My Mom had a stroke 3 years ago & has been living in AL. After a year lockdown (no visitors), she became paranoid. I had to move her to a new AL, her panic and hysteria were so bad at the other. She stayed with me for 2 weeks while I looked for another place. She has been at the other since the beginning of May. Due to covid in the facility (with the resident staying in place if the infection is not bad) and a second 2 week lockdown, I took her home with me. I don't know what happened during the initial lockdown. She is completely out of whack. Incontinent. Up every hour at night. Can't play the game she loves (yahtzee) or do children's puzzles as she did all other times before. UTI was tested for and she was on a week long set of antibiotics. She drinks an excessive amount of water insisting on drinking whatever is in her cup at one time. Maybe they didn't entirely get rid of the infection? I don't know what to do. I will have to get me some help a few nights a week so I can get some sleep time. At times, she seems to know what is going on & at other times not. How do you determine AL, MC or NH? Is the amount of staff for MC more staff per resident than AL? Where do I start?
Memory care sounds like the right place for her. If she's now incontinent, can't do the children's puzzles she liked, and is panicking and hysterical while living in your house, she has dementia and memory care is where she belongs.
Memory care has more staff than an assisted living. Dementia care is different than skilled nursing care in a nursing home. Call a few local places. Go and check them out in person and see if they look good to you. This is a start. Good luck.
My mom has had sepsis twice from UTI (1 living with me, 1 living in AL) and recently a UTI that was caught early. She goes to the bathroom frequently and is incontinent mainly at night. During the morning through mid afternoon she is fine. My mom knows she needs to stay up during the day but mainly sits by the window listening to music. She lost the desire to watch tv years ago, but loves to be out and shopping. We were able to hire a caregiver to take her out for a few hours M-F to keep her busy during the best part of her day. When it hits around 5/6pm that’s when she starts to sundown and gets anxious and scared. She too stays up a lot at night. She sleeps about 3 hours and is awake for the rest of the night at times anxious because of her delusions that my dad has another woman or women that he sees and lets into their apartment. When that delusion causes an argument with dad she’ll get agitated then at times aggressive.
We recently had to move her to MC with dad in AL due to her dementia diagnosis, the delusion, constant arguments with dad, and her calling 911. It looks like an adjustment to her medication has helped her mood and ability to sleep at night some, but her fear of being alone at night and delusions are the same. The MC caregivers do what they can to help her with her needs especially at night.
Has your mother been to memory clinic and tested for vascular dementia? Sounds like her paranoia, not sleeping at night, incontinence could be signs of it. How is mom conversationally? Cognitively? Physically? Is she high functioning? Does she stay active during the day? Is she independent and able to do her own thing like go out, talk with family, or friends? What does she do when she is up at night? Can you redirect her to stay in bed and sleep? Do her meds need adjusting? These are just some questions I’d answer in determining AL vs. MC. MC does have more staff per resident and specializes caring for those with cognitive impairments, Alzheimers and all levels of dementia.
The MC my mom is currently has a variety of residents from high functioning to residents on hospice. I’m thankful her MC doesn’t look as clinical as most and each resident has their own apartment and bathroom. The resident count in our MC is about 30 with 5+ caregivers. AL you will get depending on the community 120+ residents about 10+caregivers. I’m not familiar with NH as we haven’t needed to look into one.
If she needs more than 1 person to help with a transfer. If she needs equipment to aid in transfer. If she has a medical condition that requires skilled nursing (feeding tube, catheter, IV's, etc.) then she needs a Skilled Nursing Facility (aka nursing home). If she needs none of that then she does not need SNF.
If she has been diagnosed with any type of dementia then Memory Care would be the best placement.
If she can do most of ADL's , needs some help then Assisted Living would be alright.
When narrowing down places once you have narrowed it down to maybe 2 bring mom for a "tour" let them evaluate her to help determine where she would best fit in as a resident.
I guess we haven't had a formal diagnosis as I don't know how that affects everything else (I am POA and on bank accounts.).
Have 2 in mind. One is older and the other is several years bright shiny new. I lean towards older...more established (although management is a revolving door...the carers stay and I feel run the fort). I kinda like the new one this time though I haven't actually yet stepped foot in the building. I want a place where there is an enclosed patio that is really accessible but safe. I would like to see a dedicated carer for a pod of residence about the same level. One who gathers them up at least once between breakfast and lunch and again between lunch and dinner and engages then in an activity for at least an hour. I may be adding for too much but I can hope.
Thanks for the easy to understand explanation on MC and SNF!
Doc can order home health, which can include blood and urine collection.
The Area Agency on Aging can probably recommend doctors who make house calls (a friend recently located one that way).
Good luck!
Being a harder transport you can ask her primary for urine catch cups to keep at home. We actually have a lab that picks them right up when I call - but you could also have the cups and drop them off - I would ask if her primary has a pick up lab and ask for a few catch cups to keep at home at all times.
From what you explain I suspect her infection is still there. My mom is the star of crossword puzzles but an infection takes everything from her like your saying above.
We always re-test 7/10 days after treatment as these infections really hurt my mom and I have to stay on top of them at all times. Wishing you the best and Ur mom a quick recovery.
I think you need to start with getting mom's physical health checked out to make sure she doesn't have a UTI or other infection. These can cause behavioral symptoms in elders.
Next, consider adding a geriatric psychiatrist to mom's "team". We got great advice about level of care needed and meds from them.
Your local Area Agency on Aging may be able to do a "needs assessment" to tell you what level of care your mom requires.