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I have been helping as a companion a women who was relocated to a new senior living facility. She became a widow four months ago and the only person left in the family to help is the stepdaughter. So she was moved from the previous location where she lived with her husband. They also had a personal assistant who visited daily(who her and the husband had when they were living independently. When she relocated the personal assistant could not relocate with her. She moved into assisted living. The facility once she moved wanted her to go into memory care because of what they described as needed more assistance. What was happening was she wanted the care staff to socialize with her? When i received the call from a friend to see if I would take the assignment we were told they needed someone for maximum hours. Once working the stepdaughter complained about working too much. Money for the woman was not an issue but the stepdaughter seemed to have problem with the pay. The woman does not want to go into memory care as is feeling forced to go. The family has been paying for the additional care from the facility. The woman has not been diagnosed with dementia nor alzheimers. The doctor at the facility refused to diagnose her with either one. There are concerns from other care providers and facility doctor that the administration is pushing for seniors who shouldn't be in memory care to go there. Her family and facility had her visit the memory care to see if she would like it and she asked to go back to her AL room. I noticed that although she says that she hasnt assigned anyone POA that the facility and stepdaughter are having these meetings without her. My questions are
Can they force her to go into memory care?Do they have a right to exclude her from these meetings?
As a companion or personal assistant is there anything I can do to support her life choice?

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If the woman in the facility has not appointed a POA, then she has to make these decisions herself.

If she is past the point of being able to appoint someone, then I imagine 'eventually' the facility will see to it that they can find someone who will take 'ownership'. Just guessing, as I really think it differs from state to state.

MC costs a lot more that AL. A LOT. And the people in MC get a totally different level of care.

My MIL entered an Assisted Living based on what her kids told the director. They swore she was a level 1 (minimal care) and when she moved in and the facility did the 'same' evaluation, they said "she's a level 5, which we don't even DO over here. We're going to have to move her to MC---or a Psych facility.

I, personally, would not stick my nose into this mess and offer to be POA. You will regret it. It's an awful responsibility and to take it on for someone you really don't know all that well--you'll be getting calls and demands for your time that you won't want.

There IS a family member, All the things you are 'hearing' are truly not right from the source--you're hearing half-truths, speculation and questions that you can't answer. Let the family member solve this. Yes, AL is expensive and the stepdaughter is probably thinking of the eventual inheritance and hates the thought of losing out on some (or even all) of it.

Sadly, this woman has not made the necessary arrangements to have someone be her mouthpiece. There's not a whole lot you can do. Visit her, be her friend, and maybe, just maybe, if she's competent, encourage her to name a POA. Without one, the state steps in and nobody is going to be happy about that.
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If your friend is competent, she can walk out the front door of the AL and never return. In fact, even if she's incompetent, she can walk out the front door (unlocked) of the AL and never return. Assisted Living facilities are not prisons, and nobody can be "forced" to do anything. If your friend stops paying rent, she'll be asked to leave, nevermind "forced into Memory Care."

Last but not least, her POA has no authority to do anything if your friend is competent.

Good luck to you.
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Most Memory Care facilities and ALFs are privately owned businesses.
They do not have state regulations.
They decide for themselves what is safe and what is not safe, and they decide this based on their own thoughts, experiences and reasoning.
This is a part of the terms of placements and listed in their admission packets, signed by residents, which include definitions of circumstances under which one may be asked to leave the facility.

The answer to whether she can be forced into memory care? That is for the administration to discuss with her and with her family. A cmpetent person cannot be forced into anything, but that doesn't mean they can stay then, in the facility.
This is private to each individual and her own case. She is currently a rental customer, if you will. And whomever owns rentals decides whether the renter can continue according to their own rules and regulations. And how any eviction will be legally handled.

This is best left in the hands of the family.
But yes, she can be asked to leave their complex if she doesn't wish to go into memory care and the family doesn't believe she needs it.
She will be seeking then, a different place to live.
Some folks thrive in a smaller setting such as Board and Care with about 6 to 8 residents, but they are fewer and harder to find these days.

I wish her the best.
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If this woman truly is not cognitively impaired and has all her memory, then she is totally capable of walking out straight into the police station to report what's been happening to her. Or go directly to her doctor's office for testing to prove she's 100 functional. Or call a social worker to show she can do all her ADLs.

But this doesn't happen, and for a reason. If you are getting all your info from this woman and she is actually impaired then she may believe there's nothing wrong with her but there actually is. This is called Anosognosia, a neurological condition in which the patient is unaware of their neurological deficit or psychiatric condition. She doesn't believe she has a problem and she'll sincerely try to convince you and others who don't understand dementia to also believe it. No one without a diagnosis and an active legal representative can "force" someone to stay in a facility. That's illegal.

"What was happening was she wanted the care staff to socialize with her..." Is this her version of what happened?

"Money for the woman was not an issue but the stepdaughter seemed to have problem with the pay."

"The family has been paying for the additional care from the facility." So, there IS a problem with money apparently? Care is very expensive.

"The woman has not been diagnosed with dementia nor alzheimers. The doctor at the facility refused to diagnose her with either one." Who is telling you this and how do they know?

"The woman does not want to go into memory care as is feeling forced to go. "

"Her family and facility had her visit the memory care to see if she would like it and she asked to go back to her AL room."

Change is almost always difficult for people with dementia and memory loss.

"There are concerns from other care providers and facility doctor that the administration is pushing for seniors who shouldn't be in memory care to go there." Then the solution is to take your evidence and report the facility or talk to an ombudsman.

"I noticed that although she says that she hasn't assigned anyone POA that the facility and stepdaughter are having these meetings without her. " Yes, this is most likely because the woman at some point actually assigned her as her PoA and now doesn't remember this. Or, the stepdaughter acquired guardianship for her because it was the only legal way to help her.
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As far as I know - she can't be forced into memory care - especially if there is no diagnosis of dementia or ALZ.

However, things are not always as they seem - there may be things going on that you are not aware of that may lead the facility to encourage memory care.

I find it interesting that others are considering the stepdaughter potentially greedy. While this does happen - it's my understanding that memory care costs more than ALF - so the stepdaughter - if she is looking for money - wouldn't do herself any favors to move your friend to memory care.

That being said - if the facility is only trying to move her to memory care to control her social nature (or even to get additional money out of her) - they can't MAKE her go - but I would imagine they could make it difficult for her NOT to go - by way of behavior tracking, making her room in ALF unavailable for some reason - etc. I'm not saying this would happen - just that if they do have some kind of ulterior motives - they could make it difficult for her to stay where she is.

What really needs to happen is that she needs to be independently assessed by a geriatric psychiatrist and get an official diagnosis. You say the doctor at the facility "refused" to diagnose her with dementia or ALZ - which seems strange to me - why would they refuse to diagnose? Unless you are suggesting they are in league with the facility - but if that was the case they could easily just say she has it to check the box.

An independent assessment will put that to rest one way or the other. If she doesn't have dementia or ALZ (or any other behavior issues that might necessitate the move) and the facility continues to force a move, perhaps that isn't the right place for her.
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Well quite Honestly I dont trust these Places . Perhaps you can be her POA . I heard a terrible story yesterday On the beach from a friend involving 2 elderly woman who were removed form their home so a neice could sell it . Greed - No she doesnt Have to move into memory care and she doesnt have a Diagnosis . If I were her I would get out of there . Maybe you can become her health care proxy because the step daughter is looking for Money .
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