No facility will be perfect. And the whole industry has a bad reputation - deservedly. But OP I'll just offer a counterweight to your hesitation about the move. My dad had early stage Alzheimers when we moved him to a continuing care community. He was originally very opposed to leaving his home, and we had found decent help to keep him there. But once he moved, he was SO much happier because he was a super social guy and he finally had people to talk to all day long! And I think it was a huge relief to have everything provided to him at a time when doing the tasks he'd done every day of his adult life, like making coffee, had become increasingly difficult for him to manage on his own. In retrospect I realize he must have been frightened at some level living alone and experiencing confusion.

People with dementia can live a long time. My dad did not want to extend his life through heroic measures, but for his last few years, he could not eat solid food or take care of his basic needs. Managing that in his home or his kids' homes was essentially impossible. Because we moved him when he was still fairly aware and competent, it was a lot easier than trying to figure things out in a crisis. And because he moved in when he was still capable of engaging with others, he had built friendships that continued even after his condition worsened. When I look back on those years, I only wish we had moved him out of his house sooner. YMMV obviously but I think it's important for people to realize that there are upsides to nursing/memory care and assisted living.

Anonymous wrote:

Anonymous wrote:Don’t do memory care. We did for my Mom. Horrific. Call hospice and start in hospice. Keep the home health aide or get a new one. One that your trust, treat well and pay well.

I didn’t think hospice worked like that.

It doesn't. And it's hard to be qualified for hospice with the primary diagnosis of dementia - a doctor needs to certify that the patient has less than 6 months to live and that other criteria are met (significant weight loss, loss of communication skills, etc.)

Anonymous wrote:

Anonymous wrote:What area are you in? Maybe we can give recommendations.

I’ve looked in
Silver Spring
Olney
Columbia

Those are the areas most convenient for us.

Sunrise Silver Spring on New Hampshire is one I looked at. I hired an eldercare consultant who suggested I look up complaints. This facility had registered complaints on file, and I decided we wouldn't be sending our elder there.

In Olney, avoid Brookdale.

You can look up complaints against the individual AL community. These are kept by the state.

If they don’t have any, that’s good.

Reviews on Google can be employees.

Your home health aid may have a good point yet they also benefit from you keeping your mom at home, so they are not impartial.

We used memory care in Olney, which was horrible. It’s death care. Brook something near Sandy Spring Friends School. They did not care at ALL.

The final parent is in AL and it’s okay but they complain it’s boring. But they also can’t think of anything they want to do so I listen to a lot of complaining about how there is nothing to do but they don’t have suggestions for any activities they would like.

Anonymous wrote:Don’t do memory care. We did for my Mom. Horrific. Call hospice and start in hospice. Keep the home health aide or get a new one. One that your trust, treat well and pay well.

I didn’t think hospice worked like that.

Anonymous wrote:If your mom is at Stage 6, I might consult with a hospice for an evaluation. It can help you decide what to do because they can give you a rough estimate of her time left. I know it is difficult to think about, but once Alzheimer's patients hit Stage 7 and stop swallowing well things go downhill very fast.

When you tour places, focus on how they manage residents at the late stages. That means how they manage falls, UTIs, medications, constipation, hydration, pain/anxiety meds, and diet (pureed food, or supplementing). Some places are designed for different stages and phases. For example, lots of activities would be good for someone in an early stage, but at a late stage you want to make sure they are skilled at communicating with residents who can't anymore.

Stop by several times and try to look at residents themselves. Are they well groomed? How do residents/staff interact with them? Does the layout mean residents are often wandering around on their own unsupervised? What are the ratios? How often do they check on residents during the day and overnight? Do they have nurses/doctors that are on staff and can visit? What hospices do they work with? How often do they provide food/hydration?

For you to have true peace of mind you have to trust the place you are moving her to. It's like leaving a child at daycare for the first time. It takes awhile to build that trust. If your only reason for the move is because you think she is isolated, I would not move her. At Stage 6 she is not going to benefit much from activities or others anyway I would imagine? And the move might be stressful for her.

That being said, having teens at home with your mom has got to be hard, so that's a huge factor as well. You want to savor that time you have with your kids.

These are all good points, except I have to say, for the family who aged at home with personal caregivers, they were rarely well-groomed. Some people are so difficult even with meds, you have to choose your battles. So, I would not visit a residence and decide just because someone's hair is messy and they have nose hairs growing out the place is a bust. Also, you have to think about this stage. They aren't going to be very engaged, but you do want to see the caregivers being respectful and you don't want smells of urine and feces everywhere.

If your mom is at Stage 6, I might consult with a hospice for an evaluation. It can help you decide what to do because they can give you a rough estimate of her time left. I know it is difficult to think about, but once Alzheimer's patients hit Stage 7 and stop swallowing well things go downhill very fast.

When you tour places, focus on how they manage residents at the late stages. That means how they manage falls, UTIs, medications, constipation, hydration, pain/anxiety meds, and diet (pureed food, or supplementing). Some places are designed for different stages and phases. For example, lots of activities would be good for someone in an early stage, but at a late stage you want to make sure they are skilled at communicating with residents who can't anymore.

Stop by several times and try to look at residents themselves. Are they well groomed? How do residents/staff interact with them? Does the layout mean residents are often wandering around on their own unsupervised? What are the ratios? How often do they check on residents during the day and overnight? Do they have nurses/doctors that are on staff and can visit? What hospices do they work with? How often do they provide food/hydration?

For you to have true peace of mind you have to trust the place you are moving her to. It's like leaving a child at daycare for the first time. It takes awhile to build that trust. If your only reason for the move is because you think she is isolated, I would not move her. At Stage 6 she is not going to benefit much from activities or others anyway I would imagine? And the move might be stressful for her.

That being said, having teens at home with your mom has got to be hard, so that's a huge factor as well. You want to savor that time you have with your kids.

We've had caregivers for at least 15 years. We started at 4 hours per day. We've never had anything stolen.

Pay well. We are currently paying $31 per hour in rural Maryland. You will need to pay more in urban areas.

OP, Mom's estate lawyer gave me wise advise years ago. He has clients he supervises under care. He said with caregivers you get high school graduates if that.
He said don't be too picky.

I give the caregivers the Wi Fi password when they start. We have 3 currently enrolled in college. Yes the caregivers stream movies etc but Mom is safe, happy, clean, well fed and has 0 bedsores.

When Mom was still walking we had the caregivers take Mom outside for two walks a day. She would get outside if it was above 45 degrees and below 75 degrees. The caregivers bundled her up.

When Mom was still mobile we gave the caregivers chores for Mom to do. Mom loved swiffering with a dry swiffer. She loved wiping down the kitchen counters. Mom was also in charge of putting the silver ware away in the silverware slots in the drawer. Mom was also responsible for putting trash in the kitchen trash can. Mom also could fold laundry and would also move laundry from the washer to the dryer.

One caregiver thought Mom needed some arts and crafts. Caregiver told me what to buy and Mom started painting with caregivers.

TV has it's place. One caregiver wanted to get married so caregiver and Mom would sit on the couch snuggled together and watch Say Yes To The Dress. Mom loved the snuggling. It was the cutest thing.

If you keep Mom at home longer spell out a care plan with times for activities that you want caregivers to do. This will engage Mom more.

I've toured facilities in two states. You can learn a lot from talking to workers in the parking lots. In general the smaller, older rural facilities seemed to offer the best care and cleanliness.

Anonymous wrote:I’m a visiting nurse and I am seeing more assisted living residents have private aides (sometimes around the clock) to be sure all their needs are met. This must be quite expensive.

This is how it is in my town. Families of assisted living residents hire private aides.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All of that would give me pause to OP. Are there other memory care places you could tour? Once the need memory care they just need to be kept safe and their physical needs need to be met. They won’t need the social interaction as much. Live in care would accomplish that. I’m still touring memory care places because I haven’t found one that I’m comfortable with. One place smelled like urine and had no natural light (apartments were on the outside of a square so the interior common areas were were dark). It’s crazy because for the amount they charge the care should be absolutely top notch.

Exactly! This place is a highly rated chain. I really liked it at first until all these red flags popped up upon trying to get my LO admitted. They have several locations in this area, my brother said I should try another location.

Where are you looking?

Sunrise

The experience at sunrise is completely dependent on who is running the community. We had a horrible experience w/ LO at one location and are at another now that is so much better. We aren’t in MD so I can’t help with recommendations there but definitely tour other options and trust your gut.

Anonymous wrote:Don’t do memory care. We did for my Mom. Horrific. Call hospice and start in hospice. Keep the home health aide or get a new one. One that your trust, treat well and pay well.

Our issue is the most beloved health aides were the ones who stole. People who take advantage don't look shady. They get close to you and become trusted. At Memory care we made sure there were no valuables. Definitely check some out. The settings can be lovely with beautiful gardens. For us the difference between that and the nightmare of aging in place was life-changing for everyone. Also if you do put an elder there give it at least a month. If they are still complaining spy a little. They played along with all of my MILs brain blips-if she thought she was still working, they called her for a meeting to get her to come to lunch. If she thought she was still raising young kids they said the sitter was here and she could go out to lunch with her friends. The woman in charge let me observe her at some activities and she was truly enjoying herself most of the time no matter what stage of life her brain was telling her she was in. Yes, she had unhappy moments too, but aging in place she was rotting and yes, she fell there too even with 1-1. The person was in the bathroom and then preparing lunch and had no idea she was on the ground the whole time and didn't hear her calls. There were all sorts of issues and when she complained poor treatment there were no witnesses and eventually there was nobody the agency would send to replace the last person she complained about. Oh and the person managing her care at home was accepting gift checks from her. It's one thing if we give a big tip to a good aide, but nobody should be accepting money from an elder, especially the person being paid the most.

Anonymous wrote:What area are you in? Maybe we can give recommendations.

I’ve looked in
Silver Spring
Olney
Columbia

Those are the areas most convenient for us.

What area are you in? Maybe we can give recommendations.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:All of that would give me pause to OP. Are there other memory care places you could tour? Once the need memory care they just need to be kept safe and their physical needs need to be met. They won’t need the social interaction as much. Live in care would accomplish that. I’m still touring memory care places because I haven’t found one that I’m comfortable with. One place smelled like urine and had no natural light (apartments were on the outside of a square so the interior common areas were were dark). It’s crazy because for the amount they charge the care should be absolutely top notch.

Exactly! This place is a highly rated chain. I really liked it at first until all these red flags popped up upon trying to get my LO admitted. They have several locations in this area, my brother said I should try another location.

Where are you looking?

Sunrise

Anonymous wrote:

Anonymous wrote:All of that would give me pause to OP. Are there other memory care places you could tour? Once the need memory care they just need to be kept safe and their physical needs need to be met. They won’t need the social interaction as much. Live in care would accomplish that. I’m still touring memory care places because I haven’t found one that I’m comfortable with. One place smelled like urine and had no natural light (apartments were on the outside of a square so the interior common areas were were dark). It’s crazy because for the amount they charge the care should be absolutely top notch.

Exactly! This place is a highly rated chain. I really liked it at first until all these red flags popped up upon trying to get my LO admitted. They have several locations in this area, my brother said I should try another location.

Where are you looking?