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Laura1968 Asked August 2020

My 85 yr old mom has mild dementia. She is forgetful and sad but able to dress, bath, and keep house clean. Forgets medication. AL or IL?

My mom forgets about conversations we had 5 minutes before. She repeats questions all the time. Calls continuously and is often crying. She is physically in great shape but now has trouble working computer, tv remote, phone which is further isolating her. She can’t drive anymore. I need help deciding if Independent Living could be good for her or if she needs AL even though she doesn’t need any physical help with dressing, grooming, toilet. She keeps her house clean and her yard kept up. She has been in her house for over 40+ years. Any suggestions?

MomsBrain Sep 2020
My mom is in an independent living facility with an in-house nursing staff called "Medical Team". You can pay for a la carte services from them. They have been helping us and Mom's GP monitor her blood pressure twice a day for last couple months after some episodes and med change. Her memory is just bad enough she'd never remember to check her BP one hour after morning meds and again 12 hours later. They can also manage her meds, which is probably next as I think both her GP and nephrologist suspect she's forgetting medications even tho she has them counted out in a tray and marks them off on a chart we made for her.

The Medical Team's services are not cheap but I'm thinking they a lot cheaper than full Assisted Living and this way she can still feel independent and we can be confident she is being cared for (I live 2 hours away in the summer and 2 days drive away in the winter; brother is 40 min away). They told me as long as she is not combative to herself or others, they can care for her with these services and "Queuing" (reminding to take showers, etc.) for a long time, which sounds good to me. I have been in touch by phone with an RN there and she has been very helpful, and Mom likes her too, so that's great. Fingers crossed. This facility is called Lockwood. I thought they had facilities outside of Michigan but not finding them in a web search just now.

Grandma1954 Sep 2020
If you select IL the staff is unable to help her at all.
If you select AL the staff can be as hands on or off as much as you and or she desires.
If she needs help with medication the staff in IL will not be able to help her. In AL you/she may be charged a bit more since this is a "service" (this depends on how they charge for each service / ADL the staff has to help with)
The question is how quickly will she decline once removed from her home, her yard, her "space".
The transition to MC might come faster than you anticipate and if she is in AL the staff might recognize much faster any decline.
I would actually check out the MC part of the facility and see if that would also be an option. How active are the residents? do they go on outings? does the staff actively engage the residents or are they left to lounge watching TV? do they have the ability to get a snack on their own? If a resident is sitting in their room does the staff encourage them to join the group?

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Gracie61 Sep 2020
My Mom's place has IL, AL, and Memory Care Just different wings off a common area. ( Memory Care has own common area, garden, salon bc its locked). But IL and AL shared all the same amenities, dining and activities. The main difference between IL and AL in living space was that the units were a bit larger and had a full kitchen, instead of kitchenette in AL. So if she's getting forgetful, its probably better not to have the full kitchen. You could get additional services in IL like med management but there is more staff on the AL side if she needs help.
From your description, shes probably AL, but with Memory Care in near future. So if there is a place with both, it would be much easier down the road.

In AL she would need to be able to navigate to her room and back, know dining times and be able to chose her meal from a menu, and be able to read and understand the activities calendar and go to what she wants to do all independently. My moms place had a resident council that helped the new people figure it all out the first few days. She would need to operate her own TV in her room. I hired some sitters for part of the day who just told her they were there to help new people to get my mom to actvities I knew she would enjoy for the first couple of weeks.
AL staff will help with various ADL stuff, laundry, housekeeping and meds, but she needs to be with it enough to handle day to day life. It seems mainly for people who are cognitively ok, but their body is wearing out and people that are in early dementia stages.
Prior to her moving to Memory Care, most people were nice, understanding that one day she would say her husband was dead and the next not- but sometimes the dining room reminded me of high school again, there are still "mean girls " around.

MJ1929 Sep 2020
I'd say Memory Care rather than Assisted Living.

Not all Memory Care facilities are full of drooling, advanced Alzheimer's patients. I looked at several facilities before placing my mother, and yes, some of them were like that because they have inadequate space to separate groups, but the one where she is now has an enormous common room where the low-functioning folks are kept on one side and the high-functioning ones are on the other side doing their own thing.

Find one that has lots of activities, because a good MC will keep your mom stimulated and busy. If she can dress and bathe herself, great -- they'll be fine with that. There are several people in my mom's place like that. The important thing is what they do for the residents, and mental stimulation is vital when your loved one has dementia. I don't think AL is good enough at that kind of thing because the onus is on the resident to go participate in activities while MC makes sure they participate or are at least near those who are participating.

lealonnie1 Aug 2020
She is way way way past Independent Living. Dementia can and often does change on a dime. She can be fine today and need help with all ADLs by tomorrow. She may be in great physical shape, but she's not in great mental shape, and that brings with it a huge set of potential problems. Assisted Living with a Memory Care annex is your best bet. I'd hold off as long as possible before placing her in the Memory Care section, however, because the residents tend to be quite advanced with their dementia/Alzheimer's, so the longer you keep her in AL the better. The ALF will let YOU know when it's time to transfer her. In Assisted Living, she'll get 3 meals, snacks, entertainment, socialization (as much as possible with the plague present) and won't have to worry about much of anything anymore, which is perfect. As she needs physical help, it'll be right there available for her with no issues.

Good luck!

peace416 Aug 2020
An Assisted Living facility is a much better place for her to be moved. IL does not offer medical assistance / care of any kind.

JoAnn29 Aug 2020
I agree an AL. An IL living is like having an apartment. They may have meals, activities and transportation but no one oversees them.

sjplegacy Aug 2020
I agree. Her meds will be managed for her in an ALF. Not so in independent living. She'd be on her own and already doesn't manage her meds properly.

AlvaDeer Aug 2020
Assisted Living gets my vote in these circumstances. Do visit some of each.

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