Please share how you "tricked" your parent with dementia into going into memory care or unwilling parent into an AL?

Mom's MMSA/MOCA score had drifted down to about 12 (medium Alzheimer's getting close to severe). She was still living at home, with aides coming in 9 hours a day (we left her alone in bed all night, and alone a few hours in the afternoon). I remotely monitored her during her times alone with motion sensors and webcams. Incontinence, anger, occasional violence, and poor judgment had become intolerable in the last 6 months. Here is how I moved her directly from her home to a memory unit, despite her having flown into a violent rage visiting the place just a few months earlier:

Three days in a row, during her mentally best time of day, I explained to her that daytime Sally doesn't know how scared and erratic nighttime Sally is, and I said that nighttime Sally was going to fall and break a hip and ruin daytime Sally's life. I showed her webcam footage of herself, alone, forgetting to use her walker and stumbling scarily. In the moment, she understood it, expressing sad acceptance of the need to move to somewhere with 24/7 staff. I said not right away, but we'd try to find someplace in a month or two. I hoped that this "nighttime Sally" justification would soak in to her subconscious, even though her short-term memory seems nonexistent. I did not want to scare her with the thought that moving would happen right away.

The next night, after she was asleep, I moved her favorite chair, end table, its lamp, etc to her new bedroom at the memory unit, including a new twin bedspread that looked just like the queen bedspread she was used to. Arranged everything geometrically perfectly. I made a fake substitute of that chair and end table and lamp at her old home (it looked sort of right) to get us through the next morning without suspicion.

The next morning, I started her day with a familiar "let's get up, we have a doctor's appointment" routine. Getting dressed, routine breakfast...as if we had somewhere to go. (She did ask about the missing dresser, and I said I had moved it out in the hallway because the carpet cleaner was coming later that day.) Out the door, into the car (texting the memory unit to let them know exactly when we would arrive). Arriving at the memory unit, the door was wide open and no one was in sight. It was cold, so she wanted to get inside. Left; left again; she saw her favorite chair, table, lamp etc. and made a beeline for it, and snuggled into it, and she and I looked at favorite magazines and worked on a favorite puzzle together for an hour or two, while she slowly noticed that she was in a room that didn't quite look right, and got used to it. At lunchtime, I brought her favorite snack on her favorite dish. Just her and me, those first few hours, and one or two brief visits by the staff, just to say hello and get to know her a little. About 2:00 she expressed curiosity about "what's out there" and I said we could go see whenever she wanted. Eventually she led the way out to the common area, sat down between two ladies her age, and started chatting.

That was it. No drama. No anguish. A graceful transition.

(Ahead of time, we had planned for the worst: On moving day, I had a prescription sedative in my pocket, ready to sneak into her Boost if necessary. An insurance policy we didn't need!)

Each of the next few days, she did ask me when was I going to take her home, and I returned to my nighttime Sally / daytime Sally story, and she either remembered that, or pretended to remember it, or understood it anew in the moment. So, she was sad, but not enraged. Once, late in the day (sundowning a little), when she asked when could she go home, I said whenever she wanted, and motioned toward her new bedroom with that favorite chair, and she went there and sat down, and I think that felt like home to her at the moment.

As I type this, we are at the end of the 3rd week, and she is making friends and being herself, with less anger and anxiety than she has expressed for a long time.

The staff at the memory unit have suggested that maybe her anger and violence with her home aides the last few months were because she was afraid to be alone at night, and she immediately felt more secure in her new home, which immediately dialed back her anxiety and anger. She has smacked the staff a few times, but not as viciously as she used to hit the home aides (not aiming for the face now, more like using the back of her hand to communicate something she doesn't want to express in words).

I think another ingredient is that the staff at the memory unit are much more skilled with advanced Alzheimers than our home aides were. They simply know how to make her feel at home.

This memory unit is a big old house in suburbia, 6 bedrooms, 9 residents. I love it. It feels like a shared home, not an institution.

freqflyer wow...in a few more years at 96!!! Your parents must be a hoot!!

I do understand though. I started this process with my parents when they were in their late 50s. They downsized into an independent living condo complex at that time, and I immediately began "the talk". That was 25 years ago.

I hope that someone out there sees this in time to start the talks early. It really does help.

Angel

Angelkw, I remember one day when I gave my parents a huge brochure on a 55+ complex that I had toured and fell in love with. Hey Dad there's an indoor pool. Hey Mom you can have one meal a day in one of many restaurants on the complex. Look at the size of the apartments, some are 3,000 sqft, lots of room and all on one level. I was hinting that they move out of that darn big house of theirs with all those stairs.

I left the brochure for my parents to look over. A week later I asked what did they think. "Looks like a very nice place, maybe in a few years we will move"..... FEW YEARS??? HELLO, you are 92 and 96 !!!

I think it depends on the generation itself. My parent's siblings all continued to live in their own in their own houses, much to the overwhelming frustrations of their grown children.

Two weeks after my Mom had passed, Dad was more than ready to downsize, pack up and move to an Independent Living complex. He was 94 and the first place we came through the door, saw the beautiful lobby, Dad said "where do I sign?".

My good friend had a similar situation. Caring for her mom was just consuming her life and the stress was overwhelming. She took her mom to visit the facility a few times so it seemed somewhat familiar and she could meet other residents. After a couple of weeks she had someone take her mom out for the day and then she and her husband moved moms stuff and set up her room at the assisted living. They made her new room look very much like her room at their home. Her mom went straight to the facility and didn't complain because her surroundings felt familiar. It was the best thing for everyone involved and she wished she had done it sooner.

It sounds like you have a good plan. If you can have someone set up her new room with familiar items that would be ideal. The person taking her there has to be strong and not waiver if your mom questions it. Seeing her stuff in the room will reinforce that she does in fact live there. I'd ask the staff at the new facility for advice as well. Good luck and stay strong!!

I wouldn't say that "tricked" is the right word. When someone has alzheimers and is a danger to themselves and needs more help than any one family member can give, and yet they are refusing care then they are not making good, rational decisions.

To remedy that, you have to invoke the POA/MPOA/DPOA that was given when they were making good decisions, and make these decisions for them.

For me there really is no discussion. If my dad becomes a danger and is incompetent, I will make the decision and have him placed. If I need to involve paramedics to remove him, then I will.

it's not a trick. It's using tools to make good decisions for people who no longer can do for themselves.

I certainly would use every tool in the box, starting with a doctor's recommendation which is the most powerful. I wouldn't lie to him...not because I think it's wrong --- its not wrong to use therapeutic fibs --- but because I believe that my father will respond better to the truth, to the fact that the doctor says its time.

I must also stress that my parents and I spent a LOT of time talking about what should happen if they ever needed help. They both agreed that I'd be terrible at it. They both, independently and together, put together a plan of what they would want to happen to them. They both toured facilities, talked to residents, and made up their own minds as to what should happen. This "before" process was FAR more important than any one "trick" that I could ever use to get them into a facility.

For anyone listening...PLEASE have this talk, over and over, with your parents when they are still capable...start YOUNG as you never ever know what could happen.

Angel