Convincing someone with dementia they need to move to assisted living

Man, that’s a tough situation. My cousin was resistant to enter assisted living, but I convinced her it was short term and her doctor supported me, in that she needed help with physical therapy, medication adjustment, nutrition on track, etc. And, that I would take care of her cat. She eventually forgot about her cat and the fact she had a house. She thought the facility was her apartment. But, if that doesn’t work, you might get legal advice about being appointed her guardian. That way, you legally make the decisions about where she lives. If she’s mean at that point, she might qualify for placement at a facility for those with dementia and behavioral problems. There are a few of those in my state. Or she may need a secure memory care facility. Getting her assessed would be helpful, if she would cooperate.

I would be concerned about her care of the pets. She may think she’s being kind to them, but unknowingly harm or neglect them due to her cognitive ability. My cousin overfed her cat, because she would forget she already did it.

I’ll be honest and say that in light of the grief I get from my parents by their resistance to care…..I would not volunteer to become their guardian. I wish I was not involved in their care either. It’s too draining and traumatic, imo. I might ask another family member to step in or report the situation to social services so they can intervene, if they see fit.

Good luck. I hope you find some helpful options.

Hate to say it but what usually happens is that things get worse- pneumonia, a fall, sudden increase in disorientation due to taking meds improperly/poor nutrition. Often then to a PCP visit, then directed from there to the ER, then the person is admitted to the hospital and after a few days, the social service people help you arrange for an AL /Memory Care that will take her for “some therapy to get stronger to go home again”, she goes by wheelchair van (not you). The PT/OT starts, the days go by, she may be happy with the meals, the activities, not being “in charge”, she may say she wants to go home, but the reality is, the dementia will interfere with her being able to make and carry out a plan to do that.
The legal process of guardianship requires she be declared incompetent to manage herself and her own choices, the process requires testing and testimony. Judges are understandably very careful about taking someone’s agency away.
A note- if/when a hospital admission happens, Medicare requires a three day qualifying stay to pay for a short-term Rehab placement (1-2wks), this will get you some breathing room to look into facilities, find placement for the dogs, clean out her fridge, etc, then a direct admission from the Rehab.

Yes, that's what happened to our family. Then we all saw that assisted living was not only the best, and really the only, alternative it was like a vacation resort with all day restaurant, 24/7 snacks delivered to the room upon request, gym and swimming pool, various comfortable lounges, immaculate grounds for walking and sitting, angelic, caring competent aides (mostly), various medical professionals and friendly and interesting residents. We could visit 24/7 and it was such a relief for everyone. It wasn't even the most expensive place in the area either. The fact that we were repulsed and fearful of assisted living was totally unnecessary and frankly ignorant.

@kdub1 I'm in the process of placing my 64 yo husband into a dementia care facility and hoping he won't be too resistant (fingers crossed). I haven't brought the subject up....yet....because until its a definite and everything is a go, i don't want him to worry about it. Altho, I'm sure he won't remember if I tell him. I tend NOT to tell him too far in advance about anything we're doing outside the house because he won't remember or he'll constantly keep asking me the same questions. He's pretty good about just going with the flow 🙂 I've been playing the scenario in my head how I'm going to tell him and I've decided to tell him that I need help to take care of him and that these nice people will do that for us. And because he doesn't understand the length of time anymore (as in minutes. hours, days, etc), i'm gonna let him know that i'll be back shortly and check on him shortly. Which is what I tell him already when he's laying down to take a nap and he always says "ok" 🙂 So I'm hoping that will work the day I have to leave him there.
I hope you find help for your situation and that you can rest easy. Can you move your mom in with you and get some in-home care?
Hugs and prayers to you

I'm sorry you are going through that. It's almost nice to hear that he won't remember you telling him because it makes it a little easier to say it. I find with my mom that she remembers things when whatever is being said makes her angry. She can somehow hold those memories or at least the feeling of being mad at me. I also agree with you about not telling them things too far in advance. There's just no need to. I'm happy for you that he sounds easy going. I wish I had any of that with my mom. She's usually suspicious and sometimes mad and almost never easy to talk to.

No, she can't live with me. I work full time and she needs more care than I can give. I need to leave her at her home until I can talk her into an assisted living. I'd like to not move her multiple times if I can help it.

I hear you and I love how that worked out for you. My MIL was moved into a a facility like that and for the most part she was not resistant. In the beginning she even made friends. We thought of it more like a community rather than a facility. Having some money and a plan helped her get this.

My mom, on the other hand, is very resistant, did not plan, and outside of a small pension and her SS, has very little money. My husband and I can and will help as much as we can but my bigger issue at the moment is her blocking even a discussion of moving to an assisted living. She told me repeatedly, just yesterday, that she was not moving. She is suspicious of most things I tell her. She is demanding that she keep her two dogs with her at all times. She doesn't think she has dementia and even if she knows something isn't quite right, she doesn't want to make a plan to move. It's very stressful.

I do think we are at the point of her having confusion due to improperly taking her meds and poor nutrition. She lives in a small town in WV and I've called Adult Protective Services a few times and asked for them to check on her. Nothing came of it. They said she'd have to have bed sores or be wondering outside in order to have them intervene. I like your idea of the per PC sending her to the hospital but that did happen last October due her appearing very confused when diagnosed with a UTI but the hospital sent her back home. Since October, she has declined, so maybe they wouldn't be so quick to send her back home.

I'm in the process of getting the paperwork completed to petition for guardianship. I'm guessing that will make it easier to make her move but I so don't want to do that. I want her to have a say in this.

I feel exactly you in your last paragraph. I'm scared to become her guardian. She's already mad and screams at me over the phone (I live 2 hours from her) all the time. She is suspicious and has a lot of anger. I do realize that all of that is due to her dementia. I try and compartmentalize but that isn't easy either. She's an only child as am I. She has very little family and certainly no one who would step up and help her outside of me. Her small WV town doesn't have a lot of resources. I've asked for help from the police, adult protective services, the senior center, the neurologist and her PC. Very little help has been given.

The other thing with my mom is she tends to remember some stuff when it revolves around her being angry about something. I did take one of her three dogs because it looked skinny (the other two don't...yet). She has not forgotten that and tells anyone who will listen that I stole her dog. She also was able to hire a company to change her locks, which is shocking to me, so that I won't steal the other two.

If you are hesitant to become her guardian, you might inquire if the court can appoint the county to be the guardian. That way social workers are responsible. They have multiple people to share the load. Being guardian can be very stressful with a resistant senior. Good luck with everything. An experienced elder law attorney should be able to assist you if you go the court route.

You are facing a tough situation, especially trying to do it on your own and with an angry Mom. You definitely need the help of an elder law attorney before you finalize anything.

Here are some issues to consider in moving your Mom to a facility -
Can she self-pay or will you rely on Medicaid? Medicare does not pay for these facilities.

Does she own her home, and how much equity does she have? To get Medicaid she will need to sell it and use the proceeds, minus about $3000 and a pre-paid funeral for her support.

If she rents, what assets does she have? Again, she must use them for her care, not give them away.

Have you identified a facility that will accept her? Near her home or yours? It is important to be able to visit often (and unscheduled) to monitor her care, so closer is better unless it means moving her to a different state, which can have its own challenges like changing doctors and Medicare supplements among other things.

Consider also that assisted living facilities often will not take, or will evict, residents who are physically or verbally aggressive or disruptive, even in memory care.

Here is a different idea - Is there any possibility that you can hire someone for a few hours a day to go to her home, make sure she is eating, taking her meds and bathing regularly as well cleaning her house (even if not up to your standards) and making sure the pets are fed?

Finally, West Virginia is a state of "filial responsibility " -if your Mom can't pay, and the state determines that you can, you can be billed for all or part of the cost of her care.

I wish you patience as you work through this. It was hard enough for me with a cooperative Mom and the help of siblings.
Hugs!