When should you seriously start to consider moving your parent with dementia from assisted living to memory care?

When others at AL start avoiding them because they're "weird," when they can't get themselves to (or don't remember) activities, and when you feel like you need to do most of the assisting in addition to what they get there.

Memory care is wonderful because they really focus on mental stimulation, one-on-one conversations, and they aren't focused on everyone's medical ailments even though they all have them, too. My mother did so much better in MC when I decided that socializing and mental stimulation were the most important things for her quality of life and I transferred her there.

My mom was in a very good ALF and they were willing to keep her even with her ALZ dx. I was in constant contact with the staff and most especially with the director, to ensure they were comfortable and capable of managing her, even with her "weirdness". I also kept tabs on problems and issues she was having with them, sorting whether they were minor or significant and whether they affected her happiness.

Mom loved going outdoors and walking outside and they were happy to let her do that, as long as she stayed "in the yard". When she started getting braver and venturing away a bit, they started getting antsy about her and when she willfully eloped and got all the way to the highway (about 100 yards from the facility), the director told me it was time to look for MC. A few days after she told me that, Mom eloped again and this time punched a nurse who tried to make her go back. Police were called and she had quite a stand-off in the parking lot of her doctor's office (which was between the ALF and the highway) when I showed up. That was their final straw and she was not even allowed back at the facility at all - I had to take her that day to a memory care I had found as soon as they had told me to plan on moving her.

For us, it went VERY quickly from "we got her" to "get her out of here". Had I known then what I know now, I would have had a MC picked out as soon as I placed her at the ALF, knowing that MC was the inevitable next step.

One thing I've noticed - and I'm not sure if it is a ALF vs MC thing or if it is a facility vs facility thing - MC has been much more willing to use medication to keep her calm. At ALF, they seemed to try to minimize her psychotropic meds whereas MC uses them to keep her calm and themselves safe. I personally have no problem with that - calm and happy is how I hope she can spend her days now, more than aware but combative, which is what we were getting without the meds.

This needs to be discussed with the facility and her medical provider.
Social worker(s), nursing staff, MD at facility should be able to help you make a determination based on what your parent can / cannot do, and how their cognitive functioning has / is changing. Every person is different to degrees.

You need to consider:
* Cognitive functioning / decline (brain changes)
* Physical abilities / moving around
* Safety - how much 'hands on' care / time do they need
* Incontinent? Bathing support?
* Medication management
* Socialization / activities (options)
* What care might be needed moving into the next few months / year.

Gena / Touch Matters

When they can no longer function properly in AL, because their needs are greater than the care that's available. Or they're wandering out the unlocked front doors to outside. Or trying to turn the tv on with the telephone, or trying to make a phone call with the remote.

Well, ideally, BEFORE it gets to be a problem.

But that pretty much never happens. Most people wait until it's an untenable situation before they actually have the courage to step up and act. And it's often just awful, rife with drama, tears and confusion. (And that's the CG's I'm talking about!)

DH's mom had a bad winter--and was in an out of the ER and rehab for a few months. At that time, she should have been moved to a nice SNF. She has the money to pay for expensive care for about 4-5 years.

Instead, the kids brought her home and thus began the long road to purgatory.

For the first few months she was HOME, she thought she was in a NH and commented that it was a pretty nice place after all. So that told the kids she WOULDN'T die if they placed her.

Her dementia, while not truly dxed as far as I know, is getting worse each day. But she's still hanging in there.

She would be angry to be in a NH, but she's angry at home. I guess that's not unusual. She'd get better, more consistent care in a NH, that's for sure.

IF you can start looking at places and get input from your LO about where they would choose to live, that would be great. But, as I said, so often we wait until the very last moment and it makes the change so hard.

We grow too soon old--and too late, smart.

My MIL walked out the front door of the assisted living at 3am. That is how we knew...

But before then we had NEVER thought that she was a flight risk but aging and dementia surely make their actions unpredictable.

If you have to ask, I would say yesterday.

Start doing your homework now, don't wait until it is an emergency situation.

hlwynn: If you're posing this question, the time may have arrived.

The facility they are in should be discussing this with you.
BUT if your parent is...
At risk of leaving the facility.....it is time to move to MC.
Needing more help than they can provide in AL... it is time to move to MC
If they are becoming more isolated, will not leave the room...it might be time to move to MC where the unit is smaller, fewer people and more staff.

It is a difficult decision but when my mom began to fail, it was a quick decline. In her case, it was not a subtle downward decline. She went from functioning pretty well to not functioning at all over night. I think it depends on the type of dementia but as others have said, evaluate if the current care they are receiving is sufficient for them. Make your decision on their needs today with the realization that (except in rare cases) it is highly unlikely that they will improve.