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Typically, dementia patients are moved from AL to MC for higher level of care. But has anyone done the opposite? If so, why?

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My husband has LBD too. Medicines can make him calmer, but it is not always controllable. He got better by Depakote too. It looks pretty effective for mood control with this. Generally speaking, MC has the staff who knows and can handle better than ALF. But when you look for MC for him, you need to make sure the stuff knows he has LBD and not Alzheimer. Some place will tell you they won't receive him because of all the psychosis, agitation, etc. etc. So, you need to keep looking until you find the place who has people who knows what is LBD and they know how to handle it. Think about what if he gets agitated in ALF and hurt others. Leaving him in the place where people doesn't know how to handle him is not safe for both of them. And it is very true that he sometimes has a moment that his mind is so clear, and you feel guilty to have him in MC with other dementia patients. You need to think of the pros and cons of where to leave him. I agree the home is not safe for you. I called police several times to deescalated his agitation too. But it breaks my heart looking at him staying alone at MC, crying and telling me that he cannot do anything he used to do. Just try to be with him as much as possible no matter where you are. That is all I can tell you. Good luck with you and your husband wherever you decide to place him. Nowhere is perfect. And both of you will get hurt emotionally anyways. So be strong and always avocate/support him.
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Reply to Magir64
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SOS369 Oct 6, 2024
Magir64, Thank you for sharing and your advice! In my logical mind, I know what must be done, as hard as it is, but I just want to make sure I am choosing the right path. I asked the posting question to leave no stone unturned. Seriously, no one can feel the pain of separation and the loss of a loved one to this horrible disease or the tough decisions we must make unless they have witnessed or lived through what we have.
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I did. My mom was pretty functional. We were not sure what was best and started in memory care. In a few days it was clear that it was substantially lower in cognitive levels than she was. Most patients were non verbal. I moved her to the ALF side. She was not quite strong enough for that but seemed to thrive better with folks that she could talk to.

it is hard when their capabilities are in the middle.
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Reply to Msblcb
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SOS369: That seems highly unlikely.
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Reply to Llamalover47
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It would be very helpful to us to know why you are asking the question.
There has to be specifics of the person in memory care that you are questioning.

Generally speaking - dementia is not reversible. Although there are medications that can help slow down the process (from my understanding, which is limited)
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* I would recommend you do some research of 'dementia medications' i.e.:

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048103

In part, it says:

Alzheimer's: Medicines help manage symptoms and slow decline
Alzheimer's has no cure, but certain medicines can help manage symptoms of the disease and some can slow down disease progression.

By Mayo Clinic Staff

Medicines for Alzheimer's disease may slow or help manage changes in memory, reasoning and other thinking skills. Managing these symptoms may help people with Alzheimer's disease preserve abilities to perform daily activities and prolong their independence — factors that can improve the overall quality of life.

Alzheimer's drugs don't work for everyone and may lose effectiveness over time. These medicines tend to be most effective for people with early to moderate Alzheimer's disease.

If your healthcare professional prescribes medicine as part of an Alzheimer's care plan, make sure you understand the possible benefits and risks.
The treatment plan may change as the disease progresses.

Research into more-effective Alzheimer's medicines is ongoing. If you can't take the approved medicines or they don't work for you, ask your healthcare professional if you might enroll in a clinical trial.

FDA-approved medicines for treating symptoms

The Food and Drug Administration (FDA) has approved medicines to treat symptoms at different stages of Alzheimer's disease — mild, moderate and severe. These stages are based on scores on tests that assess memory, awareness of time and place, thinking, and reasoning. Most people with Alzheimer's disease take one or more of these medicines at some time during treatment:

Cholinesterase (ko-lin-ES-tur-ays) inhibitors.
Memantine.
Brexpiprazole.

These medicines aren't approved or recommended for treating mild cognitive impairment (MCI). Symptoms of MCI are small but notable changes in memory and thinking. The most common cause of MCI is Alzheimer's disease. MCI due to Alzheimer's can be a stage between typical age-related memory changes and Alzheimer's disease dementia. Some people with MCI do not have Alzheimer's disease but may have other causes of their condition.

Healthcare professionals might prescribe these Alzheimer's medicines for stages other than the officially approved stage. Alzheimer's stages aren't exact, and individual responses to medicines vary. Also, treatment options are limited.

gena / Touch Matters
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Reply to TouchMatters
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SOS369 Oct 1, 2024
TouchMatters, thanks for your informative reply. Please see my reply to lealonnie1 below with more info about my situation. Long story short, basically, my husband is diagnosed with LBD. He was placed in MCF cuz I no longer felt safe. He went from hitting and punching staff (and almost hit his roommate), sending one person to the ER, and in another incident police had to be called to de-escalate, to being highly functional now after adding Depakote. If people didn't know of him before and only sees the current him, they'd think he's fine/normal, no disease, no problem, and wondering why he's in MCF.
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If the facility knows about the dementia then they wouldn’t ever move that patient to assisted living . They need 24/7 care
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Reply to Trixipie
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Yes.. my 91 yr old mom was moved into assisted for 3 yrs ...after a year in MC.....now she is back in MC again.. She has Lewy Body Dementia
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Reply to Sadinroanokeva
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I would assume the administration agrees that it may no longer be necessary if the staff is hands on in Personal Care. Sometimes Memory Care is used for severe cases including psychiatric care. That is common for Alz patients to become violent sometimes and need to be away from the calmer population.
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Reply to Onlychild2024
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No you cannot do that . They have to be in a memory care wing if the facility . Too much can go wrong if they are left alone
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Reply to Trixipie
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If somebody was to move to a lower level of care, it is because another person - not the facility - is providing the care.
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Reply to Taarna
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If you are asking about your husband in MC who's "gone back to normal" with Depakote, I doubt the administration would allow him to go into regular AL. With a history of violent behavior, it's too risky. While it's great that Depakote is working so well for the past 9 months, there's no telling how long it will continue working for. It could be years or months, nobody can say. You can always have that conversation though.

Good luck to you.
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Reply to lealonnie1
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SOS369 Sep 26, 2024
Thank you so much for your input and confirmation. It was suggested by a rogue doctor, newly hired as my husband's primary care physician as he travels to the MCF to see my husband. He isn't my husband's neurologist nor is he the one who prescribed the Depakote. Worse was that he actually told my husband that he didn't belong in memory care and should be in AL, without consulting me first. This dr had never consulted with me regarding my husband's medical history at all nor did he coordinate with my husband's neurologist at Stanford. He's spewing out things like maybe your husband doesn't have dementia, suggesting another very expensive test. I researched and found that this test should be done only after dementia has been ruled out... duh ... plus the cure was high dosage shots of steroids!! Anyhow, logically I know this is all ludicrous, but I just have to ask the question in the spirit of leaving no stones unturned. Moreover, my husband has 3 police case files of the three episodes when I had to call 911 on him. Anyhow, I will discontinue service with this doctor ASAP.
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SOS369, I've never heard of that before. Note, that before that can be done, the Adm Staff at the facility would need to give approval, and probably test the resident to see if that was a good idea.
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Reply to freqflyer
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When I toured facilities I was told they have a lot of dementia patients in assisted living when they have a spouse who is pretty pulled together and lives with the dementia patient in the assisted living.
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Reply to brandee
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SOS369 Sep 28, 2024
Thanks, brandee. Sadly, with my husband's history of violence, I don't think we can ever live together under the same roof again.
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Is this a hypothetical question?
One can only assume that one would be moved from MC to ALF if the person improved. This is, while rare, certainly possible.

There is also a movement now to have a sort of inbetween. My brother died in a fabulous ALF 5 years ago. At the time, the faciliy, based on cottages, were making some of the cottages a sort of inbetween in which there was slightly better staffing tho not so good as MC. Clients could still have their own rooms, but were more closely monitored and checked on. The doors were locked which didn't happen in ALF. I think it is a wonderful model for those willing to and able to create in of their community.

I have not yet here on AC in 5 years heard of anyone moving a loved one out of MC and back into ALF. I HAVE heard of them removing from MC and taking home with 24/7 care model.
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Reply to AlvaDeer
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SOS369 Sep 26, 2024
Thanks for your input. My husband has a history of violence under this disease. There's no way I can/will bring him home. Although he's been doing really well the past 9 months with adjusted meds, there's no guarantee he would stay this way or for how long.
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