I have a grandma with dementia and a grandpa who is old and tired who we are signing up for assisted living. The issue we are having is how to actually get them there? He is okay to go, he knows they need more help and he is ready for it. She is adamant she has nothing wrong, and we need to butt out and leave them alone at home. She doesn’t remember she has fallen at least 3 times-the last time she got a staple in her head she kept forgetting about! They barely eat, we have hidden the keys from them, etc. she has gotten so mad as a result of her dementia, and she will not hear it if we try to suggest moving. We just aren’t sure how to actually get her there? Do we trick her? Drag her? Wait until she gets even worse? She gets around pretty well which also makes it hard. They are both in their 80’s. I have POA for both my grandparents. Any advice would be great!
At that point it is a matter of placing her in Memory Care. Grandpa can move into Assisted Living in the same facility.
No matter what move is made she will not be happy with the move. But she is no longer in a position to make decisions for her own safety.
As to how to get her there...tell her the doctor as said she needs to go to rehab until she is stronger.
This is going to be a struggle for both Grandma and Grandpa.
The ALF will send someone out to meet them and do a needs assessment. Probably best to trick your grandma with this, telling her it is a home health nurse sent by her doctor. They will also be required to each get a TB test, so, more trickery.
If all the paperwork and TB tests and everything else has been done and you are asking about getting her to leave the house and GO there, probably the best thing is to get them out of the house for a full day or, even better, overnight, and have someone move their bedroom suit and some clothes to the facility and take them there when it is time to go home.
A friend who was an administrator of an ALF told me that every resident there was all but DRAGGED in there kicking and screaming and throwing a fuss. It takes at least a month for the resident to calm down and start accepting the new normal.
It took a few days for him to get used to it. But the coffee station was right down the hallway, and dining room was nearby, all the comforts of home. Cable TV and telephone set up, and we were done. Then the obvious of clearing out all their remaining belongings, but soon for them it is out of sight, out of mind, and their world becomes very small. Most of the time they are more than happy to let you take care of what remains, although the more difficult parents will give you heck for punishing them and wish to know exactly where all their remaining belongings are. It is a difficult time for you until everything gets situated. That's for sure!
When there is an inevitable crisis they go "home" to the ALF instead of where they are now. Do your grandparents have emergency buttons? Can she use it to get help when she falls? You don't want her in a dangerous situation, but you do need to move forward for their safety and your sanity. Since you have POA you can put their home up for sale (if they own) or do not renew the lease (if they rent) and tell Grandma that they have to move out by a certain date; they will no longer be allowed to live there. Her choice will be moving with Grandpa to the nice apartment they picked out, where they have a long term lease and will never be kicked out, or going into a nursing home.
For most elderly people they have the concept of senior care being a bed in a ward with pureed food and a TV. They don't understand that it means having a beautiful apartment filled with their own things but having people to cook and clean for them and emergency staff on call. It means not being a prisoner in their own home; there are things to do and people to interact with and they can come and go whenever they want. This out-dated concept along with fear of change and not being able to do the work required for the move is what keeps most elderly people "in their own home" for too long.
I picked a place that is like a hotel with her own small apartment and kitchenette. I decorated it with all her adorable furnishings (greatly downsized), photos, books, etc. The facility includes call pendants, private bathroom, all 3 meals in the dining room, phone, cable, wifi, housekeeping, laundry, pest control, bathing, maintenance, utilities, doctor comes to facility weekly, all labs/tests brought in-house so she doesn't have to go anywhere for basic medical services. I did the math and the $3k/mo we pay is the same as maintaining a household and getting @ 20 hours a week of caregiving. The ALF provides 24 availability of care and a turn key experience.
I think it may help starting to talk about it like a resort, with full service and people almost "waiting on you" with all the convenience of the management being responsible for all the hassles of operating a household. Use her dementia in your favor. Don't argue at all. Find the thing she hates most about keeping up a house and then keep saying the same thing over and over..."How great! Never worry about the washing machine or AC breaking! Never HAVE to grocery shop! People there IF you want to help clean etc! LAUNDRY DONE FOR YOU!" Find her hot button and keep pitching the benefits.
Then, finally, and I mean this seriously, do not take no for an answer. Organize it with your Grandfather, move the stuff in yourself... even if he has to take her on a drive out of the house for you to do it.
Then drive her there to "take a look" and leave them there. She may be mad, but she'll forget. with 3 meals, ppl, privacy, activities... she'll forget and begin to accept it.
It is a mistake to try to "make her happy". Sadly with dementia, often a negative attitude arises that is not curable by you. And what they think makes them happy (freedom) is really a portal to neglect, injury, illness. My mom fell and fractured her pelvis twice and landed in ER/Hospital with UTIs twice! Yet she denies it all. You cannot reason with a mind that cannot reason or remember. What you can do is help them to be safe and in an environment that will support them as things get worse.... then you can start having a nice relationship with them when you visit and call. They are like your child now. Would you take an angry 6 year old literally about anything? Adopt a mindset like this: You are your grandmother's mother now. Do what is right for her well being.
One thing I always tell ppl from my experience... they NEVER get better. They always get worse. Better to plan now for this reality.
He doesn't even remember having surgery. Told him going to hotel. Made a little easier
* Realize there will always be 'push back,' i.e., "I'm okay, I remember, I am capable" communication. It is a way for a person losing independence (and cognitive functioning) to hold on to their independence as much as they can. Anger is a cover for fear. This is expected behavior.
* As another said, make all the arrangements (is EASIER if you have POA or MD authorization/recommendation) and don't tell her what is happening. Get them there and then deal with her behavior of fighting, anger, rage - she won't be a happy camper and expect this. If you need more support, have those or that person w/you.
* NEVER EVER argue with a person w/dementia. It is a losing battle and ONLY keeps the rage / negative emotions going, raising everyone's blood pressure.
* Is there a social worker involved?
* Be sure to get whatever mental health support / counseling you need to keep going. And, exercise and eat healthy - really helps hold 'us' care givers together and deals with our own stress.
* Expect the unexpected and be ready to respond. Instead of arguing, agree or 'reflect back to them what they (or she) says. I understand that you feel . . . let her know you hear her.
* We are there supporting you. All this is easier said than done, I know. Gena.
If grandpa is on board with the move, maybe he could get her to change her mind. If he says he is going...maybe she will too?
Mom has dementia. She has no short term memory at all, and cannot manage herself or a household. She stopped cooking long ago because (I think,) she could not follow instructions or steps to prepare food. That resulted in Dad being malnourished. Even when my sister and I prepared meals to heat up, she threw them out without using them. So the Assisted Living move was good for Dad since he got regular meals and other necessary help when needed.
Assisted living facilities must report falls to the state and cannot keep a resident if they exceed a certain number of falls. If they are falling regularly, they are in nursing home status, not assisted living (AL: you receive supportive services but are expected to live on your own without intensive nursing care and intervention.)
Dad passed away in February 2019. Mom was immediately moved to memory care. She could not be left unsupervised at all. Memory care costs $ 8,000 a month and we hope her money holds out. None of this is paid for by Medicare, and Medicaid pays only for nursing home stays for impoverished seniors (very specific financial qualifiers.)
So if grandpa needs AL, there is a fee for him, and a fee for grandma if she is anything but "independent." If she has memory issues and grandpa cannot manage her behavior, she may need memory care and that will be a lot more expensive. You should have their needs assessed by the AL facility to find out what solution will be most effective for both of them and hopefully they can live together.
When someone is at the stage Mom was, it was were I needed to make decisions for her, as I would for one of my children, when they could not make safe decisions for themselves. I had to do what ever it took to make it happen. As someone close to me said, "Remember when her mind was right she gave you full power to make decisions for her if she wasn't able to. She knew you would do the best care for her."
Remember, what you are doing for them is for their safety and out of love. Hope this helps.
Suggest a lunch out and arrange to take her to an assisted living facility just to visit over lunch. She can see what they are like. I know the facilities will help you set this up. We did it for my mother.
The other thing is I am surprised that your grand mothers Doctor is willing to let her return to independent living with the falls. Does your grandfather have her Medical POA and vise versa for your grandfathers Medical assistance. Or do you have her MPOA. You would be wise to get both of these in order if they are not already. Should she end up being hospitalized because of a fall, you can talk with the doctors about having her evaluated for independent and assisted living. I found Mother could not be released from the hospital, after the last fall, to independent living. We had no choice and neither did she. She was worried, frightened, and did not want to go, but once there adjusted. And if your grandfather goes too they should be able to help each other adjust.
The wonderful people who worked there were so helpful, they understood exactly what was going on with Mom. I bless them every day. Good luck and stay strong, they need you more than ever and you can get through this. Keep reading answers and talking to anyone that can help. You'll make it!
Sounds like your grandfather would yield very quickly. If your grandmother is confused about time now, she probably would not notice that the time exceeded the original ''plan''. Once installed in a facility, if it is ascertained that your grandmother is ready for a memory care unit things could be arranged from there.
That was the scenario we used with my mother. She claimed to be able to look after herself, had the attention span of a 3 year old at times, could no longer drive, could not even figure out how to get the key in the lock, was becoming incontinent, fall after fall et al. It was an unfortunate set of family circumstances that meant she had to go to Respite for a fortnight. I have explained in this forum previously that the first night she was roaming looking for non-existent music, walking into walls and could not figure how to back off, et al. We were lucky they had a lovely room available in the memory care unit.
Once the permanent arrangement was in place we never told her she was there permanently, time simply moved on, we would make excuses like she had a fall and hit her head, had to be under observation, etc. Of course she was cranky with us, she called us for everything, but it was the best thing we could have done.
I can say hand on heart it was not our original intention to leave our mother at the facility, it was only ever intended for a fortnight. It was the revelation and realisation that she really needed to be in permanent care where professional medical and care staff were available.