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July 2023 we moved my father, suffering from pulmonary fibrosis, and my mother, suffering from vascular dementia, to an AL facility. They assured us that unless my mother became a flight risk or abusive she would be able to age in place with them. My father passed away in November 2023. Mother has a 5 day a week personal caregiver and a family member is able to visit every day. Her short term memory is non-existent, but she recognized her familiars and seems content with her small room.


Problem: the manager is about to leave for another position and she has suggested to me that we should be looking at placing Mother in a memory care facility. She can barely walk, travels mostly in a wheelchair, so is not a flight risk. She has never complained or uttered a cuss word while there. Everyone, staff and residents, seem to care for her greatly. However, she is starting to have difficulty eating on her own and does require more individual attention.


Question: Should I just talk to the new manager about her continuing to reside there, maybe up her care level, or would a memory care facility be the better option? In researching, I don't see a whole lot of difference between AL & MC other than protection from flight risks. I've also read that the transition is extremely hard on dementia patients.


Nothing pressing at the moment but I will appreciate any feedback.


Blessings.

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so sounds like the AL does not have its own MC within the facility. So it would have to be a move somewhere else.

Here is what I would do - I would have an open discussion with BOTH the outgoing manager and also the new manager. Why the outgoing manager? Because they are leaving, they no longer have a business conflict of interest and hopefully will be totally honest with you.
The question is whether, with the combination of AL staff and your personal 5 days a week caregiver, can they continue to manage? Will there be any firm reasons that they say they cannot care for her, eg not eating, becoming incontinent?
You did not mention whether you have done research yet into MCs, but keep in mind many of the better/popular ones may be full and have waitlists (that is the case in my area, ML beds are harder to find than AL). So even if you are not moving yet, it is not a bad idea to start researching into ML availability for the future...
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It's not just about being a flight risk or her level of memory retention. In some good MCs they have appropriate activities and events for people in that wing. You may find that you won't need to have 2 outside people staying with her during the week days. The staff will know how to coax them to come out of their rooms and participate socially.

Please consider visiting some reputable and recommended MC facilities to learn their philosophy of care and what they have to offer. Please make sure if she goes somewhere else that they accept Medicaid. Maybe seek input locally from Nextdoor.com. Look for facilities that have been operating for a long time and have been able to retain their admin staff for a long time (this is a sign that it is well-run, well-supported and has a content staff).
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MamaChar Mar 1, 2024
Thank you for your reply. The AL she's at now has music, exercise & art classes, holiday celebrations, game nights, etc. which our caregiver is able to take her to and help her participate. She dines with a lovely group of ladies (also with dementia, but an earlier state) and in all senses, she seems to be happy and content. She does not qualify for Medicaid, but has Medicare Advantage...however, this only pays for hospital, doctors, Hospice. We are paying out of pocket for her stay at either place. I am working with A Place For Mom and will visit a few recommended MC facilities soon. I'm more worried about how the move from a now familiar place will affect her...
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People with memory issues in AL are often somewhat isolated from other residents because they don’t want to hang around people with memory problems.

Memory care focuses on mentally stimulating activities, and the caregivers are much more hands-on in terms of relating with the residents.

AL is going to leave it up to the resident to decide if they want to participate in activities where as MC caregivers will bring the residence to an activity and engage them. No one is forced to participate in an activity, but they don’t let them just isolate themselves in their rooms.

I made the decision to move my mother to MC when I decided that the one health issue I wanted to focus on was her mental stimulation. We couldn’t cure her macular degeneration, her hearing loss, or her heart issues, but we could make those last years better for her by not allowing her to simply waste away in a room somewhere. She couldn’t participate in a lot of the activities because of her vision issues, but the caregiver would sit her at the table where the activities were going on, and still help her participate as much as she was able to.

They were able to care for her medical issues at MC with no problem, and were able to care for her all the way to the end. Moving her to MC was the best decision I made.
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Thank you for your input. The AL she's in does not have its own MC, so if required, yes, we would have to move her completely to another facility. I like the idea of discussing with both managers and will make a point to do that when the opportunity arises. For the cost difference of the AL to MC, it may be possible to up her current care level or hire another caregiver to attend her there...another avenue to explore.
I am currently working with an organization called A Place For Mom which has put me in touch with a few MC facilities which I plan to tour in the near future. I'm just very concerned about what the move to a new facility will do to her fragile mental state.
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