Memory care vs. skilled nursing, questions re care?

Talk to her doctor about having her assessed for LTC (which is covered by Medicaid). If she can't feed herself, I'm not sure she's a candidate for MC, but it may differ by facility.

She can feed herself (just doesn't drink water a lot) when she's NOT in bed, lol. Out of bed she does great!! She's not quite ready for Medicaid (in spend-down mode right now) but yes I'll keep that in mind, to have her assessed by the doctor when we're at that point. The neuro-psychologist said (a couple of months ago) that Memory Care was appropriate for her, in her opinion. I'm just unsure how either MC or SN would do with her apathy...??? Maybe the only way to know is to, at some point, give MC a try.

There are ways to help your mom with memory and routines and increase independence, including toileting. I work with individuals to maintain independence, most of these things you are stating are not having the environmental cues needed.

The apathy's a result of her disease, so Memory care's probably a better fit, as a good MC staff should be trained to handle her behaviors. Ask what their staff training entails. Keep an eye on the staffing ratios too--my mom's first facility lost their RN Director and went down the tubes fast--nowhere near enough staff to keep up with the resident's needs.
Each facility is granted a license by the state to provide services, and within that, a facility may be licensed for a more intensive level of care but may not be able to be staffed to provide it, and so they set limits on what they can provide. You can search your state's website for what's considered MC vs nursing care. In my state, AL's will not hand feed or do pureed foods, but that's usually something a MC would be expected to do, but you must make sure that they will. Another cut off is whether a non-ambulatory person who needs a hoyer lift is nursing care or not. Ask them what percentage of their patients they've had to transition out to a nursing facility (all the places I looked at said they were staffed so that they took their dementia patients to end of life), ask if they will alllow in-house hospice. Basically you want to go in, explain your mom's presentation, and clarify what behaviors or physical requirements would cause her to be moved from MC to skilled nursing.
Your mom should be assessed for intake by the facility's nursing staff and they will work with you to come up with a care plan (that should be updated every 90 days or as needed) that supports her ADL's, so getting her up and out should be detailed on the care plan. It might look like ''Mrs. Mom has trouble initiating getting out of bed. Staff will assist Mrs. Mom when needed to get out of bed each day to attend breakfast.'

My mother’s MC doesn’t make my mother do anything she doesn’t want to do.

She stays in bed all day, and has to be coaxed out for meals. She doesn’t participate in activities. She’s pretty cranky, so I can understand why the aides just give up.

I think this is something you may have to keep a close eye on, unfortunately.

I frequently bake and bring treats to Mom’s nurses and aides. You may want to do the same. It’s human nature. When we get treated well, we treat people well, back.

Best wishes to you and your mom. ◡̈

I think that the answers to your questions will vary widely according to the type of place you choose for your Mom.
I would begin to explore and tour with your husband. Many ALF has both MC and ALF as well as a sort of in between.
Most memory care will not force elders to do what they don't wish to do, nor force them to eat when they don't wish to. I do think if that kind of care is expected you may be left with keeping your mom at home with you.
As the aging process moves along toward end of life seniors stop eating very much at all and sleep more. It is a part of the process. There is enough of loss and of "trying" and the time becomes more a journey toward peace.

Do visit and ask. It is the only way to find out.
Hope others have some ideas for you about their own placement of family members.
Best of luck.

In assisted living, memory care, and skilled nursing my mom was required to be up in the morning and in the dining room to eat three meals a day, then in the common room for activities or tv, even if she needed help to get out of bed and into a wheelchair, which thankfully she didn't need until the final months of her life. She could go back to her room for a nap after lunch, but was otherwise to be out in the common room, even when she was in the end not able to socialize. I think it is required to have people up, not like hospital, where patients are mostly in bed. In skilled nursing they fed her if she didn't feed herself, but I don't really know about memory care for feeding, since Mom was there during Covid lock down and I wasn't allowed to visit in the common room. Ask them if they will feed her. It should be in the contract if they do. They should go over all that with you before she is admitted.

Should want to ask of the facility she's gonna move in to and then again following up. How do you do that? Ohio is starting to make a law to put cameras in the room. On memory, how did they measure it? I got a patch started to get them here on heresay. Say but they don't measure em. I used to be in science and usually when you got something like that. You measure it before and measure during and afternoon to see if you're accomplishing anything. Otherwise the patches or treatment are just billable hours.

My personal experience with my mom in MC and mom-in-law in SNF saw much closer attention paid in MC even though the SNF was one of the preferred in our area. While both delivered decent care, there was more personal attention at the MC facility.

As a caregiver for hub and a retired RN mine is in a MC and best decision for all. His mc is based like a dementia village in Europe and approach the whole resident and their needs. They have OT/PT/ST working with them to help reinforce skills and try to get them more involved. Where he needs help esp with ADLs they encourage and help as needed . They have tried to get him to participate and sometimes he does but mainly he walks a lot goes outside in courtyard and loves watching oldies like gunsmoke. The dementia has him not remembering like has he eaten that he needs to drink fluids or shower or toilet wash hands or brush teeth. His attention span is very short and he now functions like a 3 yo . He doesn’t know letters numbers and to try a puzzle it can’t be more than 10 pieces tops. When he was still at home he’d sit for dinner but then get up just after sitting and roam not remembering it’s dinner and he sits in recliner staring at tv. Sundowning and roaming outside at 230am sleepwalking was unsafe and the pool in backyard was a big safety hazard. I found adult day care for him and a brain fitness program but not secured units and when he went to bathroom he’d end up in parking lot.
here’s my reality and I can tell you are in the same boat… we all are… we become so focused on our loved one that we end up not taking care of ourselves. You can’t do all or be all. They call this a journey for a reason… there is an end but only God knows for how long. We tend to think things will be better or if we do this or that it will help. The reality for me was nothing helps as the disease progresses. It’s not like a cancer where they fight but they are still who they are. My hub is not who he was. He doesn’t know me or the kids and for his safety mc was the answer. I go once or twice a week and he thinks I’m there all the time. He would want me to live too and take care of me and that was a hard thing to start. But he’s very happy eating what he wants and they are a wonderful caring group that is like family. He is a DNR because there is nothing that will reverse or cure this and his cardiologist told me that should something happen they will have to do something fast and to reverse decisions made in that case would take time and energy and cost to stop ie usually court. I would say I do not feel guilty at all but initially I had alittle remorse but I now see importance of caregiver groups and individual mental health therapy. It’s all about making memories and cherish them. Mine was caused from an auto accident TBI by a distracted driver and this is our now retirement… he would want me to live life and that’s what I’m doing now . It doesn’t mean I don’t care he is my one and only and yes I am trying to not be bitter but I do hope karma bites… in the end all we can really do is love them keep them safe and take care of ourselves and the rest of our family. We are the legacy🙏🏻

I think if you find good memory care
tour the place talk with them about your moms’ needs … they’ll do their best for her. I’m sure she won’t be the first or only one not to want get out bed… they encourage normal routines
showers getting dressed going dining room for meals …they encourage social activities singing baking chair exercise socializing… of course each client different but they encourage alot
interaction games etc … much more than you or caregiver can do at home !
iMHO

Hello,
Our mom had ALZ and we finally had to place her in MC. At home she didn't have any initiative to get out of bed or do any activities of daily living. At home if you woke her up and sat her up with the regular expectation it was the routine to get out of bed each day, and helped get her dressed she would at least go sit out in the living room then eat /feed herself some if you brought her some food. The MC we chose was wonderful! They would do exactly this each day. They would brush her hair and talk with her about the day ahead, dress her letting her make the choice of shirt, and 'brush' teeth all before heading out for breakfast each day in the common dining room of MC. Then go to the common gathering room. Then a nap before or after lunch. More common room, dinner, then bedtime where they changed her in to night clothes, got all her meds, and wished her peaceful sleep. Some days she was coherent and held a convo like normal, many days she wasn't there. As more absent days took over, we were so thankful to have her in MC. She had a safe, gentle, peaceful final decline. She had been in hospice for over a year. I believe that MC extended her life (of good days) and gave her much better care than at home.
I hope my experience is helpful, it's a hard decision. Best of luck

This is to provide a different approach, though it may be confronting. Your mother’s behavior is very much what would have led to a peaceful earlier death a couple of generations ago. She stays in bed, doesn’t want to eat or drink, and is not uncomfortable or complaining. She would gently fade away if you didn’t force the issue, or place her in a facility – and there your question is really whether they would ‘force the issue’ enough.

It may be worth thinking about what you, M, and your family really want for the remainder of her life. It’s a tough call!

momdaughter82: Perhaps your mother requires memory care.

My moms MC is good…not perfect but safe, active and she appears to accepted the change well. What we all want is a normal parent and that will not happen again. I am learning she will not be the perfectly dressed, coifed and spoken woman she had been until 87 years old. At 90 she is more like a 4 year old. My mom still walks about and talks in confusing sentences. She appears content. That is a good thing..Good luck.