We are finally at a point of moving my mother into a senior living facility. Should we place her in assisted living or memory care?

That's a tough call. Because if you get her placed in the Assisted Living and then shortly thereafter, she needs Memory Care if may be very confusing to her. See what her physician and a social worker suggest.

afreil: Best wishes to your mother in finding a good fit with her new residence.

I think Llamalover47 makes a good suggestion, "See what her physician and a social worker suggest."

Otherwise, I can share my experience. My mom has been in memory care for a little over nine months. The facility in which she resides is well run, has a good reputation, and the staff is well trained in being of assistance to folks with Alzheimer's and dementia. There are activities planned daily, on and off site, in which the residents can participate. My mom loves the trips to the museum in the city. 

Mom has been described as high functioning, and I have noticed she will gladly partake in activities. She does miss getting outside to walk daily, since it's been too cold, etc., over several months' time. Thankfully, spring is not too far away, and I believe she will resume walking then. She uses a cane but had PT and, so, she does fairly well. 

My mother especially likes to join in and help staff as she can; the staff knows she is a retired nurse, and she is encouraged and welcomed to be a helper.

I am surprised tha tyou were not aske dby her doctor, for a screening process firstly. However, if they have said what is best for her, Let them try it for awhile. See what happens.

That's a tough one. We were in the same situation. We went with Memory Care simply because it gives her the support she needs (and will only continue to need more of) which assisted living does not. And people with dementia almost always certainly have regression during transition trauma. The move throws all of their coping mechanisms up in the air. This presents in a myriad of ways, physically, mentally, and emotionally. We were able to find a MC that fit the bill.. Is secure but large and free-roaming, and has an unusual number of higher functioning individuals. If you are concerned about her not getting individual attention you wish her to have, hire a companion for her a few days a week. We hired a musician who was also a caregiver for my dad so he could continue to play piano, sing, and "have rehearsals." It has made a huge difference in the slowdown of his mental decline. We may do the same for my mom but that remains to be seen.
No facility, AL, MC, or SNF, will provide one -on -one companion care to any extent. Be skeptical if they tell you they do. Best wishes.

Yes, I am in the middle of this dilemma, myself. We first placed Mom in AL. After breaking her hip and rehab, she declined some from the trauma of it all, but has bounced back pretty well. However, her facility would not let her go back to AL and placed her in MC. She is not as happy there and has little stimulation. I would recommend placing your mother in AL for as long as she can. Only move to MC if absolutely necessary.

My mother who is only 77 and high functioning with dementia has been in a memory care facility for the past week and it has been horrible . She does not belong there and I wish to move her to Assisted Living facility with level 3 care . Her MC facility is telling me I can’t do that .

Afreil, such good news that mom is ready for the move.

It can increase the quality of her life so much.

I hope that she finds contentment and even some happiness expanding her horizons for this season of her life.

Maybe the reason you’ve been told that she can’t enter AL is because residents must meet a certain criteria for admittance. Mostly relates to whether the can still do basic hygiene, stand on their feet for a certain time period, etc

I’d start her on the AL side first, who knows she might thrive there. What can it hurt?

What works for one (or more) doesn't always work for others. IF adult day care works, great. IF one can move in or have the person move into your own home and it works, great. IF having home aides works, fine, but that gets VERY expensive quickly if the person needs more than a few hours/day assistance. Even trying regular AL with outside hired aides can get expensive.

I have a friend who's MIL recently had a fall and had to move to AL. They are being told she needs to have hired help 24/7, at $39/hr! One month would be $28,080 and that's on top of the AL cost!!! She does have memory issues, so I recommended MC. There are more aides/resident and more coverage for needs. Mom's MC place is $8,232/month. If her personal needs (hands on care) exceeds 1 hour, then there will be additional cost, but NOT 24/7 at $39/hr. So far we have not had the extra cost and this is year 4.

magnumpi29 - as noted above, sure, if it works it can be cheaper, however my mother would NEVER go to an adult care center and we didn't live with her, so we couldn't take (force) her to go there! She had tried that with my dad, and he hated it. She, in her mind, was FINE, and would NOT consider moving anywhere else, would not have aides in or go to an adult care center. BTW, noted many times in other posts/threads, mom injured her leg just prior to the planned move. She didn't have enough sense to know how serious it was and didn't seek treatment or even tell us about it. Her neighbor was told and reported to me that mom "bruised" her leg. Nothing new there, but... Since OB was arriving the next day, I asked him to check it, send pix and then directed him to take her that night to the ER. It was cellulitis and could have killed her. For the most part, no aide is going to check her body whether they are in the home or at adult care center unless the fall/injury happens on their watch, so this would have festered and can kill quickly. At MC, they report all falls to me and check/monitor her for several days, just in case, so this kind of issue can be avoided.

afreil - so happy to hear that your mom was agreeable to the move. Hoping that she does well in her new "home." It would be interesting to know what you decided - AL or MC, and how she is doing there. As I noted, for some this works great, for others it is a difficult transition. We don't know until we do it and although some continue to complain about it (sometimes that can go on for a long time), give it time, don't feel guilty about it and enjoy your time with her while you can!


magnumpi29
"Your mom hates a home health woman coming in but loves nursing home staff coming in her room? Something doesnt add up and seems suspicious, I hope she wasnt being abused by home health and you didnt know it"
It could be as simple as this is mom's home and she didn't like having someone there. It could be a mismatch in personality. There are MANY reasons why someone might not appreciate or accept having someone in their home. Our mother initially allowed the aides in for the 1 hour we started with, mainly a sanity check to be sure she was okay and a med check. The plan was to increase the amount of time and tasks as needed. In less than 2 months she refused to let them in. They sent their "expert" to chat with her, and that woman is lucky mom couldn't physically throw her out of the condo!

There are NO simple answers. We have to work with what we have, what works for all of us and what is best for everyone, mostly the person, but for us as well. We have to support each other here in the decisions made. We can suggest until the cows come home, but in the end, what works for each of us is variable.

For those suggesting doc assess capability, most docs don't have a lot of knowledge/experience with dementia, or even a lot of interface with the person. Those who work in the field have better understanding and would be the better choice to rely on for determining capability/thriving in AL or MC.

Respect2honor - thanks for the vote of confidence! I have likened dementia progression being like the reverse of baby-toddler-child-adult progression. Babies learn to roll over, crawl, walk and talk at their own pace. Their capabilities improve, their knowledge improves and over time can be trusted with more independence. Every child is unique, although in general if there are no medical issues, these "milestones" happen within a range. There is no real "normal" for babies or people with dementia. Some progress quickly, others not so fast (babies AND those with dementia), and there are NO warning signs!

When my daughter was a baby, two co-workers had nieces about the same age. They raved about how "advanced" the girls were and had moved to a bed (my daughter was NOT ready for one IMO.) Each had a fall with some injury, one to the neck!

Many people leave infants on beds or a couch while they are sleeping, but one can't anticipate when that ability to roll over and fall off will happen!  

Climbing & walking - my daughter NEVER climbed out of the crib, but had to move to a bed finally at about age 3 as I needed the crib for my son, coming soon. I put chairs next to the bed and several times found her on the chairs (they prevented the fall to the floor!) He, on the other hand, was more apt to climb AND had a sister encouraging him, so I had to leave the side down - less distance to fall! She walked at about 11 months, HE walked at about 9.5 months! She became chatty Kathy very early, he had a handful of words and his finger to get what he wanted and didn't say much until he was about 3.

With dementia, it is the same. They don't do this or that until they do. There are no warning signs, blinking lights or sirens to warn us that they will wander, do something dangerous, eat something inappropriate, etc. We cannot be with them every minute of the day, and as with babies/toddlers, it only takes an instant for some disaster to happen! We can "baby-proof" the home for kids and adults with dementia, but there will always be that "moment" when something untoward happens.

We moved our Dad into the assisted living side of a really nice facility. They too thought he was borderline, but we went with assisted living. He was only able to stay there for a week because he kept getting out and wandering around and going into other peoples' rooms. We found that the move to the facility from his home of 33 years caused enough confusion to push him over to the need for memory care. We find that the memory care side provides all the stimulation he needs and wants and is a much safer environment for him. Good Luck with your Mom.

I would wait on memory care and place her in assisted living first to provide her with as much stimulation as possible. I know a couple where the husband is borderline for memory care. The family is keeping him in assisted living until her deteriorates further. After all ,she may or may not decline quickly. As long as the facility can accommodate when she does need memory care, go with assisted living.

We started looking at AL because of mobility issues and mild cognitive impairment. Three years later, after a fall, we went directly into MC at the recommendation of doctors/rehab. It had to do with his ability to handle Activities of Daily Living (There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring, and continence.) He was at high risk for falls and unable to anticipate bathroom needs, so we needed someone to check in on him hourly and that could not be provided in Assisted Living. In Memory Care, there was no reason WE could not take him to any of the activities in the building provided to the rest of the people in AL (including dining) but could not count on the aids to do that for him, as they couldn't be dedicated. So they preferred someone to come in with activities/church service and preferred he eat in the MC dining facility. The only problem was that the residents of MC were not all mentally in the same place, so it was difficult to find activities appropriate and interesting for them. Meals were not social but something for the aids to get through. Yes, I think lack of stimulation/companions of his choosing made his dementia worse. It was isolating. Be prepared to supplement with your own activities, visitors, go together out to meals and other venues, etc. Give your loved one some control back over his/her life. I really think this is the key to staving off the inevitable.

Follow up to my original post... My mother had a bad fall at home on the day we were scheduled to move her to assisted living. She spent 5 days in the hospital with a gash on the back of her head. The doctor recommended moving her to a rehabilitation facility prior to her moving to AL. However, her insurance refused to pay for the rehab, so last week we moved her to AL. After being there less than a week, they are already telling us she needs to move to memory care. Her confusion has increased and they feel like she has to be watched constantly. I feel like the combination of the fall, the hospital stay, then the move into completely new surroundings has caused a rapid decline in her mental stability.

I would insist that they give her time to adjust.

1 week is not enough time for anyone to find their footing.

She's going to have an adjustment period either way. If you're determined to have her stay in AL is it possible to have a caregiver come in daily for a few weeks, then re-evaluate? She will go through the same thing once moved to MC.
My experience was that mom probably should have gone to MC sooner than she did. She lived in her AL for 7 years and the staff were attached to her so they would look the other way when she got worse. I would notice things and talk to the director who would have them do extra checks on her and said she would let me know when it was "time." It didn't happen and I had to make that decision. The final straw was a blind woman (mom) with a walker straying 2 miles from her AL alone. She was found on the corner of a busy intersection and a good Samaritan brought her to the lobby of the independent side of her residence. I moved her within days.
She was horribly confused when she first moved to MC, packing her walker with clothes everyday for her "move" to her new apartment. All kinds of things went on and really freaked me out. Gradually she adjusted and has really thrived there.
Like I always say, this is hard stuff. No easy choices or quick fixes. Hang in there. Many of us have been there and we're listening.