How to complete Mom's move to assisted living?

Does your mom still communicate with her old friends and neighbors on the phone?
I know I would do the caretaker route in her home as long as it worked. You haven’t tried that yet so you don’t know. I couldn’t do what you are doing now. id probably move her home. When she progresses I’d move her to the assisted living near you. She sounds to me like she just needs a few hours per day of care.

This is a tough one. I'm actually wondering this myself. Trying to get some ideas.
One idea is be firm. For example, you could say, listen mom, I need to i work. Or I'm busy and can't give you all you need. But there is a nice place that can. Mention the benefits of plenty of people to see etc.
All the best

You’ll never convince this lady to do anything. She’s just like my mom and 99% of elders as the executive reasoning goes away. So you’re faced with trying to force her into care, good luck with that, or waiting till there’s a health crisis or ER trip, then move her to “Rehab” And or assisted living.

With my mom I had to wait on the medical crisis and move her from hospital directly to assisted living. She was about 3 years too long at home by this time.

And get ready for the tears, anger and guilt. But you have to save yoursel and have a life. Mom will be fine.

Can you find an adult day care near you that she can attend a few hours a day to get you some respite?

Don't you have some surgery that needs to happen soon? (therapeutic fib--make it a rotator cuff). She'll have to go somewhere while you recover. Arrange respite at the AL you've chosen. She may love it.

Wait for a hospitalization. Discharge her to rehab which then becomes permanent LTC.

Have you said "mom, I can't do this anymore"? Find 2 ALs nearby and give her a choice. Keep your language VERY simple; short sentences.

Thank you for the suggestions.
I have and the the doctor also suggested an adult day program, something called Menory connections. But that was met with a resounding no. Her neighbors and friends are the ones that alerted me and my sister to her more recent difficulty, there have been phone calls in the middle of night to them, with confusion that she didn't know where she was when she was really at home. Evenings are much worse. She is forgetting how to do things she use to do no problem. For example she used to warm leftovers or frozen dinner in microwave, but her old microwave stopped working, and she cant remember how to use new one. She is very concerned, paranoid even, about fire. Ant blinking light, or strange noise and she asks do you think it's going to catch fire? She was Turing off TV early in the evening because she was afraid that she couldn't get the TV off before bed. She unplug everything before bed, because of fire fear. Which causes problems with some electronics resetting when she tries to use again.
She use to use her cell phone, but even that now confuses her. She gets a text from a friend, but doesnt remember how to answer it. Then she she a 1 next to her email con, and cant remember what that means ams worries ...fire hazard. The word confusion causes communication problem. I spent 30 minutes helping her look or her cell phone, only for her to say "found it" and hold up her house keys.
Sometimes she wakes up completely disoriented, at night or when she dozes off In the middle of day. Once she got up to use bathroom in middle of night at my house, but there were "strange men in hallway" she was scared to leave room and ended up peeing in the bedroom floor because she waited for them to leave. I was just sleeping across hall!.
She wakes me up several times a week, talking about people and things that aren't there.
I made a quick run to a grocery store, was gone less than 30 minutes, but when I got back, she was totally scared, because of a crawl message at bottom of TV screen.

Onice the driving eval and holidays are over,we are goinn to have to do something

Gracie, she is past the time when she will be reasoned into anything. Do the legwork yourself to find a good facility close to you. Get her signed up. Make her new digs look as similar to her current living space. Call the facility and get advice on how best to get her physically there so they are working with you. I'm so sorry that it's probably going to require this strategy, but she needs to go where she can get the best care all day and night. Don't feel guilty! Dementia is cruel and messy and none of it is your fault, or your mom's. It's is what it is. You still have life to live. Please read the many thousands of posts on this forum by burnt out caregivers. No one ever plans to become burnt out...it just happens. Don't let that be you! Blessings!

Your Mom needs an AL if she can afford it. Your POAs are in effect, use them. Its no longer what she wants, its what she needs. Your Mom is pretty much where my Mom was when I placed her. Mine a little further along. She didn't fight the move. I would not try to handle in home help from 200 miles away. Some aides are unreliable and may take advantage of a person who isn't there on a regular basis.

Same with Daycare, someone needs to get her up and ready. My Mom had a bus pick her up. She at first didn't like it and wanted me to take her. It was 36 miles a day if I took her. Told her no, that she needed to take the bus. The time I would have spent taking her, I got a shower and then DH and I would do something.

You go look at the ALs. You pick one you like. You are wasting time waiting for her to agree. It may never happen. She no longer can be reasoned with. She does not realize her limitations. Yes, she will be mad but now is the time. If you wait too long, its going to be harder for her to adjust. When you have made the decision, you ask one of her neighbors to invite her for a visit. Then you move what she will need to live in the AL. You take nothing valuable. Take only the clothes she will need. I did it by seasons putting the clothes not needed in under the bed boxes. My Mom played with her clothes putting clean ones in the wash, putting dirty ones back in the closet. Under the bed boxes she didn't realize were there. One coat, a couple of pairs of shoes.

Don't wait. Decline can be gradual it can happen overnight.

I would choose the place, get as much of her stuff moved in to her room in the morning, maybe your sister could do this or take mom to do something, then you say that the 3 of you are going to meet for a meal.

Park in a place that is not the front door of the facility, check out if they have multiple entrances and use the one that doesn't have a sign. Go enjoy a meal together and then you and sister make a bathroom run and let the facility take over.

She is going to have a fit and you guys are going to catch it, but she needs 24/7 care, whether she knows it or agrees or not. It is extremely difficult to place someone that doesn't know they are having trouble. You have to remember that you are the adult now and you have to do what you can to ensure that she is as safe as possible. Happiness is not part of that. She will adjust if she likes to people watch and socialize, this is one of the benefits of a facility.

I would be sure and talk with her doctor about prescribing something that will help calm her down for a day or two, change is hard on dementia patients and the facility knows this, so they expect some rough behavior for a few weeks, that is why they say stay away and let us deal with it. I didn't do that, I thought it was cruel and wrong and I was never let off the hook, my dad would ask me for things that the facility would do. It just made things harder, like not asking them for water, he would go thirsty until I got there. They really do need to learn to navigate their new home and figure out who to ask for help.

Another thing was that I was always told how awful everything was and when I would ask the aides they would say it was wonderful and he was doing great, so I stood back and watched him when he did not know I was there. He was doing better than he led me to believe, everything was not completely wonderful but, it was definitely better than awful, by a long shot. He was trying to manipulate me and keep me torn up while he was actually enjoying a pretty nice and happy life. So be prepared for the hustle of guilt and shame and anything else that she will use to get what she thinks she wants. Don't buy into all of it, watch and see for yourself.

I would bake or make homemade goodies that my dad could share, then we would visit in the public areas and I would greet other residents and offer treats, then introduce my dad, this helped break the ice and gave him people that now had a shared happy experience and a name, made it easier for him to get to know people. Then they could all say hi to one another or do meals and activities and not be total strangers. I also did activities with him so that he could get engaged without any fear of being the new guy. I found that it is a lot like a shy kindergartener, they just need us to have their backs for a bit.

Best of luck finding a place that feels like a good fit and here's some strength to do this. I bawled like a baby having to place my dad, but I couldn't do it and he needed more than I could honestly provide. His health improved tremendously with the proper care and I believe the stimulation of peers to interact with. Hugs for all you have done.

Gracie, When I started reading your post, I had to go back to see if my name was on it and it was a post I wrote a few months ago. Your mother is a mirror of my mom! She is doing the same things. She also said she wasn't going to Assisted Living. I went by myself to check out several places. I chose the one I thought fit her best. She had a friend at one of them, so I took her to visit. On the way out, she said to me, "I hope I never have to live in a place like that." That facility was beautiful and well kept. So, it was her telling me that she wasn't going anywhere. I know in my heart she was hoping I would bring her to my home, but after the last several visits to my home, I realized I was not cut out to be a caregiver of my parent. I love my mom with all my heart, but I know my limits and I know it would not have been good for either of us. Even though I was an elementary art teacher for 37 years and displayed the utmost patience with my students, it is a totally different ballgame being a caregiver 24/7. I then arranged to have her move to the facility I found best for her. I simply moved her. She still packs her things a few times a week and tells the staff she is moving home. They tell me this is normal and not to worry, that it will stop once she gets settled. She fell shortly after moving in her hip broke and she spent time in the hospital and a rehab facility. That did not help the situation. But she is now back at the facility, but instead of her Assisted Living apartment, she is now in memory care. I am so thankful that she was there and had staff that knew exactly what to do. She had been living on the family farm and the Dr. made her give up on driving. I've never seen my mom that mad before. I am having trouble now wondering what to do with all her things. For now, they are where they are and I'll worry about those things as needed. I hope you will find a nice place for your mom. Do you know anyone that resides at one? Any of her friends?

I would look at a few places. This way you will feel better. Can you have her doctor tell her it is the best choice for her? That may take the heat off of you. She will object but you don’t have any other choice.

Best wishes to you and your mom.

Gracie, my mom and I have been recently looking at assisted living facilities for my grandma. My mom was asked at one place if the power of attorney had been activated. In my state, when the POA has been activated, the individual legally has to be placed in memory care or skilled nursing. They no longer have any say in the matter. Maybe talk to a social worker or lawyer knowledgeable in elder law.

We were told to basically look at assisted living communities first and only take her back to look at 2. My grandma only needs a low level of assistance though. The place we plan on taking her to look at is a low level of assisted living and independent living.

Good luck!

All I can add is that I completely understand where you are right now. I am there with you. The guilt the worry about making a mistake in forcing a move is relentless. I’m praying for me and I will pray for you on this path we are on together.

Many Assisted Living communities have respite services available (short term stay). I would tell your mom she is going to the assisted living for a "respite stay", tell her she going to be there a week or two. I have done this with many of my clients and once they get to the assisted living they love it. Many individuals have misconceptions on what living in an assisted living is like. Having her go in as respite she can get a good idea of what it would be like to live there.

My mom has been in a retirement home for nearly 5 years and still is constantly complaining about being there to me! When I’m not there she has a great time, the staff send me pictures of her.
The facility has some residents that help get new residents settled and introduce them to other residents and activities. It gives the ones that helps something to do and feel helpful.
perhaps ask if there are residents that would be a new friend

Wow! I can’t believe how so many of these stories are exactly like mine with my mother! When I could no longer care for her in my home and she couldn’t live alone, I told her I couldn’t continue taking care of her 24/7 and we needed to find an ALF. She would agree but forget. We toured 4 and picked the one closest to my home (2miles) but she didn’t remember that either. We had some of her furniture and things moved so the apartment was ready when she moved in. She didn’t like it at all and became a handful for the staff but they assured me she would adjust.

she fell out of bed the first week and was taken by ambulance to ER where she had an MRI of her brain that was compared to a previous MRI and showed significant deterioration. There was also lung and heart function deterioration. Before leaving the ER I received a call from her PCP nurse saying the doctor thought it was time she was admitted to Hospice. She was evaluated when she returned to ALF. I was told I should start preparing for her end of life soon because her symptoms and behaviors indicated it could only be weeks. Six weeks later she appears to have improved in some ways but is totally dependent on someone to help her eat and bathe. She has a hospital bed and fall mats in case she falls out of bed again. She is definitely in the best place for her but she made me feel guilty for not letting her live with me. She says things like I don’t want her, I’ve thrown her away, etc. I wish I could take better care of her but I can’t. She doesn’t realize how demanding she is and how much care she requires.

She can’t feed herself so I feed her lunch and dinner and the morning CNA feeds her breakfast. She can’t walk and is very weak so she stays in bed all the time and sleeps most of the time but still tries to get out. She is i continent so wears disposable underwear. She needs help showering and getting dressed.

I find it very helpful to read what others have gone through that are similar or even the same as I am and what suggestions have worked. I hope that you find a solution and validation that what you decide is the best thing for your situation. Best of luck to you!

Except for the part about living with you, this could be our mother you are writing/asking about! What I have drafted is too long, so I will post the comparisons as a comment to my comment.

"So here's my problem. We have the "you can't live alone anymore" discussion."

Yup. Although her plan included moving to AL if/when she felt it was needed, just the mention of AL would bring words and facial expressions of disgust. NO interest. Brothers offered to take her in (would have been a huge mistake!) but she said no.

"Get her to agree to "go look" so we know what's available. But the next day it just starts over. There is no way to complete the task!"

This isn't going to work for several reasons. 1) in her mind she doesn't need it and 2) any discussions are like dust in the wind. She will forget the "talk", in minutes, hours or the next day, but it WILL be forgotten. You will drive yourself nuts trying to have the discussions and/or trying to get her to agree.

It would be best for you to tour a few places, make notes, ask questions, find the place that would best suit her and her finances. If needed, consult with EC attorney to discuss details. Ours told me that we couldn't force her to move (we have POAs, etc done years before) and suggested guardianship, but the place we chose doesn't do committals. Don't go that route if you can avoid it! We had to come up with a ruse to get the move done. Getting cellulitis just before the move gave YB an idea for a fake letter, which he used to convince her that she either moves where we choose or social services would move her.

"So assisted living near me is the best safest solution. She needs someone to give her her medications every day, someone to remind her to eat a regular meal, and some social interactions. She is fine to walk around, bathe and dress herself. Loves to people watch, and watch game shows on TV. Gets a little tired if she has to walk a lot. She gets a little off balance on occasion, so I think a fall monitor would be good"

When choosing a place, it would be best to find MC/AL. She doesn't sound like AL would be the best choice and those with dementia take moving hard - so if she had to move to AL then MC, it would not be good!

"What do I do? Choose a place, and tell her this is where you are going?"

If possible, choose a place for her, but avoid the "tell." If you have friends/family who can help, arrange to have them move her furniture, clothes, etc, or hire movers with someone to "manage" them, while you take her out to shop, visit the grandkids, etc and then go to the place for lunch or dinner (most will offer a free meal.) When done, walk her with staff to the MC area just to "look around" and let them occupy her while you exit. It won't be easy or pleasant, but it can be done. The staff told us to get her there, they would do the rest. They did order Lorazepam to counteract any anxiety/anger issues, but only for the short term. They also suggest we don't visit for at least a few weeks, to allow some adjustment.

"She is strong willed and has always been very independent, so I don't think she's would just say ok. She is in denial about how much confusion she exhibits and the mistakes she makes."

Yup. I'm fine, independent, can cook and take care of myself. I am old so I am allowed to forget a few things now and then!

"Mostly I just go with it, but sometimes I have to correct her, and she says I'm wrong or I changed the plan."

Best to stick with the "go with it" as it is fruitless to correct, argue with or try to convince them otherwise. This is their reality and for the most part we have to learn to live in it with them.

"And then there are times when she is talking and acting like her old self."
Yup, it is so odd what IS remembered and what is forgotten.

Find a place. Enlist help. Make a plan to get her there, enlisting the help of staff at the place. Skip the discussions.

Seems you have all the facts and the legal paperwork to go ahead and find mom a nice place in a memory care facility. Your mental health is just as important as your mom's physical health. I always default to 2 words for providing care: safe and healthy. Mom needs to be kept safe and healthy in her dementia. Happiness is fleeting but is achievable if the caregiver is kind and respectful.... but never guaranteed.

Since mom has difficulty remembering conversations - create a simple contract with her that outlines that she can no longer drive AND needs to live somewhere that kind people can oversee her care 24/7. Post a copy on the refrigerator and keep one in your "mom files". Then, decide on a "move date" so you won't prolong the process of finding and moving mom in to her new home. Post that on the refrigerator too.

Visit enough places to narrow your choices to 2-3 places. Visit those "finalists" with mom. Ask her to "rate" different aspects of the facility with a checklist (you'll need to create this). After she "judges", celebrate selecting the "winner."

As disgustedtoo suggests, skip the discussions. You can do the choosing of the MC/AL facility. Your mother will not be able to make that choice. You know what she needs and you know what you need to keep your sanity. Hopefully the facility you choose can offer some helpful guidelines and assistance in working through your mother's anticipated resistance to this move.

We wish you the best. Be sure to let the forum know how things are progressing.

Good luck finding a good AL; the bad ones far outweigh the good ones.

After posting, I read new posts, and updates from you. One note: have you checked for UTI? Skeptic when I joined the forum, but have seen odd things when they have one! Sun-Downing, when none before, bed-wetting at night twice now, which stop after treatment. Some of her odd behavior could be related. You can try a home test, but get a culture test too. If not, try anti-anxiety meds for issues?

"She has good long term care insurance, plus an income from a pension. I'm goin to look this weekend. It's just going to be messy.and emotional."

Awesome she has LTC insurance (we don't, but mom/dad were good savers and setting up a trust with proceeds from the sale of her condo added in, she'll be covered for yrs! It is 3 years now - she is 96.) Pension is good to have, hopefully your POAs can help manage these. I commented about SS. They don't accept POAs, you have to apply to be rep payee. I called my local office, not hers, and easily applied and got accepted. They didn't look at one piece of paper I brought in. Although taking over the bank accts can work to a degree, we needed the address changed to ensure we get tax/other documents. SS specifically states using their funds w/out rep payee is NOT acceptable. This applies to ANY federal entity (mom's was dad's federal pension - I had to leap hurdles to get that done! It was worse than doing the SS!) Pension address needs updating so you get her info.

"Yes, she keeps talking about "those places". Can I ask how you arranged to have her moved to the facility? While I have durable and medical POA, wouldnt she still need to sign something?"

Yup, "those places." As I noted before, her plans, before dementia, included moving to AL. At the time she needed it, she made noises of disgust. When I mentioned they have better food, she asked how do I know (she used to go to the free tours/lunches all the time and raved about the food!) My reply was ANYTHING was better than the crap she was eating. Disgust extended to Meals on Wheels too, despite coming from the Senior Center, where she used to go with bells on with others, esp when free/low cost!!! You can't reason with dementia and can barely understand it sometimes!

Sign EVERYTHING as DPOA - this is what it is for!

In mom's case, couldn't move furniture beforehand, so I bought items for her - not her taste, but the choices weren't great. I left mom's move to my brothers, expecting to get the blame anyway, like with the car. Somehow she knows better than to ask me! Thankful for small miracles! The fake letter is what pushed mom. You could try getting one from her doctor(s) stating she needs it, at least "for a while", to help with whatever is bothering her the most - then the "blame" goes to the doc, not you. You can use that over and over - doc says you need to do X or Y in order to "go home." For some this doesn't work (they say the doctors don't know what they're talking about!), but if it's worded well, she might consider a place you choose vs one the state chooses (maintain the whole time that YOU have no say in this!) If not, resort to help for moving things and get her out first, then go there for a meal is about all you can do. A little anti-anxiety beforehand might help (get this started before the actual move, so you can see if the results are good.)

Going forward, inform yourself and learn the "tricks", which can require little white lies/fibs. We are NOT lying to hurt our LO, but rather to protect them. Some demand honesty, but what good is that when you have to repeat it and hurt them each time? The fibs/lies are to divert the issue and assuage them, leaving some hope in place (we know this is it - they don't need to know and it DOESN'T hurt to give them hope.) Many demand to get out/go home, pack up/announce they're going home, cry, whine, accuse, etc, and there's nothing any of us can do other than to understand this is what happens and learn to let the guilt go. You are doing what you feel is BEST for your LO!!!

Yes, in your words: "Choose a place, and tell her this is where you are going." The strong willed, independent person you always knew is now a confused, vulnerable, befuddled, frail elder who needs 24-hour supervision. She needs you to make decisions for her care, so go ahead and make the best decisions you can with the resources you have. Although there will be days when she talks like her old self, she will never really be like her old self again, and unfortunately 6 months from now her speech, behavior, and thinking will be worse. She can't comprehend this, but you must.

I am trying not to repeat others here, but I had a little suggestion from her psychiatrist.
Find three places, two good and one bad. Take her to each and let her make the decision herself. We told her she needed the care, but not how long and not why. Going was not a question I debated with her, but I did debate the pluses and minuses of each.
Redirection is something I learned a little late in care giving.

Welp, this is the post I needed to read, exactly when I needed it. Thank you for writing, and thanks to everyone for your replies. I'm where you are, with a mother who needs help but can't understand why because she thinks she's "just fine". I can't offer advice, but I can promise warm thoughts and encouragement!

One thing is a given and that is that you have to the one in charge now.

Before my Mom moved to ALF - months before she agreed to look at places just in case… We got down to a top 2. Then months later she agreed to go for respite for 3 weeks because we had 2 trips. We picked the one that would accommodate that. It was still difficult. The following spring she said she'd go to ALF - but I didn't really believe she would do it willingly. The next summer my cousin stayed in my home and tended to Mom while we went on vacation. When we got home she said she realized she needed to move to ALF. So I just jumped on it - and within about 3 weeks she had moved in. She wound up at the one she had done the respite at as most familiar and good layout. Subsequently due to management changes mostly she is now at a different ALF. 4.5 years total. Gradual decline to where I'm getting that I need to either present 2 choices or make decisions fully. She is less and less capable. I will also say that seeing your loved one in a place you are touring gives good information regarding their "fit".