Hello! Thank God for the Internet. I am a 28-year-old caring for my 86-year-old grandma. I have been around for the last four years helping her with small things like trips to the store/doctor/etc.

Recently though, while she was in the hospital for stomach problems, the doctor said she may have the onset of dementia. I've noticed some forgetfulness in her over the last year, but nothing dangerous.

Problem: I am scheduled to leave for a job overseas in five months where I would only have phone contact with her for a year.

I am the only one in my family who is around.

My grandma currently lives in a senior apt complex. She has no problems with her ADL's and has a neighbor and pastor in the building that check on her. But some people say I should be put her in an ALF before I leave as a precaution. I'm wondering if taking her away from her support would be detrimental and if she really needs an ALF yet. I could always fly back if there was trouble.

I am unsure what to do....

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This is tricky. Since she has familiar people to check on her, and you could fly back, she may be better off where she is. If she didn't have these people, I'd say it's best to move her to assisted living. Talk it over with the people looking out for her, and see if you think they could handle things while you fly back, if they think there is a need. You could also hire in-home care for her in her retirement home, if it comes to that. There are many things to consider. Good luck. You are such a caring granddaughter.
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My experience tells me that there can be as many determinants as there are people however there are two risks that almost immediately call for assisted living: 1. Fall risk. 2. Dementia where there is danger to oneself and others.
With regard to your travels, you may wish to hire a home health care agency, geriatric care management agency, or a similar service to check on her in the morning and in the evening while you are away. This way you have established a relationship with a responsible party that can act in your absence if required. It is unfair and unwise to expect neighbors, clergy, etc. to be responsible for her well being. Placing her in an ALF while you are away seems a bit extreme.
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I have been grappling with this issue for my mother. She is now living idependently (with lots of help from me) and I am trying to help her stay in her home environment for as long as possible. In my opinion, seniors are happier if they can keep what is familiar to them.
Please be careful (and it sounds like you are) with off-handed diagnoses of dementia/alz. Too many doctors are throwing around this term without having any training in the area. I think they use it when they tire of dealing with an elder that may just be forgetful or slow to answer.
I agree with Carol, if everyone agrees that she will be okay in her apt. I would try your plan for a year. Also, hiring a caregiver to come in once a week would give you another set of "eyes" looking out for her. I hired a caregiver from a local, reputable agency and she has been great. Ask these questions: is your staff hired locally? do you have a variety of ages? do you pay your staff a salary? do they do light houskeeping and personal care? These questions give you answers as to the stability of the company and how they treat their staff. Also, have them send out a few caregivers so your grandmother can choose a person with whom feels comfortable.
I also purchase "gift cards" for mom to give her caregiver for errands. Make sure they give her a receipt and return unused cards. This way, she doesn't have to deal with cash.
Good luck...
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Thanks everyone!

This is a big help to get some other perspectives. I have been torn between canceling the job and staying (which my grandma does not want me to do; of course, she is an unselfish lady). Especially since I recently delved into medicaid law in Florida to see about her options, I'm not sure ALF is even an option anymore. At least not without a lot of work.

Other thoughts are greatly appreciated and thanks again.
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I know how torn you feel about your grandma, I went through the same thing with my dad. I live 4 hours away from him, and he has limited help close by. The easiest option would have been ALF for me, but I know that the best thing for him was living independently. He doesn't suffer from dementia, though. What he does have is the complete loss of his right side due to a stroke 20 yrs ago and he can't speak. A strong case for AFL, for sure! Wrong!
He is very independent, does his own grocery shopping, cooks, and does his own laundry... for now.
My advice would be for you to speak to your grandma about what she feels and wants. Talk to her about what care she thinks she needs, what concerns you have. Then talk to her and her doctor, her insurance, and any resources (Adult Aging services is good) about what you can do to help your grandma go the route she has chosen.
There are so many ways to help her stay independent. I went through a company to set up a camera at my dad's house - they have a payment plan where you purchase the camera over a year, then make a 12 dollar payment for monitoring service a month. The camera comes with a built in microphone, so I can see and hear what is going on at my dad's from anywhere with Internet access. It gives me peace of mind, gives my dad peace of mind, when I can't be there with him.
Meals on Wheels comes out to my dad's every day at 11 a.m. and while they aren't providers, they are a resource, a body that checks in on my dad faithfully each day.
Like you, my dad has a pastor who will visit. In fact, my mom's (she passed away) pastor and 3 other pastors from the community visit my dad several times a month (one each week) to say hi. He doesn't go to their churches, but I found most churches don't mind if you ask.
My dad goes to assisted living, daycare a few times each week to give family members who are close by a break (my 24 yr old niece who lives close by helps, as do others, anyone we can get really... it's crazy!).
My dad qualified for home health care, so he has a provider who helps him several times a week.
I pay his bills online. I schedule all of his doctor's appts remotely, and keep in contact with them after each visit to know he's okay. Doctors and insurance case managers help coordinate transportation for my dad, too.
Helping your grandma long distance is an option if she is healthy enough.
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