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Assisted Living/Complicated Parent Issues
Dealing with 89 year old LO who had MCI from TBI in 2008 plus thigh dystrophy from lipotor and see never did rehad so declined. I believe my stepdad has undiagnosed FTD, but some form of dementia for sure (but he is different when at docs) - still technically drives. About two years ago he got lost, was found 50-60 miles away, small town, lost front wheel and drove on rotor until it wouldn''t move. His daughters went with him to doc''s appt - conclusion was it was from him chewing tobacco. Last spring he parked up on the sidewalk at mom''s hairdresser''s place (they''d been going their for years) since he couldn''t figure out the on street parking. Up until more recently his eldest daughter was in denial. In Oct my LO had a small stroke which hit her where she could least afford it - her legs and brains. Up until then they were still living in a tri-level (with chair lift) marginally as the doc wouldn''t enact my POA. After the stroke, the rehab told me I was the decision maker. After rehab we moved her to AL and my stepdad chose to go with him. Then complains all the time, wanting to know when they were moving back. My LO was more aware of the situation being permanent. My LO had a UTI at the same time as the stroke. Since moving into AL she''s had 3 more UTI''s, the first requiring hospitalization/rehab (4 weeks). About 5 weeks ago my stepdad got pneumonia, went to hospital and has been in rehab since. Mom''s mental is doing a freefall downwards with him in rehab (across parking lot so she does get to see him at least once a day).
A couple weeks ago the AL sent Mom to hospital as she had a fall outside since she had a low temp and was being treated for UTI. Hospital checked for broken bones and released her as she was fine - didn't have any info from AL to check on UTI. AL refused to accept her. SW got involved, etc and we were able to take her back 'with a plan in place' where we had to have, immediately, 24/7 coverage until other arrangements are made. I took off work (had no choice). Later that day I talked to the Executive Director as when we moved in we were told that while people could not stay if there were wanderers/need 2 person transfers, that they'd watch for a trend and unless it was an immediate safety issue they'd work with us and we'd have 60-90 days. The Exec Dir told me she didn't think Mom needed anyone over night. I asked for it in writing and she refused so I stayed. We had a meeting the next day with her and the new RN and they invited the Ombudsman. They said since Mom was outside when she fell and had mentioned earlier in the day she wanted to go home that she was an elopement risk. The family believes that since we've tried to get her more independent that she was trying to go see her DH across the parking lot. She is embarrassed about the fall and won't talk about it. We came up with a 30 day plan...we had to have someone with Mom 2 hours in the morning and two in the afternoon when she was most likely to want to go see her DH. Next morning she evidently tried to get out of bed herself and slipped to the floor. Now she's a safety risk and we have to have 24/7 coverage for safety supervision ($552/day) and they are saying she is a 2 person transfer (this from the new RN that does not know LO unique way of transferring). They had home care PT assess her and they had someone who hadn't worked with her before do the assessment (although it was their PT that devised LO's unique was of easy one person transfers). Interestingly they own aides and the ones we are paying for say LO is a one person transfer. My stepdad isn't out of rehab yet. Exec Dir originally said LO HAD to be in memory care, then memory skilled care, now skilled care, maybe memory care. The folks do not do well mentally when they are apart. However, when my stepdad is with LO he insists on continuing to transfer her by himself even though he has his own physical issues...he even was assisting LO transfer in bathroom when she was over visiting (gee, if he can do it one person why can't the new RN). We've heard rumors the AL may not accept him back as they are trying to upgrade their residents. His care meeting is today and we expect rehab to release him.
I've heard our town's facilities are not in good shape/availability right now.
We are lost, overwhelmed, and don't know what to do or where to turn. We have jobs and I have already used up all my vacation/sick time and I am now using unpaid days which we cannot afford. I'm checking into local support groups but next one isn't until another week. I'm not sure how much of this makes sense...we're going crazy. :}
Sorry you must be here. I hope writing all this down has helped you focus on what needs to be done now. You LOs will probably be better off in a secure memory care. They offer more oversight and usually have more help staff for their residents. When I was looking for memory care for my mother, I went outside my town and looked at facilities within a 45 minute one way drive. For the right place-that kind of drive might be tolerable- at least 3/4 of the year. Call the local Alz org and see if they have recommendations. As well as asking the folks you'll meet at the support group if they know of anyplace that is good.
I know it seems overwhelming ,but take it day by day and step by step and you'll get to the results that are necessary to help your LO's. Good luck!
The care needs of both people you describe are far, far beyond the ability of a traditional AL setting. Let AL go.
MC or SNF are your next two options. Hopefully, a rehab stay buys you some time to visit if you haven't already chosen one of each.
DPOA's don't need to be activited, Transitional ones do, and as to the MD who should document that, a geriatric psychiatrist has the best handle, most GP's won't touch that with a 10 foot pole.