Did we move Mom into memory care too soon?

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Did we move Mom into memory care too soon?

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Hi,
I feel InWyoo nailed it. Without a diagnosis how can "they" determine what is good for your mom. Memory care units are a lot more expensive, and the staff could easily be more mindful of your mom. It's a matter of if they want to do their job, as it doesn't sound (from what you wrote) that she is a true wanderer. I can tell you this though... her cognitive decline will greatly increase without challenge, and no activities won't help. Why do I say that? Who is she going to do the activities with? Oh she';s going to do them alone? What kind of QOL is that?
I feel for you both, and sorry this is coming to pass, but get her back in her old unit and make the AL nursing staff do their job. Good Luck, be well :)

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Not sure what happened with autocorrect there. It should read "my mother is only..."

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To be honest her doctor prescribed her incontinence patches but to my knowledge he did not run a urine test. Yes that is correct my mint her is only 67. She has been displaying symptoms for the past 5 years.

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If she were my patient, I'd move her back into Assisted Living. Am I reading you correctly? Did you say that she is only 67?

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Has she been tested for a urine infection?

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Yes the memory care is on the same site as the assisted living. I've talked to the director in memory care about allowing her to visit her friends in AL. He says that her friends can visit her anytime and if I make a list of her fiends that I am comfortable with her going into the AL side with then they will allow it. I'm not sure if that will be enough to make her happy there. I haven't talked to her doctor about it yet. Should I have talked to her doctor before moving her? I am fairly young and have never dealt with anything like this before.

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Who is right for a dementia unit? It is so hard to decide. My mother has a different kind of dementia and feels everyone else is so "far gone." I do know the staff would not keep her on just assisted living unit. Set up a meeting with the social worker. Did she have a gould's assessment? What do the staff and doctor suggest? Get help in making the decision from professionals. It is too hard to be objective.

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Every individual has different needs, but when the staff and I placed my 92 year-old mother in the Special Care Unit (locked unit), she was like a fish out of water for two weeks before we moved her back to the general nursing home population, where she lived the remaining 6 months of her life. In the SCU, I noticed she was confused and anxious about living with people with severe cognitive decline. Although Mom had Alzheimers, she was not a threat to wander nor was she rude or combative. In my mother's case, we discovered she was not a candidate for the SCU, so I was happy she was able to return to the general population, and so was she.

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Staff must be concerned they do not have the locked area for your mother, nor someone to watch her. Taking medication for dementia will not change the diagnosis, and even though she is the "highest functioning" person on her memory care unit, she will catch up to the others soon enough. If staff on the other unit can supervise her walks she could walk there and then return to the memory care unit and this can be addressed at a staff meeting with you. Maybe more frequent visits by you and taking her outside the facility might help her frustration. At 67 yrs. this is an early-onset of dementia and of course she is feeling limited in her activities. Make sure she has plenty to occupy her during the day so she won't feel isolated. Maybe take up painting, pottery, sewing, etc. Discuss all options with staff and what they are able to provide. This is going to be a long road for you and your family, maybe some 20+ yrs. Best wishes!

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Question: Is the memory care on the same campus as the assisted living? If so could she not be allowed a couple of hours a day to be with her friends can her friends not visit her at her new location. What does her doctor say about the situation?

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I see a lot of good suggestions here. I feel for you and your mom. I know my mom would feel the same way and it is so sad and scary and depressing to have to wander the halls or sit in the activity room facing your future so to speak with others with such a wide range of cognitive function...in my visits, far less high functioning then those with severe impairment. So understand your moms misery.

If I felt mom could still be safe, and I could put some safeguards in place, an alarm on her door for night to prevent her from leaving the room, adult underwear for the Incontinance and possibly hiring some outside help if she can afford it to be a companion in evenings or overnight to help her remain in AL as long as she can, then maybe gently have you and companion spend time accompanying her in both venues so it won't be a shocking move eventually when it is necessary.

This is a greater expense and investment but might be something she can afford for another year or so.

Consult a geriatric doctor, neurologist experienced with dementia and ALZ and her care team at the facility and see what options you have.

If she must stay where she is, then see if you can get more friends and family, church members, seniors helping seniors or other organizations to visit more often and join in some of the activities. Maybe even you can organize some stimulating activities for the memory care in coordination with the director that. Would be more specialized for your mom and higher functioning residents -- travel speakers, movie night, game night, craft day, tea, etc.

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You wrote: "My 67 year old mother has Dementia (undiagnosed but all signs point to it and she is on medication for it)." The "undiagnosed" part bothers me. Before you make further decisions, my suggestion would be to take your mother to a physician who has no ties to the care facility and who has extensive experience with geriatric patients. I would ask the physician to perform a detailed physical examination, an evaluation of her medication, plus examinations that will determine the degree of cognitive decline your mother is experiencing.
I know of a woman whose family had these things done for her so they knew exactly what they were dealing with when locating an appropriate facility for her.

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asherry, I so feel for your situation. My 70 year old mother lived with me for about 1 1/2 while recuperating from 2 broken back surgeries. She has osteoporosis and fall a lot. It was obvious she could not go back home and live alone and I was happy with having her with me. I have a in law suite in my house and she had her own bedroom, living room, bathroom and kitchen and access to the laundry. But she decided she didn't like it and wanted to go into an assisted living. Then she started to become paranoid and delusional. She has been tested for dementia and alzymers and does not have either one. She has Sicosis. The assisted living decided she needed in memory care because she would get paranoid of the other patients and their families and was making up stories about things that were not real. They moved her to the memory ward and now she feels her life has been taken away and no reason to get out of bed. It is so heart wrenching for me. I don't care she makes up stories, but I cannot handle her being scared. They are trying new meds but she has such a high tolerance to psyc drugs because she's been on tranzine 2 times a day at 60mg a time for almost 40 years, that other drugs do little if anything at all. it is all so sad and hard on me as the only child and my daughter as the only grandchild. We have limited our visits to once a week each for our own sanity. I do call a couple times and talk to nurse to see how she is doing.

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My mother lived in a conventional assisted living facility, a "memory care" assisted living facility, and a nursing home. Here is my advice, for what it's worth. I would definitely consider moving your mom back into the conventional assisted living side of the facility--for now. It sounds as if she is truly "walking" around, not "wandering" (i.e., getting lost or trying to leave the facility). And I bet she really is one of the highest-functioning people in the memory care side. My only concern is the incontinence. Someone above said that incontinence care should be a standard part of assisted living--but it's not. It depends on what kind of license the facility has. When my mother had another small stroke in her conventional assisted living facility, and became incontinent overnight, the assisted living facility was unable, legally, to assist her with changing her Depends or changing her clothes. They could only stand there and coach her verbally, but she needed a bit more help than that. They could also only shower her twice a week. I had to hire private aides to come in and make sure that my mother was clean and dry--hiring them for several hours a day. It was more expensive to do that than to pay for the higher cost of memory care. However, if your mother loves the assisted living side of her facility, it might be worth it to discuss the option of moving her back as long as she has extra help from private aides to deal with the incontinence and keeping her clean. Also, even with private aides, your mom may need more help than that. My mom, for example, was left in a wet bed in the conventional assisted living facility (she pulled off her Depends), and was found like that in the morning by a private aide. That moved me to quickly move her into an excellent memory care facility across town, where she enjoyed nearly 3 years with a loving staff and dementia-specific activities (until she ran out of savings and had to move to a nursing home on Medicaid--also a pretty good place, fortunately). Your role here as her advocate is very important, and she's lucky to have you looking out for her. Some other advice is to a) make sure the incontinence is not caused by something fixable, like an infection, b) talk to a counselor at your county's office for the aging to see what their advice might be, and c) consider hiring a geriatric care manager (expensive at $50-$100 an hour, but well worth the investment) so they can assess your mother's situation and give you some solid advice. I wish you and your mom all the best.
--author, "Inside the Dementia Epidemic: A Daughter's Memoir"

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Do you have POA over her? She can't be kept there against her will. Her happiness is what counts. (And yes, my mother is in a nursing home.) Good luck to you. I am 60, myself.

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Karen- You have a right to move her if you do not feel she is being appropriately placed. often these large communities put a lot of pressure on the staff to fill up the beds regardless of whether the placement is appropriate or not. I know because I worked at one and now work with many of these communities. You are your mom's advocate! Do not let them push you around.

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There is a major difference between wandering the halls and not finding her room and the dangerous wandering outside. Not sure, but I think that the people that wander away from the facility are trying to get away and go back home. If your Mom is happy there and has not talked about going back home(often meaning their childhood home), and you don't think she would wander away from the AL facility, then you might want to move her back. My Mom's cognitive ability declined very rapidly after she started wandering the halls, but if we had moved her to memory care when her other functioning was so much higher than the others in memory care we would have questioned whether her rapid decline was caused by the move.

Also, trouble getting dressed and incontinence seem like normal things for AL and not a reason for memory care.

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Another option if you parent is really wandering may be a small personal care home. They usually care for 6 to 12 people ( license will vary by state) but have a higher care staff to resident ration that a big environment. Most will have alarms on the doors as an extra precaution and some may even be certified by the Alzheimer's association.

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Good to hear this KarenA. I feel like my mother is acting totally uncharacteristic. I am leaning towards moving her back. Are there ever any issues anyone has run into moving someone back? Because of liabilities?

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Thank you KarenA! So good to hear this!

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Thank you everyone for your answers. I've talked to the staff and they say they are trying to pair her up with people in assisted living that can visit but to her that is not good enough. She hates the feeling of being locked in. I too feel there is a difference between walking and wandering. As far as I am aware she never got lost on the way back to her room. I am suppose to meet with the director there in a few days to talk about more solutions. I worry she is going to go downhill so much faster memory care.

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You might consider some medication adjustment. My mother was doing the same thing. We had to send her to a mental health/alz facility for a month so they could adjust her meds and observe her as they did so. It was a true godsend!

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I had the same issue with my 63-yr-old cousin who went into assisted living 2 ½ years ago after being diagnosed with dementia. A year ago she became completely incontinent and unable to dress herself properly. It was clear she would need more hands-on care and we felt she would get more of what she needed 24/7 in the memory care unit. She was happy about it at first – probably because it was something new and different – but after a short time, she became agitated, belligerent, and started throwing things and cursing – all of which was completely out of character for her. She even struck several assistants and another resident. In turn they medicated her which turned her into a mindless zombie. The memory care unit was very small compared to where she was before, where she was used to walking the halls and seeing other people and it turns out that she felt very constrained in memory care and simply needed freedom to walk around. Fortunately a room came available close to where she had lived before, and we moved her back out in that area. Since then, she has not had one episode of violence or cursing. She gets the care she needs regarding dressing and hygiene, and things have calmed down considerably. Happiness is relative when one has dementia, but I would have to say that she is definitely happier or at least more content being back where she is now, which is out and around and able to walk the halls and talk to other residents.

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We are in this decision making process right now. My mom does wander and cannot find her apt. My dad can go find her usually, or someone brings her back. He is also suffering with dementia issues, not as bad as hers but both getting worse. However, with that all said, the memory care unit was very depressing and they would by far be the best two there. Also, they could not be in the same room as the rooms are so small. For now, we are trying to keep them where they are and working hard to help them. Staff is concerned Mom will wander out the door and get lost but snow is keeping her in right now. This is a heart-wrenching decision!!!

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Yes, I agree with the above two answers. Move her back until her cognitive level is such that she won't notice the difference between herself, and the others. I feel so sorry for her being in that position, and can totally understand your questioning whether or not to move her back. She may go downhill quickly from depression at being where she feels so upset. Best of luck with your decision!!! (And I agree, walking and wandering are different. If she is attempting to go outside and wanders away from the facility, that would be dangerous. But walking the halls....my Mom used to do that all the time at her independent living facility, until she started having trouble finding her way back. :(

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Move her back!!!

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Should have read "where I WILL be challenged"

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I disagree. Walking and wandering are not the same thing. I often see people moved to memory care way too soon. Has she gotten confused and couldn't find her way back to her apartment? That would be wandering and a reason for memory care. I love to walk and will walk around in my own home if the weather is bad does that mean I need memory care?

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I personally feel that being around people that are further along on their decline could be very bad for her. PLEASE move her back where she can be with her friends. As far as incontinence she can wear pull-ups. I'm 68 years old and lucky that I'm still healthy and very active, when the time comes that I need help I hope my children won't put me in a place where I won't be challenged to live my life as fully as I'm able. Get her back with her friends please.

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Talk to the staff and see who is the next highest functioning resident. See if you can set up a coffee meeting or a card game with those two individuals. You may need to be present to help the conversation get started. If you can create a friendship with this two, you could be enriching TWO lives instead of just one.
I had to do this with my father in law in the standard nursing home. He wouldn't leave his room, so I joined him at lunch for a few days and "I" struck up the conversation with the table mate. I would ask a question -- Hey, Jim -- I heard you like to so and so -- My father in law here - Dale -- also likes to so and so -- Dale, tell him about the time you -- etc. And I got them talking. Now, they have lunch together every day!
Good Luck!

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Did we move Mom into memory care too soon?

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