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I am caring for my husband at home and as of now he is capable of dressing, toileting, eating and and showering (his ADLs). He does have considerable confusion at times, but is not dangerous. He no longer drives. At what stage is admission to memory care appropriate? His diagnosis of Altzheimer's is new and so is his med, generic Aricept. Many thanks!

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Your goals are to make sure he is safe and healthy as well as making sure your needs (health, social, financial, spiritual...) are met as well. You will need help (family, friends, members of faith community, paid help) when you can not safely leave your husband alone at home or care for all his needs alone. It is wiser to enlist volunteer help early so that others know his routine since times will come up when you will not be able to care for him (your injury, your illness, your appointments...).

Each facility and home healthcare agency has their own screening tools to help determine appropriate placement or resources. Basically, it all comes down to needing more care than you can give alone for most of the day. That is when it will become more feasible to move him into residential care.
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The criteria is, he has a Dementia. His diagnosis maybe new, but he was probably showing signs way before. He's ready for Memory care when you feel you cannot care for him anymore.

Get you ducks in a row now. Hopefully you have POA. If not and he understands what POA entails then get one now. See a lawyer about splitting your assets. His split will go to his care and when almost gone, you apply for Medicaid for his care. At that time you become the Community spouse staying in ur home, get a car and enough of your combined monthly income to live on.
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indubuque: Please consider my post an error. I am sorry.
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I do not understand some of you that tell posters they have asked a question before or remind them you told them such and such. Those sorts of responses have absolutely no value and I consider it rude! I was once, a long time ago a new user on this site. It wasn't easy to figure out to begin with. And I am sure I posted the same sorts of questions a number of times just trying to get more input. I felt ignored an discounted often, in the beginning. How was I to get attention when there seemed to be cliques on this site. I came to learn this site is so helpful most of the time.

To the regulars, just try to remember how overwhelmed you were in the beginning and how desperate you were for an answer that would be the magic potion.....

Bring out the compassion and understanding and patience. That is what helps the most. And for goodness sake, don't gang up, it makes a very difficult situation even tougher. These people are often desperate for answers! Try to be helpful and empathetic.
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Your situation is similar to mine except my husband's diagnosis is vascular dementia and my husband needs a little more assistance with dressing, bathing and eating. He also has mobility issues and uses a walker to get around. It was becoming difficult for me to care for him constantly during the day. He has lost interest in most everything and can't do puzzles, read, or understand what he views on television. I thought his life would be more enjoyable if he were in a memory care facility where he would have socialization, activities, and round the clock care. I placed him in a care home with a memory care unit and I think it was a mistake. My husband went willingly with the understanding that if he didn't like it, he could come home at the end of the 30 day trial period. He doesn't like it and wants to come home. Unfortunately, I think I placed him there prematurely. He doesn't want to participate in the activities and his only communication is with the staff and it is very limited at best. He can still communicate but his ability to find the right words to express his thoughts is extremely limited but he does understand what is being said to him. Needless to say, it is extremely frustrating for him. In the memory care there are only four men and twenty-six women and the four men can not converse at all so my fear is that he will slowly lose what little verbal skills he's been able to retain. He does not engage the women in conversation, even those who can still speak.

I am now working on getting him into a senior day care center in my town. I can take him there in the morning and pick him up in late afternoon. He can go five days a week or only a couple of days. It offers the same programs as the memory care facility. He may not like it any better than the memory care but at least he will be living at home. I am also working on finding caregivers to help me as needed when he is home.

I think placement in a care home will also depend on your ability to care for him at home when he exhibits dementia behaviors or you become physically limited. At 82 my energy level is not what it used to be four years ago when he was first diagnosed even though I'm healthy and physically fit. I was exhausted by the end of the day and I was becoming impatient with him.

My husband also has confusion and Meletonin does seem to reduce "sundowner's syndrome".

I hope my experience is helpful. Consulting with a neurologist may also provide insight. I think the time to consider memory care is when your husband's dementia becomes too difficult for you to handle and when you are physically unable to care for him. Taking care of someone with a dementia and making decisions that will benefit both of you, at any given time, is the most difficult decision to make.

I wish you all the best.
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indubuque: You have two other separate threads on this issue. One is dated October 12, 2022 and the other is dated October 20, 2022. Perhaps to better understand your husband's dementia, you could garner information by reading the book, "The 36 Hour Day" as I suggested to you on October 18, 2022. Best of luck during this most difficult time in your and your DH's life.
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Consult his doctor. That is what with did with my MIL. Like your husband, she is fine with her ADL's but gets progressively more confused, loses things more and more, and repeats the same questions more as time passes. She is not a wanderer. In Arizona, Assisted Living facilities are licensed as supervisory, personal care or direct care with direct care being the highest. She currently is in a facility licensed as personal care and we are in the process of getting her in a direct care licensed assisted living with memory care available in the same building in the future.

Before we consulted the doctor, we toured facilities that had both Assisted Living and Memory Care thinking she might be ready for memory care. But we realized that she was more "with in" than the memory care residents and we started thinking that while she could benefit from some of the activities, she might lose her "spirit" in Memory Care. When we consulted with the doctor who tested her, he suggested putting her in an Assisted Living facility that is licensed as direct care for maybe one or two years...I now think it will be less because the decline has accelerated.

As others said some of it is up to how well you can tolerate his changes. If you have the same doctor as him, maybe he can counsel you as what to expect and what may be best for you. If you decide to get him into Assisted Living, make sure it is licensed at a level that they won't kick him out if he becomes assessed as needing memory care. The facility my MIL is going to said that if a memory care room is not available, they can provide the care in AL until Memory Care is open.

There are financial considerations too. Get an understanding of the costs of AL and Memory Care and consult your financial advisor how to make it work when the time comes.
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Everybody ages differently, and dementia is different with everyone. The best thing to do is to observe how he's handling things. For example, my mother started to use the mirowave incorrectly in her independent living apartment, and set off fire alarms a couple of times. She also was a wanderer (I call it an "adventurer"). She'd go into town and get lost and wouldn't be able to find her way back to the facility. At that point facility called me and said it was time for her to move to memory care. So the basic rule of thumb is that if a person is doing things that are dangerous to themselves or to others, first try getting them to stop doing those things, and you can be the one to do the cooking and escort him where he needs to go, for example. And expect that he'll need more care as he ages. When it gets to be too much for you to handle, consider memory care.
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You will need an order from his doctor.
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You are repeatedly asking this question....when should I place dh in Memory Care, and the answer is when YOU no longer want to care for him at home. You say he's not much help at home, but how helpful do you expect a dementia sufferer to be??? Do some reading on Alzheimer's by getting the book Understanding the Dementia Experience by Jennifer Ghent Fuller. Then you'll better understand what dh is going thru and what you can expect moving forward.

Tour some Memory Care Assisted Living facilities and get a feel for which one fits his needs best. My mother lived in regular Assisted Living for 4 years and then segued into their Memory Care building when her dementia advanced and she required more care and a shrunken world due to her deficits. Incontinence, being wheelchair bound, needing help with showers and transfers in and out of bed all made it necessary for her to have care 24/7 by a team of people. She also benefited from the socialization and activity program offered in the MC.

In the end, nobody but you can decide when it's time to place dh. Have your ducks lined up with memory care ALs to take him in when the time is right. Don't wait for an emergency situation that forces his placement...but have him make the move when things get too much for you to manage alone at home, in terms of his care. Some people keep their spouse home for the duration while others place them right away. Every case and everybody is different. We all have different tolerance levels for providing hands on caregiving, too.

Good luck to you, whatever you decide.
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indubuque, the criteria for your husband to go into Memory Care comes when you feel it is starting to become overwhelming for you to care of him at home. First, let's see how he does with his new meds.

Have you considered hiring a caregiver to come in for 8 hours a day to help lessen the duties you are doing now. It would give you more personal time to do things you like. One would need to budget for a caregiver, which can cost between $15/hour for non-Agency, to $30/hour for a licensed Agency [cost vary from area to area].

Once you feel that you need someone to come in for more than 8 hours, then it would be time to think about Memory Care as having 2 shifts of caregivers would cost more than the cost of one month's rent at Memory Care.

My Dad was living in a senior facility in Independent Living, after selling his house as the maintenance on the house was too much for him to do. It was when he started to wander at night, trying to leave the building, that the Staff informed me it is time for Memory Care, which they had available.
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when we were looking at memory care with the test results from SLUM and MoC
indicating moderate dimentia we were told the facility does their own test and will dermine their placement--after placement the unit reavaluates yearly to determine correct placement.

we only looked ar facilities with multiple levels of care. he's at home so we didnt have to activate assisted living, the one i liked best had an apartment building that was independent---just had access to staff if requested..and full independent living with three meals a day a frige and mic in their room for their own snacks, the facility did their laundry a nurse monitored their health.
it was an unlocked unit. then they had a memory unit that looked the same but it was locked and didnt have microwaves in their rooms because they can put metal in a mic and not safe for memory care patients to have their own microwave......
another facility had the independent living and memory care.. but the memory care looked like a prison. I guess they don't know or care anymore,,,but

then it would come down to beds available. the facility i liked the most only had 1 bed available in memory care..so he would have entered by that memory care then been transfered to independent living when a bed opened up.

My dad needed indepent living care and a facility that had both would be less upseting when be needed to be transfered to memory care
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baileyif Oct 2022
my father dimentia is new too. its a frustrating place to be at, always knowing the future will be worse and wanting to be prepared for that but not knowing WHEN?
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