Breaking the news to Mom about assisted living...

Hi PeterS!

First let me commend you for seeking the best options for your mom, and from afar no less! She, and the rest of your family, are very lucky to have you.

I think you may find this link helpful, since you have already made a decision for placement: https://www.agingcare.com/articles/checklist-for-caregivers-finding-assisted-living-427464.htm

Again, I commend you for doing the hard work.

Good luck on this journey!

About the dog: therapeutic white lies again. Poochy is going to live at Auntie's until he's gotten his medical clearance. Poochie has to have a 6 month quarrantine because he was exposed to an unvaccinated stray. Poochie has to go to assisted living therapy dog training first, and they are unbelievably difficult to find!(I like that one best).

And good for you that you recognize others limitations for providing care and doing what is needed to find mom the needed care. Some prefer to stick their heads in the sand.

It will be a tough conversation, no doubt. I don't think I would tell her that she is going to be assessed for assisted living vs memory care. I may not even tell her that we are going to look at a facility. Instead if I told her anything in advance it would be to look at an apartment, which is not far from the truth. Maybe even as driving by and saying let's take a look at this place. Or under the guise of a new restaurant that has excellent food. I assume you will be having lunch there which should be offered to you by the facility at no charge.

Read up on therapeutic white lies. Honesty with those with dementia does not often work out well.

It might be wise to skip Assisted Living and go to Memory Care. The only reason I suggest this is once she is comfortable in Assisted Living if she takes a down slide she may have to be moved to Memory Cane and it will take her a while to get used to that move, another group of people, another group of caregivers.
If she grasps anything at all you could tell her that the Doctor said she had to go for "rehab". Many people will accept the decision a doctor makes easier than a decision from family.

I am going through this myself, which I will wrote more about in the Dysfunction Family Blogs section....But...if this helps, or possibly it doesn't matter in your situation, but the Assisted Care Facilities I have seen allow dogs. Is she well enough to care for her dog, in the assisted living facility? If so, please look for one that will allow her to take her dog. I'm 'in love' with my dog, and it would be horrendous, if I had to part with her...Good luck in this next journey.

It's very difficult to tell anyone you love that they cannot have something they desperately want. Most elders don't really know what an AL or MC is - they consider any facility a NH with confining hospital like rooms. So in addition to wanting to avoid a NH at all costs, they are also afraid of being left alone in a strange place and losing what little control they have over their life.

I am guardian of my father with vascular dementia and placed him in MC; both guardianship and MC placement were very much against his wishes. Dad's executive decision making was completely gone by the time I retained guardianship - all decisions were spur of the moment emotional choices based on what he "wanted".

I explained it all to my father as though he was still fully competent. I think that even if he doesn't understand or retain what I'm saying, he still picks up on my tone - that I really believe this is in his best interest. I explained why he needed 24/7 care that the family could not provide. I explained why I had chosen this particular MC. I explained how I envisioned his life was going to continue in the MC, with his basic lifestyle unchanged or somewhat improved. He mostly could eat what he wanted when he wanted it. Someone would continue to visit every day. He would have a phone in his room that he could use to call anyone. There's a porch and patio area he could visit whenever he wanted. Dad would interrupt me and tell me he didn't care about that amenity or that I had no right to do this to him. I would calmly response that the judge had decided I need to help him make good decisions and MC was the best option for his care. I arranged for a involuntary transport if needed. I told my father that he knew I was just as stubborn as he was and that he would be going to the MC - his only choice about it was how he was going to get there, a pleasant drive over in the car or a transport in a ambulance. He chose the car and cussed me all the way there. We arrived while breakfast was still being served and he got to pick out a meal. He fussed with/at me for a couple of hours then my estranged brother arrived and I left so they could trash talk me.

Dad settled in quickly to the MC. I think primarily because he didn't have to be afraid anymore - there's someone there to help 24/7. My estranged bother visits him 6 days a week and the rest of the family on the 7th day.

Although Dad continues to complain to me about wasting money on MC, he told his nephew during a visit that he likes MC and is only worried about being able to stay - which he probably will because I have told him there's enough money to pay the bill for the rest of his life.

You are very lucky you seem to have the support of the family behind you. My family split over care giving for our parents. Just remember when your mother resists entering AL or expresses some hurtful comment on your care decisions the behavior is that of a broken brain driven by fear of the unknown; please don't take anything said from this frame of mind seriously. Stay calm and be as comforting as you can. Good luck with this difficult transition.

We went through all of this last year. We had to put my mother in law in a facility because she is 92 years old and lived with her 93 year old husband who could not take care of her but would not let any one else take care of her. When assessment day came we told her she was seeing a nurse for a phisical. Her husband was out of the house doing some shopping with his Daughter. Mind you, she passed the assessment for AL but about two weeks later had to be moved to memory care because once she realized she was going to be without her husband (who refused to go with her) her demencia got much worse. Keep in mind this might happen with your mother.

Realistically it takes much more than two weeks for her to settle in her new surroundings but eventually she will. My mother in law may ask once in a while when will she be leaving and I tell her that she is there because of her problem with her memory and that as soon as she gets better we can talk about it. It seems to help her and she goes for a while without bringing the question up again.

Its a difficult situation no matter what you tell her or how you get her there. Just know that she will be well taken care of and she is still loved. This was something we really were not prepared for and there will be all kinds of emotions. When a loved one gets to the point where she needs 24 hour care no one person can take care of her. You are making the right decision and it comes from the love you have for her.

Kudos to the aunt for having taken on this task for almost a year!

I had to move my mother to assisted living also under difficult circumstances. Luckily, I had looked at the places with her, perhaps a year earlier, so I kept reminding her that we had looked at her facility together and we liked it. I suggest spending the first few days with your mother if you can when she moves in, to get her into the routine and to get her used to the new surroundings. I also frequently reminded my mom of all the things she brought from her home and we made sure to decorate the place with all the paintings and art and photos that she had at home. At first she thought it was a hotel, and never complained. There was a while when she said she was going to pick up and move but that seems to have stopped. Now I think she knows it's her home and she rarely complains. Occasionally she might ask about her old home, which I had to sell, so I do tell her that it was sold. Somebody also told me that at some point, you might have to do things that you just don't want to do, but you don't have any choice. I think moving a parent to assisted living is one of those situations.

Does the facility you are moving her to have both an assisted living part and a memory care part? If it has both, I agree with Grandma1954 to skip AL and go straight to memory care. The fewer changes the better. She will settle in...eventually. It will be heartbreaking but you are doing what is best for her.

Her brain is damaged and she does not have capacity. You can't be sure what she is and is not capable of understanding. Do not tell her that she is moving. My in-laws, who both had capacity, made such a stink about moving to independent living that one would think we enrolled them in the Hunger Games.

On the day of the relocation, act as if it's an ordinary day and that you're taking her to a special senior luncheon. Make sure that a director from the facility is there to receive you and your mother and give her a tour of all the activity rooms and amenities. Let the director take the lead and you observe. Also make sure that her prized possessions are in her new room before she's shown it for the first time. Enlist the help of the other family members in getting this done. Peace.