Can memory care places refuse "committals"?

Disgustedtoo, I applaud your tenacity on getting her moved to a safe place. You know, each POA is different, and mine allowed me to make that decision for Dad, tho no one asked to see it before I signed the lease for his MC. His situation was similar, but he didn't fight as much & spent 6 months at my house first. It was after a fall, illness & rehab that I said I couldn't do it f/t anymore. He is still unhappy at times, but he does feel safe there.

Thank you very much for the update. I'm glad you found a way to make it work!

It has been a long while since I posted to this thread. We managed to get her in though without the guardianship, but without her explicit agreement as well.

In case anyone else wanders into this topic, to see if there are any ideas to be had...

Mom was NOT anxious about moving. She was ADAMANT that she was fine, just forgets a little now and then and that's because she is old and is entitled to forget sometimes. She'd had a Rx for Lorazepam before, but only used it if she was having trouble getting to sleep, NOT for anxiety. I doubt it would have been enough to override her overdeveloped sense of independence.

She kicked out the caregivers we hired, who only had the tasks to check on her and make sure her meds for the day were taken. One hour a day only, to be increased as we felt she needed it. She was still able to take care of herself (eating microwave dinners was not exactly high quality food, but I do not believe she could follow recipes or cook stuff she used to make anymore) and "passable" care of her place. The concern was the short term memory was bad and despite her saying she never goes downstairs, the camera said otherwise. She also fell, badly bruising her knee, but did not get it looked at or call one of us (nighttime bathroom trip.) I did not want to wait until she started wandering, fell down the stairs or had a serious medical issue. I felt she needed a secure place where she would get better food, not have to worry about heavy duty cleaning, get some socialization (she was self-isolating) and would have someone watching over her. She would NOT even considering moving in with one of us, even for a short while - end of discussion.

She liked the place and the food when we took her for a tour and lunch, but as noted in another post/response, she in short order wouldn't remember even why we were there and much later that we ever went. Bring it up? She was looking at houses with my younger brother... -sigh-

They clearly understood our dilemma - mom is refusing to go, attorney says we cannot drag her out and must go guardianship, and from what others have said, apparently they at the facility consider this means the client is unruly. They got to meet her, they should know that she is not, but it was a brick wall, we MUST get her to agree to move in. The only way, at this point, was to come up with a lie of some kind, to make a "temporary" move. They assured us that if we get her to agree to come in and try it, they would handle it from there.

We did get the new doctor to recommend she not live alone (she said it to mom first, ooooh boy! Wrong thing to say to mom doc! She was already complaining, wanted out, questioned what this was all about and just went nuts over that statement!) I apologized for her later.

Older brother scheduled a flight to be here and facilitate the move with younger brother (I begged off the move, but was sure I would get the blame no matter what.) Because there was some minor issue with the heating system (it was late December), and younger brother put in a Nest, a programmable Wi-Fi access thermostat, I suggested he mess with the temp - make it too hot, then too cold. When she complains, we "check" it, say it needs repair, you'll have to stay at this place until we can get it fixed/replaced. I thought it was great - excuse to get her out, she has to stay and we can stall the return. They did not even try.

Meanwhile, however, mom managed to injure herself again just before this (cellulitis, open sore on leg, no idea how she did it nor did she call anyone to report it/ask for help)... Soooo, after ER trip and days of meds/cleaning solutions/bandaging along with serious bowel upset, likely the antibiotics, younger brother types up a bogus letter from "Elder Services" at the hospital, telling her she either moves to the place we choose or they come take her and put her wherever. Oh she was madder than a wet hen!! Why are they doing this to me? Why aren't they helping people who need it? I only heard the highlights, but they were able to get her in the door with this subterfuge.

Is she happy? Relatively. She won't likely ever accept the place until she regresses more (home may become a previous place.) Periodically she has them call and wants a ride home... but she says she is at the hospital, the one she used to go to way far away, is not sick, just needs a ride. I generally just say I can't right now, or it is too late tonight, maybe tomorrow. She then worries what will she do? They assure her in the background that they have a room for her and all is well. Long before the next day she will forget. I have asked them to "pretend" they got voicemail and say they left a message for me. That should be enough - she doesn't call to chat, cannot hear well on the phone either, so let's just skip the call to me! Some visits she can go to her room with no help (it is the first one outside the common area, which I chose for that reason). Other times she says she doesn't know where it is and asks the aides for help.

Also, for all those who say we should keep our parents/grandparents, whoever, in their own home or take them in:
***She was NOT safe alone in her own place. She had fallen at least twice at home and twice now at the facility. If she were alone, who would know if she was injured and could not move? That last injury just before we moved her could have led to her death (cellulitis is a serious infection!)
***In order to stay at home, referring back to that last sentence, she would NEED caregivers, but refused to let them in. We *might* get away with bringing them back for a short while, but then she can refuse to let them in again. She will *NOT* remember agreeing to anything!!
***She refused to move in with any of us, but if we *forced* the issue as with the MC place, consider that 1) younger brother is still working - who watches and cares for her during the day? 2) older brother is in NC, two days away from us, and really does not have the patience to care for her 3) neither has the experience or knowledge needed to care for a dementia patient, as they need socialization, exercise and the condition will progressively get worse - I do not see that happening! 4) I cannot physically take care of her because of my own issues and my house is/has been under repair and will be for some time, so it is not a safe environment for her (in addition the stairs and cats could be a real issue!!)

Anyway, that part of the saga is done. There is still a lot of paperwork for other issues that I must handle. Organizing and helping when I can the cleaning out the condo and doing repairs to either rent it or sell it is another full-time job. This is yet more reason why I could not care for her - just trying to juggle all along with handling any issues, doctor appointments, managing all her finances, that cleanup/repair part-time is draining, and having to care for her too? EEk. This all has been a long road already, having taken up too much of my time for several years just to get everything in place to get this move done, and who knows how much longer this will go on. Some stuff will eventually be done, leaving more time to visit. She is relatively healthy (High BP on meds, little to no hearing one ear only with a hearing aid that she is always losing, macular degeneration) so she could outlive us all!

Anyone needing more information or details can contact me directly. Cheers!

Any good memory care will be on lockdown as far as locking memory care residents into the facility (not their rooms) because they wander. If your mother is like mine, she has no short term memory, so she remembers only some of the past. That means she will never see the need for her to move. On some level dementia patients know something is wrong which causes anxiety so medication can help, but it likely will not make her want to move. There unfortunately is no easy answer for you since you don't live close. "Workin their magic" to them means giving her reasons through social relationships and activities to make her want to stay. Commitment against her will is a legal act that is usually done in connection with government rules to ensure an individual's safety. You can call your local eldercare agency and ask for suggestions as to how they might help, but commitment usually means a psychiatric or nursing facility. My great aunt had a tendency to lie to get attention and sympathy. She told nurses in the hospital that her family was abusing her and one day a woman showed up from the state at her home to "take" her. Luckily my sister was there and our attorney was close by. They attorney rushed over, relatives rushed over and convinced the woman that our aunt was nasty and crazy, but otherwise well cared for. My aunt was terrified at the thought of being taken away and the attorney was able to use that to encourage her to do things in her best interest she was not formerly willing to do. However, a dementia patient is different. Since you do not live with your mother, it will be difficult to reinforce the idea of any change. Perhaps you can get your mother's doctor to speak with the facility doctor in conjunction with advice from the eldercare attorney to come up with something that will be acceptable to all. No matter what you do, it will be terrifying for your mother. Moving to my home was terrifying for mine. She still wants to go "home" but home in her mind is 40 years ago. I suspect I will be going through the same thing in the next year as it is becoming difficult to keep her at home. I will continue with the senior center approach and hope for the best.

Disgusted, what we are saying is that psychiatric meds will improve her ability to cooperate NOW before she goes to MC. Were9not talking about " drugging her into compliance" or turning her into a zombie. She is clearly agitated and anxious (cognitive decline and the brain changes that accompany them often do that) and could benefit from a trial of antianxiety meds and possible and antidepressant.

Pam, my Dad's Memory Care section had a lock down at 8pm. Thus no one from that floor could use the the elevator unless they were with a Staff member who had a "code". Even the front door of the Assisted Living building was locked, coded to come in, coded to go out. I doubt my Dad even knew that when he lived there.

I know I was really relieved when I learned about the lock down, as I was so worried when my Dad lived in Independent Living before moving to Memory Care, that he would forget and try to leave the building as IL wasn't locked until later in the evening.

Now that I post again the message showed up. -sigh-. I also now see LindaVal's message. No Day care there, but that would not help. She lives about 1.5 hours away from where I live and this place is about 15 min from me. Driving to her place and home again takes a lot out of me, and I certainly cannot be doing that every day!
What you say about the committals may be true. In her case it is a combination of trying to figure out why she is so against the idea, but the bigger problem is even if you make some headway (like her responses during the visit!), that is all gone shortly after, so it was pretty much a waste of time trying...
Again, they have some kind of plan, so we shall see how this goes...
Being new to this system, I don't know how to see or respond to private messages, but to the woman who said her exes mom expects her to care for her - egad, nasty woman, move and leave no forwarding address!!! 8-O

My last response seems to have vanished... The memory care unit is locked down so that residents cannot leave the building. The rooms are not locked, and I do not believe their plan is to medicate. She can get belligerent (usually at the doc office), but she was fine during our visit to the facility. So they plan to get her in the door and work on her, drawing on what pleases her (yummy food, maybe some activities), not medicate. The getting her in was the issue - them telling me she has to agree and they won't do guardianship/committal, and me saying that won't happen. Soooo, they say we have to come up with a reason to temporarily 'move' her and they work their magic? How is that agreeing? Whatever, so long as she goes, that's 90% of the battle.... They are hoping to do this in the next few weeks - talk with doctor, we get furniture in room and pay up... then we see what happens....

What they are saying is, medicate her so she agrees to go. Properly medicated the patient is cooperative and accepting. Something for anxiety at first, possibly an antidepressant later. For example, Lorazepam relieves anxiety for about 4 hours. Clonazepam works longer. Alprazolam treats panic attacks. Citalopram treats depression. Find the right meds and she will go and have a good time there.

The memory care section is locked down - they are not locked in rooms, just cannot leave the facility. Despite what my brother preferred (just plain old AL), I KNEW she needed memory care. AL is NOT locked down, and is more for people who need help physically, so they do not have to be locked in.
I know she's going to be difficult, and I'm sure they know that (or should) as many who have this affliction do not realize what they are doing. So the plan is get her in first and work with her... that's their plan - they just do not do court ordered (aka guardianship) committals. By telling me that SHE has to agree, that put us in a bind. Is that light at the end of the tunnel, or the speeding train? :-}

I can understand why they do. As our eldercare attorney explained, memory care facilities are not nursing homes. They are specialized assisted living and often will not accept advanced or problematic residents. Basically, they want the fairly easy cases and they expect someone who is committed will not be asy. Things you might try...do they take day care patients? If they do, you can go with her & try and make it a positive experience. If she likes going for the day, she might want a place there to take a nap, and you can gradually move her in. The facility can also see if she is truly a problem they won't take on. You can find another place that does have day care or respite care if this one won't work. Learn how to talk to your Mom in such a way to indicate that she made the choices and you are following her wishes. If she doesn't remember, she has likely developed coping mechanisms that make her go along on some things so her deficiencies are not obvious. I called the day care facility the senior center to make my mom think it was a social activity.

I know of a new place in Concord that advertises as an assisted living center with memory care. Here's the problem: Assisted Living cannot take in patients with outbursts or wandering problems. Check NH health laws.
Here in NY, same rules. If your parent is going to AL, they must comply with staff redirection, not yell or swear, not wander into other rooms or off the property. That means you medicate them into docile behavior or you find a secure lock up facility. I know many of us oppose "chemical restraint", but a few pills seems a lot kinder than locking them up.

making some progress - still no go with guardianship, which is fine, that is costly and time consuming! we shall see...

We "talked" guardianship because our attorney said so. I cannot stress this enough - THE PEOPLE AT THE FACILITY SAID THEY DO NOT DO COMMITTALS, which is what guardianship or whatever you want to call it entails. THEY said SHE HAS TO AGREE TO MOVE IN!!! THIS is what I do not get - I am waiting for a "normal" hour to see if I can get someone there to understand this is NOT possible.

Sorry FreqFlyer - yes they do, but because my younger brother was so fixated on putting her into strictly assisted living (more room, less old farts, so HE thinks). They have all three levels, but I know what she needs and the two women taking us on the tour said same thing - they would NOT allow her into the other levels because of her condition. It is not that they have no room, we were locked in before they even opened. We had looked at others and besides being the nicest of them all, it was a better location (for us and for "view" - one place the front rooms look out over the parking lot at a major, busy roadway (4 lanes, lots of traffic, not a nice view AND lots more expensive for that great view!)

In one of my follow up comments, I mentioned we tried the home care. Lasted about 3 months and she won't let them in. So that is out the window. Same reasoning, she THINKS she is fine.

Discussing cost is NOT the issue - we let her believe the VA benefits will pay for it. She doesn't do her own finances, I take care of it since later last year. The problem, which I plan to discuss with this place again is NO amount of discussion will get through AND stick with her. It can be as little as 10 minutes - gone. It is her pigheadedness (which will not change) AND them saying she must agree. THAT is what guardianship is about ladies in the place!!! And if you have so much experience, you (them) should KNOW that this can happen. There should be a way around this. I have emailed the last contact point I had, but she's out until Tuesday, and I plan to call tomorrow to see if someone else can work with me.

When I found this page (I have been on MANY over the last year+ to get brothers on board), it confirmed what our attorney had told us - we cannot just drag her out of her home (she refuses to go live with my brothers as well - me? I cannot physically care for her and this house I purchased is a disaster with rooms half refinished, tools everywhere, etc until I get someone to work on it, meanwhile this getting mom situated is taking up way too much of my time 2+ years and counting). What baffles me is the facility 'policy'. I was curious to know if this is standard practice. I cannot believe that it is!!
But thanks for the suggestions - unfortunately, we NEED this place to take her. There are very limited places and limited space, and we've invested all our time working towards this that we'd probably have to go an hour+ to find openings.

Does the Memory Care facility you were interested in also have an Independent Living section? I wonder if some places tend to accept those residents who are already in place in IL, thus the Staff already knows about the client.

In my Dad's case, it was the Staff that highly recommended that my Dad move from IL over to Assisted Living/Memory Care. That took me by surprised as I didn't think Dad was ready for that. I stalled and sure enough Dad started "sundowning" and calling on the phone very confused. Apparently the Staff saw the signs where I couldn't.

disgustedtoo, time to look at other Assisted Living/Memory Care places as the one you described doesn't make sense asking the future resident if they want to move into the facility. In the mean time, try to get caregivers into your Mom's home to take care of her. Would she chase out the caregivers? My Mom did :P If your Mom accepts them, even better.

Then later down the road you can discuss cost when Mom is in a clear brain loop. Tell her 24 hour caregivers cost such & such. Senior Living cost such & such, more than half.

One more thing - we have already tried the in-home thing... we started with 3 days/week, for one hour, then bumped up to 5 days... it seemed to be going well, so we thought maybe we can let her stay in her own home and increase services as needed. Nope. After several months she started refusing to let them in. They sent the 'expert' to chat with her and that woman was lucky mom could not physically throw her out. She basically ordered them out of the house. :-(
So, back to the original question: How can a memory care facility refuse to accept a resident who cannot and WILL not make this decision, who needs guardianship to make the decision for her?

PS - POA is of NO use for this. We have had that in place for many years. That only allows you to make SOME decisions, NOT this one.
If she refuses, we need guardianship (and a lovely battle and the repercussions for months after) to move her.
Our problem is the Memory Care Facility says no to that. She has to agree. WTF??

We took her to a new doctor the same day, prior to the "visit" (the previous one was useless and too far away), who saw how belligerent she was (WHY am I here, I don't NEED to be here, let's go get lunch - just plain nasty, and she has been like that with previous doctor). Dr is amazed that she is able to "function" as well as she has been - BTW, I did not make it very clear - SHE LIVES ALONE.
IF she would agree, no problem, we'd get her in this week! But she, as I said, is ADAMANT that she is fine, "only forgets a few things which she is entitled to at her age". Oh yeah, we also do the 'sundowning' thing at night... check the lock, check the dishwasher, out to the LR, turn on light, turn out light... aaaaaand repeat... every few minutes for 45 min to hour and a half.
We do not want to wait for her to start wandering or have a medical emergency. We do have some cameras in place, but they do not see everywhere. If she has a medical emergency, falls down the stairs, etc, who is going to know? If those things happen, I do not want the state up OUR butts for not doing anything. WE are trying to be proactive.
The elder attorney was going to help us go the guardianship route, but the FACILITY says SHE has to agree... and you people here (the facility) have all this experience (they tell me), how can you possibly think this way???? By the time I got her home she already forgot what we did and why. Thanks for taking me, but I won't go next time, it was too much... So she thinks we went to a luncheon or a function or something, NOT to check out a place for her. Next day my other brother tried to ask about the trip - she said she was "beat from looking at houses with Brad" (he is the other brother who went to the place with us). So she thinks that we were looking at houses for HIM.
I ask again, HOW do these people think she's going to make this decision? 1) she doesn't remember it and 2) adamantly refuses to move ANYWHERE when we try to bring it up... The two women working with us see her ooh and ahh over stuff, oh this is nice, food was good, oh they do all this, and think we just need to work with her. NOPE. IF and only if she would remember and she can't.
I really would like to threaten them with lawsuit if they refuse and something happens to her. She is NOT nursing home material, she just needs a safe place, better food (she eats frozen dinners now) and some socialization (she is self isolated). This place is awesome and as a bonus is closer for us to visit. Imagine my dismay when they tell me they won't do committal, that she needs to okay this... uh, that's NEVER going to happen ladies!!!!!

How bad is her dementia? We were able to move my dad to MC with no problem.. but his Dr OKed it.( I guess, they did alot of paperwork for us to help get the move done fast) Is her Dr willing to help? I also had POA and mom was in agreement.