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My MIL is physically doing fine and social, but often is unable to communicate well (aphasia) or be self-directed. At other times, she's coherent, and understands what's going on. She can get dressed no problem, can sometimes work a phone or tv, but not always. She's in independent living now, (very recently - not even a week) but she gets more confused at night, and doesn't watch tv, and everyone else is in their rooms. She gets confused and cries and it's heartbreaking.



What kind of care is available for someone who is mobile but who needs a lot of direction and monitoring? I'm afraid if we put her in memory care that she'll have even less social interaction. Even at this facility there's not much talking at meals, and only a few residents engage socially.



Thoughts?

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She may need regular Assisted Living but likely Memory Care AL. A person can be fully mobile, but if they need 'a lot of direction and monitoring', then regular AL is not the right place for such a person. The ratio of caregivers to elders in AL is about 20:1, whereas it's more like 6:1 in Memory Care which is set up specifically FOR elders who need direction and extra care. My mother lived in both; regular AL for 4 years and then I had to move her into their Memory Care bldg after her dementia progressed to the moderate stage and her life was too confusing in AL. The staff in Memory Care was excellent and she had FULL socialization and activities all day long. The CG would come help her get up and dressed in the morning, then out to the activity room for breakfast and interacting with the other residents. Then they'd have games, movies, and activities geared towards their level of ability. Crafts, too. There was a nice garden (that was secure) where they could walk or sit and enjoy the nice weather.

People have a skewed vision that an elder has to be drooling and incoherent to 'belong' in Memory Care, when that's not true at all. I suggest you go visit some ALs that also have Memory Care available on site, and see what they have to say. Also, the intake coordinator nurse will tell you where your mom belongs once she 'interviews' her and determines her care requirements, etc.

Good luck.
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Cover999 Nov 2022
😆. Care to share where these wonderful facilities are?
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I got my mom a private caregiver who comes in every afternoon, has dinner with her, takes her to events if she wants to, but Mostly is there to tuck her in bed at night and tell her that she’s safe and God loves her. It’s the best thing I ever did. Mom suffers from confusion in the evening usually because she’s had a busy day and she’s overtired but this has been a great help. Four hours is the minimum that I needed. I got the private caregiver that I found through someone else who was working in the assisted-living that she was staying at. I asked if she knew someone and she got me the best one. Moms AL changed license which means
even less
staff and now mom needs MC. I didn’t like their MC. I found one that is perfect and the private carer will go with her. It is like me being there.
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“Usually” but not necessarily formally, “assisted living” is the level of care between “independent living” and “memory care”.

A well run “assisted living” facility should provide ample activities supporting social interaction, conversation, and cognitive/memory stimulation.

Does her current facility offer assisted living? You may need to ask specifically to find out.
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I agree with what AnnReid wrote. Or, can she afford to hire a companion aid while she is in IL? My very elderly Aunts had a lady (from an agency) who was their companion for 6 years and she was awesome. Drove them on errands, did light housekeeping and meal prep, played games and chit-chatted with them.

Your MIL sounds like she is Sundowning. Having an aid there right after lunch until bedtime would maybe help with this.
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The idea of a hired companion is great. Those hones do not provide anything near what we eish for and what our loved ones need.
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lealonnie1 Oct 2022
Not true at all. My mother lived in a Memory Care ALF and had wonderful activities and socialization all day long every day, with a great activities director who worked there. Do not speak for 'all homes' or what 'our loved ones need.' Oftentimes, a 'companion' is not nearly enough help for an elder with dementia who's Sundowning in the evenings! What would the 'companion' do about it? "Her own home" is not often an option for elders with dementia either, as 24/7 care is WAY more expensive than a Memory Care ALF, and most people cannot afford $12K a month.
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My mother’s MC has morning and afternoon activities.

Three meals/day, and snacks whenever she wants them.

All of these provide opportunities for her to be with others.

Perhaps a tour or two of different MC facilities would set your mind at ease as to the different levels of residents who live at these facilities.
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Adult Family Homes would be better, but her own home is best if an option, then bring the care to her.
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If she is in " independent" living now and, you are noting decline changes, perhaps it is time to have her reassessed by PCP or Geriatric specialist for present care needs, perhaps to " assisted living"
( this is different than memory care unit) or perhaps 1:1 support during specific needs times. She most likely will continue through the disease process needing different accommodations at different times to remain safe. Safety is a most important factor in all circumstances.
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I’ve found that the best dementia care comes from Independent standalone facilities or adult foster care homes that focus exclusively on memory care.

Most places offering AL have mc as an afterthought. The priority is maintaining the nice Marriott foyer, maintaining the bocce ball court, drop offs to the city or symphony, which leaves less money and time to devote to mc residents.

Mom not socializing could mean she’s intimidated by a crowd that can largely do these things. In an mc environment, she’d feel less pressure.
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You may need to hire private care for her for evenings
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