My Mom (79) has been diagnosed with dementia. Is it necessary at this time for her to be placed?

Unless something has been done to keep her from falling again, that's a worry too. My first impulse was hmm, maybe you need another doctor - but I'm guessing this one 's assessment is that she just is not safe to be left alone. You are of course right that just a diagnosis, and even certifying incompetency, would not in itself mean someone "had to" leave their home. A lot depends on the individual situation and how much home care can be arranged.

I agree. If you have to unplug things in the house, that person needs 24 hour supervision. And I found that with dementia, the falls seem to continue once they start.

Do you have a very good appreciation for what she can do for herself or what she needs assistance with?

How thorough was the doctor will his memory assessment? Maybe her functioning is not what you think.

Why don't you stay with her around the clock for at least 48 hours. Then you can determine what she is actually doing for herself such as hygiene, sleep, eating, etc. With that information, you might get an assessment that would determine if she needs enough assistance to enter into Assisted Living. They have very comfortable suites or rooms with assistance on site that would provide her protection, medication administration, meals, entertainment, social interaction, physical therapy, etc. She may not be ready for a nursing home. I think that term is used generically a lot. In our area, a nursing home is where very ill and elderly go to lay in bed and get daily nursing care. If you aren't in that condition, you wouldn't go there, but to assisted living.

Ref. the doctor. If he feels that strongly about it, I doubt he's going to let it rest. I suspect he may report his concerns to Adult protective services. I think they are required to do it.

I think that you need to have a conversation with the doctor, without your mother present if he is calling you EVERY DAY. It seems as though you are looking at two different situations. What are the indicators that tell him that mom needs to be placed? Does she wander? Is mom calling him? Is the live in person calling him, telling the doctor something that you're not aware of? If this is a difference of opinion, then maybe you need to find a doc who is willing to work with mom's wishes. But remember, a doctor who sees neglect/ abuse of an elder is required to report it. Make sure that he doesn't think that your mom's situation reaches the bar of neglect.

If the stove needs to be unplugged, that would be an indication to me that she needs 24 hour a day supervision.

Most people with dementia are not able successfully to live alone by the time they are diagnosed. But your mother does not live alone, right? You say someone is living with her. Who is that person? Do they leave the house to go to work? If the stove is unplugged who is preparing meals?

My sisters and I did everything we could to extend the time Mom was able to stay in her subsidized senior living apartment alone. We got meals-on-wheels. We took over her shopping. We made sure she had a housecleaner. Eventually she had a nurse come in twice a week to supervise her pills. As I say, this gave her more time on her own, which is what she thought she wanted. But, as it almost always does with dementia, the time came when she really needed 24-hour supervision. At 94 she is now in a nursing home. To our great surprise, she is thriving. She seems to like the interaction with other adults and the attention she gets from the staff. Who knew?

Please do not promise your mother that she will never go to a nursing home. That ultimately may not be within your control.

Captain, good point. I was thinking that some continuing care facilities might have separate areas depending on the stage of dementia.

i dont really agree freq . ive read that its best to place a demented elder after theyre too far gone to be upset by it . the doc must not think that pj 's mom has enough support in her home . it definately becomes a 24 hr sitting gig .
ive been observing nh for a few months now . for someone who likes to live on a schedule it might be alright but my mother was extremely independent and distrustful of authority , and she wanted no part of nh . i dont either . id prefer to die at home by my own hand if necessary , first . had my mom and i been neanderthals we would have had our own clan . freedom means different things to different people . i chose a life of uncertainty and hard labor 25 years ago over a pretty well paying factory machine repair job because i refused to piss in a bottle . at that time my mother was one of the few people who sided with me .

PJ, I can understand why the doctor is calling you... he/she knows this will be a tough journey if your Mom isn't in a continuing care facility. The doctor is looking out for your best interest too. Eventually your Mom will need three Caregivers who work 8-hour shifts. And her home will need to resemble a nursing home with special beds, rolling walker, potty chair, handrails in the hallway and in the bathroom, etc.

Wouldn't it be better for your Mom to be placed now while she can still learn her way around the facility.... while she can learn who are the Staff.... wile she can learn who her neighbors will be in the building, thus still be able to make new friends.... while she can enjoy any outside entertainment that the facility offers?

Please note, when a person with dementia is asking *to go home*, they usually mean back to their childhood home, not the last home they lived in. Some even use that phase when they feel it is time to depart this earth.

PJ, I have to agree with Looloo. My family went through the same situation with our Mother. Making those decision is very difficult especially with all the emotion involved. We took care of our mother with everyone taking turns, with the help of Valley Area Agency on Aging coming in 2 times a day for 3 hours at a time. With heartfelt decisions we had to take my Mother out of her senior living apartment. I took her with me to help decide where she wanted to go so it would be her decision. Being a caregiver is stressful, tiring and it wears on you. My family had taken care of my Mother for over 27 years. At the end I took her back to my home and we took turns again for 10 weeks until she went to be with Jesus which is where she ultimately wanted to be. During the time Hospice was there to guide us and teach us about life passing. It was so beautiful watching her go to heaven. Some people would read this and think wow...but it was awesome. The state is making big changes with Medicaid Waiver to help people stay in their own homes, so there will be more resources coming. I have been attending meetings with lots of different care giver companies to learn about them. The new rulings will be coming out beginning 2015. I work for Welcome Home Assisted Living in Owosso, Michigan. If you ever have a need to talk or visit us, please do. Not sure where you are located but my office phone number is 989-723-3807. Best wishes and God be with you and your family. Deana

I agree with looloo and sunflo. You will know when she becomes too much to handle. I had the same question as sunflo -- why was he persistent in calling. That is unusual for a doctor to do that.

I had the same type talk with my mother as sunflo had -- that she could stay home as long as I was able to take care of her, but one day it may become too much for me. I know that day may come, so I have two facilities chosen that are good. I really do hope that she can remain home until she dies, maybe with the help of hospice. However, I know I am not strong enough (or willing enough) to help her do certain things. A facility would be the only choice. It is good to have a plan in place.

Agree with loo loo. Ask doctor next time why he is so persistent on this? Did mom tell him something during her exam that is causing him to think that residential care is best in her situation?

If he doesn't have good reason, then go with your gut if mom is okay for now. BUT do start exploring options and preparing for when she may need more skilled and full time monitoring. Stop promising that she will never go to NH... I tell my mom "don't worry, we will keep you inyour home as long as we can manage, we'll always make sure you are safe". I love you and will help anyway I can".

My mom also doesn't want to ever leave her home, but I don't promise her never putting her in NH...that is a promise I can't predict and can't necessarily keep.

PJ, maybe I'm projecting my own situation onto yours, but it sounds like your mother is safe, comfortable, and cared for right now. It makes sense that you should plan for the time when it becomes too much for you and your brother, but if the doctor is literally calling you daily pressuring you to do something that you know won't help your mother right now (later, sure, but not now), then you need to tell the doctor to respect your decision, and the discussion is closed.