When is it time for care facility?

  Continuing the experiences with my mom, there is a critical and emotional decision to be made.  When is it time for her to move to a care facility?  We have been steadily increasing the in-home care from a couple hours per day to 13 hours per day .. essentially all waking hours.  With that many hours, it becomes expensive and difficult to manage the turn-over and compatibility with my mom.  This was even more difficult since her home is in a small town.

  I had been encouraged by family and friends to move mom into a facility but I was unwilling until having her at home was not in her best interest.  Perhaps is was my fear of her resistance to moving as she displayed in full form when we moved her next to us after my dad passed in 2011.  The measure I decided to use was when mom was no longer aware of her environment.  Finally, that day came when she asked me how to get to the restroom in her house.  That was the trigger for me and so the search began.

  We had done some research and found a facility that we liked.  As a matter of fact, we tried a few months earlier and I chickened out!  But now the time was right.  In our search for a facility, I applied a formula:  50% staff competence and personality; 30% facility size, cleanliness and features; and 20% location so that we could visit often.  We found a facility near us with only 40 patients.  It offered private and non-private rooms that you can furnish or they will, lounges, library, kitchen/dining and a main den area.  We stopped by several times unannounced before selecting and were able to observe staff interactions with the patients without them knowing we were watching.  Staff from the new facility came out to assess mom and make sure she was a fit for the environment.  She was.

  So now the planning begins.  We made Arrangements for medical care (offered by facility and bills medicare), arrangements for hair appointments, supplies provided and those we must provide, how payments are made for each, etc.  Next was the planning for her room.  We followed a similar process for when we moved her last time by taking pictures of how everything was arranged and making her new bedroom look as close to her current bedroom as possible.  Unlike the previous move, we told mom nothing about the coming move.

  The big day began with me picking up mom like I did every Thursday for her hair appointment and lunch while my wife, friends and relatives moved her bedroom to the facility and set it up.  It was an hour drive to the facility and I was expecting questions from mom that never came.  We arrived at the facility, I took mom directly to her new bedroom and sat her in her chair.  The staff who had previously visited her came and we all talked to her.  We said our goodbye’s and left.  I don’t know if she knew what was happening but she told one of the staff “Guess you’re stuck with me”.    The facility suggests not visiting for 4-5 days while they get used to the new environment and routine.  I was dreading that visit fully expecting to hear “You need to take me home”.  For support, I brought my puppy who she adores and we went to visit.  Much to my surprise, she was sitting in the main area and greeted us with a smile.  Not once during that visit or any since has she asked to leave or go back home.  Indeed her state of confusion had reached the point where she simply wanted to be told what to do next.  She somewhat recognizes me and other family members but not by name or relationship.  When I expressed my surprise that mom had not complained, a friend of mine suggested that for the first time, mom is with peers.  She is finally around people who share similar or worse memory loss.   We are very fortunate that the transition went well.  It has been 3 months now and things continue to go well.  She has her good days and bad.  The facility has the same challenges getting her to eat and drink water but they have done well so far.  With the exception of a fall in the early days due to weakness, all has gone pretty well.

I hope this description helps others with the agony of decisions on timing, the facility to use and what to expect during and following the move.


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