My mom is in Assisted Living with an additional care package that includes medication management, shower assistance and reminders for ADLs, like help getting up in the mornings and choosing clean clothes, remembering to brush her teeth, etc. She has Mild Cognitive Impairment, no significant progression for years, so doc presumes it is not Alzheimer's, Lewy body, etc.
Her facility has two levels of Memory Care available, and I know they will recommend to me when they think she needs to move, but I'm seeing a decline in cleanliness after toileting, with some failures to get clean and I'm thinking that she may need more help with that.
What are the differences specifically between AL and MC at most facilities, in terms of the care given? (I know that socially, it will be a different population with less ability to form relationships and talk. She is NOT ready to move socially.). Can someone with some incontinence and cleanliness after toileting problems even stay in AL? Mom has a call button necklace, but isn't aware enough to USE it to get help after toileting.
Maybe there is a resource on this site that I haven't found that discusses the difference, but I'm also interested in people's experiences.
Thank you in advance!
Assisted living is for people who need some assistance with ADL's. It's usually the cheapest of the three. Residents go into AL for many reasons. Age is the main reason. Many have given up driving for example, or can't cook anymore, or need some help with getting in and out of the shower, and are old and don't want to be alone in their houses or apartments anymore. They are free to come and go because they are still physically and mentally able to do this safely. At the AL I was a staff supervisor in, our residents had the option for us to keep track of their medications and give them if they wanted that service. We assisted with showering (a few days a week on a schedule), meals, housekeeping, laundry, and socialization were provided. Residents could also sign up for shopping trips twice a week to but whatever things they wanted. Some residents still had cars and drove themselves. We did not provide baby-sitting service if a resident had dementia and couldn't be left alone. Then it was time for MC. Residents could use a cane if they had mobility issues but not a walker or wheelchair. They would have to go into a NH then. If incontinence was a problem, they had to go into a NH because we did not provide toileting or diaper changes. Many residents used disposable briefs or pads but had to be able to change and dispose of these properly themselves. Once in a while an aide would help if needed, but if it became a regular thing the resident had to go. AL's usually have rules like this.
A nursing home is when a person needs actual nursing care, or has serious mobility issues or illness, is incontinent all the time, and cannot meet any of their ADL's and is reliant on staff for everything. They may be mentally sound enough, but still need NH care.
Memory care is for people who cannot manage and are also reliant on others to keep them safe and meet their ADL's. These places are locked so residents cannot wander. Staff takes care of all of their care needs the same as in the NH. Hygiene care, medication, feeding, medication, and supervision 24/7. Most places don't provide the level of care and supervision these people need, but that's a profit and hiring problem and another conversation.
When mom was dying with hospice, the aides asked if they could cut moms blouses in the back so they could dress her as she so loved. A line formed daily at her door to say goodbye.
Mom had terrible blowouts and nobody ever said a word. She was clean and lotioned 2x a week. Dressed to the nines daily, hair brushed with eyebrows all crooked and lipstick askew. But that didn't matter because she felt pretty.
MC can make a big difference for dignity with an elder suffering from dementia. And keep them out of a nursing home.
You need to ask your ‘own’ facility about the rules for the details that apply to you.
I learned that when I learned of a MC facility that was very impressive. My husband is not allowed there because he has a feeding tube because that requires SNF care. A MC facility is only AL level of care.
Some AL facilities have a special MC wing that is locked but that wing is still only AL.
Ask your facility if they provide incontinence care for an additional fee.
Just remember MCI (Mild Cognitive Impairment) sometimes progresses gradually to dementia and later can be identified as a specific type such as Alheimers, Lewy Bodies, Frontal Temporal or other identified named dementia.
Many professionals suggest it's time to consider memory care when the answer to one or more of these questions becomes "yes":
Is the person unsafe if left alone for even short periods?
Are they wandering or trying to leave?
Do they need frequent redirection throughout the day?
Are they becoming distressed because they're confused?
Is their behavior affecting other residents?
Are staff spending far more time with them than an assisted living setting is designed to provide?
Often the facility itself will make the recommendation. Whether someone is graduated from AL to MC often depends on the facility. All your current concerns should be discussed with the admins sooner rather than later.