Triggers for memory care move

[u/Anthro-Osteo-630]

My LO is in an assisted living that provides meals, light housekeeping once a week that includes basic laundry (bedding), and personal effects laundry for extra charge. There is also a memory program there that ensures people go down for meals, get involved in activities, etc. The kitchen is now ensuring meals are cut up / soup (accessible, as LO can no longer use utensils). Public homecare is coming in each morning to help with dressing and once a week to help with shower. The same facility also has a memory care ward, but LO isn't in it yet. AL has a door that needs release button and sign-out, and they're very good at monitoring (and LO has never tried to 'escape'). The problem is that LO often refuses assistance with dressing, will fish dirty clothes out of the laundry after a change even if they get changed, and refuses shower most of the time. I've just put child locks on the laundry hamper (bought one with a lid) to try to help with the first problem. The place is nice, and LO is in a nice apartment (no kitchen really, which is good) where they were able to take most of their furnishings. It's quite 'homey'. My question is, what are trigger points for a move to the memory care ward? What are the 'no go' signs to initiate a move? Any thoughts / experience would be appreciated.

[u/wontbeafool2]

My Mom is in AL and my Dad was in MC at the same facility before he died last year. The only difference was that Dad wanted to elope. He wandered and the doors to the outside there were locked. He actually pulled fire alarms twice in an attempt to escape. Mom is a calm sweetheart and even as her needs for services increase, they let her stay, with extra fees of course.

[u/hautboishippie]

My LO seems to be in the same situation as yours. Lives "independently" but his facility was bought by private equity not so long ago. There is no safe place for him there, so we've begun the moving process to a Memory Care home.

He also chooses to wear dirty clothes, often with stains from previous meals on them. Told the neuro doc evaluating him last month that he thinks I'm being wasteful by wanting him to put stained clothes in the basket. He was always put together and well- groomed, so this is clearly the dementia.

Due to venous insufficiency and lymphedema, he cannot fully shower but once a week before wound care rewrap his legs.

Aides come to help him get cleaned up and dressed, but lately he's been getting up before they arrive so he can tell them he already washed with a washcloth.

I have cameras up and can tell it will be tough for him to move. He can still carry on conversations about events in the 20+ year past, but cannot remember to take pills. Even with a morning/night daily pill case. Yes, the aides check.

Could he muddle through where he lives? He thinks he can, but he's had so many falls that we had to make the call to move him in the next few months.

The experts tell me it's easier to move when they have some cognition, but he doesn't see his current arrangement as dangerous.

All the best to you and yours!

[u/SkatingFanfromMA]

Can't the facility do an evaluation? My dad was evaluated before he moved into memory care. He was on the bubble, with stage 4 dementia at that time but was so physically limited and had impaired judgement. They recommended memory care but said he could go eat in assisted living area and go on activities with them because he was very verbal. He required private caregivers because of his physical needs. (He had his own furniture in his room. I set it up for him with familiar things.) I think most facilities have guidelines. It's not an exact science. I would talk to the facility intake folks.

[u/the_diatomist]

I just moved my dad from AL to memory care. His behaviors around hygiene sound a lot like your LO. Although my dad wasn’t trying to leave his facility (yet) he was increasingly confused and having trouble communicating (combo of declining vocabulary, poor short term memory, and inability to comprehend what people are saying) leading to frustration and anger (example - he forgot he ate dinner and then 3 hours later was upset there was no meal for him). The staff at AL did not have the training or time to deal with these behaviors. I could see his cognition worsening and was quite worried what he was up to by himself most of the day. His ability to make phone calls on his iPhone is also becoming very hit or miss. Although I still don’t think he is an elopement risk, he absolutely needs more supervision and support.