When to move mom into Memory Care?

Kari

How do we know when it's time to move my mom into Memory Care? My dad is her primary caregiver and it's getting harder for him to manage her care. My mom has an in-home caregiver that comes on T/TH for 4 hours. On M/W/F she goes to a memory care day program for about 5 hours. She needs guidance with her daily personal care, but can physically manage. I think it'll be very hard for my dad to admit he can no longer manage her care at home. Also, it seems like giving up if we move her into memory care.

Twyla

Kari I have heard that you will know when it is time. My take on this is I want to take care of my husband until the end. I welcome the help that I receive with taking care of him. I also know that I have to take care of myself as well as take care of him. That’s what I try to do. Because if I get sick I can’t take care of him. I also know from others when I can no longer keep him safe, if I can’t be safe around him and I have tried everything to do that it might be time. That depends on the person some love one wanders and some don’t. Some love ones are very aggressive and combative and some are not. Some love requires more help than others lifting them moving them when they fall. So when you have done everything within your power and with help from others don’t feel guilty you are at this time doing what is best for your love one. It is a hard disease and it takes a lot of strength to see your love one slowly losing functions others take for granted. So I try to give my husband some laughter. To see him laugh or smile warms my heart.

dvellio

Three years ago, when my wife could still be involved in the decision making I decided because of her request that I would keep her here at home as long as I could possibly take care of her safely. Along the way there have been many challenges to that possibility. In the two years between 2020 and 2022 she fell a total of eight times. She refused to use the walker because she didn't need it even though she had to hang on to the walls and the furniture every time she tried to move around the house just to keep from falling. I knew that if she actually fell and broke something I would not be able to keep her here at home in all probability. She was never able to understand that. Denial seems to be a part of the dementia process.
Luckily with all of those falls the only real injury was a bruise to the middle finger on her left hand. And even though the EMT's wanted to take her to the hospital I assured them that I thought we could handle a bruise. It turned out I was right, it faded in a few days.
The bigger challenge occurred when it finally reached the point where she could no longer get in or out of bed by herself. By then I'd found a lift that made it possible for me to help her. Then came the challenge of moving her around the house in a wheelchair, most of our house is carpeted in a deep pile carpet. That necessitated laying down plastic strips designed for the purpose, and then when I found that wasn't enough buying plywood to get put underneath those plastic strips to make a firmer runway for the wheelchair.
My own health got in the way when I awoke on the Saturday before the 4th of July and couldn't put any weight at all on my right leg. That turned out to be a problem with my back which has been an issue all along. It simply had gotten worse. From that point on I have needed help to get her in and out of bed. Initially I was able to get that help from her son and his family twice a day but in September I finally decided that I needed real professional help. I actually thought about care centers at that point but as I explored the options and considered the risk to her in that environment, I decided it would be far better to hire someone to come here to help.
My major concern with the care facilities situation revolves around two issues. I don't believe they would be staffed up to provide the kind of care it would take to keep her from falling and injuring herself. I'm also not at all convinced that they would have the equipment to handle her because of her inability to move her own body and her weight.
In September we ended up in the hospital emergency room, we spent 7 1/2 miserable hours before they determined there was nothing wrong and sent her back home. Rex hospital was not equipped to help her. Part of the problem was staffing; the other part of the problem was equipment. None of the nurses in the emergency room seemed to even know what a lift was so when they wanted to move her, they literally had to put her on blankets and gather around with six or eight nurses and pick her up to move her to the other position.
I don't believe care centers are likely to be staffed much better.
The other issue I have is this. The first question she asks every night just before we go to bed is, “Are you going to sleep with me?” As long as she is aware enough to ask that question, I do not believe she would do well in a care center environment.
The bottom line is this, while there have been times when I wasn't sure how I was going to do it we have managed to this point to find answers for all of those problems and I actually believe now that is long as my own health is good enough, I will be able to keep her here to the end.
Also, I have discovered that with good caregiver assistance it is far less expensive than it would be to have her in a care facility. So, as long as I can take care of her safely, without risk of injury to she or I, I plan to keep her here. I have determined that unless she is in extreme pain that can't be controlled she is not going back to the hospital. She signed a DNR several years ago when she was still cognitively aware and I intend to help her through that process.
I'm sure that many people don't have the resources that I've had or the physical ability to make the same decision. But I'm hopeful the information on this forum can help some people extend the time they can be together with their loved one at home.

MPH

Thank you dvellio,,,it has been something i"ve been wondering about, thinking i'm not taking good care of him,,,parkinson's and dementia is what i'm dealing with,,,my husband keeps declining,,I wish it would stop,,i know it won't,,,he also falls out of the wheelchair,,i secure him in that every day,,,,I also get him into the geri chair and use the chair table to keep him in there,,,i can''t take him to the store too much,,i experience uncooperative behaviors and at times literally have to drag him out of the car, he's loaded with bruises from falling,,,we can no longer do the Rock Steady Boxing,,,I don't have as much assistance as you but i know its coming,,,,i have made house adjustments also,,i will do more as things progress,,,,shower chair and lift are on my check list,,,,i have facility concerns also,,i used to work in one,,,in a different department that cna's or nurses,,,but i observed alot,,,,its a shame nurses don't know what a lift is,,,but i can see the blanket lift,,,there is something that can help turn but i'd have to look it up, but i do believe i saw it on amazon, that may be my next purchase before the lift,,,,anyway,,,thank you for the inspiration to keep myself moving forward and the relief seeing someone else being so determined,,,,keep on giving your wife your strength,,,home can be the best place for them,,,Bill is on hospice,,,case management,,,that has helped also

dvellio

Thank you MPH for your post it's always helpful to know that something I've shared is helping someone else.
For several months my wife leaned to the right anytime she was sitting in the wheelchair or anywhere else for that matter. It looked very uncomfortable although she never really complained but everybody who saw her sitting that way thought she must be uncomfortable. The item I've listed just below is a restraint that I purchased to help her set up straight, but it also kept her from getting out of the wheelchair by herself. I found it to be pretty helpful during that time when she was still mobile enough to move her own body.

Wheelchair Seat Belt,Wheelchair Harness Adult,Wheelchair Belts to Prevent Sliding,Wheelchair
Restraints for Elderly Patient Disabled,FUSHIDA Constraint Jacket,Chest Posey Vest Restraint Belt
https://www.amazon.com/gp/product/B07Q435M76/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

It is a real struggle to stay ahead of the challenges that keep coming up while caregiving for someone with dementia. I posted yesterday in the equipment discussion topic some of the equipment that I've purchased over the last three years to help me in this process. I have a lot more items that need to be added, but I haven't had time to process them yet. Maybe in the next few days I'll keep adding to that list of items.

KEB

Thank you all for the very helpful posts above! I agree with dvellio about assisted living/memory care residential situations having tried both (one) great one and (more) bad ones. Can anyone who's hired in-home personal assistant(s) for their family member recommend good starting places in the central Atlanta area? Thank you!

MoniqueFrahm

KEB I would recommend contacting your local Area Aging on Aging! They can give you tons of helpful information and resources!

Evan-Mc

I have thought about this very thing... so far so good now though.

bjl

I'm struggling with the decision about memory care right now. Thank you for your posts.