When is it time for Mom to move into an Alzheimer's unit?

Brutune asked...

Mom is in assisted living with caregivers 10 hours a day, At night they check on her, but i am worried about recent suicide threats from her. When do I know its time for a full blown Alzheimer's ward? No one whats to make this call.

Expert Answer

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

My heart goes out to you, because you're not only dealing with the issues of a mother showing advancing signs of Alzheimer's disease, you're also dealing with aspects of her mental health and the fear that her threats of suicide are real.

The first thing I suggest to you is to have your mother evaluated and assessed by a geriatric psychiatrist to determine if her threats of suicide are a cry for attention or in fact, a real possibility. If the results of a mental assessment indicate tendencies toward suicide, you must become aggressively proactive. A geriatric psychiatrist can prescribe anti-anxiety or anti-agitation drugs to alter your mom's mood and levels of aggression that could be turned inwardly upon herself. I'm not giving medical advice here, but want to make you aware that there may be options based on the outcome of the assessment.

You also have to know that moving your mom from the assisted living, while it increases the level of attention and one-on-one care she may need for her activities of daily living, it generally does not provide 24/7 one-on-one suicide prevention level care.

Once you receive a clear assessment of your mother's condition and mental stability, it makes sense for you to meet with the assisted living director of nursing and executive director to discuss what's really going on, and talk about ways to reduce your mother's anxiety AND access to anything "“ scissors, knives, rope or belts etc. - that might be used by her to hurt herself.

The facility might suggest that you modify your mother's care schedule, either increasing the hours she has her own caregivers to include evenings up to the time when you and they can be sure that your mom is safely tucked into bed before leaving. Be sure that bedrails have been installed, or the bed is actually lowered to the floor to reduce the risk of falls "“ intentional or otherwise. The regular staff can then look in on her periodically throughout the night as part of their normal bed checks.

If finances are a constraint, you might reduce the daytime caregiver hours to 6-7 hours with your mom, and request the remaining 3-4 hours be provided in the evening, again leading up to when she actually goes to bed. Both of these suggestions are predicated upon an assessment from the psychiatrist that your mom is not truly suicidal.

You might want to reconsider the question you are asking. Perhaps it should be changed from, "When is it time to place mom in the Alzheimer's Memory Unit"¦" to "Where should we place mom to be sure she is going to safe and well cared for in the months ahead?"

The answer to that question should be provided to you and to the management of the facility in which she currently lives as a result of the geriatric psychiatrist's evaluation of your mother. Then in conjunction with the facility management, you'll be better able to decide what your mom needs and if that level of care is available at the facility in which your mom currently resides.

There is much work to be done regarding this situation before the answer to your question can be given. I strongly suggest that the mental evaluation be the first thing on your priority list. Then based upon those results, decisions can be made that will best assure your mother of the best possible quality of life. You'll be informed and can make your decisions as to the proper facility or wing thereof, and afford your mother the maximum amount of safety while at the same time giving you the peace of mind you need regarding her current threats of doing injury to herself. Best of luck.