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Moving OUT of an assisted living home?
Old 08-06-2017, 11:54 PM   #1
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Moving OUT of an assisted living home?

As many of you know, my mom had a minor stroke in May. She was in a rehab center for over a month, learning to speak and use her right arm again. We moved her to an assisted living home at the end of June, assuming she would need ongoing care for the rest of her life. We had no idea she would make so much progress in such a short amount of time.

Right now, she is not using most of the "assistance" in the home. She handles bathing, dressing, toileting, etc. on her own. She hates the food they serve, so we take her shopping and she gets things she can eat in her own room (obviously not the healthiest choices since she can't cook in her apartment). She rarely participates in any of their social activities and has never used any of their transportation services.

Assisted living is very expensive so all she could afford was a small one room studio (that's all that was available anyway). She frequently complains about not having space to move around, no privacy, and wants to be more independent. All she really does is sit and watch TV all day anyway. The facility currently handles her medications, but she wants to handle her own meds too. All they are really doing now is checking in on her daily and doing weekly housekeeping.

At this point I don't see any reason why she couldn't manage on her own, especially if we help out periodically or hire part time in-home care.

On the other hand, it has only been a bit over two months since she had her stroke. So, I'm a little apprehensive about moving so quickly, not knowing how she'll do long term. Of course, none of us know what tomorrow will bring.

Above all, I just want mom to be happy. She doesn't like where she is now, but doesn't want to move back home with a large home and yard to maintain. She would like a small apartment closer to us where she can live her own life. It would certainly be less expensive in the coming years.

So I'm a little torn about what to do. She could have another stroke tomorrow, but she could live another 10-15 years in a place she is not happy in. It seems like such as waste to pay for assisted living if she is not utilizing the assistance. If she wants to live on her own, doesn't she have the right to do that?

What would you do?
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Old 08-07-2017, 12:26 AM   #2
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My Dad lives in what I think they call a continuing care facility. It's a large complex with four different levels of care/independence:

1. Independent living houses. People live in standalone houses, but the facility takes care of the outside maintenance (window washing, painting, lawn mowing, landscaping, etc.).
2. Independent living apartments. There are several large multi-story wings with apartments in them. There are kitchens in the apartments, but most residents eat most meals in the central dining room. Facility provides light housekeeping, will change lightbulbs, will do handyman maintenance if needed. There are pull cords in the bathroom, and they check on you if you unexpectedly don't show up for a meal. They provide transportation to grocery shopping and doctor visits. Residents are on their own for ADL and their medicines, and are expected to not fall or hurt themselves.
3. Assisted living. Like your Mom's place it sounds like. But it is attached to the main building where the independent living apartments. They have their own dining room, and provide help with ADLs and meds.
4. Memory care. Alzheimer's and dementia care, with a much higher staff/resident ratio. I don't know much about this part.

My parents moved in to level 2 about 10 years ago when they (a) didn't want to maintain their large house and yard, but were still independent and (b) were expecting to go into assisted living soon. It was, and has been, a good intermediate choice between completely independent living (like in a regular condo or apartment) and assisted living.

I don't know if they're around where you are, but it sounds like the level 2 as described above would work well for your Mom. The price for level 2 is about half what the price is for level 3.
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Old 08-07-2017, 03:42 AM   #3
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CCRC would probably be best, but there are other options.

I would see if there is a "retirement community" in the area. My mom moved to one of those (under protest at first but she loved it within days). Building with individual apartments and a common dining room. She only had to walk down the hall for three good meals a day. Assisted living type help was available at an extra charge if you wanted it. Good place, and she was sorry to leave about ten years later when she needed to move to a memory care place.
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Old 08-07-2017, 05:18 AM   #4
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I would let her have what she wants. You could hire someone to go in and do a little cleaning if she needed that and just check on her. If you could find a senior citizen kind of community that would be good as they can check on each other. Of course get a 'life alert' subscription in case she falls and can't get to a phone.

Let her be independent and happy.
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Old 08-07-2017, 07:44 AM   #5
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The six months after a stroke are very important times, as a second stroke often comes that soon. If she gets past the 6 months, her chances improve greatly. It's a time to take it easy, take your meds, and be watched closely. And so often, stroke victims are not thinking their best for quite sometime after a stroke--if they ever improve.

It's a shame that your mom doesn't have any desire to join into the activities or make new friends. People get out of situations what they put in it.

My mother moved into one of those 4 level apartments after we lost my father. It cost $177K to put her there, and it was about $2K per month including 20 meals cooked by a Dutch chef. Plush place, and she ended up loving it with incredible activities going on. We got back 90% of the $177K when she passed.

If you move her to the apartment close to you, beware that you're going to either need part time help to watch her EVERY DAY or you're going to be a slave to her needs. And if she has any more episodes, she'll have to move again. Moving's not good as it upsets the routine. And being alone at this time is not healthy for her mental and physical welfare.

Another option would be to find another accommodation that has better food. And one that requires residents to get out and be sociable with each other.
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Old 08-07-2017, 08:33 AM   #6
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My Dad lives in what I think they call a continuing care facility. It's a large complex with four different levels of care/independence
We have a couple of those in our area but they are really expensive. Even the basic independent living costs more than the assisted living she is in now.
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Old 08-07-2017, 08:51 AM   #7
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The six months after a stroke are very important times, as a second stroke often comes that soon. If she gets past the 6 months, her chances improve greatly. It's a time to take it easy, take your meds, and be watched closely. And so often, stroke victims are not thinking their best for quite sometime after a stroke--if they ever improve.
Mom is mentally sharp. The stroke didn't seem to affect her mind at all. She has regained almost all use of her speech and right arm. She uses a walker when we go out somewhere, but generally walks around her studio unassisted.

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It's a shame that your mom doesn't have any desire to join into the activities or make new friends. People get out of situations what they put in it.
She has played bingo a couple of times, but she has never been a social person. So she is really uncomfortable in the assisted living environment with so many people around. I tend to be a loner myself, so I can relate.

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It cost $177K to put her there, and it was about $2K per month including 20 meals cooked by a Dutch chef. Plush place, and she ended up loving it with incredible activities going on. We got back 90% of the $177K when she passed.
She is paying $3400/month now for the assisted living with the most basic level of care. It's a nice place, best we could find for the money, but it's expensive. Most other homes in the area cost even more. She also has about $600/month expense for meds now. At this rate, she's going to blow through her savings before her CD matures and before we can sell her house.

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If you move her to the apartment close to you, beware that you're going to either need part time help to watch her EVERY DAY or you're going to be a slave to her needs. And if she has any more episodes, she'll have to move again. Moving's not good as it upsets the routine. And being alone at this time is not healthy for her mental and physical welfare.
Other than checking in on her daily, she basically relies on us to take her shopping and what not. I would plan on hiring in-home care to check on her, at least for the first couple of years.

She has several doctor appointments lined up over the next few weeks, so I'm kind of waiting to see how those play out.
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Old 08-07-2017, 09:15 AM   #8
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Personally, I think if she is unhappy she is more likely to decline than if she is happy. I would start looking for an apartment she could move into that is safe - ideally one that is set up to be handicap accessible (grab bars, no steps, raised toilet, etc.). It may take a while to find one so that's why I would start looking immediately. Also start interviewing home-care services. You might start on this without telling her so she doesn't get her hopes up in case it doesn't go quickly.

You also would want her to wear an emergency alarm. DH has one from https://www.bayalarmmedical.com that he wears when I am not home (he's in a wheelchair).

FIL had a stroke 4 years ago and like your mother, improved dramatically after the first few weeks (he did not need rehab). He turned 90 last month and still lives independently in an apartment near another one of his sons. I think if he had gone to assisted living as we originally planned, he would not be with us.

I'm impressed how you are working hard to do the best for your mother even if it is more work for you. Good luck and keep us posted.
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Old 08-07-2017, 09:34 AM   #9
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Personally, I think if she is unhappy she is more likely to decline than if she is happy.
That is my thought too...

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I would start looking for an apartment she could move into that is safe - ideally one that is set up to be handicap accessible (grab bars, no steps, raised toilet, etc.).
I haven't seen any handicap accessible apartments, but I'm looking at 1 bedroom units on the ground floor with no stairs. I'm planning to install the toilet riser wherever we go, just like we did at the assisted living.

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start interviewing home-care services.
It's on my to-do list.

Thanks!
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Old 08-07-2017, 10:19 AM   #10
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Don't forget that even though she can dress herself , feed herself and other basics she will relay on you for food shopping ,taking her to all Doctor appointments , etc. .Plus if she is a loner she will hate home health and balk at having a stranger in her home . I would proceed slowly with caution.
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Old 08-07-2017, 12:07 PM   #11
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Oh MY! This is my situation also. My mom broke her hip on 9/30/2016, surgery, rehab and now assisted living since November 2016. Mom is 91. She talks all the time about when she comes home. Only she can't live alone anymore.

She has the full assistance package which runs $4600 a month ($1600 for full assisted living package and $3000 for the apartment. The staff accompanies her to the dining room, she gets baths twice a week, has activities she can join in on, help getting dressed, etc. Mom only recently started joining the crochet group on Tuesdays. She is pretty much a loner. Even though there is stuff she could do and participant in, she chooses not to.

All she ever did when living at home was sit in front of the TV. And it is no different at assisted living. No matter what time I walk in, she is watching the weather channel. All those cable channels and she just watches the weather. I changed it once to the hallmark channel, within ten minutes she switched it back to the weather channel.

When she was at home, she would talk about how she was really getting in to the mood to..... (knit, water color, sew) but never did. She seemed to want to do things but when push came to shove, the motivation/ambition just wasn't there. She wants to come home in the worst way but I don't know how I could even begin to manage it. She is a fall risk and I work full time. Did I mention I am an only child with two siblings? Neither who work full time?

I already have to take half days off to get her to doctor appointments and my manager isn't so understanding either. He needs 30 days advance notice to take either a vacation or personal day off. I told mom, next time you need to go to emergency, make sure you give me 30 days advanced warning.

Her mind is fine and I can see her living for a few more years. Longevity runs on mom's side of the family. I struggle with moving her in with me but I still have a life to live and doing this would make me a prisoner in my own home. I am usually filled with guilt about mom's current situation. At least with mom in assisted living, I know she is safe.

I'm currently in what I call limbo land. I can't sell her house because she thinks she is coming home. I can't move like I would like to because of the mom situation, so right now I am just stuck. So, right now, I am just taking it one day at a time, one problem at a time. Even if I did pull the plug and retire, I can't do want I would really like to right now anyway.

My turn/time is coming but it isn't quite yet. I'm holding on to my dream.... tightly.
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Old 08-07-2017, 12:40 PM   #12
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Been there, done that. All too common, I'm afraid.
Mom made it to 96, the last two years in a memory care facility when she couldn't be left alone at all anymore. Tough (and expensive).

A good friend had the same situation except he lived next door to his mother and he and his wife basically put their lives on hold for eight years until she finally passed away at 103.

Have you talked to the assisted living folks to see if they know a doctor who will come there? It's not unheard of. At the one my mother was in, there were all sorts of doctors, nurses, therapists, etc. who made regular visits.
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Old 08-07-2017, 01:13 PM   #13
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Unfortunately, the one doctor is for mom's macular degeneration. She gets shots in her one eye every 8 weeks to preserve her vision and is outside the 10 mile limit of places they will drive her to. The other doctor she sees maybe every 4 months or so. I'm just glad I have 4 weeks vacation and 1 week personal. Some of her appointments, the doctor does come into the facility, like the podiatrist.

It is hard but I know my mom appreciates everything I do. She tells me often that she doesn't know what she would do without me. I will have no regrets knowing I have done everything I possible can for my mom. I just try not to think to far ahead or I get overwhelmed. I was able to find a place that let me move mom's two cats in with her, which was huge. However, this means that every night, I need to feed the cats, make sure they have fresh water and do litter duty. I work from home and mom is only two miles away from me. It could be much worse.

When mom expresses her concern for me, telling me that none of this is fair to me, I tell mom that I'm just glad I am in a position to help her. This in spite my whining on this thread right now.

I have at least another 2.5 to 4 years left to work. Better days are coming just not today or this week.
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Old 08-07-2017, 01:25 PM   #14
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. I am usually filled with guilt about mom's current situation. At least with mom in assisted living, I know she is safe.

I'm currently in what I call limbo land. I can't sell her house because she thinks she is coming home. I can't move like I would like to because of the mom situation, so right now I am just stuck. So, right now, I am just taking it one day at a time, one problem at a time. Even if I did pull the plug and retire, I can't do want I would really like to right now anyway.

My turn/time is coming but it isn't quite yet. I'm holding on to my dream.... tightly.
Give up the guilt . Most of us have been there or are in that situation . Realize you are doing the best you can and relax. You deserve a life .Maybe you can rent your Mom's house and tell her it is only temporary . In the meantime take time for yourself .
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Old 08-07-2017, 01:42 PM   #15
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As many of you know, my mom had a minor stroke in May. She was in a rehab center for over a month, learning to speak and use her right arm again. We moved her to an assisted living home at the end of June, assuming she would need ongoing care for the rest of her life. We had no idea she would make so much progress in such a short amount of time.

Right now, she is not using most of the "assistance" in the home. She handles bathing, dressing, toileting, etc. on her own. She hates the food they serve, so we take her shopping and she gets things she can eat in her own room (obviously not the healthiest choices since she can't cook in her apartment). She rarely participates in any of their social activities and has never used any of their transportation services.

Assisted living is very expensive so all she could afford was a small one room studio (that's all that was available anyway). She frequently complains about not having space to move around, no privacy, and wants to be more independent. All she really does is sit and watch TV all day anyway. The facility currently handles her medications, but she wants to handle her own meds too. All they are really doing now is checking in on her daily and doing weekly housekeeping.

At this point I don't see any reason why she couldn't manage on her own, especially if we help out periodically or hire part time in-home care.

On the other hand, it has only been a bit over two months since she had her stroke. So, I'm a little apprehensive about moving so quickly, not knowing how she'll do long term. Of course, none of us know what tomorrow will bring.

Above all, I just want mom to be happy. She doesn't like where she is now, but doesn't want to move back home with a large home and yard to maintain. She would like a small apartment closer to us where she can live her own life. It would certainly be less expensive in the coming years.

So I'm a little torn about what to do. She could have another stroke tomorrow, but she could live another 10-15 years in a place she is not happy in. It seems like such as waste to pay for assisted living if she is not utilizing the assistance. If she wants to live on her own, doesn't she have the right to do that?

What would you do?
I would start looking at apartments and let her try living on her own particularly since finances are an issue. She could always return to an assisted living facility if needed.

Would she be able to drive or have access to transportation? Some grocery stores now deliver for a modest fee. I think the main transportation need would be doctor's appointments.

My mom, age 93, is not at all social and still lives alone but has not driven in years due to macular degeneration. I'm retired so I'm able to drive her to doctors' appointments (but she is quite healthy and only goes to the doctor three or four times a year).

My dad had a stroke at age 72 and recovered well and did not have a second stroke until six years later.
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Old 08-07-2017, 02:58 PM   #16
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I would definitely move her into an apartment. The happier she is the longer and healthier she will be.
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Old 08-07-2017, 03:26 PM   #17
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At 77, my dad had 2 strokes, both early in the morning, just as he was waking up. He didn't tell anyone about the first one, but then it happened again the next day and we got him help. He lost much of his vision initially, but it recovered back to normal over several months.

He had a pacemaker put in and it has taken care of incidents without him even noticing. He is still healthy and active. He is the primary caregiver for my mother, who has significant health issues of her own.

His cardiologist recently told him in an optimistic tone "I'm confident you have another 10 years." to which my dad replied, "What do you mean, only 10 years"

Certainly the risks are higher for mortality after a stroke, but there's also a strong minority that can go back to normal lives. Another thought... there has been a lot of talk recently about the improvement in health and happiness from cohousing / multigenerational houses. maybe that could be an option as well?
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Old 08-07-2017, 03:35 PM   #18
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Mom & Dad are both in memory care now. The boys moved them (against Dad's) will into AL almost 2 years ago. Dad was resisting strongly (take me out feet first). Once Mom saw she did not have to cook the deal was sealed.

We sold the home about 6 months later. Once they were in AL they never brought it up anymore. Like never, ever. I don't think we have even told them we sold it

Would your Mom want to go look around the home? Probably not. Does she have to sign off on it if the home was sold? That might be a bit harder. I'd probably sell the home. Save on insurance , property tax and maintenence
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Old 08-08-2017, 09:24 AM   #19
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Don't forget that even though she can dress herself, feed herself and other basics she will rely on you for food shopping, taking her to all Doctor appointments, etc.
She's doing that now, so nothing new there...
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Old 08-08-2017, 09:34 AM   #20
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I would start looking at apartments and let her try living on her own particularly since finances are an issue. She could always return to an assisted living facility if needed.

Would she be able to drive or have access to transportation? Some grocery stores now deliver for a modest fee. I think the main transportation need would be doctor's appointments.
I'm actually taking her to look at a couple of apartments this afternoon. No obligations, just to get a feel from her about moving forward. She's used to her large 3-bedroom house, so I don't know how she's going to feel about an apartment either. She still might feel like there's no privacy with too many neighbors around.

Unfortunately, most apartments in the area require a minimum of a one year lease. So she would basically be obligated if she moves to one.

I also need to make sure she knows I would want an in-home care giver checking in on her regularly. For my benefit if nothing else. I still need to research that and see what kind of costs will be involved.

I don't mind taking her to doctor appointments or grocery shopping occasionally. But it would certainly be easier if she wasn't so far away from us.
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