Moving.

When my mom got out of hospital > rehab and finally went to board & care I took her to her primary and we addressed the weight loss. She was not on hospice at that time. Primary wrote an order to give one high calorie protein shake if meal consumption was 30% or below. This is for breakfast, lunch, and dinner so she could potentially have three shakes per day.

I don't obsess over her calorie intake anymore like I used to. She was not underweight then and she isn't now but these big drops so quick weren't right. She is 91 and on hospice (though I'm beginning to wonder if she'll qualify next time) and I can request the order be dropped any time that's appropriate with her disease progression.

Are they making food that's easy for mom to eat? I watched aides in the hospital and rehab put my mom's meals down in front of her with the lid still on the plate and never remove it. During her heightened confusion in these places, she wasn't sure sometimes that food was under there. I'd open it and it'd be a dried up chicken breast and there was no appropriate utensil to cut it. Dry rice would fall through the fork tines. My mom had the hardest time eating and she'd just give up. I couldn't be there every single meal to help her and me bringing it up to the charge nurse either fell on deaf ears or who knows where the actual failures occurred. One time I came in after breakfast had come and gone and mom was sitting up in bed with the still-covered meal in front of her. Another time they served a cheeseburger and it was all deconstructed on the plate with condiment packets on the side. You expect her to build this herself?! Refused meals? NO! She has delirium for chrissakes! Help her! I can feel my blood pressure rising just thinking about those incidents.

So, just a little tip based on my personal experience... be there at some of the times they serve meals and see for yourself if there's an explanation why she's dropping weight.

If she’s on hospice why are you worried about her losing weight?

First, you don't get to place someone under hospice care just to get more help. Your mom has to be deemed by her doctor that she will be dead in 6 months in order to qualify for hospice care. And if her doctor has done that, what is your mom supposedly dying from that will take her in the next 6 months?
You say she's only in "mid stage dementia" so I'm guessing there must be a lot more going on here than what you're sharing.
As far as moving her, please know that folks with any of the dementias do best with routine, and moving her and disrupting her routine will be very hard at first, but hopefully she will settle in eventually into her new routine.
Hospice typically has a nurse to come visit and check vitals once a week to start and aides to come at least twice a week to bathe your loved one. That totals about 2-3 hours a week total, so do know that 99% of moms care will still fall on those in her facility.
Please don't be misguided into thinking that hospice is going to supply all this extra help, when in fact it won't.

My late husband was under hospice care in our home for the last 22 months of his life and hospice truly did the bare minimum when to came to his care while I got to do 99% of it. His nurse came once a week to start for about a half hour to check his vitals, and the aides came twice a week to bathe him which may have taken them 45 minutes if that.
The only time that I think hospice does a really good job is when one is placed in one of their hospice homes, and when the person is actively dying. Then you get pretty much get round the clock care.
Other than that it's hit or miss.

I would think long and hard before making this major move for your mom, as she can always go under hospice care where she's at now when the time is right.
But again remember, hospice is not much extra help in the big picture of things.

Kayla, I'm so sorry, we know how hard this is.

I'm wondering about your mom's age and health conditions before we can give you the best information we can.

Difficulty for the new facility or the old one? Really its your responsibility. You find a new place, you give the old one notice and you pay to have Mom transported.

Hospice is end of life. What is wrong with Mom that Hospice excepted her.

Tell Mom she’s moving to a new apartment because they have to renovate the one she is in .
You hire an ambulette service to bring Mom . Don’t bring her there yourself , she may refuse to get out of the car .

You will have to move all her belongings .

I suspect she will act similar to when you placed her the first time , since it’s only been 4 months . Typically , moves are discouraged , because they can upset , confuse them .But it doesn’t sound like Mom is loving it there anyway , she’s not going to activities , no friends maybe too .

In your case you are not happy and have found a facility with a better staff ratio .
FWIW though , in general assisted living is not like a hospital or even skilled nursing home .
You need to keep on top of things , they are not staffed like a hospital so they will miss things.
You may have better luck with the better staff ratio for what you have complained about .

Good Luck .

Are you POA? If so , didn’t you have to meet with someone from hospice and sign papers??

My husband just did that this past January for his father when he was in assisted living.

The facility that you are moving mom to can help with the transfer.
The Hospice Social worker can also help with this.
If you like the Hospice that you have chosen make sure that they go to the facility that you are moving mom to.

She is 84, and I would say she is mid stage dementia.
She is higher functioning, she knows what she wants and doesn’t want. She has a walker and wheelchair, but refuses both, so she walks around without both.
She can feed herself.
She is articulate, even though are conversations that we have don’t make sense. (Example, the other day when I saw her she asked me if I ended up ordering the cookies that I wanted and what did I order. None of this was true, but I just went along with what she was asking).
She needs help with showering.
She is not fully incontinent, urinary incontinence.
She doesn’t do the activities they have there. Once in a while she does.
My mom is feisty or maybe she’s just stubborn.

I never can get the full picture on what’s going on with my mom from this current facility. I met with the executive director and director yesterday and I felt I was being gaslight when talking about the lack of staff. They don’t build relationships with the residents, my mom was gravely ill back in April and had to spend a week in the hospital and just recently she had a UTI and no one noticed anything was wrong with her.

I’m mentally tired of arguing with these people, so that’s why I’m going the hospice route for now. She will be visited by hospice 4 times per week.

The place I thought of moving her to is small 20 memory care residents. Right now the ratio for caregiver/resident is 1:5. And the don’t count the LPN in that ratio. I’m scared to move her because I don’t know how difficult it would be on her to do so.

I would like to apologize to the Forum and to Kayla for feeling it was necessary to defend my experience with Hospice care. Poor form on my part to respond to Way on Kayla’s post. Just speaking for myself here.
I am very fortunate to work with a hospice group that provides excellent care in several respects. I wish you all such an experience should you or your loved ones require hospice care.
I have attached a link from Medicare.gov that opens to a booklet that explains hospice. It explains the ability to go on and off hospice as desired and to stay on hospice so long as the patient is deemed terminal with an illness they could die from within six months if the illness runs its normal course and how they can stay on hospice indefinitely if they still meet the criteria.
I agree with Way that some hospice providers are better than others as not all hospice companies will provide all the services Medicare lists as benefits…Such as Physical therapy.
Although I was able to get that while aunt was at home, just not in the NH except when off hospice. This offered just as an example.

Kayla I do hope you will return and give us an update on your mom. I promise to behave. 😇

https://www.medicare.gov/Pubs/pdf/02154-medicare-hospice-benefits.pdf