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DownSouth Asked December 2016

I need advice on how to explain to my mother that assisted living is what she needs now?

My mother with moderate dementia has been with me for 3.5 years in my home. Due to her seperation anxiety issues I am facing having to either increase the home aid coverage, or move her to assisted living. I found one that is like a 5 star hotel, within her budget, heck I would move in. Because we are also in the midst of a caretaker transition (day one, not going smoothly, first replacement lasted only an hour), I broached the subject of considering assisted living. You would think I signed her death warrant. And her dying brain is making me the evil daughter that now hates her, and that she wanted to live with family, etc, etc. Not going well at all. Do I just suck it up and do what is best for her even if she does not agree? How can I convince myself to turn a deaf ear to her crying and anger at me? Any suggestions will be greatly appreciated. I don't have any siblings that can help so I have to pay for assistance.

DownSouth Dec 2016
Thanks - mom does not need a placement or financial assistance. Thankfully she has a great retirement and LTC policy that will cover at least 1/3 the cost.

Bigsis, the 6 facilities that I toured DO have assistance to get people around the facility, it might cost extra (monthly fees based on level of care) but it is available.

My mother's GP will not dispense meds for mental issues, he just refers them on to a psychiatrist. The assisted living facility did give me the name of an agency that might be able to help.

I'm going on day two of my mother going from major depression to major anxiety to major anger. She cannot grasp or recall why she needs to move. She does not understand that she panics if we even try to leave her alone to go pick up pizza. And she need socialization and a higher level of care that I can provide. I've been doing it for 3.5 years, and I'm at the end of my rope.

I feel her pain and worry and fear, and I know that she will most likely love the place in a short time, heck, I want to live there. But I need to find some reserve of strength to get me to moving day.

Sunnygirl1 Dec 2016
Downsouth, I would make it clear that you are not responsible for your mom's care and services. That cost is for her, so she would need a place that she can afford or apply for financial assistance to see if she qualifies.

If her doctor doesn't know any different, he may believe that all mom says is true. He has to informed otherwise. What I did was write up a memo of my loved ones issues and made sure the doctor read it before the appointment, so he know what's going on. Such as refuses to bath, won't change clothes, lies in bed, doesn't open mail, can't administer own medication, constantly repeating herself, unable to arrange for her own medical care, can't operate a tv remote, eats spoiled food, etc.

And if she gives the doctor incorrect info during the appointment, stand or sit behind her so you can nod your head or mouth the correct answer. My loved one's Primary diagnosed her in the office after a Mini Mental Health Evaluation with dementia and said that she had to go to AL. Of course, she was living alone. Since your mom lives with you, they may consider that she's fine living with you. You may have to explain that she can't live alone and she can't live with you any longer.

I know its sounds harsh, but, her resistance is common. And, it sounds like she is no longer able to comprehend what your abilities are regarding her care. So, you have to put your health as a priority too. I think I'd share with her doctor, that she will need placement, since she can't continue to live with you and she can't live alone. The doctors see this all the time.

Placing people who are intent on refusing placement is challenging, but it can be done. You just have to figure out the route you will go. As she progresses, she may forget all about her resistance and even like her new place. My loved one is in Memory Care and she loves it. She calls it her apt.

Memory Care is actually a great place for those who need that level of care. What is unfortunate is when a resident is in regular AL and their needs are greater than what regular AL can accommodate. There's no shame in getting the appropriate level of care. I'd talk to some directors of a few places and get info on what they can offer and how you can transition mom in there.

And if mom is anxious, worried and distraught, which many dementia patients are, her primary may be able to prescribe medication for that. You might schedule the psychiatrist appointment for later down the road.

You just have to take the insults. It's the illness. You can't let her mean words prevent you from getting her proper care and you relief. It's rare that a dementia patient calmly and with ease enters into a facility. But, once there, it's much better, based on what I have seen.

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bigsispjt Dec 2016
Pam, Thank you for responding. I'm due for a conference this morning with the healthcare team. I have plenty of questions, praying for answers.

pamstegma Dec 2016
bigsis, from the hospital she will have to go to a nursing home. Assisted Living will not take a person who cannot get to the dining hall. Senior apt is out of the question completely. You need to meet with the social worker and discharge coordinator at the hospital ASAP.

bigsispjt Dec 2016
Can i piggyback on your question. My mother doesn't have dementia, however we just spent all day in the emergency room because she called me this morning and could not walk. Her apartment is on the second floor and she lives 20 minutes away. She is due to get a senior citizens apartment next month, piggyback on your question. My mother doesn't have dementia, however we just spent all day in the emergency room because she called me this morning and could not walk. Her apartment is on the second floor and she lives 20 minutes away. She is due to get a senior citizens apartment next month, but now I'm wondering if she is going to need a greater level of care like perhaps a handicap accessible unit or should I be looking at assisted living. She has a very limited income and I'm not even sure we could qualify for Assisted Living unless they have assistant living facilities with people with limited income. She does have very good health insurance however. I to feel like I'm in a tough place. She said she's coming home tomorrow. But she can't walk, so that's not an option. I still work and travel, too.

pamstegma Dec 2016
First we got mom on Ativan and Xanax (Rx by her primary physician). Then we took her on tours of AL facilities with a free lunch, so she could decide which one she would move to "when the time comes, not now". She decided to try one for a month when they offered a one month trial at half off. She stayed, her own decision.

DownSouth Dec 2016
I won't survive long enough to find a geriatric psychiatrist here to get her medicated in less than six months. We have a horrific shortage here.

I'm sure she will put on a brave face and a good show like she did for the twenty minutes in her regular doctors office today in front of the doctor, so that if I were to even mention that she has depression and anxiety issues they would act as if I were the evil daughter trying to keep mom drugged up. I'll try to call the one office tomorrow, but not holding out much hope.

As the day has worn on she is sort of grudgingly accepting the idea as I keep stressing how much this is killing me and that I can't stand much more of it.

Thanks for listening. If any one cares to share how they convinced a dementia patient to move to AL that would be ever so helpful.

pamstegma Dec 2016
If she will not accept services at home, she will not accept them in assisted living either. So they will call you to come and get her.
Nor should you suck it up either. You get her nastiness medicated out of her before you move her anywhere. If you don't, her only option will be a lock up unit in a memory care center. Honest.
I have seen patients properly medicated who do well at AL.

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