She was recently diagnosed with moderate dementia and we were told that she should definitely not be living alone anymore. She is still with it enough to express her displeasure at the prospect of living in an AL community and believes she will eventually be able to return home to her apartment. She will definitely not want memory care although we think there is a good chance she will not be able to stay in assisted living for too long. Should I have the conversation about such a move a few weeks before it is scheduled or right before it happens? Any other advice is much appreciated.
Sometimes persons with dementia develop more physical impairments, need too much help with ADLs for assisted living, and move to a nursing home environment.
So your mother may or may not eventually need a different type of care environment.
I used to think that a community with continuous care options would be best for the person with dementia, to minimize the disruption of moving. Experience has revised my opinion on that a bit.
Moves and changes in environment are often very confusing and disruptive to persons with dementia. But if Mother needs to move from ALF to Memory Care or NH it is a move -- whether it is across town or across the care complex.
My mother had to move to different room for a few days while the facility painted and maintained her room. She was extremely confused. She ate with the same friends, saw familiar faces in the hallway, and was familiar with the routines. But it was a move. It was disruptive. And she was confused again for a few days when she returned to her room.
Her facility had memory care, assisted living, and nursing home care, in different wings. But moving from one wing to another would have been a full move, just as if she went to a facility in another city. The dining room would be different. The staff faces would no longer be familiar. There would be different people at the dinner table.
Having all the care levels in the same facility is somewhat easier for the POA -- billing system is familiar, lots of routines are familiar -- but I've come to realize that it isn't as important to the resident as I had originally assumed. A move is a move. It is going to be disruptive regardless of the distance. That can be (and has to be) dealt with.
Personally, I wouldn't give the all-in-one feature a lot of weight when selecting the best care center for someone with dementia.
People with dementia tend to be worrisome and fearful. She would be anxious and apprehensive and probably ask about what is happening all the time. For some reason, they know when something is up...
Just enjoy her and be positive. Go visit places which will be enough to let her know that something is going to happen. Then, just before, let her know and go out her in.
I told my hubby on the way to the memory care!
Any of the AL's will give you and your mom very nice tours and include lunch. Go with her to several and see if there are any where she feels comfortable.
Also, it would be best if she didn't have to move later so find a facility that can care for all levels in the same facility. Less moving is better than going through this again.
You'll find that most people in the facilities are used to people being reluctant to move and will make the transition easier for you.
Be positive about the move and be reassuring to your mother while "shopping" for the right place.
My husband ran away from two AL's before I got him into a more secure memory care facility. He was running away and calling for me....breaks my heart! Now I'm waiting my two weeks before I go see him and hope he has settled down a bit better.
This is just not easy....best of luck to you!
Regarding the move from ALF to memory care, I think you might be getting a bit ahead of yourself there. It sounds as though you still have quite a lot of negotiation to do with getting her to agree to the ALF; and even with the diagnosis, until it is formally determined that your mother is no longer able to make the decision she is still in charge of where she lives.
Do you have Power of Attorney for her?
Sorry, more questions than answers - could you fill us in on the background, please?
Recently my Dad [94] moved into Independent Living which allows him to stay even if he needs a higher level of care. He's happy as a clam being there as now he feels safe. He saw what had happened to my Mom attempting to live in their single family home with a lot of stairs, and he is scared that he was going to fall at home, too. Mom passed away due to a fall. Now he doesn't worry about that.
When I moved my Mom to memory care (she WAS a wanderer) it followed a hospitalization and rehab. I simply said that the doctor wanted her to get more practice walking and to get stronger. I was blessed and she never questioned me or gave me a hard time. I'd keep her in regular AL as long as possible and if she needs to be moved, keep any explanations QUITE simple. In my opinion, you can't relaly reason with the dementia so the less said the better. Good luck and keep us posted.