My hope is to make this a simple checklist – but don’t discount that this is such a personal and complex topic. My Mom is currently in an Assisted Living facility that is geared toward someone who needs help with the Activities of Daily Living (ADLs). The residents include individuals in wheelchairs, some with vision-loss, and others who have mild cognitive impairment.
The needs of someone who has partial vision loss is very different from someone who has no idea what day it is. For a variety of reasons, we began a search for other living options for my Mom.
On my tour of the first community, I marvel at the communal dining arrangement. My Mom has difficultly making choices and I realize that having to sit alone and then choose a meal is a dis-incentive to visit the dining hall. I understand why my Mom has been choosing to eat most of her meals in her room and makes her own peanut butter and jelly sandwiches.
My Mom has also started to ask me what she should be doing. She has always been in motion and not knowing what to do to stay busy is difficult for her. Most communities that deal with individuals with dementia offer very structured days with activities that can fit a range of individuals in varied stages.
When looking at a community, I recommend you:
1) Check out the activity schedule. See how the day is structured and attend some of the events to see how they work. Having something to do and being invited would be very helpful for my Mom. All of the offered activities are also geared toward someone with memory loss.
2) Understand the meal service. The first facility I visited explained the family style meal service. They make the delivery of the food feel very home-style and tailor each meal to the residents medical needs and personal preferences — but do that on their behalf. All of the dementia-based care facilities offer this as well as monitor if the resident is eating and make adjustments for them because most are no longer able to make meal choices.
3) Consider other care needs. If a doctor is needed or skilled nursing required, what are your options? How do they manage end-of-life needs?
4) Talk to other families with loved ones in the facility. I visited three different places and only one of them offered me the ability to call the families of other residents. That speaks volumes!
5) Listen to your Gut. One of the facilities I toured was absolutely beautiful. I could picture my Mom in the apartment and we could furnish the whole place with her furniture. However, I realized that the facility with smaller rooms that come pre-furnished that we could tailor with my Mom’s belongings is probably the smarter choice. The idea is to have her engage with the other residents of the community and the smaller rooms encourage that behavior.
As a closing thought, I recall how difficult it was moving my parents from their independent living apartment into assisted living. We had about two weeks to pack, move, store and dispose of furniture, clothing … stuff! While I don’t mean to be so grim, I know that my Mom is never going to get better and the less we have to sort through when she has passed away, the better I will be able to manage and deal with the final bout of grief that will come once my journey with my Mom has ended. Considered.
Excellent checklist, Kay. My mom went into a memory care assisted living facility after her meltdown, only because I needed to make sure that (a) the meds were working and (b) that she had as much social interaction as was possible.
I am an introvert on the extreme end and Mom was an extrovert, not extreme, but I knew she needed a lot of social interaction, especially with people her own age. This was our stop gap measure.
I was there every day, many hours each day, and built teams with both the residents and the staff (and between Mom’s PCP and the staff), so that was as if I was there 24/7.
Mom finally needed more care than assisted living, so she came home to live with me until her death. But I still maintain my relationships with her assisted living staff and they use my blog and books to help families coming in with loved ones with dementias and AD.
Probably the best outcome any of us could imagine.
My mom has been a loner but always had my Dad around. Now she is so lonely and finally joining in some new activities. Her needs continue to change which still surprises me!
Great information. It’s so true that when looking at residential facilities, you have to think about what will offer your loved one the best quality of life. My mom doesn’t have dementia, but she did require emergency surgery and placement in a skilled nursing facility. While the three choices I visited had their pros and cons, ultimately I picked the one with the best physical rehab facility, because my mom needed to learn to walk again. Despite the food being atrocious, and the nursing staff stretched very thin, the rehab was very good. Mom even earned a certificate in the “Rehab Olympics.” 🙂
I know institutional food service is difficult, and catering to special diets that many seniors require makes it even harder. But my mom was served more red meat (and mystery meat) at her SNF than she probably has had in her entire life! This was of particular concern to me since Mom was recovering from colon cancer. Mom usually would barely pick at the meat, because she just doesn’t like it. I know these places go for “comfort food” but I hope healthier alternatives can become an option.
Thanks – It’s sooooo complicated! I wish we did not have to trade off options but already know that awaits us before we make a final decision.