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I was thinking memory care - they say ALF
Posted: Wednesday, May 1, 2019 3:09 PM
Joined: 4/9/2018
Posts: 66

I went to look at an ALF/memory care facility for my mom today. I've worked at retirement communities and in skilled nursing facilities so I'm somewhat familiar with different aspects of care.

 Mom still lives at home with a caregiver 4 hours a day and me stopping by daily after work, bringing meals, shopping, cleaning etc. She can dress & feed herself and doesn't wander. She's lost weight and doesn't remember or bother to eat much, hides dirty laundry, unplugs things, and sometimes doesn't recognize that she is at home and gets scared. She has the usual OK days and pretty bad days. Maybe I oversold her abilities because the coordinator (salesperson?) said my mom sounds like a good fit for the ALF.  She said her behaviors are very common with dementia - "lots of the residents are like that and they'll be checking her every 2 hours and look at this delightful menu - she can pick anything she wants." I said "but she won't be able to pick, she'll be overwhelmed." "Oh that's OK we'll figure out what she likes to eat when we get to know her. These folks are playing cards and here's an exercise room." She can't play cards! She reads the same junk mail over and over for a half hour then rips it into tiny pieces. How does that fit in with elderly people playing cards? 

There were other things mentioned that they could or would help with and there are different prices for the level of care she might need in addition to the base apartment price and they'd be glad to do a free assessment.  

I was trying to be proactive and scope things out in advance but now I feel like I'm back where I started - keep her at home where at least most days she knows it's her house and where she knows how to get ice cream from the freezer and where to hide her underwear. 

I'm thinking I could look at some other agencies since the current one doesn't do any of the stuff they said they would (She won't "let" them") and maybe schedule it so they can see that she eats lunch and dinner. Or I could wait until my sister comes down for her biannual visit in a few weeks and let her make some calls and arrange things. 

I feel so tired and confused and defeated all the time.

Posted: Wednesday, May 1, 2019 3:50 PM
Joined: 10/25/2018
Posts: 238

Forget the coordinator. The head nurse for the facility should be doing the assessment as to the level of care that she needs. That is the person you need to communicate with.
Posted: Wednesday, May 1, 2019 5:46 PM
Joined: 12/17/2018
Posts: 222

I know that overwhelmed feeling.  

Assisted Living isn't where your mother belongs.  She will feel out of place and be unhappy.  It will also pull on you and that overwhelmed feeling will continue. 

I just moved my mother into MC.  I was fighting it as it's the unknown right?  She was in AL prior to the move.

She talked constantly about going home while at AL.  She was always waiting for her mother or going out to catch the bus (in her mind).  She wasn't happy.  But it's what we knew so I was hesitant to move her.  The only reason I went ahead with it was because they had the talk with me... 'it's time to look at alternate placement for your mother'.

She's been in MC for 2 weeks now.  It's been a Godsend.  She loves it.  Always smiling.  She never mentions going home.  She never mentions her Mom anymore.  She's never trying to catch the bus.  

She feels secure there.  There are a ton of activities to keep her distracted and occupied.  The folks in her neighborhood are like minded so they sit out in the common areas together.  One of the ladies isn't as progressed as Mom so she 'takes care' of Mom.  Pushes her in her wheelchair and helps my mother with her robot cat.  There is another lady who is frail and more advanced that my mother, in turn, takes care of.  She chats with her and tells her to go to sleep etc. etc.

When I was over there today my mother actually said 'I'm so glad I'm here'.  

What I would recommend is take a good look at the facilities in her area.  I chose one that had the best recreation program as my mother needs to be occupied.  This place has 6 different neighborhoods.  I kept telling them that I would not accept the 'non-verbal' neighborhood.  The residents there are more advanced and it would not suit my mother's need to be involved and social.

It turns out a room came available in the most cognizant neighborhood.  I was a little concerned as my mother doesn't know where her room is anymore and is progressing.  However she is still social and likes to be involved.  Turns out it's perfect.  The ladies there like to sit together and although some are more cognizant, she smiles and nods and ahhhhs at the conversations.  The care aides are much more pro-active when it comes to their care.  They direct them which is what my mother needs.  When they play games like Bingo, there are always a few staff that help those who need extra attention (my mother).  

I think you will know it when you find the right place.  This place felt like home.  It also has a large AL section on the other side that I can bring her to.  We go to the Bistro, watch charades, listen to the music events.  I'm so happy.  I finally feel like I will be able to get my life back.  I actually didn't think that was possible.  But my mother doesn't cling to me for dear life anymore.  I'm so happy.

I wish you the best in finding something perfect.  Keep looking... it's there.


Posted: Wednesday, May 1, 2019 5:57 PM
Joined: 3/8/2018
Posts: 788

From what you’ve described I think MC is the better fit. And think more about what your mom is like on her “pretty bad days”. When I was looking for my mom, people here said “you need to think of the care needed on her bad days, not the good/ok days”.

This place may or may not be “the one”. Maybe increase the aide hours and keep looking.

Also: do you have a Plan B for when her funds run out? All the private-run MC places I looked at won’t take Mcaid

Posted: Wednesday, May 1, 2019 8:24 PM
Joined: 4/9/2018
Posts: 66

Lucky for me, her finances are pretty solid. I agree though, about continuing to look at other places and maybe tweaking the home care situation. I wasn’t looking to do anything right away. 

 She was fixated on her address book again tonight, looking for relatives so she could call them to take her home to PA. She moved out of PA in 1954! She thought she’d just go home to her parents & said she’s “done” with her house. I told her PA is impossible but I’d look into some apartments for her if she wants to move. She saw my sister’s (her oldest daughter’s) name in the book and said “ Now here’s my sister’s number.  I wonder if she’d know me if I called.”  I wonder who I was? An aide maybe. 

Posted: Wednesday, May 1, 2019 8:49 PM
Joined: 12/17/2018
Posts: 222

I really believe our LO's tell us what they need even when they don't know how to express it.  It sounds like your mother is telling you that she is getting ready to move.  

My mother, in her last week in AL, actually said 'let's get this move over with already.'  

The thing is... I didn't tell her she was moving. Not a peep.  But she was ready to go.

Posted: Wednesday, May 1, 2019 10:34 PM
Joined: 10/21/2016
Posts: 2422

I always wonder what's going on behind the sales pitch.  Is it possible that they don't have any rooms in memory care?



Posted: Wednesday, May 1, 2019 11:18 PM
Joined: 6/20/2016
Posts: 1943

JJAz wrote:

I always wonder what's going on behind the sales pitch.  Is it possible that they don't have any rooms in memory care?




This is very possible - OR - they can nickle and dime "services" for a more lucrative monthly total in AL.  Their goal is to get her in any way they can because once they move in, the family can't even begin thinking of how to "move" the LO again.

The description of the level of impairment says MC to me.

Posted: Thursday, May 2, 2019 4:37 AM
Joined: 3/6/2017
Posts: 1642


I'm with the others- color me wary of marketing goals over a good fit. 

I got a lot of good advice here when I started to explore Plan B for my dad. He was home with my mom but his care was impacting her health. I knew I would lose one parent to this dreadful disease- I was prepared to sacrifice the other as well. 

I limited my search to places that would accept Medicaid should dad run out of money. I needed to preserve some assets for mom's care should she need it; she has osteoporosis and is losing her vision so odds are good she might need care in a SNF at some point. 

When I toured, I looked at MC (sometimes called assisted living for MC) and SNF. Sometimes the MC side of things was much nicer than SNF- not just décor, but also the engagement of staff with residents. In a couple of the larger CCRC places I toured,  each sales representative was responsible for a specific level of care. It could be your rep "sells" and has quotas around AL exclusively. At one place, the rep told me I couldn't tour the MC side that day because they had a disruptive new resident; when I visited the next week the sales rep claimed they hadn't had a new resident in almost a month. 

Or it could be they have a waiting list for MC or feel you would be a good candidate for bait and switch or considerable upcharges for needed support in AL.

Good luck going forward>

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