Isolation in memory care facilities?

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Isolation in memory care facilities?

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After months of debate, we finally agreed to place mom in a memory care unit. Had already made a deposit, then the state mandated the stay-at-home, before we got all the paperwork completed and mom moved in.

Now, almost 4 weeks later, we are back to an impasse. The facility has stopped all interactions between the residents. Their only interactions is with staff members bringing in food and checking on them. My sister is adamant that we are not moving her in under those conditions, and she holds the medical directive for mom.

Personally, I am on the fence. I think she needs to be there. But I also agree with my sister that current conditions would be make it very difficult for her to transition from the comfort and familiar surroundings of home.

Two questions:

1) Would you consider placing a family member, knowing there will be no interaction with other residents, and that person effectively will be confined to their room?

2) For those who already have a family member in memory care, is this isolation something other facilities are doing?

Mom is 91 and still fairly social, so I am leaning to delaying the move. Other siblings, some of whom have been in the rotation of staying with mom sometimes, may balk if a delay occurs and that will shift all the responsibility to my younger sister and I, and we both live out of state.

Alzheimer's & Dementia Care Decisions Memory Care

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My mother is living in Memory Care now and being pretty much isolated from the other residents, or at least 'socially distanced', and having to wear a mask when coming out of her room. She's been complaining non-stop, and hasn't seen us in about 5 weeks, which is not helpful at ALL. The regular Assisted Living section of the home has all the residents in their rooms at all times.

Now is NOT the time to move your mother anywhere, for obvious reasons. She will likely have a horrible time adjusting to such a situation, and who wouldn't??

If you're able to keep her home for now, do so, that's my suggestion. Most of us who have loved ones in residential care homes are feeling like we'll never get to see them again before they die. And if the virus does hit their facility, they can die without loved ones nearby to hold their hands or any of the usual end-of-life things that happen under normal circumstances. Everyone posting here is feeling guilty for having their loved ones in such a home to begin with. Don't add yourself to those statistics!

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Lealonnie1, thanks for the response. My younger sister says it would be "cruel and unusual, possibly a death sentence". I wouldn't go that far as mom literally lives in her own world and typically sleeps 14-16 hours a day. That said, if there were to be an outbreak in the facility and mom were to die alone, that would be heartbreaking. And the differences between us siblings might become permanent.

She is in Ga and even though the Gov has started lifting some restrictions, the facility is saying that they will stay in place until they get an 'all clear' from the CDC, and who knows when that may be. Thanks again!

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Please keep in mind that facilities must allow family to visit (with protection) in compassionate care situations, according to the CDC, such as hospice or end of life. As a long-term care ombudsman, I would urge people to advocate for such visitations so that the loved one is not alone.

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And, what about most of us 'kids' who are high risk ourselves for getting the virus? How wise would it be for us to put ourselves into the eye of the storm, so to speak, to visit loved ones in a COVID-19 infected community? It's a no win situation we're all faced with.

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I would not move her now. Tell the unhappy family members to grow up and deal with it. In my state, 25% of Covid deaths have been nursing home patients which is understandable. I have 2 family members in 2 different facilities that cannot be visited. I would not say that it is a death sentence but it could be a high risk environment as new cases are still being found. As to whether she could die alone, I think that could happen at any time anyway.

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My Mother is in a memory care facility ,and all of the residents are confined to their rooms, and have been there about a month. There is very minimal contact with aids when she is brought meals. She doesn’t have a smart phone or computer by choice so the only way to contact her is to call her which we do everyday. Without any activities I can see mom going down hill. I would not move your Mom in until things are back to normal.

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I am an RN in a LTC. Currently in our facility, it is completely lock down, as per state directives. No visitors allowed at all. However, Activity coordinators are still doing their best to make their lives are as normal as possible. They do hallway bingos, coloring and puzzles and we have PC, iPad or wireless phones for those who wanted to communicate with their family. Is your mother is cognitively intact? If she is, she should be fine.

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That might be true where you work/live but in regions with significant outbreaks in LTC the residents are effectively under lockdown in their rooms with all interaction, even with staff, limited to essentials only. Yes, those who have the physical and/or mental capacity can colour, do puzzles, or visit electronically but that gets old pretty quickly, and unfortunately a significant percentage of the population who require that level of care aren't capable of even that.

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Based on what I've read, the virus rates in GA are likely to go up, with all the lifting of the restrictions and not having met any of the goals that should be met before lifting them. If it is feasible to manage her care outside of the MC, then, I would try. For some family members they are just not able to provide hands on care for a person who has dementia, so, for them, I'd try to find a way around that or hire help. For some people with dementia, who have very high needs, it may not be possible to care for them in a home setting. We do the best we can.

My LO is in MC and I might be more concerned if she were alert, but ,she is in a semi-vegetative state and has no idea what is going on. She stays in bed most of the time and sleeps. I trust that her caregivers at the MC are doing a good job. They and hospice nurse are taking care of her and let me know what's going on. I spoke with a staff member yesterday who said that the staff is VERY careful with PPE, taking temperature before starting shifts, regularly wash hands, change gloves, etc. and that they are putting the residents welfare as their top priority. I appreciated her telling me that. The entire county where this MC is located only has 3 confirmed cases, with NONE of them being in a LTC facility.

Maybe, someone else knows this, but, isn't the restrictions against visitors in long term care facilities related to a federal restriction that is for recipients of Medicare and Medicaid? I thought I read something about that.

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Sunny, for the past 4 years, my 2 sisters and I have been rotating days at a time with mom. But there were some church friends who would come in and gives us a couple of hours of a break. For obvious reasons (most of them are 70+), they told us a few weeks ago that they could not come back until this is all over. Depending on one's definition of all over, that could be months and months away.

One sister (2 hours away from mom) broke her foot and is on crutches. She is still helping, but the foot is not healing as expected and she may be facing surgery and will be out for the next few months.

Sister 2 is 8 hours away, and I am 4 hrs away. On one side, I agree that the timing is terrible, but the positive is that the MC unit only has 25 residents, and has yet to see a case of CV19...so I think she would be safer there.

With the rotation routine, all 3 of us have been in and out of moms over the past few weeks. There is an argument that mom would be safer/less exposed at the MC unit than she is with us in and out.

At this point we are holding off on the move. If sis 1 does have to do surgery, that will create another "test" moment, with sis 2 and I both a fair distance away, and no other support, something will have to give, sooner or later. Thanks for your insights.

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There is going to be no perfect answer for the difficult circumstances we all are dealing with now. I got the opportunity finally after digging for a new place for sis for 6 months. I had to grab the spot when it was offered to get her out of the awful place she was in. Yes, it was in the beginning of Corona. I had no idea we would still be dealing with it now and for how much longer.... Sis has had a hard time-Yes. She would have a hard time with transition anywhere and at anytime. I can go do a window visit-with sis on one side of the lobby vestibule and me on the other-thick glass in between. First time I took a white board and wrote simple notes. She cried most of the time. The allowed me to come watch PT from the same vestibule. I clapped, thumbs up and big smiles. I did enjoy seeing the PT. I talked about it on the next phone call-how proud I was she is working so hard to stay active and healthy. She seems to know I am there except when she is paying attention to PT lady. I am glad I at least get to see her period with PT instead of at the window crying-is way to hard. I call on the phone but she gets upset-crying-i tried calling mid morning and early afternoon still gets upset. Staff have been good at keeping me in the loop about crying, mood and appetite-she had lost 30 pounds at the last place in 6 months- they are saying her weight is stable and we are trying a couple changes in meds to help with crying.

I have explained there is a bad flu going around-i don't want to make her sick. All staff are wearing masks so by now she understands flu is a real thing not something I made up. I had to get her out of the awful place she was in. New community does not have any cases thus far. My state is now posting the facilities that do get positive cases-there have been several facilities positive and several deaths. My son is still working and could bring home the virus at any time-i think sis chances are better where she is to stay healthy and get care if she should get sick. Hopefully we will get thru this and we can catch up on hugs and going out for pancakes in a few months.

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You are a wonderful sister!

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There are families who do not have a choice. Sometimes a placement needs to be made right now- even under these difficult circumstances.

But if you have any control over the timing of the placement, now is not the time to enter any kind of care facility. If you just can't care for the person any longer then you must place them. If you can safely delay the entry until we have reached the new normal, that's what you should do.

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I would wait. I’m in NJ. It’s bad here. My mom actually caught the virus in her memory care. She’s fine now. Didn’t even know she was sick. But being isolated is horrible and has made her very angry. They are off their routine. Hopefully things will get better in a couple months and you can admit her. In NJ almost 40 percent of the corona deaths come from long term care.

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I would definitely hold off from placing anyone in a facility at this time.

It would be Downhill for anyone from the moment they walked in the door.

I ended up hiring around the clock Caregivers so my Dad could stay in his own home.

You might think about hiring part time Caregivers to give a brake to the ones caring for your mom now.

You might even consider hiring a Live In for your mom

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Never in a million years. I often think how it would be if my father was alive during this pandemic and left alone to die in a big giant room to where he looked like the smallest kid in bed with dementia wondering where he was, and what he was doing there, waiting for us to visit...No way...No how.

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Your instincts are right: NO! Do not move your mother. My sister is in one and if I could care for her at home I'd have her out of there. They are keeping people virus-free at the cost of their overall well-being. Residents are not thriving, they are bored and lonely and there's only so much we can do with phone calls and visits to windows. And we can't check on quality of care this way. Keep your mom at home, if possible, until this is over.

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I’m sorry you are going through this. I had my husband in memory care for three years before he passed in December. My first thought is unless the residents can’t move on there own I don’t know if I believe they can contain them in there rooms. They are usually all over the place and if they got tired they find a bed and lay down. So many didn’t know there room from anyone else’s. You also can't just ask them to stay in there rooms they won’t remember. In my experience they tell you what you want to hear they are always understaffed and underpaid. I do still have my Mom 91 but she is nowhere as advanced in the disease as my husband so I can still deal with her by myself. I would not if I could at all help it put anyone in a facility unless you can go there everyday at different times to really see what goes on in there. I was there everyday for three years unless I was sick. The more your there the more you see or overhear unfortunately.
Prayers to you and your family with this difficult decision.

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The question you really need to answer is

Why do you feel you need to move your mother into a memory care unit?

The answer is NOT "Because she has advanced dementia".

Is it that none of the family can care for her in her or their home? Is it that she needs 24/7 caregiving because she can not conform to family's lifestyle, especially being up and wandering at night? Is it that the finances do not exist to pay for in-home care providers? Answering these types of questions and searching for solutions will help every person to come to agreement on residential facility or other types of arrangements.

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Don’t do it. They are human beings.

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My Dad resides at one of the Legendseniorliving brand care homes. They operate many Assisted living facilities across the USA.
During the lockdown they prohibit anyone from visiting at windows. They consider this trespassing.
Legendseniorliving also charged every resident a daily fee for room service, to bring meals to their room. And are charging a monthly fee for gloves!
Legendseniorliving Homes across the USA have taken advantage of a very grim situation.
I would suggest not moving anyone during this time, it probably is best to keep loved ones home as long as possible.
The Cares Homes for our Seniors are doing what they want during this time, because no one can police them because of the lockdown.

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Thank you for publishing the name of that greedy god-awful place.

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No. I would not put an elderly person into a new place AND one in total isolation at this time. I would wait until things calm down and the facilities have a better handle on allowing patients to mingle again. Moving is a big thing. Total isolation would be even worse.

Talk to the siblings carrying the load at this time and find out what they need to delay the move a while. Maybe pay for some in-home health care, if you and sister have been isolating (go get tested to confirm you don't have the virus)-go help or bring her to where you/sister are.

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This is a tough one.
I know communities that are isolating memory care and others who are not. It is difficult, and many would argue cruel, to isolate a person in the later stages of dementia. They are not able to understand the purpose nor benefit of confinement.

However, none of the communities I work with are allowing new admissions to memory care anyway. They are not doing strict isolation in memory care and so it would be irresponsible to bring someone new in and potentially infect others.

if your chosen memory care is doing isolation and you think your mom can handle it, go for it. If not, wait awhile.

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If you can wait to place her I would. My mom was isolated in a single room with a femur break 5 years ago at a rehab facility. Except for family visits she did not interact with anyone but the staff, including meal time. My mom went down so fast mentally in 8 weeks. Right now she is home with dad and I am managing her care, until I can bring help back on board.

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I Believe that trust in your instincts is imperative here. We put my mother in the Benton House over a year ago. She has adapted extremely well and they work really hard to help her stay adapted. Her situation is good. I was able to put a bird feeder up outside of her window and visit her whenever I want outside the window. However she's never in her room because they've continued activities at a social distance of 6 ft in the hallways and offer video chat with the families. They've done everything they could to ensure that her socialization has been met. But every assisted living and memory care unit is not this way and it takes quite a bit of effort to help them feel socialized and networked with one another even as the disease takes over. I can't see that putting somebody in a memory care unit at this time would be a good idea with the amount of work it takes to help them acclimate. I would wait for this quarantine to pass and then find a facility that works extra hard to help there memory care patients feel like where they live is their home. We even have a hard time getting Mom to leave. She doesn't want to miss out on the activities.

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That sounds like a wonderful place! I wish they could all be like that. God bless your family and mother.

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In my personal opinion, I would not place a loved one in any facility right now with the looming virus. No one takes better care of your mom than her own family. Right now, the medical community is stressed, overwhelmed and some short staffed. Being isolated in a place that is not familiar to you is not easy to begin with, but now, you also don't have that personal interaction. My husband has LBD and requires a lot of assistance and is on hospice. I use to use respite on a monthly basis to give me some rest, but with the issues they have now, I would not even consider sending him just so I could rest. I may want time to myself, but I would be worried sick about him in that sort of environment. I suggest to hold off until things get back to normal and they have a control over this virus. This is only my personal opinion, God give you the clarity you need to make your decision.

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You’re kinda between a rock and a hard place, aren’t you? The distances you all have to travel to care for her are burdensome, especially when it goes on for a long period of time. Then if you have to take one sister out of rotation, so that only two of you have to handle it, that’s almost unmanageable from 4 and 8 hours away.

You may have to look at hired help, if affordable. If not, placement. I’m sure people are being placed in facilities daily because there is no other option. Just do the best you can to pick the right choice, then go with it.

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I strongly urge you not to move her in there now. Wait until after this virus has run its course. Nursing home staff and residents are dying of Covid-19 at alarminly high rates. These facilities are notoriously understaffed even in the best of times. My dad had Alzheimer's and contracted C Diff, a very unpleasant and highly contagious intestinal virus. He was trapped in his room with no TV and very minimal human interaction for many days straight. He became agitated and violent with staff because he was unable to verbalize his confusion and despair. My mom ended up sleeping there to try and keep him calm.

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My Mom died April 18 in a 'good' ALF since end of Feb.A letter in the mail recently dated the day she died in the ER says at least 2 aides with the virus.Those you need to rely on not a 100%. My Mom relied on me and I relied on the ALF.I'm sorry I did.

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I thought I would be racked with guilt placing my mother in a facility as well. However , now I see that it was much better for her to be there then home. Being at home I would have had to quarantine myself with her , with no outside help , due to C19..
My mother has late-stage Alzheimer's & there's absolutely no way I could have done it by myself & continue to work my FT job.

Even with my siblings offering , they would not have been allowed to see Mom or be there to help with her care due to social distancing.
And any at home care mother was approved for would not have happened either as we could not afford to have people in and out of the house potentially exposing my mother.
With all this being said, I feel at peace with my mother in the facility.. yes, she was exposed to a resident with C19, thankfully her tests came back negative..
They are monitoring the residents very closely taking temperature three times a day.. Residents with a temperature above 100 are moved from the unit to a dedicated isolation wing.

I am blessed to have such a wonderful facility available for my mother with a dedicated staff.. we call our mother every day and we can FaceTime her.
For our family, this was the best decision .. The care she is receiving ,the protocols in place at the facility, peace of mind , moms demeanor, & continued contact with nursing staff all make for a confident decision that she is truly in the best situation possible considering the circumstances in the world today.

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I find it odd and for many difficult to keep those with dementia isolated. Sure, those who are bed-ridden, it would work, but anyone who is mobile, how would they restrict movement? Do they lock them in their rooms?

Our mother is in a MC unit, associated with IL and AL (not a nursing home.) The other units are restricted to their room, and more recently are not allowed out for anything other than a medical appointment (shopping lists must be used to get supplies), but they said the MC residents have freedom to move about, as before. They eliminated hairdresser, bringing in outside "activities" and "entertainment", no access for them outside the MC unit and limit who comes in. So far, so good.

With limited access, protective measures and not a lot of cases in this area... yet... they stated these residents would be allowed to move about the unit, as before. Meals are more staggered, to allow spreading the residents more from each other. If the virus gets in, it will likely spread quickly, but even with being shut into their rooms, the virus, if it gets in, will still impact many or most. So, why "punish" these people? It's bad enough that they have to live in some isolation before the virus, why make it worse for them? They don't understand it at all.

We get weekly updates on the facility, some pix sent, messages about anything that needs to be said, etc. No real way for me to visit or interact with mom. Her room faces into a garden, can't get to the window, her hearing is bad, so we didn't get her a phone, she doesn't do computer-type stuff, so there's no way for me to "interface" with her. The last pic was taken during bingo, shortly after a tumble. She certainly looked happier than I am!!! My own "isolation" is about 2 years in the making, due to financial issues, and just when that was resolving, this happens. So, I'm not really any better off than she is!!

While it is difficult to manage the current situation, you'll have to weigh all the pros and cons in order to make a decision. If her care is untenable, then as bad as room isolation is, it would be better to move her. If it means hanging on a bit longer and you all "suffering" a bit more, then find a way to make the current situation work for a little longer. It seems like we are reaching a point where some restrictions might be slowly lifted. Since none of you is really local, do you move into her home with her in weekly shifts? Can you bring her to your own homes, where you might have help from your spouse/kids, temporarily? Hiring outside help to alleviate some of the stress can help, BUT then you have to worry about that person/people bringing in the virus.

I wouldn't want to be in your shoes... :-( Hope that something works out for you.

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If you can I'd take her home.My Mom similar condition in a 'good' ALF since end Feb.Isolated in rooms since first week of March.She died April 18 from the virus.A week later a letter in mail to all families that they are taking precautions but have at least 2 workers virus test positive.I got the letter returning home from picking up my Mom's possessions.The letter is dated the day she died.Best wishes.

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Keep her Home as long as you can.Do the best you can.My Mom was in an ALF since end of Feb.My last allowed visit was March 3.Minimal info-contact by cel msg from an aide until April 17 that Mom has some bleeding being monitored by their Doctor (found out later off a few weeks for virus). Friday night a call she sent to Emergency Room she has high white count,needed fluids and non-coherent.Saturday night she was dead possible or likely virus.Had I kept her in her house I'd still have overall care problems but she would not have died from the virus being given to her by those I relied on to keep her safe.If at all possible keep her home family isolated until good on spot testing available.The leaders of our government let us down by dismantling programs to deal with this.Anyway,best wishes.

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I live in assisted living and they have tough rules to follow as lives are on the line. There really is no choice given this virus and what is happening. Most all of the people are confined to their rooms - for their own safety - and is necessary. I feel if it is necessary to have someone placed in a facility, there was a reason for doing that - they don't just take anyone in because someone doesn't want to be bothered with them at home. And if they are in a memory care unit, it says they have some degree of dementia. Nothing you do or say is going to sink in for more than the immediate second, if at all. I would go for safety for all. Every facility is doing the same thing. It is sad and awful but it must be done - right now there is not much choice.

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My mother is in memory care and I have not been able to visit her for approximately 6 weeks. If you put your mom there now, you won't be able to visit her, so you might want to ask the facility if you can wait until the lock-down is lifted, if you can continue to take care of her. The facilities have to keep people separated to lower the risk of transmission of the virus. As soon as they can, they will put people together again. When she goes into a facility, they become responsible for her health.

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Revisit this decision after the Novel Coronavirus is over.

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I have worked in nursing homes for the past 10 years. If at all possible, I would try to hold off another couple months until admitting your mom to a dementia care institution. Presently (in CT anyway), measures are (very slowly) being undertaken to move patients who have the Corona virus to certain specific nursing homes within the State to hopefully decrease the spread of the disease. Healthy people in their 30's - 60's (and other ages) are dying from this highly contagious virus. Though probably not intentional, health care workers are spending even less time with patients to prevent possibly causing cross-contamination between patients as they go from room to room caring for their assigned patients. It's highly unlikely that staffing has been increased, and with all the (necessary) precautions that need to be taken now, staff just doesn't have any extra time to socialize with patients. After all, they still have to protect themselves from becoming exposed. If there is ANY possible way that your family can hold off until maybe the Summer ??? it could make a life and death difference.
Regarding the isolation, I certainly hope that ALL facilities are observing these precautions. Do you know how many or what percentage of the patients have been diagnosed with the virus at the facility where your mother will ultimately reside?
Lastly, though you didn't ask this, you mentioned that the majority of the caregiving responsibilities will fall onto 2 of several siblings if mom is not admitted soon. Just as an FYI, while the others may not wish to continue to care for their mother in person, it would probably be equally helpful or maybe even better depending upon their attitudes, if they were to contribute $$$ to her current care and maintenance so that there was a more equal balance. Caregiving affects the caregivers physical, mental, and emotional well-being. They need a break. While placing mom in a Respite care facility would bring up the same problems, Respite care in the home is still available and individuals such as CNA's and HHA's, and even companions can be hired from Home Health Care agencies. Some agencies will provide a live-in caregiver on a weekly basis. If your sister as the POA has access to mom's funds she may need to start to use them for home care if siblings are failing to hold up their fair share of caring for mom. Sometimes the thought of chipping away at an inheritance might cause some siblings to suddenly have more time available... :)

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At this point, zero cases at the MC unit. They have shut down all visitors and all of the folks who would normally come in for activities, or offer spiritual guidance. All residents are in their rooms on lockdown. All staff members are monitored before starting a shift, and every 4 hours until their shift ends.

In my opinion, purely in terms of CV-19, mom would be safer their than with us kids still rotating in and out, bringing in groceries, etc...any of which could contain the virus.

There have been times where we had to move mom for days at a time, hurricane warnings, scheduling, etc. Everytime we have done so, being out of her usual surroundings has been difficult, to say the least. But in those situations, she was at my home with family, or at one of my sisters with their family. This would, in all probability, carry the same 'change of familiar setting' issues. And it would add the isolation issues. Which is why we are on hold for now.

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