Mom moved into independent living section of a CCRC Type A facility with MC, AL and SNF all on-site. That was one of the main reasons she selected this facility. Mom developed dementia and facility wanted her to move into MC within months. Mom was still in the VERY early stages of dementia and such a move seemed premature.

During the COVID lockdown she fell and broke her leg. There were Covid-positive residents in MC and SNF sections at that time so I decided to bring in private caregivers to her IL apartment to assist her 24/7 while recovering, rather than move her into a unit where there were active outbreaks of Covid infection. She fully recovered from the broken bone but her dementia progressed (she’s middle stage now) during the last couple of years so family and doctors agree it is time for MC. Unfortunately the facility is saying she has “missed the window” and MC will not be of benefit to her now. Furthermore they say the unit is currently “pretty high functioning now” and she would require more physical assistance than most of the other “high functioning” residents require (mom needs some assistance in the shower, uses Depends due to long-standing incontinence and a walker for mobility, but is otherwise able to do most other things - with occasional reminders/prompts), so they don’t won’t accept her into MC.

I have even offered to pay for private caregivers to assist her 1:1 during waking hours but they don’t want that. They want her to go straight into SNF unit. I think this is crazy. She is slow and weaker but still ambulatory. Cognitively she is in the middle dementia stage so she could absolutely make use of MC activities and programming. She is pleasant, talkative and not disruptive at all. And with her own caregiver on the MC unit, she would be virtually no extra work for facility staff. Going directly to the SNF unit, I fear they’ll just let her languish in bed all day with no specialized cognitive engagement/activities so I’m reticent to proceed to SNF.

Any suggestions?

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You're being scammed. Memory Care is PRECISELY for a person just like your mom, who has even MORE issues going on, never mind the few she does! She should not require an aide of her own, furthermore, and has nowhere near the issues required for a SNF, never mind a SNF with a private aide! I'm flabbergasted at the bill of goods this place is trying to sell you and feel furious FOR you. Tell them you'll have your lawyer go over your contract with a fine tooth comb looking for the language that discusses this "window" they speak of, that an elder with moderate dementia "missed" in order to qualify for MEMORY CARE, which is what such a facility is for.

My mother lived in a Memory Care Assisted Living facility for nearly 3 years. Started out with moderate dementia and scoring about a 13 on the MoCA exam, incontinent and wheelchair bound. By the time she died in February, I'd be surprised if she'd score a 6 on the MoCA, had very advanced dementia and more issues than Newsweek, the poor woman. And she was cared for and treated like a queen the entire time by the staff, even on the days she fell 3x in 2 hours because she forgot she couldn't walk. I never had to hire a personal aide, either, or her funds would've been used up very quickly and I'd have had to apply for Medicaid to get her into a SNF. That's what I was trying desperately to AVOID.

Something is very wrong with what this place is telling you. Throw the "lawyer" word around with them or move her out of there and into a Memory Care of your choice. Here in my state, however, entry into a CCRC requires a large buy-in fee up if thats the case with your mom, that's a big problem. You're not going to do what THEY want regarding her've got to do WHAT YOU want. What'll it take to achieve that? Maybe a lawyer or the threat of bringing one in to look over their entire operation which sounds awfully FISHY imo.

Wishing you the best of luck with a difficult situation
Helpful Answer (9)
Reply to lealonnie1

" Window? ". This sounds like something the facility is making up.
Helpful Answer (6)
Reply to RedVanAnnie

The "window" thing is quite new to me and I've been in long term care administration for many years. Also live very near a well known CCRC so I know how they operate. Sounds like your Mom is a prime candidate for MC to me.
Check your contract and then tell the administrator or whoever is blocking the move to MC that your attorney is going to be reviewing the contract. I'm hesitating on just telling you to move her to a facility because most real CCRC's require a large entrance fee and you may have passed the time limit to get any of those funds back. Additionally you may have to come up with another entrance fee to get her into a new facility that you like. If the care is good but the administration is loopy and greedy, you might want her to stay there so the mention of the lawyer may put them in their place quickly.
Also this is the a clue for your to check out their long term operation which can vary greatly from facility to facility. In both of the facilities in which I worked residents were invited to activities based on their interests and their needs, not on which care unit in which they resided.

Please keep us updated. Good luck and blessings to you!
Helpful Answer (6)
Reply to geddyupgo

This doesn’t sound right at all. MC is for people like your mother, they are/should be built around a living situation and activities and whatnot for people with memory problems. My mom’s in a small MC with people of varying cognitive abilities and it works just fine!

Throwing the lawyer word is one option for sure. IMO though you might want to look for an MC elsewhere if that is a financial option. If they treat you guys this shadily now you might be fighting more battles if they do let her in. Who knows what else they might try to get away with?

Dementia is hard enough without dealing with stuff like this. So sorry you are going through the wringer! Huge hug and truly wishing you the best
Helpful Answer (5)
Reply to Madisoncuckoo7

This is strange... that whole spiel about "missing the window"...? Not a thing that I've ever heard of unless it is outlined in their contract. Plus, her doctor is mainly the person who would be recommending LTC (which she doesn't seem to need).

Sounds to me like this facility is just "filling beds" regardless of the residents' actual needs to satisfy their business model. Which would cause me to find another facility, if I were you. Maybe consult with an attorney if she is bound by a contract. You may want to hint to the facility that you're reviewing the contract with an attorney...
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Reply to Geaton777

If their MC isn't willing to do their job, I'd get Mom out of there all together. Find a MC that understands what its purpose is, has activities for various levels of dementia, and will care for her until end of life.

Skilled nursing is for people who need constant MEDICAL care like rehabbing from a surgery, a broken hip, or stroke. DO NOT put your mom there, because the one thing SNF does very poorly is care for dementia patients.
Helpful Answer (3)
Reply to MJ1929

Is finance part of the decision?

Does the SNF seem pleasant, peaceful, well run, well staffed?

There are numerous structured activities in my LO’s SNF, although she has been a passive participant since entering it.

However “the window” was established by administration, COVID has done nothing but make decision making harder and more painful and difficult for every aspect of patients’ lives and staff care.

If she goes to the SNF with an aide for part of her day, would you feel more comfortable with that?
Helpful Answer (2)
Reply to AnnReid

Express your concerns directly to her case manager at the facility and see if there is any room for flexibility on their part. If she can do many things on her own and just needs help with bathing, toileting, etc., she sounds like she doesn't need skilled nursing yet. I agree with one of the comments below that skilled nursing is not the best place for someone with dementia, unless they are bedridden.
Helpful Answer (2)
Reply to NancyIS
jemfleming Nov 15, 2022
I’m not sure that being “bedridden”should be the deciding factor for having to go to a SNF. My mother lost her ability to walk her stand due to age induced weakness, but she otherwise had a fairly sound mind - with some early dementia- and has been able to groom herself, eat, swallow, and assist with changes in bed by rolling to one side or the other. I have to use a Hoyer to move her to a chair during the day. The need for a Hoyer eliminated her eligibility for AL. She takes very little medication and has no significant health issues. I view her as an “in-between” case. She can’t walk or stand but she doesn’t need 24 hour nursing care either. I fear she would spend most of her time in bed being ignored at a SNF facility so I have her at home with a caregiver to help me during weekdays. I wish she was eligible for AL or MC. I sympathize with the poster’s problem.
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Be careful what you wish for. I wanted AL and MC for my mother because I wanted her to have those interactive services. What I found was she had no interest in them, and the facilities were so understaffed that they weren't caring for her physical needs. She kept falling and having other medical issues that required repeated trips to the hospital. It was a huge mess, and she ended up in a SNF anyway, where she is getting much better care. Many SNF have things like bingo, arts & crafts, etc. Ours does - and my mother still doesn't participate.
Helpful Answer (2)
Reply to TrishFL
Geaton777 Nov 15, 2022
TrishFL, we worked hard to get my MIL into a nice facility only for her to refuse to even go eat with the other residents. But then, after 2 *years* the staff was able to convince her to get into her wheelchair (Hoyer lift needed, 2-person assist) and go to meals. And now she allows them to take her to events and activities. I think her memory impairment and mild dementia made her forget that she was resisting. Just saying that in your mom's case you may at some point be surprised.
Your mother has dementia no matter what stage. Should be in memory care. Ask her doctors again and don't give up.

We do rely so much on each other but Covid doesn't care. Unfortunately, social distancing is not possible in memory care and nursing homes because residents are there for their primary reason, CARE.
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Reply to Patathome01

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