.
If her memory is gone enough, try approaching it like she suggested some changes. Show up at her house a few times and tell her she had asked you previously to take her by a couple of places to look at.

[unclebilly]

Went through this a few years go with dad.

I visited him tonight and took him out for supper.

Of course she doesn’t want to move into a care facility… who does?

The bottom line is that these facilities exist exactly for this. They look after people with dementia and they do a darn good job at making them comfortable and safe.

We no longer get calls from the RCMP about my dad rolling his electric scooter into a ditch on the side of the highway filled with blackberry brambles while how blood sugars are at 27… all the while refusing his insulin because that blood sugars number is normal for him… I’m not worried about him falling and breaking his hip again and laying in the floor in a puddle of pee for hours until a neighbor stops by to check on him (this also happened).

He is in the right place, he enjoys it there. Because we moved him close, he gets to see us and his grandkids all the time now instead of a couple times a year.

Also since his sugars are under control with diet now, no more insulin and he can have a treat when we do go see him.

It was a guilty decision when we moved him but we knew it was the right move and it was.

Move her in, visit her in a couple days. The staff understands this. Her working there probably complicates things. Can you make her think she is there to help?

[Noah930]

Sorry you have to go through this. You never imagine it when you're a kid and your parents are vibrant and healthy.

My mother developed dementia a couple years ago. She also had Parkinson's, further complicating things. My dad was stubborn and wanted to remain in their house. We tried to float the idea of an elder living facility, which as time went on became a recommendation for an assisted living. But they refused. With time, my dad admitted that it was too much for him to care for my mom alone in their big house.

My dad, being cheap and Asian, of course tried to find an under-the-table caregiver. He tried three or four of them, all live-in. Ridiculously cheap. But that's because they had no useful skills. Predictably, that failed.

So my wife found a memory care facility. They're not cheap. They run about $5K to 14K per month (a topic which deserves a whole 'nother thread, but is crucial to this discussion of elder care options). My mom lasted there 2 weeks. But it was my dad (and sister) who couldn't handle it. They couldn't stand to see my mom there, amongst strangers. It was heartbreaking. So my sister volunteered to take in my mom. Which, by default (because of our medical backgrounds) became Casa Noah taking in my mom. I felt like one of those Looney Tunes cartoons where they ask for volunteers to step forward, and everyone (but Mrs. Noah and I) takes a step back.

We hired professional caregivers for M-F, daytime hour coverage. Mrs. Noah and I took night time and weekend duties. We did it for about 8 months. It was hard. Not so much because of the physical aspects; Mrs. Noah and I have medical backgrounds. But it was challenging to run a household with 2 children AND be there for my mom. Fortunately my mom was always a pleasantly demented person. No nastiness. No combativeness.

Of note, your two options for home caregivers are either going through a staffing agency, or hiring those same women, but on the side. The benefit of hiring on the side is that you get caregivers who know what they're doing but for less than what you'd pay an agency (and they like it because they get paid more than what they normally receive while working for an agency). But, if that caregiver cancels last minute, you're sometimes left scrambling for coverage at 9:30 pm for the next weekday morning. And sometimes they go on vacation, too. And it's very typical for them to go back to their home country on vacation...for several weeks at at time. So you kind of need a couple of them on per diem basis. The alternative is going through an agency. You'll pay more, but if the caregiver can't make it, the agency will be able to provide backup coverage.

But last summer we went on vacation, and we moved my mom back in with my dad. Again, it was critical for my dad to be able to stay in his own home. So we used an agency to provide 24-hour, live-in caregivers. One woman would work M-F, and another would cover the weekend. It was about $4K per week. Not cheap, but that's what my dad paid so that my mom could live out her last days at home (which was also important to my mom, before she lost the ability to tell us herself). My mom passed earlier this year, but she was able to do so at home.

Other issues: hospice. It doesn't cost you anything. It'll be paid for by insurance/Medicare. And they do offer some useful services: a nurse or aid will come once or twice per week for bathing assistance; hospital bed/wheelchair/walker rental; and oxygen and narcotic pain medications for comfort in those last moments.

My dad has some unusual elder care insurance plan which reimburses for half of elder care costs. So while he had to pay $4K per week for 24-7 home care, he would get half of that back. Not a small deal, as I counted up his medical care costs for 2024 taxes, and he paid about $100K out of pocket.

Cost of those memory care facilities: In LA, they seem to run between $5-19K per month, depending on fanciness. Mrs. Noah works at such a facility, which charges about $14K/month. How does anyone afford any of these? Well, a lot of elders don't have high incomes (even if they have assets), so they may be able to qualify for Medicaid (MediCal here in California). So you pay full fare for the first month or two, and by then the Medicaid application comes though and you're no longer responsible for anything. My parents--between pension, social security, and rental income--made too much to qualify for MediCal, so they would have borne the full cost.

[Noah930]

Oh, and my dad's accountant recommended: if your dad moves into one of those elder care apartments: rent, don't buy. Because if you buy, frequently you can only get back pennies on the dollar when you (eventually) sell.

[cabmandone]

Originally Posted by ErrorMargin

He has told her several times that he sincerely wants to go to that facility in the building next where my mom will be that is low security, private studios, just meals, cleaning, check ins and activities. My dad does not yet qualify for the insurance to pay for this.

The nursing facility can't keep your parents in the same room? The facility my dad and in laws were in had tiers. My father in law needed "level 3 +1" care which was the highest level. My mother in law needed no assistance so she was a level 1 (that's meals, cleaning and well checks) They were in the same room. I think I'd talk to the director of the facility to see if you can keep them together.
I know what you mean by "qualify" Need assistance with two or three activities of daily living.