Hi everyone! My mom is still in the early stage of Alzheimer's so she can still live independently. However, I am still not comfortable with the idea of her living alone since I live a few hours away from her. I was thinking of moving her to memory care, but she refused since she could still do chores and other things on her own and suggested a retirement home instead. I know the difference between long term care and retirement home since I read it in an article on the Seasons Retirement website. However, even if she's still independent, I think moving her into memory care is the best option since she'll get the care she needs. Or is it too early to move her into memory care? Is it better to move her into a retirement home first? Any advice?
Too many people go in wowed only by the independent living amenities, which may become inaccessible in mc.
While she was there, they realized that she really needed Memory Care because she was very forgetful and had trouble keeping her balance. She never got lost, just that she would ask the same questions over and over (e.g. what time is dinner, is it time for lunch yet, etc.)
3 months later, for respite, she entered Memory Care in the same facility. They turned off TV at night at 7 pm - 7 am because they wanted the residents to sleep. She chose her food the night before and when it came, it was pre-assembled and lukewarm. Everything was borderline overcooked. There were no tablecloths or cloth napkins. Silverware was sometimes plastic and always paper napkins. No knives allowed as the food was pre-cut or ground. Whenever she left her room, they made her go back to her room. There were people in the dining hall that had trouble eating hence, they would choke and spit out their food. Because she was in Memory Care, she was not allowed off the floor just to get some sunshine or touch real plants (her room did have a terrific view.)
That was an eye-opening experience for me. Now I was able to ask the "not so obvious" questions when I toured and get past some of the marketing-speak.
Thankfully, my Mom experienced it before she was permanently placed in memory care. We nixed the entire chain, even though each location was allowed to operate independently.
When I reviewed the great reviews on Yelp, I realized the reviews were from the assisted living viewpoint, not the memory care. One would not know that unless one either experienced it or was told it.
So yes, make sure you visit the different levels of care. I wouldn't have been surprised if they were overcharging for MC to make up for the really great, fantastic service they had in Assisted Living.
In independent living, it is like living in a hotel suite that contains an efficiency kitchen. Basically, you don't want to do yardwork any more and you can cook your own meals, if you want to.
In assisted living, you can come and go as you please, ride the elevator to other floors, choose to go out if you want to, own and drive a car and be expected to follow instructions. However, you might need help preparing your own meals and making sure that you take the right pills at the right time. You may not have a efficiency kitchen in your "room".
Memory Care is for individuals who can no longer live without someone to watch over them. They cannot remember to take their medications, need help going to the bathroom and keeping up with hygiene. MC is a much more structured living program as people who have memory issues, need routine and repetition and consistency. The activities in MC are more geared toward keeping their memory exercised, whereas in assisted living and independent living, the activities are more geared to learn and accomplish.
When my Mom was borderline AL and MC, it was really up to the nurse who evaluated my Mom to determine whether she went into AL or MC. It was very hard to place her.
I would start interviewing. I would look for places that have both AL and MC. Ask them how they would place your Mom. AL is usually less expensive. However, as you add on the services like medication management, laundry management, how much time they perceive they will have to watch your Mom (fall risk), it becomes more economically feasible to be classified in Memory Care. However, the activities are very different and the food is very different. I would not put your Mom into an MC environment unless she needs to be. It would be similar to a middle school child being in the same class as a bunch of 1,2 and 3 year olds. Yes, you can do that, however, the middle school child will not be in a healthy living environment.
After interviewing a few of them, you will start to understand the difference between MC and AL. I would also find out whether they can stay in the facility until end-of-life or whether she will have to move out. Do you have to pay in, then pay a monthly maintenance fee (like a timeshare), or do you pay a monthly rental fee?
I think it is too early to move her into Memory Care. However, the nurse that evaluates new residents, will tell you which he/she thinks is better for your situation.
People think they are helping their parents moving them into these facilities when it so often leads to depression and early death.
Memory care is the last resort.
She can’t use these but The place where she is now at actually has dementia homes! People in early dementia move in, think they are living independently but they are closely monitored. So, as their skills slip with cooking, eating, cleaning, etc care is provided until they have to move to long term care. Maybe there is something like this in your area? They are provided by Shepherds Care Foundation. In Canada.
They listed amenities including golf and other activities. So, something like a 55+ Del Webb community where they highlight home features like spa bath, entertainment space, and specialty kitchen storage.
https://www.delwebb.com/Design/Life-Zones
If there are lots of assets so sell/spend; then a high level AL with continuum care may be a good option as many have memory care and nursing home options, rehab too right there and one can transition from independent AL to AL w/more assistance, to Memory or Nursing/rehab as needed . For these higher end facilities, one pays a large up front fee (about $100K where we live) and then the person buys the AL unit (can be 3 bed down to a studio size, about $250K to $100K or more depending on size chosen). But if one has a house to sell those proceeds can be rolled over. Then there are the monthly fees (about $15-18K where we live).....In other words several millions needed for a longer life expectancy. Sorry, this is not in expensive. Medicare and Medicaid does NOT pay for this. If one has private long term care insurance, that may pay for some.
Group home ALs can be much less, about $9K a month were we live and no up front fees, no need to buy an apt. But then your mom does likely does not get a private bath or suite, just a room. And in these "home like" AL, there are fewer activities as all are group for the 6 to 8 residents there. All meals together, no choice of meals in the room. If she needs "nursing home care" or "memory care" at some point, she'd have to be moved as these "group home ALs" are not nursing homes, some offer "memory care" are licensed for that but that would be more expensive, more like $12-$15K a month (where we live, east coast urban area, may be less where you live).
For all these situations where we live, one has to bring in their own furniture or rent it monthly and all require a hospital bed but Medicare should cover that.
If there are little to no assets, then one can spend down and in time qualify for Medicaid. It would be good to find an Elder Care lawyer licensed in your state to help you navigate this. Hopefully you have already executed things such as a durable power of attorney to step in and handle her affairs as needed. And hopefully you have an Advanced Directed executed so you can make medical decisions for her if needed as well as to serve as her "medical agent" as needed.
For my situation, mom w/no real assets and moderate dementia but also cannot do ALDs and IADLs; we had to do the spend down to qualify her for Medicaid. She was placed in a traditional nursing home that is Medicare and Medicaid qualified. AL would have been nice, but there were not millions to handle that expense for the hight end AL places. And the cheaper group home AL facilities w/no private bathroom, lights out at 10 and no ability to have meals in her room (she is anti social, does NOT want to be with anyone, cannot be w/a roommate due to nocturnal behavior and outbursts) the nursing home w/a private room was the only real option. Because she really cannot walk further than about 10 feet with a walker, there is no concern about wandering so the "memory care" unit was not needed (these units are locked to prevent wandering and they have lots of activities to help maintain memory, but my mom refuses any activity even in the nursing home unit, won't even go outside to get fresh air....They do not force things, that only triggers the meltdowns/outburst so it is what it is at this point.
Good luck with this. This is not a fun journey.
If you can locate a pleasant “stepped” facility near you, she’ll have the option of being moved to a level that’s appropriate for her if Assisted Living isn’t enough structure and support for her needs.
See what you can find online. The progressive living arrangements in my area are-
Independent Living - Assisted Living - Memory Care - Skilled Nursing.
I also am considering assisted living which I think is the best option for your mom. I don't know what a retirement home is and it is not really an option in my area. AL is the thing to look for. Meals, med distribution, activities. Where my daughter worked, they reminded those with dementia to head down for meals or to activities. They didn't just let them sit alone in their little apartments. Unless they strongly refused, then OK, stay in your room.
For my mom, I think she's too far gone for AL but not bad enough for MC. Kind of between a rock and a hard place. But it sounds like your mom is less advanced than mine if she is still living on her own. Start searching today.
Best of luck.
I think the retirement homes in the article are more for people with an active lifestyle, providing amenities rather than support.
My aunt was having trouble being alone in her condo so we helped her find a nice independent living place. It was a one bedroom unit that offered a nice variety of support features including meals, linen service, medic alert pulls and pendant, wireless internet and cable, scheduled shuttle service and group activities. No caregiving was included but individuals could hire their own and the staff were a reassuring presence. The unit had a small kitchenette, mostly for snacks or preprepared meals, and the on site laundry rooms were complimentary. For a while, dropping in with the echo show device was good enough for medication reminders and she made friends there. Then caregiver visits were needed.
When she got worse, she moved to a studio unit in memory care, where she was safe but not happy, because she couldn’t come and go freely. They would have moved her to Medicaid if necessary after a period of self pay, but it wasn’t necessary.
Are there any facilities nearby that offer the continuum from independent living through assisted living and memory care on the same campus?