Mom is now in AL and doing well. How will her care needs change as time passes?

My mom’s dementia was severe enough that I could not trust her feedback on the care. You may be one of the lucky ones that has an incredible facility that does everything perfect. Those are few and far between. They simply do not have the staff. I visited to monitor her care and to provide those things the AL could or would not do. For me, placing her was getting help but it certainly did not remove my need to oversee and monitor her care and her decline (and to provide special things to bring her joy). I knew my mom better than anyone. Seeing her helped me avoid issues before they became a crisis, (Swelling legs, potassium levels, sore gums, temporary confusion (UTI’s), monitoring weight, cracked skin……..and on and on and on. Time will tell how your mom does. The one thing that is sure, with dementia, is that they WILL decline. This is not a steady state. Enjoy this time while you have it.

My mother needed lots of things in AL that they did not provide for her....me providing those things did not mean I "was too stupid and doing the ALs job for them."

Should the AL have gone to Kohls to buy her new shoes or bras or clothing or socks? Or taken her to the specialty shoe store for fitted shoes to deal with her neuropathy issue which required inner soles with lifts?

Or the time I had to drive to Wal-Mart to buy 8 pair of shoes in various sizes bc her feet were THAT swollen that none of her shoes fit, and nobody knew what size she wore? Then I had to drive the others back to WM after we found 2 pair that fit.

Or perhaps they should have sent a CNA to buy her a new bed and mattress with linens when the old one wore out. Or moved her 3x, lock stock and barrel, from one room or bldg to another, when the need arose?

Or the times I had to meet the doctor at the AL to discuss treatment strategies, medicine changes, equipment updates. The various times I had to meet the ambulance at the ER, the hospital stays, conferences with doctors, rehab facilities, getting her transferred from one horrible one into a good one, etc etc.

This doesn't even include Memory Care Assisted Living when her needs doubled.I don't know what needs your mother will have or not have, but to say that AL covers ALL of a residents needs across the board with no help from family or POAs is to not have any firsthand knowledge of managed care whatsoever.

Yes, while I was able to handle several ordering items like snacks and Depends over the phone, there are issues that arise (especially with dementia) that cannot be handled that way.

Seeing a loved one in person weekly is also crucial imo to make sure she's being cared for properly and not neglected in any way by the facility. Laying eyes on her firsthand is the only REAL way to know for sure. I went weekly to see mom in MC even during covid when I had to stand outside in the cold and speak to her thru the window over the phone. Such a thing may not be possible for you, granted, but don't expect to be able to do all that's needed over the phone 24/7 either.

Oftentimes mom needed me to talk to her in person when she was agitated or Sundowning, so that's something else to consider when dealing with dementia. Yes, all elders needs will vary. But I've yet to see an elder who never needs anything from their children at any time while living in AL. It's unrealistic.

Unless she has a very swift decline and passes quickly, there is a high probability she'll need things from you in person over the course of her stay in MC. My mom was there for 3 years, and in AL for 4.

Best of luck to you.

Perhaps you are not missing anything. These things cannot be predicted. Once my POA and Trustee for my brother was arranged, and I was in charge of bills and all other entities from banks to CPAs knew I was POA, my brother's routine settled into the every day. I did the financial and kept the records.
He had been diagnosed with probably early Lewy's dementia but was still relatively well physically and mentally. He suddenly got sepsis and returned from hospital per his request to his ALF with Hospice and died there within a week. It was at the beginning of Covid (tho that was not the cause of the sepsis).

During his stay in ALF my bro got nothing but better. He was assured everything was handled and he could just relax. We wrote our usual letter and spoke on the phone often. He died before he could become more confused, need memory care, get more physical fragility. Your mother may die before this happens, as well.
HOWEVER.............................

She may not.
She may deteriorate mentally requiring you to be POA and handle everything, requiring movement into MC, and she may require medication, MD intervention.
Or she may decline physically, requiring a higher and higher level of daily care.

Point is, for now things are OK and you cannot predict them. My brother did not wish to move closer to me; he had become a SoCal boy and his friends were there. I wasn't myself moving for Northern California.

I wouldn't "buy trouble". I would take it that today is OK and tomorrow you will handle as you must, given your documents for your mother are already handled. If you are on Forum and are reading you can already see some of what MAY happen. As to those getting through quite well, they aren't really the ones writing us questions.

Best of luck to you both. Yours is an excellent question.

I’m the one that notices when my mother’s meds need to be changed. The caregivers just deal with her each and every day, and aren’t allowed to make medical decisions. I am the one to report symptoms to the medical team associated with the Assisted Living Memory Care.

A couple more examples of how I think it’s important for me to have eyes on her, once a week:

Every once in a while, my mother runs out of TP. Because she has dementia, she has no initiative. That means that she doesn’t ask for replacements. So, she sometimes uses whatever washcloth is drying in the bathroom. And, re-uses it. Ummm, gross. I catch it, call the caregiver, and Mom gets restocked.

Mom hoards used cups and used napkins. The maintenance staff is not allowed to throw anything away. So, I go around her room, collect trash, and throw it away, despite my mother’s strong objections.

I check her closet, bathroom, and drawers, to make sure that she’s not hoarding trash in those places.

On and on.

Perhaps you could hire someone, with your mother’s money, of course, to get eyes on her, once a week.

I hope she has family and or friends who can drop by and visit and physically check on her from time to time.. Not saying that staff doesn't do that, but sometimes you just want to see your LOVED ONES...TRULY... CONNECTION WITH A FACE AND MEMORIES, STORIES.

I love the old adage, “Don’t trouble trouble ‘til trouble troubles YOU.” Let well enough alone until forced to do otherwise. She’s adjusted, she’s happy, and you may well look back at these easy days with HUGE nostalgia, if she deteriorates.

I am going to take the last of your questions first. Some people do as much as they do for loved ones because

1. They may think it is expected. This could be due to cultural reasons. Or this is how they were brought up. It could be because the loved one is demanding and used to getting what they want when they want. And for some that most misused word.."guilt".

2. this should have been first...Because they want to, their parent or loved one is truly a loved person and a joy to be with and care for. The facility should do a good job of keeping you informed about moms condition and her decline. (I am sure that they will be quick to inform you when she needs more "assistance" as that will generally mean an increase in fees. And when and if they inform you that she is no longer appropriate for AL and needs to move to MC.)

I would try to schedule a monthly meeting so that they can keep you informed. As mom declines more possibly a Care Manager might be a good idea. Who is going to go to doctor appointments with her now? Someone should be with her as she declines so that correct information can be passed on to the facility and to you.

The only difference between living in an apt and assisted living is you have help with ADLs. There is a point a resident can no longer be cared to at an AL. ALs do not do skilled nursing.

As Lea said, theres lots a family is still responsible for. Me it was Depends, toilet paper, tissues, wipe and toiletries. Aides did the laundry and cleaned her room. At that point Mom had enough shoes and clothes. But if she needed anything, that would have fallen on me. I took her to doctor visits because I needed to know what was going on.

When Mom went to Long-term care was when I got a break. They had a doctor associated with the facility so no more doctor appts. Even though I supplied her toiletries, they used their own. Depends were supplied as was, TP, wipes, and tissues. If I had to worry about anything, it would have been shoes and clothing.

Its a shame u live so far away.

She is in a facility.. They offer aging in place...right? So, when her health declines, they can move her into a more proper area of the same establishment. My friend did this for her parents and her great aunt, and her FIL, all in the same establishment but other WINGS... for the appropriate care needed...and she would visit, have meals with them, take them places. etc.VISITING your mom more often when possible if she still knows who you are and she can still talk... When they stop talking... :(Perhaps, you have too much on your plate as is... but I had to have my LO's near me, so I could get to them just in case... I needed to see them on a regular basis.. I put them in the same facility.. My doctor actually saw me after I did that and asked what changed? It was a one stop shop... I could see both of them at the same time..drop off their supplies, make sure they were okay. And I had them within minutes of me..... The one time I decided to go out of town... facility called me and said 911 was on their way.. quick come over... What? 5 years or more.. of not going anywhere farther than 2 hours, she chooses this weekend, that I was 8 hours away... Aunt pulled the same thing on me... I was actually coming home, and was 45 minutes away,, they called and said, come quick when are you going to be here? What? I was driving home when that call came in.. I guess, for me, it was a personal choice. I did not move away from my parents. I was close by.. I needed to be near them..one died of cancer, the other had ALZ..which was easier for me to handle? It's a double edged sword..I suppose my answer would be guilt if I didn't see them on a regular basis.. because I put them there; spending time, trying to get them to be happy, dancing, giving them as much of a normal life as possible... hamburgers and milkshakes with ensure..trying to stimulate their minds a bit.. talking, walking, reminiscing etc...

I moved my parents to AL near me and they did not have dementia. When my Dad was alive I was at the room sometimes twice a day even during Covid. Mom had complete respiratory failure and ended up on hospice.

dad passed away and I was still going almost every day and I began to get burned out.

I ended up hiring someone in my neighborhood, a retired nurse who sees my Mom two mornings a week. My Mom loves the company and it gives me a much needed break.

This might be helpful for you since you can’t be there. you can go through an agency for this. I believe one company is Caring Angels.