Update: Alzheimer's mom in Assisted Living
A little background for those who like to be fully informed:
https://www.agingcare.com/questions/approaching-a-turning-point-in-level-of-care-492608.htm
https://www.agingcare.com/questions/cognitive-assessment-appointment-493603.htm
Mom has been disabled for nearly 15 years after a catastrophic accident. Despite my heroic efforts to get her to move into a more manageable place than her five bedroom home about ten years ago I gave up. I no longer live in the same state. Her lifetime of personality disorder and deceit made it tricky to realize when she started moving from fake incompetence (to get me to fawn over her) to true cognitive disfunction. In the last few years she's declined from being capable of managing everything (except her bills which I oversee) to not being able to make a reasonable grocery order. She was diagnosed with Alzheimer's last spring.
I was ready to place her in MC at that time and was surprised to face a crazy amount of backlash from everyone from her sisters to her best friend. I'm aware it was my decision but I ended up giving in and letting her stay home. This was temporary, depended on increasing amounts of help from regular housekeeping, a visiting nurse, a friend to help with medications (which didn't work), and another woman who came and cooked meals. She had someone visiting every day and wears a fall alert pendant but I knew it couldn't last, and I knew it would fall apart during the holidays, and it did.
A trip to the ER and short hospitalization gave me a few days of constant contact with the hospital doctors, nurses, discharge planner and social workers. I got everything in order and a few weeks later I moved her into AL.
Why AL and not MC? This was the recommendation by the (very excellent) facility where she now lives. They reviewed the doctor's assessment and had their own staff assess her in person as well. Because she does not wander and is able to use the restroom properly, put on a nightgown and put herself to bed, etc. she is able to be in the AL side. Meds are managed and distributed and she wears a fall pendant with a locator and is not allowed to leave unattended, and so far has not tried. She has a hired companion through the facility to take her on walks and to and from the dining room. It's both cheaper and nicer than the MC side, and I'm happy if they're happy!
How did I get her to move? I lied, of course. Told her the County needed to tear up the road in front of her house and so she would have to stay in this apartment for a few weeks. She has her own furniture and even her cat, who is also cared for in the facility. At some point she will either stop asking or I will tell her the doctor says her house was not safe and she's staying. If she becomes unmanageable at that point I'll have to look into medications to calm her and she may end up on the MC side sooner rather than later. I'm fine with that whenever it happens.
How is it going? Her health has improved drastically with proper nutrition and taking her prescriptions on schedule. She's sundowning at night but thanks in part to a sedative prescription I requested from her doctor for bedtime she's not calling emergency services or leaving me screaming voicemails.
Why did I wait six months longer than I had to? The backlash from her sisters was one part. She was a neglectful single parent who was abusive when forced to deal with me, so I didn't have the kind of worry you have for someone you love. The help we cobbled together for her to have at home this past year was low cost or free. I pleaded with folks to let me pay for things but was mostly refused. It was a gamble, but one I managed to win, partly through luck.
I'm on now to getting her home listed for sale, which is way easier and more enjoyable than dealing with her personally. I'm happy to answer questions. I think it's always nice to hear back how things worked out for people and what they actually ended up doing.
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Though not as dramatic, my mom also greatly improved cognitively after being moved from IL to AL, but it took a fall to get her there. She's more perky and content overall than she has been in many years. It's not the awful place she thought it would be and she is responding to the increased human contact, frankly.
We need more examples like this to convince our elders, and sometimes other family members, that a move to more care can actually improve their quality of life. It's not moving them to a prison or warehousing them.
It's not always a mistake to wait to place a loved one either, and pressure from family and friends tends to break down the most stoic among us. What irks me is all the advice from the Armchair Critics in general. I'm glad you placed mom in AL and wish her well in her new environment.
Good luck to you with the sale of her home. I understand fully about it being a lot easier dealing with details than the actual person. My mother was a very difficult person to deal with or get close to as well.
I am also impressed that you found what sounds like the perfect facility for her including caring for her cat and a paid attendant to walk her to meals, etc. It’s even better that her health is improved and she is somewhat calmer.
And while it took a crisis to get it done, I think that is unfortunately very common — but you kept your head and executed the plan so wisely, without guilt. My hat is off to you.
I hope that I can follow your example when the time comes.
“tricky to realize when she started moving from fake incompetence (to get me to fawn over her) to true cognitive disfunction”
and
“ In the last few years she's declined from being capable of managing everything (except her bills which I oversee) to not being able to make a reasonable grocery order. She was diagnosed with Alzheimer's last spring.”
This all rings out so true in my situation.
Legally speaking, a person is either competent or incompetent — black or white. But in the world of elderly care, the gray zone can go on and on for years.
You handled a very messy situation so deftly.