Convincing someone with dementia they need to move to assisted living

You might check to see if her state has a program of financial assistance to those who need and qualify for Assisted Living, as well as Memory Care, which is a division under Assisted Living. It’s state run and not Medicaid. Medicaid covers financial assistance for nursing home care, but not assisted living. In NC, the state program is called Special Assistance. The income and asset requirements are similar to that of Medicaid. Each state program may be different. A social worker or admissions director at an assisted living facility would be able to provide more info, as well as an elder law attorney. Owning a home doesn’t normally disqualify you.

Obviously you’re very knowledgeable…thank you for this information

My sister is 78 and was diagnosed with Alzheimer’s a year ago. She lives by herself but has no pets. She has recently begun to decline. I have to leave her notes about her day if she has appointments and if someone is coming over to visit or pick her up. She forgets to take her medicine, has become very judgmental, and at times mean. I took her car keys a month or so ago and she keeps calling me mad and insisting I bring her keys back. She asks the same questions over and over. Her friend and I have discussed with her about moving to a retirement community with assistance and she is not interested. She says those places are for “old people” and that she is more active than they are, which is not true. She says she is not moving.

@jrelliott , does she have transportation available to do what she needs, like getting to doctor appointments, groceries, etc,?

Is there anyone else who is responsible for her? Because in order to gain authority to make decisions for her own safety, you may need to get Guardianship by the court. That’s a huge responsibility. With that, you decide where she lives. I’d consult with an Elder law attorney to explore what that involves and if you have grounds. Each state’s laws vary.

There are facilities for those who have dementia and aren’t keen on being there. A professional could inquire what level of care she currently needs. Most people who need memory care aren’t able to use good judgment about their situation. They aren’t likely to appreciate it’s for their own safety. Often they aren’t happy about it, repeatedly say they want to leave, insists they don’t need to be there. So, unless there are special circumstances, it’s unlikely she will be convinced. I might adjust the expectations about it.

If her doctor tells her she needs to go in for “rehab”…..that’s what we called it when my cousin needed to go. We explained it was temporary, so that she could get her meds adjusted, nutrition on track, PT to work on balance, etc…..It made sense and was rather true too, but I knew my cousin was there permanently as she had severe dementia. Within weeks she was double incontinent. She soon went to memory care where she forgot about her home. She was content though and seemed to relax due to the good care.

Good luck! It’s a lot of work and very frustrating.

Thank you for your input. I really appreciate it. Six months ago I would have said she could have moved to a retirement community with someone coming in twice a day for meds. Now I think she needs assisted living with someone coming in for meds and to take her to the store and to check on her. I have been taking her to all of her appointments and making sure she gets what she needs. Her friend takes her to jazzercize once a week. She still cooks for herself and does her laundry. She failed the driving test her neurologist had her take at the Local Rehabilitation Center run by Occupational Therapists in conjunction with the DMV. I took her keys because she was driving with a suspended license. She was really upset that she couldn’t go to the grocery store by herself. She was going every other day and buying the same things. She calls me and is very upset saying she needs her keys and that I need to bring them back to her.
If i am doing something and tell her what I’m doing and why, she will continue to ask what I’m doing and why about every minute that passes. She is easily frustrated and gets angry. I think she now needs to move to assisted living, but I don’t want to drag her out of her home. I do keep mentioning that I think she would be happier around more people and moving would be a way to be around more people. She agrees, but then says she is not ready to move.

@jrelliott , these things sound familiar. If you were to stay in her house with her, you would probably discover even more disturbing facts. I found spoiled food in my cousin’s fridge that she was convinced was still edible, piled up mail with insurance expired, stockpiled items cause she kept buying stuff repeatedly, obsessions, not taking meds though claiming she was, etc. Neighbors shared stories of incidents and their concerns.

I immediately got her a doctor’s appointment and started trying to get her assessed and placed in assisted living. Which I did. Unfortunately, it became apparent that she really needed memory care, which is a specialized unit. Assisted living staff will provide reminders and assistance, but when dementia requires more than that assisted living refers to memory care. I wasn’t aware how that worked. So, in the assessment, it’s important for them to have more info than just the person being assessed.

While I was trying to assist my cousin while she was in her home, I got a call from Emergency responders who were at her home. I was enroute to her place at the time. They had responded to neighbors who called when she was yelling for help from her front porch and waiving her arms in distress. Upon arrival she seemed fine, but there was definitely something wrong. I explained I was working on getting her help. I knew that if I didn’t adult protective services would step in. So, if she continues to live alone and progress with her symptoms, I’d be prepared for an emergency call or a call from adult protective services, because someone else who sees the situation may report it. AND doctors will sometimes report it to adult protective services. I’d speak with an attorney about it to help sort out your responsibilities, if any. It’s unnerving to await the crisis that will eventually occur when someone who isn’t competent is unattended.

Good luck with everything. I will say that my cousin did much better when she got the proper level of care. It was a relief to me as well. ……almost forgot.

My cousin’s doctor told us that she needed assisted living and that living alone was not an option. I knew what she meant.

@jrelliott
Sounds like it will probably take an emergency before you can get her out of there, like she falls or forgets to turn a burner off. Scary.

@judimahoney Those thoughts are in my head frequently. Thank you.

@celia16 Fortunately I was able to talk her into making a trust and will. With that said I have POA as well but I don’t think I have the power to move her out of her house if she doesn’t want to move. I’m trying to figure out which assisted living community in our area is worth looking
At. We’ve looked at 2 already thinking she could live independently while paying someone to come in for meds but I think she needs assisted living now. She is having cataract surgery soon and after that I’m going to set up some appointments with a few more assisted living places to hopefully get this started. Last week we had a lot of snow and her power went out. She stayed with my husband and I and I got to see how she has changed. (Moody, snippy, asking the same questions etc).
I hope your cousin is doing well. This is definitely a stressful situation for everyone. I’m glad you were able to get your cousin in a safe place with good care. Thank you for your thoughts and information.

@jrelliott There are things she can still do pretty well. She functions in her house, does her own laundry, cooks for herself, cleans up spills, opens and closes her blinds morning and night, things she has been doing routinely for years. Her problem solving skills are almost existent though. I do worry about the oven and stove. She tells me I’m treating her like a child when I try to help her. I’m going to call her son who lives in another state and have him come home to help convince her to move. Otherwise I’m going to involve her doctors and I don’t want to force her out, I wish she would agree to move.