Assisted living for 93 y/o with dementia?

[Anonymous]

My 93 year old grandmother has dementia. It is pretty advanced. She still lives independently in her home. We have a private caregiver who comes a few days a week and my mom visits daily, but she is alone in her home for many hours each day and overnight. It's not a safe situation. Last week, she lost consciousness and collapsed. Fortunately her caregiver was there with her at the time and called 911. She is now in the hospital and they are planning to discharge her to a short-term rehab facility. We are trying to figure out what comes next after that. We don't think she should go back home. Memory care would not be a good fit for her. Is there such a thing as assisted living with wrap-around services for people with dementia? She is generally content to doze in a chair, watch the birds and squirrels outside her window, and will watch tv if it's on (she no longer knows how to operate the tv). She does not wander. But we would like to have "eyes on her" throughout the day, or at least multiple checks. I would be grateful for any insights or advice. We probably have about 2 weeks to figure out a plan.

[Anonymous]

She needs memory care or 24-7 help.

[Anonymous]

Assisted living will typically only visit 1-2 times per day for meds administration and limited assist with ADLs.

Dementia advances progressively and soon the things you don’t think are an issue will become issues. She’ll forget how to brush her teeth and wipe herself after toileting. She’ll forget how to safely sit down on and get back up from the toilet. She’ll forget that where she is is home, and she’ll go wandering.

You can do AL temporarily as a bridge to memory care, but only if you are prepared to have a supplementary caregiver visiting to fill the big gaps left by AL staff. Eventually that will be 24/7 caregivers and then it’s a numbers game whether that is more expensive than memory care.

[Anonymous]

Why do you think memory care is not a good fit?

[Anonymous]

Anonymous wrote:Why do you think memory care is not a good fit?

OP here. Memory care settings lack privacy and residents with a wide range of behaviors are grouped together in large communal spaces. My grandmother would absolutely hate it. She may not know what day it is or what she ate for breakfast, but she knows that she doesn't want to be forced to sit in a locked room all day with a bunch of other people. She has always been a solitary person, happiest at home with a good book and a dog at her feet. Many memory care settings also seem to have programming designed to keep residents active and engaged. She would hate this too. She just wants to be left in peace. I understand that the activities are meant to enhance quality of life and have benefits, but at 93 years old, the value of this type of therapeutic programming is pretty limited. If I'm wrong about memory care, please correct me. But this is what I deduced by researching programs online.

[Anonymous]

She needs to be pretty functional to be in assisted living. They will send around CNA's in the morning to assist with dressing but the residents are on their own most of the time.

[Anonymous]

How is her money situation? You could expand the caregiver hours in her home.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why do you think memory care is not a good fit?

OP here. Memory care settings lack privacy and residents with a wide range of behaviors are grouped together in large communal spaces. My grandmother would absolutely hate it. She may not know what day it is or what she ate for breakfast, but she knows that she doesn't want to be forced to sit in a locked room all day with a bunch of other people. She has always been a solitary person, happiest at home with a good book and a dog at her feet. Many memory care settings also seem to have programming designed to keep residents active and engaged. She would hate this too. She just wants to be left in peace. I understand that the activities are meant to enhance quality of life and have benefits, but at 93 years old, the value of this type of therapeutic programming is pretty limited. If I'm wrong about memory care, please correct me. But this is what I deduced by researching programs online.

My mom is in her own private 2 room apartment in memory care. All memory cares are not locked floors filled w/ rows of beds. There is a wide range of cognitive function among the residents living there and the floor is locked, so they don’t walk out the front door, but there are absolutely memory care floors where she can live in her own space.

[Anonymous]

Anonymous wrote:How is her money situation? You could expand the caregiver hours in her home.

This was my thought. If she can afford more at home care this sounds like a better solution. And the rehab facility won't release her until you have proof of a competent situation to which they can discharge her. With my dad we had to prove we had 24-hour care in home before they would release him. They wanted to keep him and go to full pay after Medicare ran out.

[Anonymous]

Anonymous wrote:Assisted living will typically only visit 1-2 times per day for meds administration and limited assist with ADLs.

Dementia advances progressively and soon the things you don’t think are an issue will become issues. She’ll forget how to brush her teeth and wipe herself after toileting. She’ll forget how to safely sit down on and get back up from the toilet. She’ll forget that where she is is home, and she’ll go wandering.

You can do AL temporarily as a bridge to memory care, but only if you are prepared to have a supplementary caregiver visiting to fill the big gaps left by AL staff. Eventually that will be 24/7 caregivers and then it’s a numbers game whether that is more expensive than memory care.

OP here. This isn't what I want to hear but it makes sense. We've been down the 24/7 care road with my grandpa who had Lewy body dementia. We used a home health care agency but it was a lot to manage and the quality of the aides really varied. There were also frequent problems with people calling off at the last minute and no backfill from the agency. The only reason it worked at all was because my grandmother was living there and managed everything. That's why I was hoping that there was an alternative. Something that would be safer than continuing to live alone at home, but more palatable than memory care.

[Anonymous]

Just hire more in home care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why do you think memory care is not a good fit?

OP here. Memory care settings lack privacy and residents with a wide range of behaviors are grouped together in large communal spaces. My grandmother would absolutely hate it. She may not know what day it is or what she ate for breakfast, but she knows that she doesn't want to be forced to sit in a locked room all day with a bunch of other people. She has always been a solitary person, happiest at home with a good book and a dog at her feet. Many memory care settings also seem to have programming designed to keep residents active and engaged. She would hate this too. She just wants to be left in peace. I understand that the activities are meant to enhance quality of life and have benefits, but at 93 years old, the value of this type of therapeutic programming is pretty limited. If I'm wrong about memory care, please correct me. But this is what I deduced by researching programs online.

My mom is in her own private 2 room apartment in memory care. All memory cares are not locked floors filled w/ rows of beds. There is a wide range of cognitive function among the residents living there and the floor is locked, so they don’t walk out the front door, but there are absolutely memory care floors where she can live in her own space.

OP. Really? Ok, that gives me hope!

[Anonymous]

Op, there are no good options. If you want her in an institution they will insist on memory care and it will most likely suck

Try to keep her at home and up the number of hours

Personally I’d rather die from a fall at home than be locked in memory care

[Anonymous]

OP here. Theoretically we could afford to expand the in-home care which would allow my grandma to stay in her home, but in practice it is very hard to manage. We had 24/7 in-home care for my grandpa for the last 5 years of his life, through several different home health care agencies. It took so much effort to manage everything and the quality of the aides really varied. There were also some disturbing incidents which luckily were observed and reported by my grandmother. It's not a road that we want to go down again and don't think my grandmother would accept a revolving cast of strangers coming in every day and night.

[Anonymous]

Home care with camera's