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Is there a magic moment in the progression of dementia when adjustment to AL is most likely to be easiest for everyone?

With my MIL, the siblings chose a beautiful facility with many amenities and activities, but imho they were about 2 years too late. She was not able to adjust; would not leave her room; was terrified of the elevator; would not engage with other residents even when escorted to meals. MIL only lasted a month, a month in which one sibling or another was staying in her room with her almost 24/7, before being moved to a not-so-pleasant group home setting where her visiting children provided her only social interaction.

I feel like the large, lovely facility should have evaluated my MIL better before allowing her to move in but maybe they were just trying to ‘make the sale’ so they could move her to the MC unit later. (Or, the siblings might have been a little less than honest about mom’s condition….?) I also feel they should have nipped the siblings hovering in the bud to give MIL a fighting chance.

So, taking $ out of the equation because that is so variable, when is the optimal time for AL placement? I’ve heard some of you say it is when your LO no longer recognizes you but it seems to me that if your LO can no longer socialize, maybe it’s too late for placement in a social setting.

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My mother had advanced dementia and recognized me till the day she died. She was in Memory Care Assisted Living for nearly 3 years before she died. You place a loved one when his care becomes too much for you to manage.
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Reply to lealonnie1
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My mother was in Memory Care WAY before she stopped recognizing me.

If you're considering Assisted Living for your husband, maybe giving us some more specifics as to which symptoms that he's having?

We were considering Assisted Living for my mother, since she couldn't find her apartment, and would go up and down the hall, in a panic.

She had lost weight and was forgetting to eat.

She couldn't handle taking care of her pet.

She was paranoid and was sure that someone was looking in at her through her windows.

She had become almost paralyzed by her OCD.

Her short term memory was at about 10 minutes.

She was having extreme trouble keeping track of her two medications.

Like I said, we were considering Assisted Living.

She was assessed, and Memory Care was actually the correct placement for her.
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Reply to cxmoody
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The stage when your LO no longer recognizes you is so variable that it’s not a good indicator. For instance, my LO suffers from aphasia, meaning that in general, he often can’t come up with the right words. He knows who I am, realizes I’m his wife, but he can’t say my name. His lack of language skills doesn’t mean he doesn’t recognize me. He definitely recognizes friends and neighbors but can’t say their names either.

My mother, when she was at the same stage he is, didn’t know who I was at all. She’d regard me with a puzzled frown. My name or the word daughter meant nothing to her.

To me, the “recognizes” criteria seem useless. On the other hand, peeing all over the house and being unable to understand that this is inappropriate behavior is an unmistakable indicator that they need to be placed.
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Reply to Fawnby
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The verbal "agreement" I have with my 95-yr old Mom (who does NOT relish the idea of going into a facility no matter what)... is that she gets transitioned when she is no longer safe or is overwhelmed in her own home OR I am overwhelmed with her care and management.

Peasuep, you seem to put a lot of responsibility on the facility, but in the end the decisions need to come from the resident or their PoAs/legal guardian. It's not their job to "nip" the hovering of family or visitors. That's the job of the PoA. Also, the staff cannot force anyone to socialize if they don't want to. We went through this with my MIL who was in an excellent facility with lots to offer. It took 2 years for them to coax her out of her room to even eat in the community dining area. Now she does lots of things -- and she is on meds for depression and anxiety.

"I feel like the large, lovely facility should have evaluated my MIL better..." They do the best they can with what they see and are presented with. They aren't mind readers or magicians. Dementia creates a lot of variables in people, making it very challenging to find the right care all the time.

I see below you are pondering your past experience because you now have to go through it with your husband. I'm so sorry for you having to deal with this. You cannot allow yourself to burnout, so I think the trigger is when *you* are feeling the very earliest inklings of it. You can consider starting with a companion aid in your home as this helps the both of you. I wish you much wisdom and peace in your heart on this journey.
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Reply to Geaton777
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Peasuep, the best time to place someone who is now living with memory loss is while he/she is able to learn their way around a Memory Care or Assisted Living (to start with) facility and to learn the faces of the Staff. Plus learn the new sounds, new smells, new views from the windows, and where everything is in their apartment or room.


I did the above for my Dad, and everything worked out great but it was Dad who wanted to move to senior living as he was too tired to maintain his house. I know not everyone's love one wants to move to such a place. Dad was happy as a clam living in a senior facility. And when Dad's dementia was advancing, I was so glad he was there, safe and sound. I was able to be Dad's daughter's once again :)
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Reply to freqflyer
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Peasuep Sep 16, 2024
Thank you, freqflyer. Your answer is very practical and greatly appreciated.
I assume your mother had already passed and dad was left with the entire responsibility of his home. Unfortunately (or fortunately for him) my husband has not had responsibility for much of anything for a few years so it’s hard to blame him for wanting to stay right where he is.

My husband, just this minute as I’m typing this, looked directly at me and asked “where’s P—?” (me). That is the first time that has happened and I’m a little freaked out but very calm on the outside, for his sake. I think I may be too late to take your good advice but I’ll know more in the morning after we’ve both had a good sleep.
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Sounds like she needs to be in Memory care on anxiety medication.
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Reply to JoAnn29
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Peasuep Sep 15, 2024
Thanks JoAnn, and I agree.
I should have been clearer, I’m asking this question more generally since I am now going through this with my husband and want to be as thoughtful as I can.
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Thank you. So, no magic moment; I was afraid of that. Reading between the lines, the moment that placement is best for HIM may not be the moment that is best for ME. That definitely makes the decision more difficult.
I'm afraid my burn out will not come until significantly after my husband has lost his ability to make friends and participate in activities in AL.
I’m afraid that by that time, my grandchild will be grown, my garden will be an impenetrable jungle and I will lose the physical strength I rely on every day.
If you detect a bit of self-pity here, you’re probably right.
To me, regret is the absolute worst feeling there is.
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