[Jim727]

Dottore -

Very sorry to hear that you are facing this. My mother used to say "getting old is not for sissies" - sadly, 'tis true.

We have been through this as well with my MIL - alzheimer's. Good advice has been given here, hopefully I can add a bit.

First, for your own mental well-being you need to steel yourself to the reality that what you have now is as good as it's going to get. She might become the nicest or the meanest person in your world, but whatever you get you can't take it personally. It's harder for you than for her.

Second, no car. You didn't say if she drives, but there is nothing good for her on the road. Lose the keys. Disable the car. Whatever it takes.

Third, now is the time to find assisted living for her. Do not wait until you need it - good facilities have waiting lists and you don't want to get near the bad ones. When evaluating assisted living, cost is not an indicator of quality - the first evaluator is your nose. If it doesn't smell good, run away immediately. The second indicator is how the staff relates to the residents. Some treat residents like objects, some like valuable people; guess which you want. Ask to be introduced to a resident - if they don't know patient names that's a warning flag. Ask how they treat incontinent residents and how often they are bathed. Incontinence is not out of the picture with dementia, and how the facility treats the incontinent person speaks volumes about their care methods. Also, look at dining facilities in the unit. Some look like they are meant to be hosed down and others look like a Marriott. The really good ones will invite you to a meal in the dining facility. Ask about no-notice visitations. If they want you to make an appointment, that's not good. Look at their activity lists, haircut and bathing schedules, etc.

We also went with a facility that had skilled nursing in the same building. When the time comes that skilled nursing is required, you don't want to have to start the research/wait cycle all over again. We used Heritage Club in Colorado for my MIL - they were half the cost of a dreadful place and the care was outstanding.

If your mother is living alone she will deteriorate faster than if she has an active social life. That's one of the reasons why assisted living can be so valuable. Television is a lousy companion and definitely mentally passive (and deteriorating). Good assisted living will prolong her quality of life significantly. In our case, the assisted living gave my MIL a much better standard of living than she had at home with part-time caregivers and at only a marginally higher monthly cost.

My MIL was an inherently unpleasant person and also would not take advice from anyone. She would, however, respect her doctor's opinions as an authority. We managed to consult with her doctor and start the process of nudging her in the direction she needed to go. Kicking and fighting, as it may have been, at least we were able to gain a slow step-by-step progress toward the concept of living somewhere else. She never bought in, but I think it helped a great deal.

The move was "interesting". She was adamant that she would not go - even though there really was no option to let her stay alone at home. We stopped trying to talk her into the move and just did it. To ease the transition, my wife took her to lunch while I moved her most familiar furniture into her new room. That way she had some familiar items as comfort items. Once in the facility she rebelled for about a month, but then forgot that it wasn't "home" and actually ended up enjoying her new friends. That part, at least, was rewarding.

Last, I encourage you to review finances and legal options. Unfortunately, we had to go the full court-appointed conservator route as her parents did no planning whatsoever. Not fun - I recommend getting a trustworthy attorney familiarized with the situation early. If you don't need much help you have bought peace of mind; if you do need help you are ahead of the game.

I much prefer your fantasy of life in old age. Let's hope we get to do it that way.

Wish you the best.
Jim