Don’t Dread the Move to Assisted Living

I was physically ill the days leading up to my parent’s move from Independent Living into Assisted Living. They fought the move, and would not allow personal care assistants into their apartment in Independent Living which could have allowed them to stay there longer.

The community they lived in forced the issue. They were a danger to themselves and others in the community. They gave them the choice to move out, or move into Assisted Living. Navigating that with my Mom was an incredible challenge, she was ready to hire a lawyer and move out. Thankfully, my siblings all came to town to help manage the move.

My parent’s living space went from 2,000 to around 600 square feet.

We all knew that my parent’s were not happy about the move. However, they also were both in a moderate stage of different dementias. We tried to make the time more of a family reunion and distract them from the reality of the move.

Thank goodness there are 4 of us. It tapped out all of us emotionally.

The big surprise? How happy my parent’s were in the smaller apartment with a view of the front entrance. My parent’s were the happiest I had seen them in a year.

After my dad had his celestial departure, we found that mom needed to be in a memory care community. That move was a little easier. I had someone help move Mom’s things while I took her out to lunch and we drove to her new community. She really liked her new room with all of her things and her habit of wondering when Dad would return to her apartment disappeared. She was now in a community that wouldn’t make her choose a meal off a menu (all the choices overwhelmed her); she always had table mates (the other residents in Assisted Living didn’t want to sit with the woman who couldn’t remember their names); and she always had an activity that would meet her where she was.

dancingMy mom was never a joiner. But her personality and interests changed through her dementia. What I have seen over and over is that the longer you wait for the move, the harder it is for your loved ones to adapt to the new community. I was shocked to arrive one afternoon to see my Mom dancing. She always shooed my Dad away when he asked for a dance.

I know how hard it is to face the decision and be the one to make it happen. You are making the best decision you can with the information you have. They are lucky to have you in their life to be their advocate. Believed. 

Medication Roulette and Dementia

rouletteMy Mom is sliding into the deeper grasp of dementia. It is surprising to many people (and often to me) how one moment she can be so lucid, and the next, totally disjointed. She continues to try and join in the activities of the Independent Living community she was a member of for over a decade. Now, she’s confrontational and many of the residents are complaining. It’s sad that the community can’t deal with her, but even those that are well-trained are having a hard time re-directing her when she gets aggressive.

In my Mom’s community, Assisted Living is a hallway away from Independent Living. Now that my Mom’s full-time companion, my Dad, has passed, she is alone and really having a hard time finding a footing. The dementia is making it impossible. She’s very lonely, but on top of her grief, she is unable to make new friends and her friends are finding it hard to engage her now too.

Mom founded many of the bridge games and loves to play, but she can’t remember, nor does she recognize that she is no longer running the games. She’s short-tempered and rude with most of the other bridge players — a concept that would horrify the woman who raised me. However, this is the woman most of the bridge players see and don’t know the caring woman that formerly inhabited my mother’s being.

The doctor changed her medication and added the Exelon Patch (to help cognition) and Risperdal (to minimize anxiety and paranoia). They also asked us to hire personal assistants from 1 to 9 PM daily. The first two weeks went well and then things fell apart. The doctor is increasing her dosage and we have replaced the assistant that worked on the days I noticed my Mom having the most trouble. Risperdal is an off-label prescription and when we first got the recommendations, we did our research and gulped as read the side-effects. We have to try something new, because now, she is not doing well.

The current options outside of increasing her medication:

  • Move her to the section of Assisted Living and put on a Wander Guard. This prevents the doors from opening and the elevator from working. I can just visualize my Mom banging on the doors and confronting anyone that tries to use the doors if they don’t work. Both the AL staff and I don’t think this is the right solution.
  • Check her into a psychiatric facility so they can treat and manage her dosage and find the right mix. This could be a 2 to 3 week visit. The change is living arrangements alone will confuse and frighten my Mom and my biggest fear is that they will medicate her into a submissive state and she will return to just be admitted into the lock-down memory community.
  • Find a new facility that is dedicated to memory care and move her from the community she choose. This seems like the most logical next step for us to pursue.

Please let me know what your experience and suggestions maybe as we try to navigate this new transition in my Mom’s care. Pleaded.

Prior Related Topics include:

The Benefit of a Continuing Care Retirement Community

Your Parents Agreement with the Retirement Community is being Terminated

We are Ready to Move into the Retirement Community


When Did we Pick Out This Place?

butterflyinflightI’ve become a little obsessed with trying to figure out what and why things stick in my Mom’s brain. My Dad has Alzheimer’s and my Mom has Vascular Dementia. My parents have changed in different ways.

My Dad is much quieter, even solemn now. He was the prankster in the family growing up. Now, he will obsessively pick at lint on the couch or floor, and when he finds trash ANYWHERE he picks it up and will throw it away.

My Mom is more talkative and fills time by reading things or sharing a story about the things in her surroundings. Her stories don’t jive with my reality, but they are tethered to things that did occur in the past.

My Mom has transformed the events leading up to their transition into Assisted Living. Today, She was wondering what year it was that they picked this specific unit and was pleased with their luck in getting one that let them watch the lobby entrance. She felt this place was much better than the prior apartment they had — the one we worked so hard to manage their transition out of and into this apartment.

I remember walking into the apartment with my Dad for the first time. I had to blink vigorously to keep the tears in my eyes. My Dad fully understood what was happening and I watched as his shoulders slumped a little when he looked around the empty apartment. My Mom joined us and complained about every feature the Executive Director mentioned when listing the positive attributes of the apartment.

At the time, I would never have believed that in 5 months, I’d be sitting with my mother who would be saying how lucky they were to get this apartment. Transformed.

The Battle to Keep My Parents Together Has Begun

itsalwayssomethingThe Assisted Living community has tried three times to get blood from my Mom and she’s refused each time. I hear the haunting voice in the back of my brain telling me that if my Mom starts to be combative on a regular basis, she is going to be moved to the next level of care … the “dementia” unit.

The only time this was mentioned to me was a few weeks ago when I was asking the head nurse if they could reconsider how they might get my parents to eat lunch. The nurse mentioned that my mom has been somewhat ornery when it comes to eating and was making it difficult for my Dad to eat in the lunchroom. This issue has mostly resolved and now my Dad usually eats lunch on his own, and my Mom stays in the apartment and makes herself a peanut butter and jelly sandwich.

My Mom has always been the one we have to navigate around. During the move to Assisted Living, the doctor prescribed a pill that reduced my Mom’s anxiety (Ativan or generically called lorazepam). She took it temporarily, but she has been much more agreeable, even well after being taking off the medication.  They only prescribed it for use during the initial transition into Assisted Living.

As I hang up the phone, that little seed of fear lurks. My parent’s are the happiest I’ve seen them in years together. I told the nurse I would get my Mom to a lab to get her blood work done. It’s always going to be something. Unfazed. 

Gracious Mom has returned

graciousI am still a little skittish … am I in the eye of the storm? Is there a second wave of emotional turmoil that will arrive as swiftly as the first one disappeared? My mom was so difficult to manage during the actual move that I’m waiting for her to return.

The retirement community knows what they are doing and I’m thankful for the resource. They notified my parents of the move and gave them two days notice. My parent’s knew that was unreasonable and fished around to see if we knew in advance. No one broke ranks.

The fact that all four of their children were in town on the day of the move went unmentioned. However, the day they were notified my mom found and called a lawyer. She failed to write the appointment in her calendar and had forgotten about it. We had already looked into the legality of the move and timing and knew the community had the right to make this move.

When the movers arrived right after all four of us children showed up, my mom was surprised. She was angry, confrontational, disruptive and combative. We made it through the day and left my parent’s in the new apartment with the staff as the community recommended.

When I call a few days later to ask if I can come visit, my mom is excited to hear from me. We had a pleasant trip to the grocery store.

When I arrive today, they have already hung more pictures and moved the furniture around. My mom is working on enhancing the frame of a family portrait we had done two Christmas’s ago. It contains everyone from my parents down to the four grandchildren. They have placed it in the middle of the living room wall where they seem to now spend most of their time.

My mom has a list of things to buy and a smile on her face as we head out the door today. Endeavored.

Making the transition to Assisted Living when your parents refuse – Part II

lessonslearnedAfter my parent’s driving licenses were revoked by a doctor, they continued to drive. Their brains filled in the details with their own manufactured information. At first, my mom admitted they were revoked and showed me the letters, and then later, they would pull out their licenses as proof that they were still valid drivers.  The letter from the state requires that you turn in your license, my parent’s refused.

We had to take their car keys. My brothers came to town and my parent’s initially handed over the car keys. At first they just took the keys and moved the car’s out of my parent’s garage. One was sitting a block away from their home. After my brothers left town, my parent’s found it and hired someone to rekey the car. I’m sure they would have driven more if the electrical system wasn’t toasted in the process.

Eventually, we hid both cars by putting them in storage.

I’m one of their four children, with two older brothers and a sister. We worked well together and thankfully, my brothers came to town to manage the dirty work. When they left, I could still be the go-to for my parents and could tell them I had no idea where the car’s were. My brothers had taken care of the details.

My brothers accomplished this by following what they believed to be the moral choice. What if my parent’s had another accident (they never shared the first one with us)? In the event that my parent’s would reported the “theft” – one brother visited the local police department (we live in a major metropolitan area) to share that our parent’s continued to drive without a license, their diagnosis (and inability to remember) and tell them we had stored their cars.

At first I struggled with having to lie to my parents, however, as things got more bizarre, I came to realize that giving them a modified version of information helped manage us through several transitions and was the best course of action.

After about two weeks, my parents had created their own version of the car’s disappearance and I just feigned ignorance and helped out where I could by giving them rides to the grocery store.

The first two of the three steps that helped us support our parent’s transition were:

  1. Address driving if you think it’s an unsafe activity for your parents and their doctor agrees.
  2. If they continue to drive disable or hide the cars.

If you have been reading my blog, you know this was not an easy process, however, I hope that my experience can help others more easily make this transition with their parents. Learned.

Let’s go get groceries.

lady winter coatAfter a few days, I call my parents to see if they need to go get groceries or run errands. My mom answers the phone, “That would be great! You know we are in a new apartment now right?”

When I arrive my mom is happy to see me and we talk about what kinds of errands we need to run today. We create a list and my parent’s go to get a coat but neither can find a winter jacket. I hand my mom my coat and my dad grabs his windbreaker and we head out to the car.

The one thing we failed to move were winter coats. I’m not sure where to find them since both places are in the midst of major clean-up and organization. However, I’m happy to report that finding my parent’s winter coats is now my biggest concern. Relieved.

Don’t lock the door

lockfrontdoorWhen my dad and I return from our trip to the grocery, we find that the bulk of the items have been moved. The new place is just a bedroom, living room and small kitchen area, so the movers got the bulk of the big furniture moved in a few hours, despite my mom’s interference.

Apparently while I was off with my dad, my mom went to speak to the Assistant Executive Director that she has known for more than a decade. She was very agitated by the moving and in order to placate her, he tells her they can visit their old apartment anytime they want. Oh no!

Maintaining access to the old apartment in Independent Living was not part of the game plan. Our goal was to move everything they needed and close down the old apartment. Given our parents inability to give up their town house and move into the retirement community full-time (even after the stroke and broken hip), we wanted this transition to be a clean break. We had their apartment in Independent Living rekeyed so we could ensure our parent’s would not be able to return.

By late afternoon, we are in the apartment working to pack up final items like pajama’s and toiletries. My brothers invite my parents to dinner so they could get them out of the apartment. We believe it’s critical that our parents stay in their new apartment tonight. My mom has said she plans on sleeping on the guest bed in their old apartment tonight. Before my parents and my brothers walk out the door, my dad instructs them: “don’t lock the door.”

My sister and I work a little longer and take the last of the boxes to the new apartment. As we leave, we diligently lock the door behind us. Closed 

It takes all four of us to manage the move

fourkids (2)The past year has made me regret not having more than two children. Since I grew up with four kids in my family, I always believed I would have four children myself. That was until I had the first one! He was a tough baby, or possibly, I was an ill-prepared mom.

I started late, having my first at 33, so that by the time I was ready and actually did get pregnant, my second arrived to a 38-year-old mother. Given all the high-risk discussions and the additional needs just a second child brought, my husband and I felt for us, it was too late to have more. I am lucky to have two healthy kids.

On the day of the move with my parent’s, we can barely manage my mom between the four of us. Our game plan was that two of us would give our parents a specific task to keep them busy while the other two would manage the move and movers. My mom always behaved nicer when there were two children in front of her — she would often bully you if you showed up alone.

When the movers arrived we have them start with the bedroom. While they are loading up the furniture, we task our parents to decide which sofa set they want in the new apartment. My sister and I invite my dad to go to the new apartment.  My mom is furiously trying to redirect the movers. My dad invites my mom along and she comes with us to the new apartment. Our job is to kill time so the movers can move.

After we linger in the apartment, we suggest getting lunch. On our way to the dining room, my mom sees their furniture being moved down the hall and takes off for their old apartment. My dad decides to follow me into the lunch room. My sister takes off to the old apartment after my mom.

My dad and I order lunch and try to find a topic to discuss. It’s only been two hours since breakfast so I’m unable to really eat anything. I know if I don’t eat, my dad won’t eat so I try to at least fill up my plate with a salad and some fruit and move it around on my plate.

My dad is ready for this move and does not want to fight it. My mom is making him very uncomfortable. I ask if he will come with me to the grocery store and we can pick up some of his favorites snacks for the new apartment. He agrees.

My mom and sister make their way to lunch and we tell them of our plans. We invite my mom along with us. She is not interested.

We all go back to the apartment and my mom is very upset. She keeps trying to tell the movers to put the furniture back and runs to the office of the Executive Director. I leave my mom to my siblings to manage and take my dad out to shop. Wandered.

Are you sure you don’t need my son’s help?

mysonthelawyerMy older brother, W., is taking a full day shift with my parents. It’s tough duty given my mom’s anxiety and anger over the pending move.

After being notified, she finds a lawyer listed in the resident’s directory and makes an appointment. However, she fails to remember she made the appointment and does not meet the lawyer when he arrived. My brother stayed in the apartment to meet him and give him an explanation.

Neither parent has mentioned the request for a lawyer today nor mentioned the appointment. My brother decides not to raise the issue and lets it be.

At dinner, another resident comes to the table and asks my parents “Are you sure you don’t need my son’s help?” My parents don’t know who this woman is and have no idea what she is talking about. The woman goes on to explain that her son “the lawyer” stopped by to meet with them.

My brother can’t believe this woman. She does not know my parent’s but has come up and pressed them on calling her son “the lawyer”. My mom is a little put-off by the woman and wonders aloud to the woman while she would call a lawyer when she has a daughter who is a lawyer?

While I find the mother’s follow-up horribly inappropriate, my brother is floored at the chain of events. Thankfully, my brother W., can escort her back to her dinner table before this day get’s any messier. Appalled.

My mom’s not here

purgatoryWe are in Day 2 of purgatory. My parent’s were notified they will be transferred to Assisted Living and we are managing through “the day after notification”. Tomorrow, the movers will come.

After being notified by the Executive Director they were being transferred, my mom was angry and defiant and my dad was resigned to make the move without a fight. During the course of the day, my mom got my dad to agree that they should have 30 days to move. I would agree that seems fair, however, they can’t recall how many times the retirement community has encouraged them to make changes that would keep them in Independent Living (they refused to hire an aide several times).  They also do not remember (or believe when you tell them) what happened that forced the community to require them to move swiftly into Assisted Living.

We took the advice of the retirement community that suggested we communicate the news and make the move swiftly. My parents have lost the ability to plan ahead so we are just biding time until the movers show up tomorrow. In reality, the retirement community could move my parents without any notice if they are concerned for their safety or the safety of others.

My mom found the name of a lawyer listed in the resident’s directory and made an appointment for 1 PM today. What my mom failed to do was write down the appointment. She will be playing bridge and won’t be at the apartment when the lawyer is scheduled to arrive. My oldest brother, W., is on site to meet the lawyer.

At 12:30 my dad decides to go eat lunch so W. hangs back. The lawyer arrives at 1 PM and my brother greets him and tells him “My mom’s not here” but welcomes him into the apartment. During the course of the conversation, my brother suggests the lawyer talk with the retirement community staff and lets him know my parents have each been diagnosed with moderate dementia.

We wondered if we should have paid the lawyer for his time, but decide that we didn’t call him and had he done some qualification when my mom called him, he could have saved himself the trip. Averted.