Strategies for moving an unwilling Mom to assisted living?

For one thing, set up medical transport to take mom to the AL.

Talk to her doctor about calming meds to be given or increased the day of transport.

Call the Sheriff's department and ask for Civil Standby for the day you move her.

Have your official copy of guardianship papers on hand.

Hire help (with mom's money) to move her stuff and do set up.

Do not talk with her (or your brother) about the move beforehand. You will just upset mom and alert your brother.

Talk with the administration and SW at the facility about whether it would be better for you to stay away while she adjusts.

Difficult to physically make someone move when they don't want to. I guess at the last minute you just need to demand that it be done.

Is she even able to be in AL? If you have guardianship, that kind of implies to me that she might be past that point?

Are you thinking of taking things from her current home to AL? That could prove difficult but if you want to do it, just do it and as you say you will have to deal with her wrath.

Will she remember and/or understand if you explain this to her? If so, sit down and tell her what's up, at the last minute, and just say, nicely, it is decided and she IS going.

How tricky do you need to get? IDK. Do you tell her you're going out to lunch and do so and after go to the AL?

Since you have no one to help, maybe you need to hire someone to help move her things.

I do not envy your journey here. I imagine it will be hectic, for both of you, but it must be done.

Personally, I think BarbBrooklyn is spot on with her recommendations about how to handle this move. You may also check with the AL and see if they have any tips about how to make this transition a bit smoother for your mom. Remember; they've seen situations like this many times before and may be a wealth of knowledge on the matter.

My 92 y/o mother moved from the AL portion to the Memory Care portion of the community in May, after living in AL for 5 years. She hates it in MC and wants to go back to AL, which is not possible for obvious reasons. She wasn't able to handle life in AL for about 9 months BEFORE she got sick and went to the hospital and rehab, etc, but of course, she doesn't 'remember' that at all. In her mind, she was fine and 'they' were making up lies about her.

MC had a picnic this past Saturday. My mother sat there talking all about the new resident, POOR SOUL, who just moved in who's family 'tricked' her into MC by telling her they were taking her out to lunch and BAM, moved her into the community. Tsk tsk, isn't that HORRIBLE? She's doing fine, by the way, just complaining to everyone who will listen. I mentioned to my mother that it's not so easy for ANYONE in a situation with a parent with ADVANCED OLD AGE. Who wins? Nobody wins, that's who. We lose, because we're the Bad Guys for putting mom in a FACILITY to keep them SAFE, OH MY GOD. They lose, because their lives are Taken Away, never mind that they had no life to begin with that was safe or not ruining their children's life. Sigh. The whole damn thing is a mess for ALL of us, and I feel your pain. I hope and pray this move goes off with as little anguish as possible, for all concerned.

Rest assured she WILL adjust. Rest assured she WILL complain but she WILL be fine. Rest assured the food will SUCK in the community and she will mention it every chance she gets.

Don't visit too much at first. Allow her to adjust and to get settled in, which she WILL do. Best of luck!

I know if I were in your position, I would print out Barb's answer and make it my checklist.

First of all - never call it a nursing or retirement home (brings up bad connotations). Say it is her "new apartment".
Second, tell her the doctor has ordered her to have therapy there and, hopefully (white lie) it won't be for long.
Ask her to go around her house now and show you the things she wants to take. Take her somewhere for the day while her belongings are being transferred to the new facility.
Visit frequently the first few days and help her get the routine down (Yes, I know what others say about not visiting for a week. As mentioned above, maybe get advice from the AL?)
I bought mom a big landline phone that I could program numbers in and actually has people's photos by their number. Made it easier for her to call people. She rarely did though. (You can also do this with a cellphone).
Send notices to her friends and other relatives asking them to visit her occasionally.
Brother is SOL at this point. Make sure mom doesn't still have money he can access (in her room). Let him know he WILL be prosecuted if he tries any more shenanigans with mom. (My younger brother went out and bought new cell phones for everyone in his family and charged them to her ATT acct. )
My mom loved her retirement (AL) facility and thrived there.

There is no easy way to do this.

You have guardianship, she can’t refuse but divert and fib if you have to to get her there.

Maybe figure out some some way to occupy brother. Don’t let him know when you’re moving her and put out an APB on him with nursing home staff. Do not allow him access.

When I finally got my mom and dad into assisted living I told them it was temporary “Until mom gets better”. That worked for a few days.

And I would wait till they were having meals in the dining room then go like crazy moving stuff into their room and fixing up the place.

It was still the toughest few days of my life but the relief of getting those two into care was indescribable. Immediate stress relief.

Just so you all know, I would never in a million years have not made sure my mom was settled into her new facility. But this is very much a situational issue.

If you have a parent who is cooperative, accepting of the idea that you are doing your best to do the right thing for her, and who "rolls with the punches" ( my mom was generally all of those things) then you have more latitude in settling her in.

If your parent is in the later stages of dementia, inflexible, has mental health issues in addition to dementia, and you have other family issues in play like a thieving sibling, you may need to adjust your game plan and be guided by folks who have been down this road before, such as the SW at the facility.

You do need to let her know that "behaving like an *sshole " will end her in a very bad facility where they don't care how she behaves because they will drug her into a long sleep. Tell her that it is in her best interests now that she cooperate, and that you love her, will do whatever you are able for her, but you now have to act in her protection, and you intend to do so. They may ask you not to visit frequently at first and that is likely for the best. You will hear only complaints (start with the food), and you will b distraught.
There are some things that cannot be made "happy" at this stage in life. And think back over your Mom's long life. When was it perfect happiness. There are tough times in our lives and end of life is one of the toughest. Just reassure here that you are there to do the best you can for her. But that it is decidely in her best interests, because if YOU cannot do it, then a Court Appointee Guardian will do it, and she will have nothing whatsoever to say about it, nor will you.
So it is good cop/bad cop
and you are BOTH.
Good luck. Let us know if anything helps because others face the same sort of thing. Remember. Not everything is happy; not everything can be helped; this is no ones "fault".
I haven't yet walked the path, but I can see the signs ahead. So far my bro has entered assisted living on his own and he knows, while he isn't happy about it, it is best and safest. But some of his faculties are slipping, and paranoia occ. rears it's ugly head. And there will be some times that will not be happy, for sure.

We all suspend reality when we “plan” how to get someone functioning with irreparable cognitive failure to do what we want them to do.
We have realized over the passage of time that something negative has happened, and is continuing to happen, to the thinking and reacting and interpreting and managing ability of someone we love, cherish, admire.
We know that for all intents and purposes, SOMETHING must be done to keep them safe, comfortable, and relieved of decision making.
We know that they themselves are past the point of making a life change based on their own choices.
Yet, when faced with the moment, out of the love and concern we feel for them, we falter. We question ourselves and we question them and we question whether there might not be some better way. But there isn’t.
Our situation had been made simpler by the fact that the home in which she’d been born, and loved, was a veritable snake pit of fall risks, with absolutely NO WAY to make it safe. I had no choice except to make the choice I made.
I tricked her into thinking she was going for “a week trial”. I grieved that I was telling her a lie, but forced myself.
Her adjustment was rocky, but thanks to a very good therapist, she now receives appropriate mood regulation medication, enjoys our visits, and knows that we love her.
Not by a long shot what I would have wanted for her, but the best of all the lousy choices I had access to.
Hang tough. Do what you know is the very best you can do. Let anyone who would criticize your efforts walk in her shoes (OR YOURS) for a day, then ignore what they say.

As her guardian you can deny your brother access. I am a firm believer that we should never interfere in relationships, however, there comes a time when we have to stop someone from causing needless harm. If your brother is keeping your mom from settling in and keeping her angry and defiant then you need to keep him away.

Tough situation to be in, but you now have all the power to protect her. Use it as needed.

Good luck with the move, I would use what barb recommended. Stops a whole lot of headaches for you.

First, accept that no one is going to be happy during this process. Do not engage in any negotiation with your mother. Just act like this is happening no matter what and that her threats of bad behavior, etc are no issue at all. Do not even respond to them; act like you don't hear her complaints. Do not ever waver in your decision to follow through. Once she understands that all the threatening and crying in the world won't change things she will continue to do it but with less intensity. (Think toddler tantrum behavior). You have guardianship and can ethically and legally make this decision for her.

Make the move as quickly as possible after the decision has been made and space procured. Prolonging the move process and trying to convince her to go willingly will not help anything. The day of the move have everything you plan to take clearly marked and have the movers come. You need to have someone take your mother out to lunch, a manicure, shopping, something that lasts a few hours, to give you time to get the furniture and stuff moved and set up into the new apartment. She will leave her current home and be returned to her new apartment. It will not be easy and it will not be finished but have familiar things out and pictures on the wall. That makes it seem more homey and permanent.

She will cry and rant and rave. Ignore it. Do not engage with her behavior. The Assisted Living staff has seen it all. And just like a toddler - she'll eventually stop if no one engages.

If she owns her home sell it immediately! Do not allow anyone to think that she will ever move back to the house. If your brother lives there you may need some legal help to get him out but DO IT.

Do what you and the Assisted Living staff think is best when it comes to visits the first week or so. I found that very short visits to do a bit of work in the apartment each day were fine. My dad would complain and I would work. Eventually he stopped complaining every minute I was there.

I, too, was alone with this but didn't have a useless brother to contend with. Just accept she will be mad at you and sometimes you'll think you made the wrong decision. YOU DIDN'T. You are doing your very best for her and sometimes that is really hard.

I too had to deal with a mother who adamantly refused to leave her home. She had Alzheimer’s so I took advantage of that and “kidnapped her” for a drive across the country visiting sites she had once loved and daily making our way while making up stories about why we were traveling.

It wasn’t easy, as I was alone with her this way for two weeks, but I learned a lot and spent some truly valuable time deepening our relationship and understanding her better.

In the meantime I had her favorite possessions picked out to move to her new “home” and set up for our arrival.

What a difference it made for her to walk
into her new space surrounded by all the
things she loved! I was amazed at the smooth transition, all the while having to
make up stories to address her questions.

Of course, it took weeks of basically full time being with her making her days fun, watching BBC animal content,
comedians, etc.

After a while she was making her own reality stories about her new home and how long she had been there, etc.

I understand about your brother as I had to be clear and strong about the gravy train being over, too. Sad to say a sibling could be so selfish. Just plow ahead with what you know is best and thereby never suffer from not having done the right thing.

Best of luck!!!

Involve Adult Protective Services, please. They will have all of the answers. With you now having Complete Control, I realize How Hard this will be for you.

You've visited twice, and she liked the place, which helps a lot: on moving day, you are "visiting" again. Book lunch at the ALF and then after lunch she goes home - to her new room. Don't hang around for too long after that, not on the first day; leave your contact number with the person in charge in case of emergencies or practical questions, make sure your mother has everything she needs, then make yourself scarce and trust the team to settle her in.

If you have a good removals firm in the area, I should write a detailed list of what furnishings and belongings are going to the new home and get the removals firm to come and pack them and take them away a few days in advance. They can then deliver them and unpack them at the new home for you, preferably in time for you to go and check that all is according to plan. If you don't know of one, perhaps the ALF staff will - after all, they see this happening week in week out and should know who the most helpful movers are.

Please do not try to negotiate with her, be firm.

I would suggest that you have her go visit someone for a week or so, move her things that she will absolutely need to the AL facility.

The staff will deal with her, when she is first there, do not visit her for a week or so. If you do she will not acclimate herself.

Be prepared for a lot of drama, manipulation and tears, most try this to get their way.

My best, I know that it is not easy!

Some good suggestions below, the idea of having her go "on vacation" as a transition is an interesting thought, even if it is just for a day or two. If she has to go to assisted living, there is no negotiation. After she is moved, you can tell her that this is her new home and it is not possible to go back to her old home. It's always difficult for people with dementia to be moved. It means getting used to a new place, new people and a more rigid schedule (not her own schedule). My mother continually asked when she was 'going home' for 2 years after she moved to a memory care unit, and she had her own furniture and pictures around her. The question usually means that she wishes she were back in the days when she had her independence. Some people differ and the place where she's going may not want it, but I think it's good to try to visit her often when she first moves. You can see if this seems to help or not.

Keep repeating to yourself, " This has to happen. She is fighting it, but it has to happen."

Thank you all for the wonderful advice. This is absolutely one of the hardest things I have ever had to do. I'm definitely in one day at a time mode. It seems the minute you clear one hurdle, you are staring down the next.

I am hoping to persuade my mom's two sisters to come for a visit and get my mom out of her house for a day so we can get her stuff moved and ultimately deliver her to her new apartment at the assisted living community. It's a lot to pull off in one day, but I think it can be done.

I am looking forward to finding our "new normal." Even though I know it's the dementia talking, it is so hard to hear over and over how her dogs and house are more important than me and her grandchildren. How she will disown me. I hate that I always let her calls go to voicemail so that I can decide how to respond based on the message she leaves. Most of all, I am so sad that I am losing precious time with her. She is still clear enough that we could be enjoying each other's company and having lovely outings making more memories. Instead, it's constant conflict, and I dread speaking with her.

Number 1 - tell your brother to back off, he wasn't appointed guardianship.
Number 2 - Just take your mom for a visit on 10/5 and leave her there.  Then go back and pack up what you think she needs to have with her in personal stuff.  The staff can work with you to have her out of her room while you put stuff away.
Number 3 - Yes, she will be mad at you but give the staff time to get her settled and introduced to others.
Number 4 - No place is perfect, she will always have something to complain about, that  is actually good because then she is aware of what is happening and hasn't slipped to far.

Get some support there on the day of the move and don't let other family members push you around! Luckily I had the buy-in of my other 3 siblings and no one else wanted the guardianship so I ended up being 'it'. Hardest thing I've ever done. I I work full time so this just adds more in the week. Frankly, I don't wish this on anyone. Luckily dad can afford a care manager and she pretty much runs the weekly operations - I do weekends. We were only able to get my dad to move when he ended up in the hospital. He became dehydrated at home and caused him to 'lose it'. He spent 5 days in the hospital and the doctor would not release him to go home. He has been in assisted living about a week and insists he is walking out tomorrow. Says he feels great but the doctor has said he will become dehydrated again (assisted living has beverages 24/7 and he is eating a balanced diet -- he won't do that at home). All the legal paperwork in the world cannot keep him from walking out. I suppose I could call the police and have them escort him back, but I don't want to if I don't have to. Tomorrow is going to be interesting.

yes, it is a dilemma...Question: is your serenity not just as suitable a goal as your siblings judgments?

My sainted wife was in a rest home for over ten years....Early in her living there she wanted to go home...I told her the doctor said she needed to say another month or so for "observation." I kept saying that whenever the subject came up, I'd empathize with her and repeat that the doctor said wait awhile...Before too long she was satisfied.

In fact, the doctor said if I took her home, my severe heart condition would eventually lay me low. (die).

Grace + Peace,

Bob in North Carolina

Is she on anti-depressants or anti-anxiety? Maybe up the dose for a couple days. Ask the doctor--it's probably a very common question / request. No one will fault you for it.

You said she likes the place when she visits, but doesn't want to go later on. Maybe you could move her things on over there and then take her there to visit. Go directly to some of the activities that she would enjoy when you get here there and ask her to give it a try.

Dear roxynicole,

In addressing your question: "How on earth do I do this to cause the least amount of agony for her and for me?" I'm just going to say that unless your mom is willing to make the move, you are not going to be able to avoid this agony for either of you. But that doesn't mean that you aren't doing the right thing for all involved. It sounds like you have a lovely place set up for her and you have all the legal documents in order. You are way ahead of many people who find themselves at this crossroads. But this process is not without its difficulties and often there is no way around it. Because of an older sister's insistence that we get my mom (who has Alzheimer's) in a frame of mind to accept that she had to move, we spent nearly all of 2015 supporting my mom in her own home alone (which was her adamant wish), and holding our breath that she wouldn't cause injury to herself. My sister thought she could reason, cajole, bargain, beg my mom into acceptance. My mom would agree that she needed to move, only to laugh it off the next day and claim she never said that. And the plan involved my mom moving into my home, a place she was comfortable with and enjoyed coming to. Eventually in spite of her resistance, we moved her and I can honestly say that she never quite forgave me, but she was safe and well cared for. Today she is in a residential facility, still well cared for, but no longer aware of where she is.

You are keeping your mom safe, you are providing her with care and that is what you need to hold on to during those times that are painful for you. There are so many instances in life where pain cannot be avoided for whatever reason, but we take solace in the fact that we are doing the best that we can do for a situation we cannot change.

Hope it goes well. Others have asked, is it MC AL or just AL? If just AL, there's nothing to prevent her from walking out.

For the flip flop/threats/thinking we're OK to live alone, Mom's previously DID plan for AL, but once dementia kicked in, nope. She would visit ALs for free lunch/tours. At onset of early dementia, she repeated she was fine, independent and could cook. She refused to move ANYWHERE and if AL was mentioned, she nastily said she would never live in one of those places.

Although your mom changes her mind (they forget saying it was nice - mom forgot why we were there by the time we got her home - she thought we were looking at places for my brother!) and threatens, I wouldn’t worry about it. It's hard to hear what they say, but understand it's the condition, not your mom, talking. Distract, blame on doctor, redirect focus to something, whatever it takes to get her mind off what is upsetting her.

If you can move her belongings beforehand, go for it. Many say set up the room like it was at home. We couldn't do this, so we got new furniture. It's an option, if there's money to buy something new. You can pass it off as a temp place doctor ordered for her. If you must move stuff, you mentioned attempts to get her sisters to take her out for the day. That might work, if they can keep her long enough.

Have the sisters meet you at the AL for dinner and you all eat at the "restaurant." Pre-arrange with the facility for meals, then you all go right to her room. Sisters could oooh and ahhh over the place, reinforcing how nice it is, wandering about checking out everything! Once staff can distract her, y'all can beg off to use the bathroom, and leave. It's your decision whether to visit right away or not. Staff recommended not and ordered Lorazepam, just in case. So, work on that plan with sisters taking her for the day/dinner.

Some said try medication. Our mom refused moving, YB used a fake letter from medical to "force" the move. Facility wouldn't do "committals", aka guardianship, DPOA doesn't give you power to force a move. The Lorazepam they got was minimal dose. It doesn't take time to work (10-15 min, not days) and doesn't "dope" them up. It's just enough to take the edge off, calming (we used it later during a UTI/sun-downing episode!) In our case, I left it to my brothers to take her there and stayed away for about 2 weeks. I expected to get the blame, but surprise it didn't happen. It did with the car key, despite YB did all the talking/took the key, I just stood there, said nothing. Somehow because I was there, I took the key?

As for brother, ensure the facility knows he is NOT to escort mom anywhere. Whether he can visit or not should be up to you. If she is moving into AL not MC, this might present another problem. They can't guarantee he doesn't get in/leave with mom. Definitely NO info about when or where she is moving to. If he doesn't know where she is, it deters him gaining access. She should not be given money, credit cards or access to funds. Never mind brother, money/charges can be easily taken/bilked out of someone with dementia.

"I realize I probably just have to suck up whatever abuse she wants to send my way..." Sometimes this is what it is. Sometimes the backlash never happens. You just have to learn to let it slide and try to change the subject. If you do visit and she becomes unruly, beg off, say you'll be back when she calms down and leave. Often they complain to you about the place, food, staff, residents, etc., but when you aren't there, they enjoy, join in activities and seem to like it. You can always ask how she is doing and/or try to visit without her seeing you and observe yourself.

NO guilt. It is what it is, and by ensuring she is in a safe place and well cared for, you ARE taking care of her (and yourself.) Do come back and share your experience with us! We care and others might benefit from anything you did to smooth the transition.

Is your Mom able to manage assisted living on her own? It sounds like she may already be ready for memory care. My Mom managed to make it for about a year in assisted living, but she didn’t fit in, had to be prompted for mealtimes, and wandered around the halls aimlessly (and into other residents’ rooms). You might want to look around at availability for memory care in the area , just in case you get a phone call from the place and you have to quickly re-place her. As for moving her now against her objections, you could just go ahead with all the arrangements/ movers, and matter-of factly go forward. You know it’s the right choice, and that she isn’t safe on her own . I cleared out my mother’s hoard, and have been renting out her house for the last five years. It’s been a good steady extra income, and it helped to offset the cost of her care for the things that her long term care policy didn’t cover. I placed her house and some of her assets into a trust. Take care and please update us on your progress.

If sisters won't help or it doesn't seem to work well, other methods might work for getting her to agree to move "temporarily", such as:

- if she lives in her own home, some major work needs to be done (come up with something plausible - like turn off the heat, AC or water, so she can "see" there is a "major" problem.) Move is "temporary" until we sort it out.

- if she lives in an apartment, try the phony letter trick "from" the complex saying some renovations need to be done and residents need to move, temporarily.

Then, like OldBob says, you just repeat how the work is still going on, soon, soon.... workers having delays, parts not available, etc. Excuses, excuses, there are a million of them!

Because our mother got cellulitis just before the planned move, YB drafted the "Elder Services" letter saying she either moves to where we decide or THEY will place her! She was madder than a wet hen, but reluctantly went. Even though it is now almost 3 years (January), she will still periodically mention going home. For the first 9 months, it was the condo they had for about 25 years. Then it was the house before that (along with asking about her mother, gone 40+ years!) It doesn't come up every time, but periodically it will. Fluff it off, use the 'soon' excuse, whatever to distract and change the subject. I never use the D word, never tell her that her mother is gone, never say NEVER will you go home/do this/see mom. It would be so painful to deny her outright and/or make her angry. I leave the "door" of hope open, defer by saying things like maybe tomorrow. She accepts that. Others maintain we should tell the truth. If the truth hurts, then fibbing is better. Lies are told to hurt others, fibs/bending the truth is done in these cases to protect the person, avoid upset and leave them with some hope.

I think your mom will not accept any negotiations.
I think you will hav to take her to lunch or another errand and then go to the AL. Once there tell her you both need to go in to give them updates on her situation. Inform Al what the plan will be. Let the AL come up with a plan to keep her busy while you meet paid movers to load her things at home and move the necessary things right away for her. You can always get the smaller items later.
She will not be happy as you already know but it’s all part of the move. She will adjust at some point.
I have all respect for you for being strong enough to make this decision.

Again, thank you all. Your kind words and advice are soothing and helpful.

Some additional info for those of you who have asked. I did manage to get my mom evaluated by the AL community last week. They deemed her appropriate for an AL environment. The community also has MC and skilled nursing when the time comes.

My mom's two dogs will be coming to live with my family (I would adopt a zebra at this point if it meant making this process easier!) I will be able to take them for visits to the AL whenever I want, they just can't live there.

I have explained to my mom that this is a risk free move. We don't have to sign a long lease, and we don't have to sell her house (yet.) My suspicion/hope is she will enjoy the place once she is there. When I took her for lunch there the other day, all of the residents were so friendly and outgoing, and the staff were interacting with them beautifully. Frankly, the place is kind of like an all inclusive resort. Of course, I know that while it may seem like a rational conversation is taking place with my mom, that is usually not the case. So all of these efforts to persuade her with logic are futile.

She is on an anti-depressant, but is extremely leary of any type of medication. I can barely get her to take Tylenol when she needs it. I doubt I will be able to get any thing extra into her for calming purposes.

I am fortunate to have a wonderfully supportive husband and two kids who understand what is going on. That being said, I am barely focused at work, and things in our day to day are slipping. I frequently feel like I can't budge from all of the emotion draining me dry. Today I have randomly burst out in hives. Fun stuff! I worry that this role as caretaker will take over my identity, but I am working hard to make sure I build time in for things I enjoy. Spending time with family and friends, going on walks, reading etc.

Do you have a friend whom she likes or are there nieces, nephews, or grandchildren to help keep her occupied? What I would do is arrange for an outing or visit for her away from the belongings you need to move. Pick the day in advance and coordinate with the assisted living. In the meantime, pack possessions that she would not notice their absence. If possible the same day the outing is arranged after the possessions are moved, have the designated person along with you transport her to the facility. Engage the facility's help and expertise as much as possible. It's going to be difficult but you need to stay calm and strong. Good luck. My thoughts and prayers are with you.