Balancing Senior Living Choices / Dementia

[Anonymous]

Mom, recently diagnosed with mild dementia, lives out of state. Looking at senior living options for her to move to DC area. (me moving to where she lives is not an option) She is mostly independent now but could use help with meals, transportation, and social engagement. By no means does she seem eager to move, but being closer to me would be an incentive.

Thankfully, she has enough in savings and home equity to pay for senior living. Problem is, at what price and for how long? She loves the neighborhood where I live now, and there is a senior living option nearby but it is very expensive. Paying for it for a few years would not be a problem. But thinking about more than that starts to stress me out as I can't afford to supplement if she get close to running out of money.

One view in family is that the extra expense is more worth it *now* while she would still benefit the most from the social engagement and being close to me. The view of these family members is that I could always move her to a more affordable place further out (even if it would be difficult for me to get to visit often) if she lives longer -- that by that point she may not know who I am or where she is, so it will not matter where she is living at that point.

Curious if anyone has been there and has thoughts on how realistic or not this view is of how things may play out over time.

[Anonymous]

This is the OP again.

Other options being considered are:
- a regular apartment near me until her care needs rise to the level of assisted living. However, I work FT so this option would not improve her social engagement much beyond what she has now. I don't have a lot of support so a concern is that this may quickly exceed my capacity to help and that getting home companion care to supplement may be difficult given labor market/prices

- me trying to move temporarily within the DMV to a lower cost location where nearby senior living is less expensive (bringing a whole other set of pluses/minuses)

[Anonymous]

that point she may not know who I am or where she is, so it will not matter

this is true
she will not know

[Anonymous]

The neighborhood the assisted living facility is located in won't matter. As long as it's located close enough to you that you can visit as much/little as you want to.

IME, please do not move yourself or get her an apartment to prolong the inevitable.

[Anonymous]

Why not do caregivers at home as long as possible, then transition to assisted living facility? My mother lived with dementia for 15 years. Her care cost over $1.5 million dollars.

[Anonymous]

She will do much better if she stays in her own home and community as long as possible, with caregivers. See if there is a senior center with transportation and daily lunch and activities for her to do.

[Anonymous]

Anonymous wrote:Why not do caregivers at home as long as possible, then transition to assisted living facility? My mother lived with dementia for 15 years. Her care cost over $1.5 million dollars.

Would you share what age the dementia started? We just made the move to assisted living and pondering the long term financial needs.

[Anonymous]

Price out efficiency apartment near you plus caregivers.

Mom lived 20 years with dementia.

[Anonymous]

Generally the cheapest would be keep her in her home for now and get 4 hours per day for caregivers to assist with driving and meals.

Reevaluate down the road.

[Anonymous]

This is the OP. Thanks for the replies thus far. I will do some research on caregivers costs locally for comparison.

She rejected the idea of senior living near where she lives now but said she was open to moving near me.

I'm afraid to go it alone trying to manage caregivers for her long-distance while she stays in her house. (I saw another family member really struggle managing caregivers, and they lived nearby to the person they were caring for.) The push to try to get her to move is family dynamics, to be honest. There are two family members near my mom, but both are over 80. Another family member, who is not much younger, is worried that this will end up on her -- so telling me that this is my job, this needs to pass to the next generation (which is just me, an only child), etc. I told her she needed to back off and give me some time to develop a plan. But the bottom line is that family say they want to help me but the actual offer on the table seems to be to help sooner rather than later with getting her moved to senior living somewhere and then they are out of it. Since my pool to draw on for any help whatsoever is small, I am hesitant to forgo even that.

[Anonymous]

As far as how long she will live, how much medical intervention does she/you plan to engage in? If she got cancer, would she do chemo? Would she have a heart surgery? Where she (and you) are at with respect to medical intervention will matter for life expectancy.

My grandmother was basically like “nothing hard once I’m 80, I’ve had 80 good years.” So she got breast cancer and had a mastectomy, but no reconstruction or chemo. She took meds to relieve edema, but she wasn’t going to do dialysis. She would not have had open heart surgery, etc.

[Anonymous]

I have been here with my own parents and inlaws. This is your job. You cannot expect older relatives to help at all and the fact they offer any help is generous. Also, keep in mind if your plan is to keep moving her as her issues increase, you may have your own health issue or a family crisis at the same time she needs to move. Better to think long term. Consult with an aging care expert about finding the right residential setting long term that she can afford.

Also, the caregivers at her own home gets exorbitant very fast. One break of a hip or the stress of coping with death of a sibling or friend could cause rapid very rapid decline and the need for 24-7 care.

[Anonymous]

A new place isn’t necessarily going to take someone with moderate or severe dementia, especially if the person has behavioral issues, so the place you move her may be the place you are stuck with long-term. I wouldn’t count on finding a cheaper place later. A lot of places are open to taking someone in the early stages of the disease and moving them into memory care later, but will not accept directly into memory care.

[Anonymous]

Find a place now near your house.

[Anonymous]

Anonymous wrote:As far as how long she will live, how much medical intervention does she/you plan to engage in? If she got cancer, would she do chemo? Would she have a heart surgery? Where she (and you) are at with respect to medical intervention will matter for life expectancy.

My grandmother was basically like “nothing hard once I’m 80, I’ve had 80 good years.” So she got breast cancer and had a mastectomy, but no reconstruction or chemo. She took meds to relieve edema, but she wasn’t going to do dialysis. She would not have had open heart surgery, etc.

This can be—I won’t say a blessing, but a way out of an unsolvable situation. But you can’t count on it. My mother in law lived decades with dementia. She was physically tough and in great shape and still intensely physically active despite losing so much cognitively. It was a difficult combination. Lots of broken bones from injuries because she had no understanding of her surroundings. But you can’t NOT treat a broken arm, you have to treat it. It can go n and on, and it’s awful.