Dad comes home on Hospice today. We had made arrangements for both parents to go to assisted living next week and now Mom who has Alzheimer’s, will lose him before the move. Friends in the medical field tell me she should still go and soon. There isn’t room yet in the Memory Care Unit and she’d have to be in a room alone until there is. They say she would leave the door open and can come and go from her room. Not sure if it’s better to have her in her home, lonely with a caregiver or go where there are more people around but in a new environment?
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Questions:
* how hard/fast is the impending loss?
* how long do they anticipate the space in MC?
* were/are they living with you and for how long?
* would you lose the MC if you opt not to move her to AL?
If your dad really will pass within the week, this is a tough decision. Some really do pass quickly (after a second stroke, my mother lasted only a day), but others can sometimes rally and linger on for much longer.
You will have your hands full while your dad is still living. Hospice isn't there 24/7, so you'll have to juggle his care with hers. It's also hard to make judgement because "staging" and dementia can be capricious. How capable is she? Can she do any self care? Is she mobile? Is she a wandering risk or other danger? If she's relatively capable and the facility can hold the MC slot until there is space, I'd almost want to wait. One move vs two and a better situation for her. I'd have concerns about them saying leave her door open - in AL there isn't 24/7 supervision, so she could wander about or even out when no one is watching her. If you do choose to move her to AL while waiting for MC, I would suggest hiring someone to be with her. When it was time to move our mother, my YB kept insisting on AL, but I disagreed and so did staff. There was nothing to prevent her walking out the door and becoming lost!
Generally there is an "adjustment" period for the person to become more acclimated to a new place. They suggested we stay away for about 2 weeks, to let her get into a routine. In her case, they were just reopening after a rebuild, and for about a week, she was the only MC resident. They would often take her upstairs, with supervision, to mingle with others. There's no guarantee your mom, unless she is/was extremely social, to get benefit initially from being around others in a strange new environment. Mom had the benefit of being doted on, and having only a few at a time move in, over several months.
When your dad passes, she may not be able to or retain the news. If not, as suggested, have answers as to where he is when she asks - use places that would make sense to her - at work, shopping, getting car repairs, fishing, whatever he used to do that she would remember (it may have to be old memories!) If her short term memory is gone, you'd have to tell her over and over again that he passed and she would have to go through that pain over and over. It is much kinder to keep his memory alive and use fibs to fill in the gaps.
If the facility is willing to forgo the AL and wait for the MC space, it might be best to keep her home and hire someone. When the space opens up, I would even keep the caregiver on for a while, to help her "navigate" and get used to the new space, so she'd have a familiar face to help her through that.
So sorry about your dad and impending loss. Keeping mom home a bit longer might also be beneficial to you, so you don't "lose" both at the same time. You've already lost a bit of mom, so use this time to forge a bond with her, and perhaps be able to "support" each other, before the move happens.
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Alzheimer's disease is characterized by loss of short term memory. I would suggest that moving her where she will have her needs met is paramount.
You can always visit her frequently.
if she remembers he has died
... acknowledge that and tell her dad would like her to live there.
if she doesnt remember ... they moved together and he has gone to the bank ? Grocery ? Outside for a short walk ? so you and your mom could have some chat time together and he’ll be back in a few minutes.
You say she would be lonely if left in her own home- did she say that or is that your opinion? Placing her in a facility would place her with strangers, some she may befriend and others not, a strange environment, and a different routine (meals, bedtime etc.). Her placement might not be as smooth as you hope for and envision. Your dad's death and a change in her environment so suddenly, may be very difficult for her to accept.
I don't mean to dissuade you from placing your mom in a care facility, I'm just asking you to consider some important issues. Certainly, if you've maxed out in your caregivng, there is no plan B. She should be placed for your own sanity.
I am so sorry for all the sorrow following you all at this time. I pray that you will all be blessed with peace and grace.
I do worry about your mom going into the wrong type of care, particularly because that can be a real problem. My mother went into skilled nursing because I didn't know it was the wrong thing for what ailed her. She was there for seven months and would have been gone from neglect if I hadn't gotten her out of there. She didn't need skilled nursing and was allowed to be alone because she had fewer needs than the others in there. She refused to come out for meals, so they brought them to her on trays, and she slept in a chair all day and night. She developed terrible edema from her legs hanging down all the time (she never slept in a bed for seven months), and her dementia quietly became worse.
My husband is the one who said I needed to get her out of there before she wasted away. I moved her to a memory care facility near me, and she's received far better care. I have no doubt I'd have buried her two years ago if I hadn't moved her.
Consider waiting for a memory care space and keep Mom at home with an attentive caregiver until one opens up.
Mover forward with the plans, of you don't, she may not have a place to go as your mom's Alzheimer's progresses at whatever pace.
Some will criticize and claim that it is a sales pitch. No, I don’t believe it’s a sales pitch at all. There are no shortages of residents. Plus, there are often wait lists for good facilities, so grab the available spot!
I didn’t get the chance to place my mom, long story, but I do feel that everyone would have benefited, especially my mom.
I really am surprised they can not find a room in MC so they can both move into MC so she will not have to be moved again. Even moving into AL them moving to MC , even if it is a hallway or floor different will be confusing for her.
You could also have mom placed on Hospice. Then ask the Hospice Social Worker if there is anyway to "find a way" that the two can be moved in together.
If that is not possible I would move her as soon as the room becomes available.
If you take her to her previous home, or your home, or any other home, then there will be the jolt of leaving there, and the fewer jolts and changes, the less unsettling the transition.
Be sure the staff in the residence is fully informed of the issues in her present life, be available to help them in ways they suggest to make her more comfortable, listen when they offer suggestions about assisting her with enjoying the safety and comfort of her new home.
You are doing terribly hard things, and the loving choices aren’t always the “best” choices, but must be made as the best accessible. Make them as objectively as you can, with love.