How Do I Move Mom to Assisted Living?
How to transition a parent with vascular dementia and serious conspiracy delusions to an assisted living facility from independent housing. My mom of 75 years of age has had a decline in both cognitive thinking and memory and is easily confused. Her doctors have recommended moving her. i do have living power of attorney. I want the best for her and for her to enjoy the balance of her life in a safe place. She is reluctant, accusatory and the conspiracy stories are rampant. I am afraid that I am going to have to force her to move but am looking for any advice on how or what to do... any ideas or experiences that someone could share for insight?
stressed out in seattle-
Moving someone with dementia is difficult, but often necessary for their health and well-being. There are some excellent dementia specific assisted living facilities where the staff is trained to work with persons with dementia. The activities and generally the layout for the facilities are focused on the needs and behaviors of persons with dementia.
Begin your planning by reviewing the options. Contact the Alzheimer’s Association for a listing of the facilities and also ask them how to access the quality data from the appropriate state agency that licenses the facilities. After doing your homework, contact the facilities and schedule a tour. It is good to compare a couple of facilities and weigh factors like stability of the staff, training, and your overall evaluation of the facility for your parent’s specific needs.
If you want assistance in expediting the process, you can use the services of a geriatric care manager who is knowledgeable about the facilities.. To search for a geriatric care manager by state, visit the National Association of Professional Geriatric Care Managers at: www.caremanager.org..
After you have determined one or two options, consider taking your parent for lunch at the facility. Just invite your parent to go to lunch with you and then go to the facility. Don’t give her time to find lots of reasons not to go. Taking another person with you so that your parent is more likely to enjoy the event is also a good idea. The dementia facilities are obviously used in dealing with the behaviors you described and can assist with a plan. You can also use the doctor’s recommendation as well as ammunition for the need to move.
This process may not be easy for you. Remember that your parent selected you as the power of attorney to make good decisions for her. Remember that she has dementia and much of her response to issues is really the dementia speaking for her. Remember that using logic in this situation may not be an option. Have the courage to make the right decision for your parent and the tenacity to see it through.
It is not an easy thing to do. However, my mother chose a continuing care facility for her golden years. The administrator immediately placed her on the waiting list for a more structured area "when that time came". She stayed in a free-standing apartment, where she could cook, etc. for several years, but finally it was time for more assisted intervention. It wasn't easy for me to tell her that she had to move, but it was the best decision. When she got there she had some of her own furniture. When I became the girl in the picture, I started labeling all the pictures. She received help with her mediciations. She was enjoying herself. Since I lived out of state, I had to trust the administrator. I called frequently both to my mother, and the administrator. I trusted her care to another as I had no choice. Her cousin could visit her as well as other friends. You also said your mother was too young. I encourage you to listen to the expert answer. It is a good one!
Mary Koffend's advise is excellent. Having managed a dementia-specific assisted living community I would reinforce the importance of acknowledging the mother's feelings. She is confused and thus frightened about what is happening to her and since she can't trust herself, she can't trust anyone else. As Koffend said, logic doesn't work but recognizing her fear and conveying that you are their to support her can be helpful and comforting. Hopefully, if the staff at a place being considered is well trained, they will be validating these feelings and family supporting them will provide reassurance during her adjustment and stay.
Be very careful screening for assisted living. If she needs assistance with taking meds, dressing, bathing, etc. she may need nuring home care. We made the mistake of putting my husband in an assisted living. He had spells of hostility which they surpressed with meds. He was an active individual that enjoyed talking and taking walks with other indivduals. They promised to take him for walks, but this never happened. Individuals were separated at meal time, so there was no interaction. Unfortunately they over-medicated him, because he refused to sit all day. The credentials of the staff are most important to your loved ones well being. Check the credentials of the facility on-line. Go to the Medicare site and you will find lists to compare facilities; assisted living & nursing homes.
I agree with Anonymous about the importance of screening for assisted living, however I would caution against choosing a skilled nursing facility if the elder just needed help with activities of daily living such as taking meds, dressing and bathing. Skilled nursing is appropriate to manage an unstable medical condition or when nurses need to be available to give shots, manage tubes, etc. Assisted living encompasses a spectrum of services from board and care at the least, to memory (dementia) care at the highest level. Good assisted living facilities focus on giving their residents the highest quality of life that goes beyond attending to physical needs. It is important to do a thorough screening when choosing a facility which includes visiting more than once (at least one time drop in unannounced) and talking to the families of the residents. Unfortunately, there are bad assisted living facilities out there who use medications to manage behaviors. Medications are wonderful when managed appropriately, however they can be abused and result in creating lethargic behaviors to encourage docility. Look for a facility who will give timely feedback to health care providers to strive for the right amount and kind of medication - enough to relieve the anxiety that can be present with dementia, but not so much that the resident is zoned out all the time.
You might also consider an adult family home option if assisted living turns out not to be a good "fit" in terms of dementia care for you mother. These are independently run, licensed homes with up to six (in our state) residents, most in quiet, residential neighborhoods and often are an ideal situation between assisted living and a nursing home, especially when dementia is the primary disability. The level of care can be more customized here and usually far less expensive than a nursing home. Some will accept Medicaid if private pay is too costly. And for the resident, it can seem less anonymous or institutional since it is a real "home" for him or her. Many are able to allow a resident to "age in place", even including hospice if needed. Of course, it is very important to thoroughly evaluate each home for quality of management and care, just as you would with any other kind of facility. For my own 86yo mother, her adult family home has been a blessing for both of us!
Contact your local assisted living ombudsman to reduce the risk for involuntary discharge from the assisted living facility. Most States have rules and regulations as to what is and what is not allowable for discharge. Also you can visit the website for the Assisted Living Consumer Alliance (ALFA) for information related to assisted living regulation reform.
I am in this same situation. The description of your mother fits mine to a T. My mother just had another mental exam which resulted with the same previous year's score, very low scores particularly with executive functioning. My doctor, her social worker, my brother, and I met together to talk about how we felt, discuss what our next move will be, and truly validated my worries for my mom. Our plan is to move my mother to a brand new memory care unit opening in August which is located close to my house. My mother opposes everything we try to do to help her, and as we drive by the facility, she adamantly says she would NOT want to live in a place like that. So, unfortunately, we will have to "trick" her into moving to this facility. They call it theraputic fibbing, and it makes my gut wrench. Although I have all professional and unprofessional people telling me that my mom is unsafe in her home, I know she loves being there with her two large dogs. They are her babies and she lives for them. I couldn't sleep last night just thinking about this move in August. My mom will start raging, my brothers will be very angry with me, and if this is the best move for my mom, it will take some time before things will settle down. I just can't imagine jumping into this, but I have to. My mother's dementia is forcing me to do this.
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