ALF says they can't provide care needed, but her needs haven't changed in the last 3 months. Can they just say that and discharge?

I would not feel comfortable insisting that my mom stay in a place that has told us that she needs more care than they can give her. They may not have the staff or they may have underestimated your moms care. Either way, it sounds like this place is no longer a good fit for your mom.

Moving her is a big deal and I get your resistance to do it, but things change on a dime with the elderly. It is a constant mode of evaluate and adjust.

I wish you luck in finding a new place that fits all of your moms needs. We have had to downsize my moms things several times. First when I sold her home and moved her into assisted living and then again when we moved her into memory care and then again when we moved from private pay memory care to medicaid accepting memory care. Their world keeps getting smaller and smaller and their need for assistance and care keeps getting bigger and bigger.

My LO was in a truly lovely continuing care placement, briefly in AL, then in MC, then 2 COVID infections.

There were levels of care within MC, and by the time we were able to visit her on a regular basis, her needs had become both difficult for her AND her very caring staff.

Through the kindness and concern of the MC staff, she continued to live there until it became obvious to all of us that her presence WAS distressing to other MC residents who had fared through the disease better than she had, and she was moved to the next door SNF, where she lived for a year in hospice care.

What grieved me was that she’d failed as much as she had, and that year was certainly the most difficult, but the decision to move her was clearly the correct one.

Independent Living and Assisted Living both want to be attractive places to live for people who want companionship, plus a little support and assistance. In AL, if most residents are virtually semi-invalids, it’s not an attractive place to move into. The activities won’t be great, not much companionship, getting together isn't a lot of fun. Very expensive without getting the life-style you wanted.

If the new ED has come into a place which isn’t very attractive for new residents, perhaps she really is ‘clearing out all of the seniors with higher levels of care’. It’s a sensible business decision, and AL is a business. Unfortunate, but true.

Yes, in my state if the resident can not help by standing and pivoting to transfer with having just a bit of assistance by one aide they can not stay . The minute they need to be lifted or have more than one person help them in anyway they go to SNF , or the family has to hire an aide to come in . AL’s are not staffed with enough help to handle residents who need a lot of assistance .

My father was evaluated by the head nurse at the AL my folks wanted to live in before he'd be accepted. He had to prove he could transfer with a minimum of assistance before he'd be cleared to live there.

If an AL feels a resident is a 2 person assist or a huge fall risk, they are not approved to live there or asked to leave as a resident. This is for the safety of the resident and to insure they won't be sitting there for an hour waiting for transfer assistance to the toilet if the facility is understaffed.

Everyone seems to see nefarious reasons behind the rules an AL creates, yet by asking a resident to go into a higher level of care, they're losing a huge check each month. Its mind boggling how much an elder can decline, mobilty wise, in a 3 month period.

Get mom into a situation where she can be properly cared for, that's my suggestion. Good luck.

My wife was in a memory care facility. She developed a UTI and lashed out at another one of the residents in fear. They called 911, took her to an emergency room where they strapped her down because she kept pulling out the antibiotic IV. The memory care facility called me to say she was evicted, the hospital called me to say they were sending her to a psych ward. The psych ward would only let me visit her for 30 minutes a day. Her arms were terribly bruised from the straps. They eventually released her to me where I will keep her safe at home with me and away from them. So, yes, they can and will evict. Had I known any of this in advance, I would never have placed her in memory care. I would have spent the money on home care where I would be the supervisor.

Yes they can as AL is not place for people for people who are no longer self-sufficient.

We had to move our stepmother from AL to MC as she had mentally become beyond the point of staying there.

If it is not safe for the staff or your loved one they can ask you to find another place that will meet her needs.
You may not see all that happens early in the morning or in the evening so it may appear to you that her needs have not changed when in fact they have.
It may even be a matter of time. If she required 1 person to assist her to get up and that took 5 minutes but now it takes 1 person 15 minutes so they get another person to assist that takes staff away from others that need help.
Depending on where you live ALF can not use equipment to make the process faster and easier so helping a person can be m ore of a safety risk for both the resident and the staff.
SNF can use equipment to make transfers safer, easier on the resident as well as safer for both staff and resident.

I would suggest that you look at the contract it may spell out what can and can not be done. It is very possible that your LO should have been in SNF from the get go.

My Moms AL allowed people with Dementia. Actually one man they had there may have been better off in a SNF. I would have never lived there. It was not what an AL should be. Which is they just assist. The resident should be able to do alot for themselves. Those with Dementia passed a certain stage should be in MC. A person who is a 2 person assist needs to be in LTC. It was found in the 3 months Mom was there, that she needs more care then they have the ability to give or want to give.

The rent may stay the same for a year but its usually 30 day notice when it comes to Mom leaving on her own or the AL is saying we cannot care for her.

ALF are private businesses that often do not accept state and federal funds; therefore they are not governed in most states by the same rules that a nursing home is. Their contract on admission (you will have one if you are POA, or your elder has one) will enumerate the circumstances that allow them to request a move from a resident.

In my brother's ALF the line they walked was fine indeed. Many residents, including my brother, were overall mentally and physically fit. There were certain some residents in W/C. And there were the usual levels of care from I to IV. There were some folks with early dementia (my brother had a dx. of probable early Lewy's Dementia), but when anything progressed to needing more care, or as disruptive to the community cottage in general, moves to more comprehensive and better staffed care was required. They tried very hard for families who could not afford moves to MC, but when residents complained overmuch of the needs and requirements of a single resident, or the workers said that they were not well staffed enough to meet that resident's needs, a move was required.

Basically the answer is that they like CAN ask for this move. Your best hope is to TRY to find out EXACTLY what the problem is, and see if it can be remedied in some way. If not, I am afraid there isn't a lot of choice. I am sorry and surely do wish you good luck.