Due to finances I’ve no choice but to move my healthy 98 yr mom to AL this fall. Have a nice one picked out, grateful that I’ve got a few months left with her at her home due to Covid. Right now she’s very happy, age related memory loss (not horrible) will land her in the memory side of the facility because she would not remember to go to meals, and does need a little help with dressing showering. My biggest worry is how it will affect her. I’ll get her moved out by the fiblet method of ‘house needs fixing and septic broke’…but once she’s out I HAVE to sell her house. There will be no coming back. So at some point I’ll have no choice but to tell her the truth. I cannot not bring her to my house, it’s too long to explain but it’s not an option nor is it for any of my siblings. She will still get visits if they allow it. I know that’s what happens. Right now I’m spending $135,000 per yr on 24/7 private care and it will be less at the AL because she’ll finally be able to use her LTC policy that will pick up 2 years part of the bill. I am her POA, Health Care Proxy, and all her affairs are in order.
Can you help me on how it went with your parent that you had to do this to when you know they would not choose to go? How did you cope with it both before and after?
You might want to join the parents taking care of parents thread 
I would make sure it is memory care that she needs. There are many residents in assisted living, as opposed to memory care, with some level of dementia. Does she wander? Fall frequently? Is she a behavior problem? She may be able to go into regular assisted living. Assisted living aides can cue for meals, and help with dressing and showering .
That said, going directly into memory care will mean having a chance to establish routines and connections before her dementia gets worse.
Sorry got interrupted. If her memory is bad enough to require memory care, then I would think the fiblet would get her there and then she would forget about her house. Is this the situation? How will she react to the fiblet and arriving at the facility?
For some of us, the hardest part is getting them there!
Does the facility have furniture or will you have to move it beforehand?
If you do do memory care, my experience is that they are better when an all memory care facility, but then again, if she starts at assisted living then you would want a mixed facility so that she could easily transision to MC.
When we moved my dad into Memory Care the social worker that was working with us told me to basically lie. It was hard at first, but it has been almost 4 years and I am still lying. “We are working on the house to fix it”, “just need to finish the floors”, “painting”, etc… At first we put his stuff in storage and eventually got rid of it. He will occasionally ask about it and we will talk about everything that is in there. My dad has Alzheimers and is fairly young (84), but there are a lot of very sweet older women in his Memory Care who are still pretty with it. They have a lot of programming (art, van rides, etc…) and the ladies are super cute together.
If it was my Mom, I would have a detailed discussion with facility about whether your Mom qualifies for regular Assisted Living vs Memory Care. If she is not a danger to herself or others she will enjoy the activities and social life better. Memory Care is sometimes so depressing no matter how hard the staff tries with activities. There are always several loonies that disrupt.
BTDT x 4. All of mine had steep declines in condition when they were moved. You mentioned her affairs are in order so I assume you have had the DNR discussion and know her wishes and communicate them to the facility.
That’s what I’ve seen too. If it’s the least
Bad of the alternatives, it’s what one does. We are going through this with a dear aunt. 5 kids and none in position to help. She can’t stay at her house without personal care 24/7 —shes’s sadly demonstrated that it’s too dangerous. For her because this was delayed so long, she’ll be going to whatever they find that’s affordable and can take her now, from the hospital.
It’s very difficult in any case like this, but with this aunt, she seems so danged normal , and then she dies something dangerous and unexpected.
I’m sorry you are going through this.
AT 92 my mother had early AD. We had her in a memory care unit for one month. It had a shared bathroom. Men were coming into her room thinking it was their wife, etc. She threw a fit and we took her out and brought her to her home with daily care givers for one hour and meals on wheels.
The social worker told us that they had no legal authority to keep her if she asked to leave. My brother and I had POA. We would have had to go for guardianship.
One year later with moderate AD she was tricked to go to the ER for a ‘foot problem’. Her paranoia and hoarding were out of control. I called the ER and arranged an AL bed. She was placed in the assisted living side instead with a private bathroom. (She did not ask to leave until the end when she was severe AD.) That was much better and they gave her cues to go eat. The AL cost more because they did the meds and helped with showers and laundry. Basically an ambulatory NH.
During her time in the AL she became complaint and controllable, although she was never pleasantly confused. She became moderate to severe AD. My brother did the estate sale of the home and car about 6 months into this stay. We paid AL costs from her checking account. She was never told we sold the house. We would say she needed to stay where she is and that we are looking after the house. I lived 1500 miles away and visited monthly for weekends. My brother lived 500 mi away and visited less often.
I really had no problem coping with this. She was in very good hands, and her sisters in laws visited weekly. They asked me to leave her there, and moving her near me would have not been as ideal. I made the medical decisions in the end. She died at 94.
Strongly recommend the ‘parents taking care of parents thread’ here. It was extremely useful to me during this time period.
Varied experiences with each parent depending on the situation-- 2 died in assisted living, 2 died at home needing round the clock care.
Logistically- lying really works. There is just no way to get a non-compliant, overall healthy person to agree to give up their independence and privacy to move to a facility without some subterfuge. We had the added complication with one parent with a brand new car (what dealership would sell a car to an elderly person who clearly has some dementia? Answer- ALL OF THEM). We just stuck to the story that “this nice hotel has limited parking, so until your name comes up on the waiting list for a reserved parking spot, we’re keeping the car in your driveway so nobody else can drive it”. Eventually- stopped asking about the car. And we always referred to the facility as a hotel. There was a reception desk, right? A dining room? A lobby? An elevator with lots of rooms? We called it a hotel. Who wouldn’t like the idea of moving to a hotel temporarily?
Got to say- both of the Assisted Living parents ended up having very limited interactions with the other residents, but LOVED the staff. So that’s the important thing. The folks who drive the courtesy van-- hugely helpful. The activities staff who plan the little outings, the waiters in the dining room who quickly learn the routine, the meds management aides- these people are make or break. Your mom may not have the mental energy to build relationships with her peers, but the staff is trained in making people (mild, moderate, severe, end-stage) with cognitive issues feel valued and happy.
Financially- you are about to get a lesson in LTC coding. Either find a friend who is already up the learning curve, or give yourself a tutorial. If your mom’s insurer is anything like the ones I’ve dealt with, they will do ANYTHING to avoid paying out on the policy. You can outsmart them at their own game, but it’s not as simple as just sending on the bill from the facility and getting it paid. First a nurse (their nurse) has to go evaluate your mom, then there’s a waiting period, and then they start denying parts of your claim. And after a couple of months when you finally have the code cracked, the cycle begins all over again- a nurse to certify that your mom needs help with daily tasks, the facility making mistakes on the codes, etc.
Hugs to you. By far the hardest thing I’ve done as an adult. But unless we wanted the phone calls to continue (mom fell inside, cops found her 8 hours later inside her house dehydrated and asleep; mom going to bed with the front door open) it was the only viable/safe solution. And managing the care in a private home- in addition to the cost which of course is astronomical— aides don’t always show up. Snow. Kid with flu. Our stress levels would be off the charts dealing with the care agencies…
You are doing the right thing.
My MIL had a serious stroke many years ago, then in her last year or two was fading away, but not full on dementia, maybe the beginning. She broke her hip and we moved them both out of the house of 50 years. We lied, we told her she had to rehab to go back and she never got better enough, but that was post broken hip so a bit easier.
FIL kept telling her about the house renovations, we actually updated it a bit and rented it, so had not sold it, but she was very worried about her stuff. She would have been crushed to witness the estate sale we had 6 months before she died, absolutely crushed. We never told her! Lying is a kindness. We did talk about repairs etc.
We moved my mom into her memory care unit 2 years before she died. She had Alz but was very physically well when we made the move. For safety reasons I won’t go into here, she couldn’t be at home.
My brother took her out to breakfast and for a drive along the water while the movers came and brought her bedroom furniture to the facility. Other family members set up the room so it looked just like home. When they were done, they called my brother and Instead of going home, he took her to the facility.
I’m not going to sugar coat it. The first few days were horrible for everyone. My brother actually stayed with her for a few days overnight and then the facility strongly encouraged no one from the family to visit again until our mom had time to adjust. The first 3 weeks were very hard.
After that, my mom really settled in remarkably well. Even though she was on the ALZ floor, there were plenty of residents who were still verbal and friendly that she could sit with for meals and do activities, She started eating again and gained all the weight back she had lost (she was down to 90 pounds when she was first admitted because she wouldn’t eat at home). At the facility, their dining room was set up like a fancy restaurant with printed menus, flowers on the table, piped in. music, and of course wait service.
My mom was a very active lady and the facility had scheduled programming all day long. The routine was super good for her. She went to yoga, gardening, cooking, crafts, and music almost every day. They brought therapy animals in weekly, took “field trips,” had movie night, bowling, etc…
After the first 2 months, she was proudly showing visitors her apartment and introducing her friends. She died in March and I have some peace that her last few years were actually quite happy and safe. She was always smiling!
There is also a big benefit to having people move before they are really “ready” - it gives the staff a chance to know them when they are verbal and doing OK. By the last 6 months of her life, my mom lost her ability to communicate almost entirely, but by then the staff all knew her likes and dislikes, how to make her smile, etc… Basically they knew her as a person and not a non verbal patient.
Good luck to you! I know it’s not easy but it sounds like you are doing the right thing!
To all of you who’ve shared your experiences I truly want to thank you. My mother might make it in regular AL as opposed to memory care. I guess that would be better? Weird thing about my mom, is she became the mom we never had once she had to rely on us. And her home is safe and she’s super happy. I just can’t afford it, and she def can’t. So there’s no other way. If I tell her it’s a financial thing she looks at me real confused and says she doesn’t understand. Her care team is AHMAZING!!! I live close by so I visit a lot but don’t stay too long because she has so little to talk about and honestly, now with Covid neither do I. She’s so compliant though. And it’s been this way for 6 years. I pray daily that she dies in her sleep of natural causes or gets Covid and that takes her out. Might sound cruel, but I think having to leave your home and go live in a totally different place at 99 with all new people is cruel. And if I couldn’t visit and had to stand outside and wave thru the window.
I try not to think about it too much because quite frankly it’s depressing.
Blossom, your comments about LTC are super depressing. Imagine doing all this and finding out they don’t pay her policy. Thanks for telling me we are doing the right thing. I know so many folks who’ve done it and when it doesn’t go well they have quite a hard time, but eventually they get better.
Mostly why I came on here as opposed to Parents taking care of Parents is I wanted specific advice to this transition. I was hoping there’d be that poster who says they worried about it for so long and it worked out just fine!!
My mom might have dementia or just plain ole bad memory due to age. She’s getting the cadillac of care right now, and picturing her stuck in her room with no one unless it’s her time to be checked on.
Sigh
Another story - my BFF’s family moved her 98 grandmother into an AL for financial reasons. She was very happy at home with her caregiver but they couldn’t afford to continue. She LOVES her facility! She picked up playing cards again and was the person everyone came to for advice. She’s 104 now and still doing great although she was moved to the memory care side this year because she started wandering. It really can be a positive.
And in my experience, facilities rarely leave patients in their rooms during the day (covid -19 non withstanding). My mom’s facility chased after residents if they got up and left an activity and gently would try to bring them back.
Are you sure the LTC insurance pays when the insured is in a facility and not at home? In a family members case it was just the opposite.
My in laws moved to AL last fall. We were fortunate in that they, at 91 & 92, understood that they needed to do so. Their facility is amazing … I can’t say enough good things about it. MIL resisted liking the change, because she doesn’t need AL care; FIL is the one who needs help with showering & certain other needs. It took a few months, but eventually MIL settled in, found that she enjoyed the activities, and is content. She would prefer to be in her own house, but she knows that she is where she should be. Oh, and both of my in laws are thrilled with 3 meals a day & snacks/coffee always available.
I question the need for memory care. In laws’ place has a woman with early Alzheimer’s who lives on the AL side, and the staff reminds everyone about meals, activities, etc. Dressing is part of AL if needed. Those who eventually need to be in the memory care unit will be moved to that side if that time comes. I suppose some may opt to go to memory care right away to make sure they can get a room. The staff integrates memory care residents with AL/independent living residents as much as possible. Friday happy hours have been well attended by independent, AL, memory care & family members (before current restrictions); memory care patients come to bingo, balloon volleyball, etc; they even go on some outings.
On the other hand, I am aware there are memory care patients who are stressed from being away from spouses or who were unable to participate outside of the memory care unit. It’s not all sunshine and roses.
If it’s what your family feels is best, my advice is to find a place that makes you feel comfortable when you cannot be there with her. This is a tough situation, but I hope you will experience with your mom the peace we have found for my in laws.
P.S. My in laws live many hours from us. They chose to stay in their own town, rather than to move near us or my SIL (who lives 3 hours from them). We visited for a week at a time, every couple weeks, until the lockdown. We got to know the staff & the other residents really well. It really helped with their transition, because we had to help them learn to ask for what they needed. They were NOT good at that, but they are much better now.
This can be a very positive move. It really can. (And one of my mother’s best friends at her AL just turned 100).
Assisted living residents, in the facilities I know, have apartments, either studio or bedroom and living room. Memory care tends to be one small room, so that they don’t stay in there all the time.
I am glad you are going to look into regular assisted living as an option.
OP- big hug and I didn’t mean to scare you. Just review the fine print on the long term care policy so you are ahead of the curve in terms of the waiting period, the guard rails the insurer has set up, the daily maximum (relevant, in addition to the total policy maximum) etc. Then work with the facility to make sure the monthly invoices are in compliance so you can get the maximum payout in as short a period as possible. The pitfalls are things you don’t often think about- e.g. the facility is going to bill you ahead of time for the base charges, but will bill you after the fact for incidentals. No insurer will ever reimburse you BEFORE a charge is incurred… only after. So stay on top of what’s been paid. Get a system in place so that every time the insurer needs a physicians letter (verifying that your mom still needs assistance with dressing, eating, bathing, etc.) you can email the letter to the PA or nurse at your mom’s PCP or gerontologist and get the signature, then scanned back to you.
People who haven’t gone through this don’t have a clue how expensive care is, and assume that “insurance takes care of things”. No- diligent children who worry about being bankrupted by a parent’s care takes care of things!
You are for sure doing the right thing. Even a modest uptick in your mom’s physical activities (my mom loved chair yoga, for example, and MIL loved “virtual” bowling and golf) and social engagement with the staff is going to really help keep her sharp for as long as possible.
And don’t feel guilty for your COVID fantasies. I don’t know a single person with an elderly parent who doesn’t pray for the quick resolution vs. the 14 years bed-ridden version (which was my story with one parent).
Hugs.
How all of this comes together so depends upon the LTC insurance, the facility , the person, and all the pieces in that picture. It’s heartening to read that there are cases right here in the board where things turn out well. Sadly, it has not been the case in my experience and for friends’ and family members in this situation. A lot of luck can be involved in all of this too. We always hope for the best.
We are facing this with two elderly members of our family. A cousin with no children and an aunt with many. Difficult situations, both of them and no satisfactory or acceptable scenarios yet found. COVID19 also has made things more complicated. Several people we know have taken their relatives out of care facilities because of the risks involved with group homes of any sort. Colleges have closed for this reason, and elderly who are at far far higher risk in such environments are being moved to private homes if at all possible. It’s a particularly difficult time to make the decision to place an elderly person into these homes, and exposing them to additional risks to their health and even their lives. Sometimes the choices are all bad ones, and we have to go the least threatening route.
Even with affordability out of the picture, finding the right place for our mothers was not successful back a few years ago. We had them on some waiting lists and short term stats for rehab purposes at some mighty highly rated places did not go well. Right now, we are going through the process of getting the exact payouts from Long Term care insurance for our cousin, and it is problematic. We are getting an attorney to address the matter as Things stand.
I’m bringing up pitfalls and problems because if you run into them, it’s not just you. Happens all of the time, and too often part of this process. I’m hoping that you find an easy resolution that works well. Many of did not , have not, and not for lack of trying.
My father lives in an assisted living facility. He moved in a few years ago at 85. He picked the place himself (realized he needed out of the long time family home since it had steps etc. and he just couldn’t manage on his own anymore). The place has a separate memory location within the facility and I don’t think the two sides mix.
He has a private room with a mini kitchen and bath (no oven)- just like a studio apartment. They provide his three meals a day and come looking for him if he doesn’t show up for a meal. They have tons of activities every day (from bingo to chair yoga). They also have lovely grounds outside when the weather permits.
My surprises once he moved in is that many residents only leave their rooms for meals. Even he only participates in a couple of activities a week. There is definitely socializing at meals and at these activities. As mentioned above, he also enjoys socializing with the various staff, when I visit they all seem to know him well.
I think it is what you make of it. You can go and just lock yourself in a room and be lonely or you can go to every activity and keep busy. (Sort of like the advice we give kids freshman year of college.)
His physical condition has definitely deteriorated in his time there. He went from needing no help on a regular basis, to needed an aide much of the day. Not sure if it is just an aging thing, they do give him PT 2 times a week.