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My 93 year old mom has been in a big memory care facility for 7 months and is having a rough time with all the commotion and unchecked behavior of younger Alzheimer's residents.
While she's not bedridden she has had many falls and several compressed veterbrae
I don't want to move her to a nursing home but need to make a change away from from where she is as it is unsafe and what too expensive

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I was fortunate to find an AL place that converted the lowest level of the 3 floor building to memory care apartments. I had a choice of a two bedroom, one bedroom or an efficiency apartment for my two friends with dementia and memory issues. It was the only place with memory care apartments large enough for a husband and wife to live comfortably there together and it was crucial they stay together. They also provided excellent care and documented everything they did.
For a while the they participated in some of the group activities, but after the wife passed, the husband prefers to stay in his room and watch TV and read the daily paper, only leaving to walk to the dining room. He is happy with the new friends he has made there. It was a great relief to find a place with those space options and have quality care go with it. I check periodically with the health administrator and she updates me on my friend's needs and how things are going. I have health care power of attorney and also pay all his bills so I am involved in every aspect of his care, agreeing to it as need change and signing that I do. I am there two times a week usually, more if we have a doctor's appointment or something to go to. I am relieved that my friend always tells me how happy he is there and I have gotten to know and like some of the other residents, too, and we always have big smiles for each other. It's too bad more facilities don't offer this flexibility in apartment sizes for their memory care units. I was able to make their apartment look just like their bedroom and den in their condo with the same furniture arranged the same way. When they moved in, they were happy from the start, never once talking about "going home."
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Being her home with help. She'll get one on one care for less money. Most if all she'll be happy. Her her off that seraquel, its crazy stuff. If she needs anything ask dr for Depakote . She can have live in care or go to day care . I kept my mom 8 years with me, would do it again, as hard as it was.she was a great mother to me. I spoiled her. She was bedridden the last 5 + years. Its scary enough getting old but not being home is worse. Please think of whats best for her and what you would want if it were you. she wont live that much longer. Best wishes
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My mom is almost 93. She is in a memory care house with about 16 private rooms. It is set up like a house and is very good. She has been there almost 3 years. Before that she spent a month in a "state of the art" place, but it was just too big and confusing. The residents and staff are familiar to her in the smaller place.
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Sparklegirl, Mom is in one of their facilities. Not all residents have dementia but majority do. But, they r not equipted for skilled nursing.
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You might also look into the Greenhouse nursing home model. They set up homes for about 10 people, with individual rooms and common kitchen and dining, like a big family. But since they are a nursing home, if you are on medicaid, that will cover the cost (which medicaid won't for ALF). They exist in various states, I'm hoping more open up near me
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Oh my, that is costing a fortune!! My mother is in the private home care. Costing $4,000 a month for a private room, shared bath. 3 meals a day and snacks, they do the laundry, cleaning, showering and will even transport to appts, if necessary, dispense meds, give nebulizer treatments and will work with how she is feeling. There are two caregivers there during the day and one at night. She wears pads, which we supply and I get at Costco. I wish they did have more stimulating activities for them and some places do. A couple even had a hair dresser available. One was a bit nicer with a private bath but was going to be $4,500 a month. A good place to start for places and infirmation is A Place For Mom on the Internet. No charge. They can give you a list of places. I checked reviews on the Internet, licenses, etc. you want one that is State licensed. All in all, I still think this is the best place for my Mom but I do keep a vigilant eye.
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I managed three high end 6 patient RCFE's located in Southern California for about a year. Almost all of our residents had significant dementia. We had to CNA's during the day and one (hopefully awake) at night. I am a little amazed at some of the comments already posted that in smaller facilities there was less instance of one resident affecting another. I have to say that I think that what one sees as visiting member and what actually goes on, are two entirely different matters. Dementia is what it is, and people are affected by it irregardless of what size facility they find themselves in. Where we did excel, I think, was in our response. We stove to involve the residents doctor by almost immediately informing them of marked behavior changes. For the most part, physicians were responsive. Sometimes a resident was removed to the hospital for total reevaluation of their medications, and to have a professional determine if anything was in play psychologically. Night staff was expected to be particular vigilant to keep residents safe from unwanted intrusions during these difficult times. At the end of the day, there is no such thing as total safety for your loved one, unless you are willing to pay for one person to watch them 24/7, and literally follow them around. Even in the best of homes, staff is notoriously underpaid. Generally speaking, these lower paid care givers are a mixed bag of characteristics, they care, work hard, usually resent the owners for financially abusing them, but never take it out on the residents. If a better offer comes a long, they will jump at it, often with no notice. Turnover is high, and it was often difficult to find new workers, and really hard to retain the very best. Make no mistake about it, facility owners do collude with their local care giver business owners to keep wages low. As a manager I did what I could to give perks to great workers, but had to do it behind the owners backs. I quit the position after one year, when it became clear the owner knew I cared more about the well being of my workers, more than her profits. The residents well being all comes down to staff, family support, and a willing and responsive physician. Visit your facility often and unannounced, and if you know what to look for, you can gradually understand what is going on.
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I can tell you from experience that I have an 82 year old mother-in-law with advance stage alzheimers in a nursing facility. My mother, who is 84, has mid stage(s) alzheimers and lives at home. The grandmother of my husband had beginning stage alzheimers when she was 82 (her doctor told me I could not care for her 24/7 anymore). Three very separate cases. With the "right" nursing home that is made either as a family decision or individual is a BLESSING. There are good people that work in these facilities!!!! And, I am a nurse and have worked in many good nursing facilities. Good luck and let me know If I can be of assistance.
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My father just turned 98. He lived 7 years in a rather large assisted living facility near our house. Then his mild dementia got worse, and we couldn't afford the much higher rates at that facility's dementia care wing. We also knew he'd be cooped up inside all day, with people that might be worse off mentally than he is. So we moved him to a local 6-resident board and care home. He's doing fine there, been there for about a year and a half now. That said, there's not too much to do there besides watch tv in his (private) room and socialize with other residents and staff. (He's never been big on socializing.) There is a gal that comes in weekly to lead them in singing and small excercise games, which is good. All in all, he gets good care, the small staff knows all his quirks and habits, etc. We visit 2x a week. Sounds like your Mom might like the relative peace and quiet of a place like this. Do check a few before you pick one, though, so you get one that you won't have to move her out of for reasons of cleanliness, poor maintenance, etc. Do your homework. Good luck; I know it can be tough.
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MsMadge, can you mention your suburb or message me? I live south of L.A. I have only started looking at places. A couple were recommended to me but might be too far from you. Cannot you believe you have to hire services on top of services!
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That is an outrages price for diapers! We ordered diapers by the case and had them stocked piled in moms closet. The cost ran around $120 with free shipping for 4 cases.
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Thank you all for sharing your stories - since I work close to 60 hours a week it was important to me to have her nearby when I initially placed her and having made the decision while the Medicare clock was ticking during a hospital stay I've regretted it ever since

We are in a suburb of Los Angeles and costs are very high - facility is $300 a day plus $450 a month for diapers - since she fell there in her room during the night I've had private caregivers with her 12 hours a day adding another $260 a day to the tab - if I pull them she will be in harm's way - I visit 3- to 4 times a week sometimes very late at night and put her to bed since they would just let her sleep in her clothes without a diaper and not even have her walker nearby - once it was folded up and put in a corner - no doubt how she fell her first month there

If I could find a nice home for even $6,000 a month I could keep private aides 4 hours a day and pay less than her facility now - she is very dependent upon me and calls my name when she wakes up during the night - it's heartbreaking to me
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My Mom is 85 with dementia and we are doing home care but have to start considering other options, which I hate. I think we would like the personal care of a small place but I wonder if the provide much activity or stimulation? It would be really hard for us to consider placing her. The only upside would be having her closer because we go back and forth all the time and her apt is 40 minutes away.
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My mother is 94 and lived with us for 2 12 years. Prior to that, she insisted on living alone in her home after my father passed and I had to go there daily. I am having my own health issues and it was getting difficult for me to leave her alone in our home and husband and I were very limited as to what we could do. I made the difficult decision to look fir a care facility fir her. Sge has worsening dementia, COPD, CHF, a bad arthritic shoulder and bad back. I looked at many facilities. Actually, my eye doctor referred me to a woman that helps find placements. I was concerned about the Aide to patient ratio in the big facilities and her having to go to the dining room to eat, etc. we were then told about some private homes, licensed by the State, that usually have no more then 6 residents. Long story short, I have her in one of these homes and feel that is a much better environment for her. They can cater more to her schedule and needs. There is also someone there at night. After a month, she seems to have adjusted well and no complaints. At first, I was going there daily but now go every 2-3 days. Take her out to eat sometimes. They have any questions, they call me. This is not cheap but not all that much more then a large facility that can tack on charges. She is a spouse if a surviving Vet so should qualify for some VA benefits. It is good to consult an Elder law attorney for this process.
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My folks were in an AL until dad became too sick to monitor mom and she kept leaving the apartment. The same family run facility has a memory care unit with about 14-20 residents. Mom still is in the one bedroom apartment and were looking to move her back to the building that is closer to my home and only has 9 memory care apartments. We pay $6645/month so to think there may be a cheaper alternative in a smaller setting would be better. Mom does not like "all those people" coming into her apartment frequently throughout the day to check on her/give her meds/meals. They still do not help with showering/bathing and just mark "refused". That is the most frustrating part. Will begin to look at alternative lodging. On the other hand my mother-in-law is in a memory care unit of a large nursing home and it is okay but my mother would hate it there as she is still cognitive enough to do things. Not sure what the cost is for that place.
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MsMadge, how much is mom paying now?
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My mother lives in a beautiful 6 resident home here in michigan it is wonderful. If anyone needs help finding a home in michigan send me a private message i would be happy to pass along the name of a site you can use to find one. The great thing about these homes is the patient to staff ratio. At my moms place there are always two people or more as the family lives in the home. The fact that they are small is also a great advantage for dementia residents as they have far less to deal with which leads to less confusion. Staff turn over is less. My mim has had the same caregivers for the year she has been their. They have a visiting doc, hairdresser, pediotrist,and pharmacy that delivers. I cannot say enough good things about these small homes. Again if you need more info message me. I hope you find what is right for your mom, and a place that gives you peace of mind.
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Just be sure to visit the group home unannounced. I placed my mother in a clean group home run by a family. They told me my mother enjoyed watching television with the other residents. When I visited, I found her strapped in a chair facing the TV. She wasn't uncomfortable, but past the stage where she could comprehend what was happening.
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Forgot to mention that they always made sure that mom used her walker and they had chair alarms on her chairs in case mom got up and they were not in the room. I provided an electric recliner which mom did not know how to close do that they would ask her or mom would tell them if she needed to get. Near the end they send a wheelchair to move mom around the home in. I had a hospital bed ordered with side rails the last month for mom.
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I moved our mother into a private assisted living/age in place home that only had 4-5 residents. Each person had their own bedroom. There was a dining room and a community room. They had a patio with shade out back. Complete personal care including laundry, medicine management, bathing, all meals freshly cooked, activity person who visited, library visits, adult senior bus if needed and social events like cookout with families invited.They did not provide overnight awake staff but did have bed alarms if a person got out of bed. Due to dementia in the end I paid separately for overnight wake staff. I took our mother to all Doctor appointments. In the end my mother was brought back to this place to die since there was nothing that the hospital could do for her. The cost was $3000 a month.
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My wife has had dementia since she was 59. I have tried various assisted living facilities with memory care units. None worked or they just did not take of her. Too many patients to handle with only two aids. I finally found a residential assisted living home. It is called the Path Of Life and it is owned by a Register Nurse. The only take patients with memory care and the staff is trained for these people. Someone is there 24/7 and usually there are two staff members. The most they can have there is 6 patients. This facility takes care of everything. Meals, laundry, doctors, nurses, medications, and recreational. It may cost a little bit more than the big faculties, but I figured it out and for me to have her a home and pay some one to be there 24/7, that did all they do, I would be paying double what I am now. You should try to find out if this type of facility is in your area and check them out.
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Hi, I put my disabled brother into a tiny facility, one floor, in a small town. He's on the residential care end with 10 others, and he's there because he falls too often and has too much difficulty organizing his own life. The facility also houses others with medical and dementia issues - I find something that helps him, is that he has regular routines of 2 times out of the facility each week.

Just that extra attention to some positive individuality gets them to treat him better I think. I don't like usual facilities - group oriented care is very demeaning, especially if it's all the time. I don't like the model - the meds make it easy for staff to not have to brainstorm about what changes could make things go better.

I don't know if it's possible for you, or if it would help, to hire an aide from outside, who could go regularly - and if not an aide, someone who can be regular for 3 hours a shift once a week. Some in those programs do hire aides. (I've been hired as an aide to get a pt w Alzheimers up and into the shower in the am. I ended up quitting, when I found the staff focus was on my communication about arbitrary little rules, when I was the only aide who made it my challenge to make sure the woman actually did get up and shower. I started early with her, roused her gently with arm around her, joked with her, let her wake and started talking about shower, then pause, and chat other things, then mention shower positively, and it took about 20 min, and I was inching her towards the bed edge during that time. Then I could say "good, OK, I'll help you up - and guide her to get up and come with me and I'd walk her into the shower room, often ended up as wet as she was, by the time all was done.

I hated that other individually hired aides with the same job would write on their report, "patient refused shower" and they gave up, did not give them, just gave a bed wipe - after I left, that woman got an infection so bad, she needed pain/oxygen hospital for months.

They don't do enough persuasion with attention and patience, much is lost when staff are always rushing.

My brother's facility has great local music, at least twice a month, and the place is small enough, that humanity comes through. It sits on flat land, so my brother can walk outdoors with a walker. I work to affirm their efforts, even if I sometimes complain, say this is not right sometimes, and meet with higher ups, but my goal is to do my best to express that I understand they are busy and challenged, but ask for special help at times, and notice each good thing they do for him, so the interest in quality does come up often enough.

Choose a spot where there are outside visitors easily, including you, and if you can't get there dependably, hire one person, one day a week, to go and do special activities for a couple of hours each week, chosen by you, with your mom.
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My mom was in Hearthomes, and she had a private room. She seemed to like it. Maybe 20 patients? I can't recall. It was fairly quiet, she liked the food, and she got decent care. Move your mom out of that place, If possible.
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My Mother with dementia is now in a small, 39 room, facility. It is designed for dementia patients, with their safety and concerns in mind. The staff are specifically trained to work with the issues that are unique to dementia and Alzheimer's sufferers. Look for a facility of this type. "Enlivent" companies offer these facilities. Look for one or similar in your area. They do come with a price tag, but it's doable.
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Sunny
Thanks- I realize there's no place like home but I need to move her for both financial reasons and her safety - she has told me she can't take it there anymore - I have visited three other memory care facilities which are smaller than her 62 bed facility now but didn't find them appropriate - she primarily needs custodial care but because she is difficult to handle with the dementia even on seroquel I'm afraid she won't last anywhere for long
Her doctors have no suggestions and just say there aren't many choices
While my siblings have completely walked away I can't and won't and she still wants to enjoy life so I'll still fight to give her a chance
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I recall all the issues that you have had with her facility. It's really too bad too. It seems that I recall that your mom also had some issues. Is that right? Maybe, her conduct is saying that she does need a smaller environment. Is that why you are considering it? You might consider a small Memory Care facility or one that is a wing of a larger regular AL. I have never actually been inside one of the home boarding places, though, I have rode by a few.

When I moved my cousin from regular AL to a small Secure Memory Care AL, I looked online at a list of all the state licensed memory care facilities that were in reasonable driving distance from me. I narrowed down the places, including some home boarding type places, called and even went to visit some in person. Those home boarding places are normally full, but I didn't have the option of getting on a waiting list.

Have you considered a small Memory Care facility or one that is a wing of a larger AL? The one I found is small and family owned. It's not perfect, but, I don't have that many complaints. She tells me she likes it there and that they are all very nice. Plus, the rooms are super large.
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MsMadge, my best friend's Mom kept her mother (BF grandmother) home with her until her mini-Parkinson's and dementia kept her fully bedridden and wheelchair bound. She found a small residential facility in MI with less than 20 residents and the owner lived there and supervised staff. Grandma was very happy there and had "new friends" every day (she forgot daily staff but they were kind). She lived at the Loving Care home for 18 months quite affordably. The smaller care homes can be great if you don't require lots of direct medical care, but more custodial care.
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Thanks Babalou
Mom just takes a BP med and a diabetes pill - we check her A1C every 4 mos

Given her bad back I'd like to keep her in her own comfortable bed as long as possible
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Bumping this up; I think it's a very good question.

Nursing home, though, are not JUST for bedridden patients. My mom was ambulatory when she was admitted. But her CHF and various pulmonary problems qualified her medically for NH care.
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