How to we explain the need to move to assisted care?

Not everything can be fixed, and sadly a broken brain is one of those things.
You approach this with honesty that you are sorry but can no longer provide safe enough care.
My fear is here that placement is going to be very difficult for someone requiring a sitter, even in a nursing home, and that medications are going to be needed, so the doctor and medical team has to be a part of this move.

Yes, she will cry. Is this loss not worth mourning? Could you ever conceive of her accepting and being happy about this move. There is nothing happy in any of this. You will have to be honest. Your honesty (or dishonesty) really won't matter anymore in this.

I cannot imagine a way out of heartbreak in all this. We live too long and that's a fact you will be confronted with every day if you choose to stay on this forum. I don't read here any "good stories". There is little of "happiness" to be found here. There is for the most part a wish for the peace of an ending for most. I am so very sorry. Do try to seek some help for your OWN grief in his. A few sessions with a licensed social worker in private practice who specializes in working with people dealing with life transitions may help a bit. Again, so sorry.

Any move will be difficult.
You can do a few things but she will not "get it" or retain the why's of the move.

You can start talking about doing some redecorating and the need to paint the house. Because of this she needs to move back to where she was before. (If it is the same place you can tell her that "Betty, her nurse is excited to have her come back" )
or
"Mom, "Bill" and I are going to go to his college reunion and we are going to bring you back to the "Sunshine Home". They are glad you are going to come back"
or
"Mom, it is getting so that I am worried that it is not safe for me to take care of you any more. I don't want to hurt you while helping you and I don't want to get hurt. I called and "Sunshine Home" has a room for you"

Like I said she will hear you..she will not retain any of these great reasons.
Just buckle up, Be prepared for her to be upset. Be prepared for her to cry. Be prepared for her to decline.

Please make the move to Memory Care not Assisted Living.

Before you even talk to her about it, please consult with her primary doctor about meds to treat her depression and anxiety. My 95-yr old Mom recently started taking the lowest dose of Lexipro and it has helped her a lot.

Then, once she seems less anxious and depressed, then you tell her a "therpeutic fib": we will be having some repairs on the plumbing in our house and the water will need to be shut off for quite a while so you're going to a temporary apartment until it's over..." etc. or whatever story you think she'll accept. This is not immoral or unethical, but to help keep her calm during the transition period. The facility staff should also be told since this won't be their first rodeo and will gladly play along to make it easier on everyone.

It is perfectly normal to feel grief over this but not guilt. You and family have done yeoman's work for 4 years, making a huge sacrifice on her behalf. Be proud of this rather than wrecked over this new phase of her care. May you receive peace in your hearts at this decision.

Your profile mentions dementia, meaning your mother no longer can reason out why this change is needed. These conversations aren’t getting anyone anywhere, merely frustrating you both. Find a place that will eventually take Medicaid for the time when her funds are depleted since you know this will likely happen. Look into a med for anxiety, it will be a gift to her. My dad had no dementia but a daily dose of Zoloft was definitely a huge help in calming his anxiety and sadness. Make this move happen with the guidance of the staff where she’s going, they are used to these transitions. This is called making the best of the situation, do so without argument or more discussion. I wish you both peace

I've just (literally, this morning) told my stepdad to call an ambulance to take Mum into hospital, without discussing it with her first. She has dementia and isn't capable of making decisions for her own health, so it won't help to involve her, especially if (as is likely) she says that she's okay and doesn't want to go into hospital.

Someone with dementia can't reason and make good decisions for themselves, let alone anyone else. They seem selfish, but it's just that they can't think of anyone else's perspective, which is needed for empathy. It's not their fault how their brains work (or don't work).

So, don't make this a discussion, or even a conversation. You just tell your mother that this is happening for her own wellbeing as well as for yours. You let her know you love her and that you look forward to visiting her regularly.

When you tell your mum will depend on how she deals with information. For example, I kept telling Mum that she was moving, in the weeks leading up to her and her husband's move, so that she got used to the idea. However, if she felt anxious about it, I probably would have told her just before she moved.

In your situation, I would probably use the therapeutic fib; I'd tell Mum that she will be going into a home while I move house, as there will be too much movement and things going on for her to be safe or me to look after her. Then, I'd say that things aren't sorted, so she needs to stay where she's being looked after. If I were going to take Mum to my house at Christmas, or similar, I'd say that the sale got held up and we're waiting for it to go ahead. However, I probably would keep Mum in the care home because of the difficulty with transitioning.

My stepdad wanted me to go into hospital with Mum, as I did the last 2 times. I stayed with her for hours, through the night and into the next day, while she was on an A&E ward and until settled on a high dependency ward. I sat on a hard chair, having no meals (kind nurses kept me supplied with tea and biscuits) and no sleep. I missed work and had joint and muscle pain (I have nerve and mobility issues) for no reason - me being there didn't help my mum. In fact, I became a focus for her anxious need to go home, as she kept trying to get me to take her out of there.
My stepdad thought I was being selfish, but I've just explained that Mum is likely to settle better without me being there. My needs - the things I have to do, myself, or just being able to sit in a suitable chair or have a meal - don't figure into it. But I've learned that I have to take care of me, otherwise I'll make myself ill again. I can't keep doing that - neither can you.

Don't feel guilty for doing what's needed, or not doing what others think is needed, but you know better.

I'd recommend / encourage you to not over-state / over-explain it - for several reasons, mainly:
1) Depending on her cognitive functioning, she won't understand the 'why' nor her decline. Over-talking encourages emotional upset - for her and you.
2) The goal to her on-going care is to 'keep her as calm as possible.' This means doing whatever you need to do - and how.

I would recommend you tell her it is a temporary move - for whatever reason you want to tell her, i.e., the / her room is being painted, the house needs to be fumigated for bed bugs. It doesn't matter what you tell her. She will still be update although it she hears the word "TEMPORARY' - it may calm her down in the moment / present time.

Expect she will be upset, cry, be emotional. If you expect this, you can better manage your response, i.e.,
- Comfort her with gentle touch while saying "I understand how you feel." It is important to acknowledge her feelings / that she feels heard (it is validating to her - as a person, it shows respect.
- Don't prolong discussion as it will keep her in an emotional state of despair, alert, sadness. Change the subject.
- Do not tell her when she will actually be moving. It will give her 'more time' to feel scared / angry / sad. Tell her the day the 'exterminators or painters' as coming - on the day she is to be moved. Not before.
- If she tries to continue a discussion or keeps crying (to keep you engaged perhaps), leave the room "I have to prepare ... in the kitchen now." Then walk out. This may seem cruel or rude although you want to 'shift' the energy and focus FROM her going into AL - to something present time (i.e., lunch time ... did you know that xxx is getting married (a grand child) ...
- Remember, you are doing this for her ... and that you are in transition TOO. It is sad for all in the family. Give yourself space and time to grieve. And, know that you / your quality of life (w a husband) is important, too. Affirm that you deserve a full life - and acknowledge all that you've done ... and continue to do for your mom.

Gena / Touch Matters

mindywardlaw: As your mother unfortunately suffers from dementia, she requires residence in a memory care facility.

We emphasized Safety. Extra safety needed by full time staff.
And we discussed medical needs, but not in an insulting manner.

Look for a small group home rather than a large facility. She might be one of those who thrives in a place where it's more like a real home - gathering around the dining room table for meals, an aide to give her a manicure, walks with others around the yard. The residents are encouraged to bake cookies on cookie day, or put out decorations for Fourth of July.

I know people who live in places like these. You can take her to visit for lunch a few times without saying she's going to be living there. Then when you do take her there to live, she knows the people, has already said it's a nice back yard, or whatever.

I am going through the same thing right now. My 93 year old mother and father in-law live with me and my husband. They pretty much do everything for themselves in our home, but they’ve taken over. Me and my husband have no life. We told them they had to go to assisted living a few weeks ago. We found a great place 2.5 miles from our house. His mother gets it, but his father has been miserable. He told us yesterday that he feels like it’s going to hell. He keeps asking us to take care of them another year. It doesn’t matter what we say. He just won’t accept it. I can’t do this anymore. I just wish he could understand. I feel like he’s being selfish.