I met with the Ex Dir of the AL/MC yesterday. I called the meeting regarding the phones not being answered when I tried calling last week to check on my mom in AL multiple times around 5am (she had called). Anyway, mom is a low emerald on TS scale, managing decently in the AL for 6 months now. She has level 1 care and updated her care plan w/nurse director early July. There was an issue that mom was near the front doors a few weeks ago on what I was told was very crowded that day, and she walked out since the doors were open. She has no hx of seeking to get out though she if she has wondered about her car, they just redirect her at the front with no problem. I discussed with the Dir of Wellness and she said it was okay, got her redirected, and didn't make a big deal of it. That was not the same story with Ex Dir yesterday. I felt blindsided that this seemed to be a much bigger deal than anyone made it out to be. I am there every other day, take mom to the grocery and am fairly familiar with her behavior. That said, the director said that she is recommending MC due to her "seeking" behaviors. Again, new info to me. And she said they are holding a studio apt in MC for her. That she and the Dir of Nursing were going to meet with her PCP. I said I would be there at her appt. later this month. I'm guessing they would have not included me in that discussion otherwise. In the meantime, I suggested she wear the Wanderguard and the ED went with it.
I realize that mom will be headed to MC but something that was not an issue, has not been brought to my attention, was taken lightly by the Nursing director, and became an issue yesterday. Mind you, I have graciously had to f/u with many things not being done according to her care plan so I am most likely the thorn in their side. My husband reminded me that this is a business, they have an open studio in MC and she is the most available to fill it. I appreciate this community and your honesty and compassion and would like to know your thoughts. I'm trying to live in reality. Thanks!
The facility where Mom lives does not have a front desk person after 7.
My Dad started to get sundowning, he would call me at home (thinking I was my Mom) telling me he plans to catch the last bus home from work, so he was running late. Or telling me his meeting lasted longer so he will stay at the hotel (which was actually his apartment at senior living).
My Dad was living in the Independent Living section at the time. I was surprised to learn he was trying to leave the building later in the evening (Front desk was closed), and was so relieved that he could move over to their Memory Care section. Yes, it costed more but well worth the money knowing he was safer.
For example, my dad was a "level 1" AL at his last place, but largely because he refused to take help that he really needed, and they did his re-assessment without me present, and dad said "i'm fine by myself", so they dropped him from an initial Level 4 after hospitalization to Level 1 ! then when asking at other places, they were implying he might be even closer to MC level if he came there! We did move him, and he is in a semi-MC situation in the new place, jumped right to there from the supposed "level 1"! So what they are at and what they need may not always correlate.
It makes sense from a business point of view that they might try to push for MC if they have a room open and your Mom was the closest to needing MC. What is best for you is to advocate for what is right for Mom given the situation. It seems you did that, and negotiated the change to adding the wanderguard and staying in AL. Seems things worked out, assuming otherwise she was ok being in AL....
as far as attempts to exit the building from AL, what they advise may vary based on what security or electronic monitoring they have on the door, and how many hours a day a live person may be there monitoring the door..... that can vary quite a bit from place to place.
It is likely she may not get another opportunity to remain in the AL she lives in now when her memory care needs increase. Take the availability and move your mother in now.
Yes, care facilities are a business and the MC apartment is going to cost more but your mother will be getting more. AL does not provide the level of elder-sitting a 'seeker' or 'wanderer' needs. That's for memory care to do. At the AL I worked for, residents had to move if they were requiring regular redirection from the staff and 'seeking' behavior started up.
I'm speaking from 25 years of experience as a caregiver to care clients with every kind of dementia. The AL is making your mother a good offer to let her stay at the facility. Take it or someone else will.
Do you think your mother will be able to acclimate to a whole new facility with staff and people who are total strangers to her?
That's what will happen if someone else takes the MC apartment. Her dementia has advanced and they want her out of the AL residence. They're making a good offer here. Take it.
ALs are really not for those with serious Dementia. Its for people that need help with ADLs. Or like a man I knew on oxygen and a widower. MC is lock down.
It sounds to me like the AL is making a good offer to the OP's mother. They should take it.
If the AL was NOT making a big deal deal about moms wanting to leave the premises, that would be a problem, imo. You cannot expect front desk staff to redirect a resident with dementia every single time, especially when its crowded. Shes a huge elopement risk, and the AL is doing their job by wanting her in Memory Care, at 93, where she belongs, with locked exterior doors.
The AL is not trying to bamboozle you in any way, imo. The ED and DON are meeting with moms PCP to discuss her exit seeking behaviors and get advice. If mom were to successfully wander away, you'd be saying they should've insisted she move to MC. It only takes ONCE to successfully wander off and get lost and possibly die. I took care of a couple once who suffered from dementia. Jim wandered off one night and fell in the street at 2am. He wasn't found until hours later when 911 was called. He died the next day of a subdural hematoma.
Dementia only gets worse with time. My own mother had to segue from AL to MC at 92 when the AL felt they were no longer able to properly care for her. I felt grateful they had a room for her in MC, to be honest, not that they were trying to squeeze more money out of me. I placed my folks in AL because they needed more help than I could give them. Why, then, would I question the guidance I was given when mom was struggling? She did fine in MC but continued to decline, as expected, until she passed at 95. They vowed to keep her until death, and they did, in spite of all of her issues and chronic falls. I was grateful to have kept her out of Skilled Nursing and cared for by a loving staff.
Best of luck to you.
From a business standpoint, the facility is already in a high-risk business (with people falling, making false claims due to faulty memories and paranoia, and assaulting others). They are rightfully focused on risk mitigation, which benefits your Mom as well.
I'm personally aware of a story of a man who ran a successful restaurant in southeast FL. He was taking care of his wife with dementia at home. She was fine managing at home on her own while he was at the restaurant -- until she wasn't. One day, she wandered out. They never found her or her body. It was the first time she wandered according to her husband.
The facility gets to decide what level of care your Mom needs. Your Mom's care plan now needs to be adjusted to protect her. It's a mental and emotional leap for you, that you must come to peace with.
I am a firm believer that a person with dementia should not be in AL.
(I guess the exception would be if a husband and wife were in AL and the spouse is still somewhat managing the other)
the fact that you say mom has gone to the door on other occasions and they redirected her is an indication that she could possibly leave if there was no one there to redirect her.
If that had happened the blame and responsibility and liability would fall directly on the facility for not keeping her safe.
And even on the off hand chance that YOUR mom might not leave the facility HAS to have limitations/restrictions/rules for everyone and they have to be consistent with the policies.
A lot of people think once a LO is in a facility "caregiving" is no longer an issue. Care Managing is sometimes more difficult than caregiving. Your job is to make sure mom is safe and that they follow through on policies. This is what the facility is also doing.
Honestly since they see your m om and observe her probably more often than you do I would think they are more aware of how often she hovers by the door and are concerned that sometime the receptionist will be occupied and she will get out.