Finally had enough to reinitiate contact with the facility I want to put mom in. How am I going to deal with her anger?

I so empathize with your situation. Although I could barely do the brushing of her teeth, the stench from the incontinence and the bathing scene was something I dreaded. I also found myself short tempered and impatient which translated into poor driving. The potential of unsanitary conditions on furniture, floors, and the bathroom made me OCD on hygiene. I didn't mind the cooking and the feeding. I did mind the denial of liquid on the floor, on the chairs, on and near the bed, and near the toilet area. The use of towels to mop up the floor then the towel was returned to the closet made me incredibly angry (who wants to use those towels on their face and body? My Mom denied any of it and couldn't smell the urine.)

I say, get your Mom into somewhere as soon as you can. It doesn't matter if it is AL or MC. Places will evaluate and make their own decision whether it is AL or MC at their place.

The incontinence and denial of the incontinence was part of my Mom's dementia. She couldn't tell or didn't remember that she had gone to the toilet. One of the caregivers recorded her going to the toilet over 30x in 7 hours at night. No UTI, she just thought she needed to go. It messed up her sleep too. And because she had the potential to fall, each time she went to the bathroom, the caregiver had to assist her to/from the bathroom. We couldn't figure out how liquid got on the floor or chairs, even though she wore Depends that were dry. We could not retain caregivers due to the nighttime activity, and other more minor issues.

The way I did the move is that I blamed her going to the MC on me. I told her that "I could no longer take care of her". And I repeated it over and over and over again. And told everyone to tell her that I could no longer take care of her. Whenever some well meaning person would say oh that is too bad, she would ask them if they would take care of her and of course they would say no, especially after she told them that she had a hard time keeping the same caregiver at night.

From the time I selected a place, to the time I could move her in, the process took about 1.5 months due to all the forms, doctor's visits, home visits, TB test, etc. I suggest you start doing your research and put in a down payment now as it probably will be after the beginning of the year when she will be physically there.

As for taking her home, I was worried about that also so I made sure she didn't go back into her condo after she left it. When she moved into MC, we made sure the MC room had all the important pictures from her bedroom and hallway, and some of her bedroom furniture so that the room really looked like hers. After 1.5 months, she begged to take a look at her "old home", and my sister took her. When she went back to her "home" of over 20 years, she said that she wanted to go back to the MC unit as it felt strange (she even looked into the drawers and saw that there was different stuff in it than she remembered).

Prior to the move, I marketed her stay at the MC to say that it was a way to get reliable and responsible night care. MC for me is the ability to have reliable and caring facility to take care of my Mom, especially for those incontinence and night time visits to the bathroom. Currently, I DO see her everyday and I DO take her out with me on appointments and errands like we used to. I DO bring her her outside food. I DO work with her on her exercises.

It is all about how you and others sell the future to your Mom. Don't promise what you cannot keep. If she really has dementia, she cannot accurately remember from one week to the next, but she will remember broken promises. (I've been told that negative thoughts and actions are easier to remember than positive ones.) You do have to save yourself if you are going to provide a good environment for your Mom in the future.

Maybe start mentioning nice facilities, one sentence only. Then ease into a friend whose parent recently went into AL and is adjusting. You can make that part up. No expecting conversation because you don’t want to engage on this. When the day comes that you tell her you’re going that afternoon, it all may be so blurred in her mind that she’ll feel fairly comfortable. Be positive and no long explanations, just go.

Round of applause for you for following through! Once your mom is settled, you’ll be glad you did. Not that you won’t come home and cry, but there will be the relief of having taken the step.

I think the “when” question is answered first by how long your mother’s memory is.

If telling her a few days before will help her acclimate to the idea, then that is a good choice.

If she will forget your “prep talk” by the next day, I’d wait till the morning of the move.

When we moved my mother, I packed her things, and my husband kept her busy for the hours it took for the movers to move her furniture. It would have been too anxiety-producing for her to watch all of the changes happening.

Keep us posted on your next steps. 😎

Again,
How goes the transition?

Has the evaluation been completed?How did it go, for each of you?

Again,

We told my mother that she was moving to a place that would help her to be not so afraid any longer. A place where there would always be someone right there to help her.

There may be something like that , that would help her understand.

And, as I tell my daughters, just because something is hard, doesn’t mean that it’s not necessary.

It will be hard. Guaranteed. But, you will be okay. We are here for you.

You ask how you should deal with this. I would say gently and with the recognition that old age is loss after loss after loss with no upside coming. It is worth raging about. It is worth crying about. The losses mount. Our ability to be continent, to think, to remember, our mobility, our eyes and ears, and our control. Everything gets taken from us. I am assuming your Mom has dementia and that you are POA and this is your decision to make, because if not she may decide not to move and there would be little you could do about it. By moving your Mom in the home is hers in that she is a tenant whether paying rent or not. It isn't as simple as saying "I am moving you". I hope my assumptions are correct and this goes relatively well for you. But there will be pain, and it needs to be embraced. I am so sorry it is difficult right now.
As to the procedure, I am uncertain what to tell you as a friend had this procedure or one similar years ago when this was new and experimental, and she has actual electrodes causing problems in her lower limbs that cannot be removed. I am uncertain the details.

I had to place my parents in assisted living almost 4 years ago. They did not have dementia but they were stubborn as heck about going. They both had health emergencies and I scrambled to get them placed in my state 1/2 mile away.

they were not happy at all and I was the evil one. They were severe hoarders and wanted all their stuff etc. I had to clean out the home, sell it, it was a nightmare and I did it all myself.

i packed the bare necessities and brought a few items they loved after they moved in.

as stubborn as they were they both realized that their quality of life improved and they had regular care (it is still a lot of work on you) from me.

You are in a tough position but I would let her know ahead of time there is an evaluation being done and go from there. She wont be happy and it will be a tough transition but she will adjust just as my parents did. They actually ended up appreciating the effort I put in and still do for my Mom. Dad passed last year

I'm going to start by saying I would never be one to roll my eyes at anything you're saying. So many times families hesitate way too long about putting a LO into facility care. It's better to just do it now while your mother still has some of her wits left and her dementia isn't so bad that she'll be totally bewildered and overwhelmed by a new place. Now is the time to do it.
You know you're going to have to take the heat that comes with placing her and it's going to get hot, my friend. You already know this and I'm sure are prepared for it. Be strong and just do wht you know you have to do. She's going to fight you on it beause she wants to stay at your house. If she refuses to help you go through her stuff and pack up, just go right ahead and do it. Tell her that you may be throwing things away that she wants to keep if she won't help. Make offers to take her to visit the AL she's going to. Tell her it will be easier when she moves there if she gets famillar with it and meets the staff. If she refuses, let her know it's going to be all the harder on her the day she leaves your place.
As for bringing her home for the holidays, I wouldn't if you're placing her now because the holidays are right around the corner. She will not have had enough time to acclimate to the AL she's moved into and will not consider it her home if she's only been there for a little while. Guaranteed she will ruin the holidays for everyone if you take her out of the AL for them.
What you and your family can do is have these holidays with her at the AL. It doesn't have to be on the actual holiday. It can be the next day or any other day.
As for the surgery to reduce the urinary incontinence and trips to the bathroom, don't do it yet. Try medication first and there is medication now that does help.

Also, from now until moving day, I would not ask what things she wants to bring, etc. I would not talk about it at all. This is partly to smooth things for you, but mostly because it is better for her. Making decisions is horribly stressful for someone with dementia because the illness prevents them from being able to think things through clearly. It is scary.

I know that sounds bad. Dementia flips us into bizzaro world. You have to handle situations in ways that you would *never* do when someone is healthy.

And moving quickly now that you have started is a good idea. So is getting this done before the holidays. Holidays can be lovely, but with dementia, there is a danger of sentimentalizing them to the detriment of making good decisions.

Maybe my experience is different, but it seems odd that they are evaluating her on site. I have only seen that happen through the dr office. Dr then sends results to MC.

So this appointment is just to be evaluated, not to move in? That is a hard spot.

Maybe be vague about going to a check up. From what you have said, the time for talking with her about memory issues is probably past. It may just make her worried and skittish.

I would make the whole morning as normal and routine as possible. They can’t always figure things out, but they still can read your energy. We got to the point where we didn’t talk about appointments until it was almost time to leave. And when we were moving them, we didn’t say anything about it until they were inside the facility. It was still very, very hard, but it was for the best.

When you are almost to the MC, maybe start talking about old memories in a relaxed way. If she notices something when inside, you can say you are there as an outing to see what the place is like. Hopefully, they will be evaluating on the sly and don’t make her feel like she is under the microscope.

I wish, for your sake, that they were doing evaluation at dr’s office.

”This is not optional.” Keep this front and center in your mind from here on out. If you do have to tell her, be very kind but also matter of fact. We have some things to take care of, Mom. Doctor needs to see you. Later on, you may be here for rehab (or whatever) for a while. We’ll figure it out. No worries. (Even though inside you will feel like you want to vomit.)

You can do this.

I'd be as prepped as could be the night before. Paperwork ready in bag, clothes laid out.

I wouldn't mention it too early.. maybe just carry on with the getting ready & then "let's go". Where? "To that appointment with *insert a name*. I mentioned it last week, well I think I did. Anyway let's go".

Hopefully others can add to or improve this?

How about this--"Mom, I have a procedure scheduled, nothing big, but it's going to put me out of commission and prevent me from doing any caregiving for 6 weeks. So you will need to stay elsewhere. I've found a nice place and the process is that they need to see you first".

With my mom, who was living alone, we used coming bad weather as an excuse for moving her into an IndependentLivingfacility "temporarily". By the time Spring came, there was not talk of going back to her home.. I'm a big believer in therapeutic fibs.

Sometimes, the patient needs the fib to hang on to to maintain the whole "independence" thing in their heads. It's like "I'm not old and in need of care-- It's because of XYZ".

Does your mom understand how burnt out you are? Does she show any insight or compassion into YOUR situation? "Mom, I can't do this any more" wasn't an easy convo for me to have, but my mother understood that I was endangering my job and my health with what I was doing.

There are advantages going into mc as opposed to a blended environment that mostly focuses on independent and assisted living.

The Atria nearest me is being criminally investigated for feeding three of their mc patients cleaner instead of juice. Two died…but they have a beautiful entryway, marketed to be like a hotel.

Right down the street is an mc that is just an mc. Compared to the Atria, it’s rather dowdy. Residents don’t even have showers in their room, but it is one of the highest rated in the area. One reviewer opined how surprised she was to not have to hire private aides. Nor did she have to pay staff more as mom progressed…whereas Atrias and Brookdales are notorious for demanding both.

This mc is also about half the price, too.

How about some advice on HOW to tell her?? Appt at the facility is at 130 on Friday. A caregiver will be here from 9 AM until we get ready to leave about 1245. I have NO idea what I'm going to say???!!! I've got a great beginning - "OK, mom it's time to get ready for a 130 appointment". After that, I'm kind of stuck.

The questions will start - "I didn't know I had an appointment!"
"Where?" + "why?" + +++++++

I guess I could say "It's for an evaluation about your short term memory issues".

But once we enter the facility, it will be obvious that this is not like going to the doctor's office. She will know it's a nursing home type of place.

Is there any benefit to telling her earlier than when it's time to leave? I'm worried she'll just be mad and making a big stink about it and maybe refuse to go. She also won't like being blindsided. So do I just be honest and tell her something about it being high time for her to move out and this is the best place in town?? Ugh. I'm not looking forward to this part of the journey AT ALL.

If she leaves home for facility, then bringing her back for Thanksgiving dinner would just be a poop 💩 fest. No dinner 🍲. It would be a bad idea. & then you’ll never be able to get her to go back. Or you’ll never get the nerve to do it again. If she has dementia, she won’t know if it’s a holiday or not. . It won’t be perfect in facility either. & then you might feel compelled to go check up on her …running back & forth. That can get exhausting too. As far as that procedure, I think it will help doctor more than her. Have her wear depends or pull-ups. Hugs 🤗

Againx, read and re-read what LeaLonnie wrote. You will STILL have a tremendous amount of work to do with your mom in MC. But you won't have to live in fear of E.Coli everywhere.

Please remain open to the idea that your mom may actually enjoy being in MC and having a wider circle of folks (both staff and residents) to interact with.

(((Hugs)))

This is said with love Again; you waited so long to place mom, that now it looks like she'll be needing MC instead of AL which is a different ball of wax entirely. Had you gotten her into AL a few years ago, she'd have segued into MC with no issues. Now, if you wait any longer, she won't even qualify for MC but have to go into a SNF which is an even BIGGER ball of wax than MC! Don't wait another minute to place mom. She'll live through it, crying and complaining & everything, I promise, and you'll both be able to forge your own autonomous lives moving forward once you do.

You will not bring her home for the holidays, but bring the holidays to HER in whatever managed care AL she winds up moving into. We used to cook a lasagna with all the fixings and reserve a private room (like the library) at mom's MC, then take Christmas eve over to her, complete with gifts and everything. She may still be with you for Thanksgiving, so you won't have to figure out how to do that holiday. When mom was in AL, they had a great feast on TG and we'd go there for it, or bring her to our house (which got a lot harder as the years progressed) b/c she lived in managed care for years so going back at the end of the day was no big deal: she wanted to, in fact.

With dementia at play, I think I'd avoid the sacral nerve stimulation that's been suggested to you b/c they seem to have a harder time dealing with such surgical/medical procedures in general. My mother was a nervous wreck on her best day, but add some medical or dental procedure into it, and OMG.

It's time for you to stop having every day of your life ruined while you worry about making life 'nice' for your mom. You've done enough. You've been a great daughter and will continue to BE a great daughter to her once she's living in managed care. There are lots of opportunities to be her advocate PLUS there are TONS of things you'll have to do for her once she's a resident. TRUST ME ON THAT. You're not abandoning the woman..........you're moving her into a higher level of care where she'll have activities and others to socialize with. Change your thinking before you decide the whole move is 'too cruel' which it is NOT at all.

Wishing you the best of luck.

Again,
As Alva says, this transition is worth grieving. Have that good cry. Maybe, over and over. It really is kind of like a death. Loss for her. Loss for you. Then, grief upon grief, as the dementia advances.

I’m glad that MC is the decision. The incontinence is past the AL stage. In MC, when there are issues, there is someone to notice and take action. In AL, an incident might happen, and someone might not see for hours.

We made the decision for my Mom 2 years ago this December. Thanksgiving was rough here. Mom was deep into dementia, and it was so awkward for us, and for our guests, as well. Christmas was a whole lot more relaxed.

We visited Mom on Christmas Eve, and had Christmas Day with our grandson, who had just turned one. It was a relief to just have a normal day. For you, that would mean a Christmas without dealing with incontinence. Phew. Your Mom will be safer, too, without the mess of it.

Keep coming back here. We will cheer you on, and let you cry, when you need it.

C.

I was thinking of when you know when you need to take some medicine.. You may not WANT to but something ails you & it is the best recommended option. Side effects can happen. These must be endured, unless really too ominous or painful. Then an alternative to the medicine is needed. Or you must continue to put up with the original ailment.

Looking for a new home for a parent may not be wanted. But may be needed. May be the best recommended option.

I guess any anger is like a side effect you don't want. It comes with the medicine. But the medicine is still needed.

Thank you all for your kindness and great advice, as usual. So, a hard NO to coming home for the holidays. Emailed with admissions and going in for an eval Friday and they do have an opening in MC. OMG this is starting to feel real. I'm on the verge of tears because it's so sad to have to do this but I do know that it is time. I'll be leaning on you nice folks for some support. And my hubby will be here for real hugs and wiping my tears away.

Thankfully, my sister is 100% in support of this. I haven't told my kids yet but I'll wait until it's real. It's hard for them to watch their grandma decline and haven't wanted to hear too much about it. They do know that I was going to eventually have to place her somewhere so at least I've prepped them that much. They are adults and they will be able to handle it.

I know the peanut gallery (her brothers and friends from back home for example) are going to be critics but I'll just nicely tell them to pound sand and try not to let it get me toooo pissed off.

I think the confusing thing for outsiders partly revolves around not understanding that there are levels of dementia. You just don't all of a sudden wake up and severe dementia and can't remember your own name. It's a slow steady process, at least in her case. And you don't have to be that severe to be beyond the capabilities of your caregiver either. Just coming up with rebuttals for the crap (even if it's subtle) I will receive. Ahh, the joys.

If Mom has dementia, please go for memory care. Folks in AL don't want to socialize with someone who doesn't have all their marbles, and it's very isolating. MC is geared toward that, and they'll be focused on mental stimulation, getting her to participate in activities (AL won't do that), and her socialization won't be entirely on her.

Ideally, you want a MC that can take her through the end of life, incontinence and all. They know how to handle it, and you shouldn't want the focus of her care to be her bladder but rather her mental stimulation.

Do u know about 211 phone number. That was a phone number to reduce calls to emergency phone numbers for non emergency issues.. a 211 operator has a list of all resources in the area . Call 211 and describe ur issue and see what info you get... Long time ago I helped set up 211 for this area . My job was to contact numbers to see if they r still an available resource... Big one was plastic surgeons who offered their services for free to abuse victims... Services to care giver at end of her rope must also exist.

againx100 - where is your mom living now? I am confused.

You said: "Any time I've brought up mom, 79, leaving my home, she gets mad and cries..."
You then asked: "do I bring her home for the day for Thanksgiving? Christmas?"

Where does she live? With whom?

I hadn't heard of InterStim so I looked it up and found this very detailed guide:

https://www.nbt.nhs.uk/bristol-urological-institute/urology-patient-services/urology-patient-information/sacral-neuromodulation

Have a read and see if you still think it's a) appropriate and b) feasible for her. What does she think about what she's been told so far? Is she up for it? Only I can't see it working in a person who needs continual prompting or repeated explanation, is the thing.

First and foremost, heed Ann's advice and DO NOT bring her home for the day.

Just shrug off her anger, there's no avoiding it, but you need not let it bother you.

The line in the sand to be placed in a facility is unmanaged incontinence, so you're making the right call.

My Mom had InterStim. She was about 83 and in good health. It helped slightly, It helped some with frequency, but did NOT help with urgency or leaking. It has to be reprogrammed or turned up and down fairly often. My Mom couldn't do by herself. I had to help her and considered it a total nuisance. So did she. Battery had to be replaced after 2 years. This is a surgical procedure. Supposed to be quick. But, scar tissue had formed around the unit and the battery could not be replaced. It had to be taken out and a new one implanted. What should have taken about a half an hour out patient, turned out to be about 3 hours and an overnight stay in a room at a surgery center. My mom had great service from the Inter Stem technician when she called. But. the technician said her calls and issues were common. She went to very good urology practice at the University of Cincinnati who were very honest about the results they had with other patients. They told her upfront the results were mixed. They did not push for her to do the device. She had had previous sling surgery which gave her better results. Mom had excellent insurance and they paid all of first surgery, along with some Medicare payment.. It was incredibly expensive.

Mom was traveling a great deal at that time. Going thru airport security was bad. Having to explain to TSA in a busy airport why you just can't walk thru. It makes metal detector alarms go off. She actually had to go in a separate area and show them her surgical scar and let some TSA woman feel the implant under her skin.

When she needed a new battery the next time she declined and subsequently had the device removed - another surgery.

She found it much easier to use Depends. If I had the same problem, I would not consider having the device implant done.

Don’t bring her home for holidays. She needs to accustom herself to a new living situation and letting her snark at you would be dumb once she’s out of your house. As for the Interstim, if doctor thinks she can tolerate it, why not? If she agrees, that is.

No “bringing home just for the day”. Drop by, cookies, gifties, cards, “see you over the weekend’, hugs, QUICK EXIT.

If you’ve seen enough care settings, there will be holiday decorations, menus, entertainments. If you take her home, she will be more adamant in her refusal to go back.

The bladder issues? I’d wait until she’s adjusted to her surroundings and been in a structured timed toileting program before you move forward with anything else, unless you are pretty sure she’ll get optimum benefit.

These decisions are HARD. You need her to be safe and supervised, and she won’t want to be.

I remember how happy I was when my LO began to refer to her residence as “My hotel”, especially because I knew she meant it.