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We just placed our 93 yo mother, beginning stages of dementia, in a board and care residential home. It's been VERY difficult. She's not adapting and it's been 6 months. There is a large turnover in caregivers. They don't engage with my mom, or do anything with the other residents either. Our family has been paying for outside caregivers to come in to give her activities. Is this the norm? What should we expect? Everytime she gets upset, they giver her 1/2 Ativan.

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Memory Care facilities do not attempt to cure or improve dementia. As you know, dementia is incurable and progressive. It gradually pulls the patient to his eventual death. The disease targets the neurons and its connections in the brain, killing them. As the disease progresses, the brain loses the ability to communicate with other people and gradually the person loses contact with the outside world. The disconnection involves intellectual and emotional aspects. As the disconnection worsens, the patient withdraws into a tinny little world of its own, that is created by a few surviving neurons. This personal little world has no communication with the environment or persons outside. That's why it's hard for them to engage with family or caregivers. Medication is used to control anxiety, agitation, depression or insomnia because verbal reassurance or commands don't reach their inner world. The thick shell that separates the imaginary and the real world, is just too thick. Expecting too much in the care of demented people, causes a lot of frustration and a sense of helplessness. It is better to accept the limitations from the very beginning and to forget that you can improve dementia with "stimulating" activities or by love and self-sacrifice alone. The frustration can grow to the point of getting angry at the patient, and even wishing that he or she dies soon. As a result, many caregivers end up suffering from guilt feelings and depression. All from having unrealistic expectations, sometimes encouraged by self-appointed google "experts".
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poodledoodle Jun 2022
“It is better to accept the limitations from the very beginning and to forget that you can improve dementia with "stimulating" activities or by love and self-sacrifice alone.”

This is wrong. There are many degrees of dementia.

And in the early stages, of course stimulating activities help. Keep the brain as active as possible. You can absolutely slow down dementia, even if dementia has already started.

By the way: hearing and dementia are very linked. If your hearing is bad, you’re much more likely to develop dementia. This also means, hearing aids (if there’s hearing loss) can help slow down dementia.

Of course love helps. Hearing a loving voice, a loving touch. We are human. No matter what the illness (physical/mental), of course love helps.

TChamp, my guess is:
that you yourself never cared for your elderly parents:
either they died at a “young old age”, or died quickly (not long, drawn-out illness), so you didn’t have to care for them.
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Board and care homes are cheaper specifically because they don't offer the activities that a facility does.

When I placed my dad I chose a board and care because it didn't offer all of the amenities that he never used.

I had to supply all of his enrichment activities. I made a point of including other residents so that they could get to know one another and interact. This worked really well and other residents actually started having their friends and family do group activities.

I did know exactly what to expect before moving him in, I asked lots of questions. Are they fulfilling the contract for board and care? If not, contact the ombudsman and file complaints against the facility. I did that because they weren't providing the contractual services.

I would also go interview other board and care homes to find out what is industry standard in your area.
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You are not asking too much........the board & care home is not doing enough! No caregiver or nurse has the right to give your mom Ativan when she gets upset unless there is an order for that medication written FOR her by her doctor, with instructions on when it can be administered. The purpose is not to 'shut her up' if she complains, but to calm her down if she is agitated.

The board and care home's job is to keep your mom stimulated and occupied, as the Memory Care ALF did for my mother when she lived there with dementia from 92 to 95 years of age. The caregivers interacted with her all the time, and made sure she was well cared for and socialized with the other residents.

I suggest you have a sit-down meeting with the Executive Director, or whoever is in charge of this place, and get a care plan going for your mother; one that meets with YOUR approval. If such a plan is not forthcoming and seen to within the next few weeks, I'd get her out of there and placed in another Memory Care residence that has a good reputation and a willingness to properly care for their residents.

I'm sorry you and mom are going thru such an experience. Wishing you the best of luck moving forward.
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