Anonymous wrote:My mom is at a place where when you transition from independent to assisted, you literally stay in the same apartment and they just increase the amount of time a caretaker spends with the resident. Going into memory care is another story.

+1.

I’m the OP and just thought to check back on this thread thank you for thoughts. Actually I too am just in the middle of Being Mortal! It’s a great book, I’ve read in past but felt I needed the refresher. Re-hygiene: in her case we’re not talking about not showering every day. We’re talking about conditions that are basically unspeakable. Details not ones I want to go into but nobody should live like this, and yet she doesn’t seem to mind. The dogs are a big part of it , but by no means the only problem. But they also keep her alive in their own way. I dunno. It’s really hard.

Anonymous wrote:

Anonymous wrote:OP I am currently reading Being Mortal. It is a great book that talks about how one's quality of life is more important that being 'safe'. The dogs are so important to her. Please don't minimize the importance of them.

I just finished Being Mortal and I 100% agree with you. I can't imagine separating her from her dogs if that is what makes her most happy. And by whose opinion do you think she lacks hygiene? When my dad was in assisted living the assistants worried because he didn't shower every day. I don't shower every day - I don't work in the coal mines!

Are you the OP? Because the OP specifically flags her mom being unable to take care of herself in matters of health and hygiene.

OP, in addition to the home health aide -- which I completely agree with -- you can also look at getting her a visiting nurse service to help on the health side. I.e., make sure she has her prescriptions, take her to doctors' appointments, etc.

My mom is in a great CCRC and I really want to keep her in her independent living apartment with whatever supports she needs (right now, just the visiting nurse) as long as possible. She has a cat and her cat is a huge part of her life, but I'm positive you can't take pets with you to the AL part of the facility.

I would hire outside help to stay in independent living as long as possible. You lose a lot of autonomy in assisted living. The facility then becomes responsible for administering all medications, etc. The facility takes on more of the burden of care, which means the resident gives up a lot of independence. Independent living is usually a lot cheaper also.

Agree that the standard of cleanliness can vary. But from what I've seen, most of the time the objection to not showering every day would be for someone who has an issue with incontinence. Daily showers become very necessary to minimize the smell of urine and its effects on skin.

Anonymous wrote:OP I am currently reading Being Mortal. It is a great book that talks about how one's quality of life is more important that being 'safe'. The dogs are so important to her. Please don't minimize the importance of them.

I just finished Being Mortal and I 100% agree with you. I can't imagine separating her from her dogs if that is what makes her most happy. And by whose opinion do you think she lacks hygiene? When my dad was in assisted living the assistants worried because he didn't shower every day. I don't shower every day - I don't work in the coal mines!

My mom is at a place where when you transition from independent to assisted, you literally stay in the same apartment and they just increase the amount of time a caretaker spends with the resident. Going into memory care is another story.

OP I am currently reading Being Mortal. It is a great book that talks about how one's quality of life is more important that being 'safe'. The dogs are so important to her. Please don't minimize the importance of them.

I agree with getting your mom an aide if she can afford it and is willing to go along with it. Do you know the monthly cost of her facility's assisted living? Every facility is different but it's likely that you would have to pay at least hourly rates on top of rent for any assistance she would receive.

I would first hire someone to come in a few days a week. The minimum is 4 hours per session. They usually will also include some light cleaning.
I would have them come in twice a week (Mon, Thur or Tue, Fri) to help her bathe, brush her teeth, change sheets/towels, run laundry, do dishes, light vacuuming, fill up pill box, make lunch (like a sandwich). Also could take her outside of the facility for a long walk or just to sit outside and get some sun (weather permitting), or take the dogs on a long-ish walk.

It would be cheaper to do this until she really can no longer live on her own. Also find out if she is involved with social activities. That would be the advantage of moving to AL; they usually really encourage residents to be involved with activities. If she isn't, the aide can take her to clubs or activities to make friends.

Imo, a lot depends re: the convenience for the facility. Do they have the room available? In AS? If they don't, they will look the other way. If they can rent it to someone -other than your Mother, they will look the other way re: what's most optimal for her. If they can rent it, immediately, to someone, they will.

Since Independent Living is like living in her own home, care decisions are your family's to make. Btw, elders do bathe a lot less than the rest of us think if optimal.

You're right in that the dogs are an issue. Ask. I wouldn't be afraid to ask the facility. They know the dogs, their personality. Sometimes it might depend on the dog.

Have you considered hiring an aide to come in a few mornings a week to help her with hygiene? It sounds like if she is happy and has her dogs, the best outcome would be for her to stay put as long as she can...

Would love to know insights from anyone who has worked with their parents to make this transition. My mom is in a C-o-C type facility, still in independent living apartment. She seems really unable to take care of herself in some basic ways (health and hygiene related) but she is also perfectly okay with it. We don't see any obvious signs of dementia but her inability/unwillingness to provide this basic care for herself may certainly be a sign. She also has 2 old dogs that are her reason for living that I assume could not go with her to AL. My sister lives nearby and helps her out as much as she can but can't go every day. My mom will have zero interest in transitioning to AL and while I think it would obviously be safer for her would also significantly worsen her depression. We are concerned about bringing our worries about her self care to the facility as they may very swiftly make the call to move her. So my question for anyone who has gone through this is - who ultimately makes the call about when a resident should and when they must move from independent to assisted living? What does that look like? Any insights or words of caution?