How do I decide if it's time to place my mom?

What is the phenomenal lifestyle mom is living at your house, exactly? That you're so afraid she's going to be lacking at in the ALF? Do you realize she'll have activities, others to mingle with and complain to? Movies, outings, 3 hot meals a day, doctors coming in to see her all the time, caregivers waiting on her 24/7, changing her soiled briefs, washing her clothing, dressing/undressing her, showering her, rubbing lotion on her body afterward............? The list is endless. My mother had 'her girls' waiting on her hand & foot, literally, every day of the week. Plus she had me and DH visiting her, showering her with gifts and snacks and pretty tops with matching jewelry so she could always look spiffy. The 'locked doors' so they can't get out they're not even AWARE of, g/f. In the activity room of mom's MC, the door to exit had a mural of library books covering it. The residents all thought it was a wall of books, not an exit door at all.

Nothing will make the 'transition simple' or make your guilt any less. You have no reason TO feel guilty, of course, b/c you've done enough for mom and now she needs a level of care you're no longer equipped to provide for her. You're just looking for 'reasons' to allow yourself to DO it. And you don't need any reasons. The one reason is, she has dementia and needs that exceed your scope of abilities, and it's time NOW she go into managed care. In fact, it's BEEN time for a long while already, you're just holding back for some reason.

Tell the admissions director you need a nurse to come out to YOUR HOUSE to do the evaluation. And that you'd prefer mom to go into the highest functioning group in the MC, at least at first.

You're expecting the worst b/c you've conjured up all sorts of horrible images in your mind of how bad life will be for the Poor Soul in Memory Care. I can tell you my mother quite liked being the Queen of Sheba over there, getting dressed up and comparing her rings with the other ladies' rings. Who's got a nicer top on today and who's eating more lunch than whom? It's a big day camp for seniors, Memory Care, and they do all sorts of fun and silly things, like have walker decorating contests and pretzel rod decorating contests. No lie. They have FUN. And they do more together in that activity room than they will EVER do alone in our homes in the kitchen, that's a FACT.

Stop over thinking this and just move forward. It's time now, my friend. You're tired and mom's ready.

Oh boy I really feel for you.

After ( another ) stroke, Mom could no longer live independently. She had to be moved to MC, but ,she was high energy and would have been the higher level functioning in MC so Assisted Living was also a temporary option…but just barely due to her memory…she would have ended up in MC sooner or later anyway. I talked a lot to the admin, doctor, care folks, etc..anyone who knew her well and asked for their opinion. Even they were throwing up their hands. I opted for MC and said, “ please tell me if you have any other opinions or better ideas. “ It was awful feeling like I was cooping up my mother - this was truly a case of choosing the least bad of the bad options.

I’d say definitely get an eval , at the least for some peace of mind with decision making. Most likely if your mom is like mine, no matter what she’s going to be super peeved with everything…just prepare for that…sigh….feeling like I was ‘jailing’ my mother was horrible, I could really sympathize. I needed to be told the truth , which was , she was getting the best help possible for the situation. So I pass that message on to you!

I also did something unusual for MC - I stuffed her room to minor excess with lots and lots of pictures and personal Knick knacks . Because she was highish functioning I wanted to give her as much control as possible , and have a big project from the get-go, namely choosing her own things to keep or to move out. This might have helped a little. Usually MC spaces should be more zen but I wanted mom to use her energy for her own purposes.

Fyi she’s now gone way downhill, this MC was the right choice, and she’s MUCH more comfortable and in a clean safe space with lots of attention. It’s the beginning that’s really rough.

You are taking great care of your mom. I am sending you a huge hug and a bringing over a big glass of wine! ( If that’s your thing ) Good luck and here’s another hug

The Director of nursing at my Mom’s place came out and did the evaluation.

We fibbed about the reason the nurse was there. We said that it was for insurance, or something like that.

They want your money. It’s EXPENSIVE. They should be happy to come to her.

Is there any way to arrange for the admissions evaluation to be done in your home? I’d be begging someone to come do that. I know it’s done in some cases where I live. I’m sorry for your anguish in this, so hard…

I had the same concerns. We did an evaluation and I placed my mom in MC but after a week, the staff and I felt like the ALF side was a better fit. I was concerned that it would cause her to decline faster in MC. She has been in the ALF 4 months. The hardest thing I have ever done. The first month was not easy. Now, due to her condition, she has forgotten my home completely and thinks she has been living in the ALF for a long time, I guess you can say, , in this instance, the memory issues have been a blessing. I still have concerns and I am still working through some adjustments. I visit daily and my time with her is precious. Not as much task oriented as it is more “together” time.

It is the hardest thing you will ever do but if you can get through transition, it will be better for your mom and for you. I know my stress level and health is much better.

You will be in my prayers.

I decided early on that it would be a matter of SAFETY for me to make that decision.
If it became unsafe for ME to care for him at home I would have to place him.
If it became unsafe for HIM for me to care for him at home I would have to place him.
Safety can mean :
Physical safety
Mental safety
Emotional safety.
Luckily I never had to make the choice. I have a house that was built accessible
I got all the equipment that I needed to care for him safely from Hospice
I got the mental, emotional support from friends and Hospice.
He was never aggressive or violent so physical safety from violence was not a problem.

YOU decide what you can and can not do. YOU decide what your "line in the sand" is.
Making a choice to place someone in a facility either Memory Care or Skilled Nursing is not a failure it is accepting that the level of care required to keep this person or yourself safe is more than what can be done at home by 1 or 2 people.
Hiring more caregivers is an option but often more daunting and sometimes more expensive than placing in MC or SNF.

The "Big Something" that happens may come at a time that you are unable to find a satisfactory placement for your mom. Your mom reads you like a book. She knows you are uncomfortable about placing her, so she throws a tantrum.

My son and I visited seven facilities before my husband "chose" his favorite continuing care facility. When we began our search, I told my husband what we were doing. I promised him that when we narrowed the list down to the top two, he would choose which facility he moved to. After many tours on the same day of the week at the same time of day, we decided on our top two. I took my husband to lunch at both facilities. Both facilities had excellent staff to resident ratios, lovely suites, delicious food, beautiful grounds, 24-hour RN, on and off-campus activities, etc. Guess what--My husband chose the facility with the friendliest residents, something neither my son nor I considered.

I, too, thought my husband qualified for MC until the facility's counselor performed her assessment in our home. She recommended Level 3, Assisted Living. As time passes, he will move up to MC. Now, my husband has what he calls his "gang." They play games together, they eat together, they go to the movies together, they go shopping together, they exercise together. His best bud reminds my husband when it is time to "dine" in the opulent dining room. He has gained four pounds in the three months. He has a social life, friends, nursing care, mental and physical stimulation, nutritious meals, laundry and housekeeping service. My husband leads a more active social life, eats healthier, sleeps more soundly, plays harder than I do. I am in our house sitting in front of my computer typing this reply to your quandary while my husband is listening to an entertainer in the Rec Room with all his friends and will go to lunch with his friends in an hour and a half.
Note: We have been married 57 years.

I think it’s a blessing that they have a space available for her. If she needs care 5 days per week, then it seems like a placement is needed.

How much longer can you do this?

TALK to the people running the place you're considering. Don't make assumptions, but get concrete information from them.

First, it's likely they'd send someone to her to evaluate her, not the other way around. My mom was in a SNF 40 miles from the MC I was moving her to, and their admitting nurse came all that way to evaluate Mom without thinking twice. It's what they do.

Also, Memory Care is always going to have people with varying degrees of dementia and needs, and the place should have programs in place to handle that. Mom's MCs had three distinct areas -- one for folks who were completely independent and could do things like watch TV on their own, make their own coffee with a Keurig and read books and magazines, one for organized activities like bingo, crafts, trivia games, and exercise games with the mid-range-ability group (the majority of the residents), and a third area for those with the lowest cognition. Those folks had the assistance of multiple caregivers for their activities, which was mostly things like sing-alongs and manipulatives like giant Legos.

Ask, ask, ask questions until you're satisfied.

Please seek a remedy and make her an appointment with a Gastroenterologist and a Geriatric Psychiatrist who can help with placement and medication. You can seek out a therapist for yourself to work through this complex and tortuous relationship with this woman you call, "Mom."

You might want to put mom in respite care to give you a break and get mom acquainted with her reality: accepting change takes courage.