How do I tell my 90 year old mother who has dementia that I'm considering a Memory Care Facility for her? Or do I tell her?

You can explain things until the cows come home. It will not sink in and if it does, she will deny it and cause more problems for you. Yes, she raised you but you did not have dementia. She does. And her condition, behaviors are affecting you and your family greatly and she needs care. She is not who she once was and you simply cannot take care of her and your own life. You are doing the only, right thing you can do by placing her somewhere. Do not feel guilty. She will adjust or won't even know something is different. Now is you time to think of YOU.

Here’s what you get in Georgia for training in assisted living facilities:
CNA (Certified Nursing Assistant- used to be called aide). High School education plus 2 weeks training. These hourly employees make $11 per hour.

Med Tech- 16 hours training after CNA training. Then allowed to give all meds, including narcotics, insulin shots and blood checks, over the counter meds. These employees make $12-13 an hour.

LPN (Licensed Practical Nurse)- High School education plus 1 year medical training. Supposed to be supervised by an RN or Physician. Most facilities have only this kind of nurse and no supervision.

RN ( Registered Nurse). 4 year college degree in Nursing.

Dining Room servers can be “Community Workers” which means the same people who help with showers and dressing also serve the food. Or if separate employees can be 18 or over and never worked in a restaurant. Same $11 per hour and no tips.

Background checks are required, but if the person has stolen, assaulted, or raped and hasn’t been caught or prosecuted, their background goes undetected.

ED (Educational Director) The Director is over the entire facility. A high school education and 4 years experience in a facility. These employees make over $100,000 a year.

How would you like for your loved one to be cared for by these people?

The really cheap facilities charge around $2,500 -$3,000 a month. Rates can go as high as $10,000 a month. And that does not include the “Community Fee” which is non refundable and can be around $2,000 and up to $15,000. Pet fees can be $500-$1,000 non refundable per pet.

What level of care can we expect from these employees? Many of them come from foreign countries like Africa, Jamaica, and others in the Carribean and have learned how easy it is to get these jobs with minimal training and time.

You cannot believe the BS marketing verbiage that is thrust upon you from the moment you make that first phone call or visit. Check the website ajc.com/neglected for a series of articles exposing this enormous industry. Also, Google AJC/ants for a case history of one resident and her death.

From a resident. My prayers and heartfelt best wishes for you and your family.

You can't explain things to a person with dementia, and I don't think it's helpful to try to prepare her ahead of time if she is not understanding things. And it will only get worse and could last for years. I found with my mother who now has advanced dementia that it takes a village to care for her. Like your mother, she needs help with dressing, bathing, eating. She no longer walks and it sometimes takes 2 people to move her from the bed to her wheel chair. She's much better off living in a memory care facility where professionals are caring for her. My mother is on hospice-type care, which means no hospitalization, and we don't force her to do anything. The goal is just to make her comfortable. The doctor stopped many of her medications. The facility has a doctor who comes to her room if the aides can't take her to his office on a particular day. Make sure all of the paperwork is in order: power of attorney (POA) for medical decisions and financial affairs, will, living will, etc. If she has dementia already, it may be too late if this hasn't been done. Speak to an elder attorney, if you need advice. Some banks have their own POA forms. If you are her POA have all of her bills and statements sent to you. It's going to be difficult emotionally for you to put her in a home, and any change is difficult for people with dementia. Try to be as positive as you can when you talk to her about it. She'll be in a place where she will be safe and people will care for her. She can meet new people and they will have activities for her. Bring some familiar things to her room that she enjoys (pictures, music, pretty bedding, etc). My mother now likes stuffed animals. On the morning of the move tell her that she will be moving to a place that can give her more care. The downside of moving her to a memory care facility during the pandemic is that you may not be able to visit. It took me a long time to realize that my mother is OK even though I am not visiting her regularly. The visits are as much for me as they are for her, as I feel better seeing her and knowing in person that she is well cared for. And don't forget to tell her you love her and will always be there for her. Good luck!

Talking to your mom about move to memory care or assisted living is a little futile; she will forget the conversation. Focus on finding a place that can care for her needs now and as well as adjust as she becomes more dependent on help.

As her adult daughter, you ARE taking care of your mother. Your realize she needs more help than you can provide. You are making sure her needs are going to be met, that she will be kept safe, and that she will be healthy. If you visit, she should also be happy.

Stop guilt-tripping because you realized your limitations and are doing something about that - making sure that your mom is well-cared for.
You ARE being a good daughter.

I wouldn't discuss it with her unless she can remember and process the information. It's just going to upset you both.

Choose the facility, set up her room with familiar objects and take her there.

This is rough. I'm sorry.

I edited this comment to second what Lauramay had to say. Get some professional evaluation done to make sure your mom is being appropriately placed or you will have to move her and that's very disruptive.

The Office on Aging may be able to put you in touch with someone who can evaluate your mom's medical needs and make sure Assisted Living is the proper placement. The Assisted Living sales office is predisposed to say yes even if her needs might exceed their ability to care for her.

Dear lady, I had a similar situation with my mom, my sister who was taking care of my mom was very up set with me when I propose to take my mother to assisting living house, at the end we convinced her it was good Idea, this because my Mom don't want to take a shower or eat, the professionals in that house knows how to deal with this kind of problems, it was the better idea and decision we ever took, my mom was there very happy with other ladys same age and when we took my mother to a restaurant for a dinner she was always asking please take me back us get house.

You are not alone, and you are doing the right thing it seems to me. My father is sliding into an assisted living center, and I will be so glad to be friends and not a slave or a vent for his frustrations. I can't imagine how torn I will be when it is time, but you and the others give me strength.
Thank you.

Imho, you're doing the right thing. Prayers sent.

This is my reply to Tryingtime and anyone else who has never lived in assisted living. I have done my research. I have lived in 3 of these places and personally visited 20 others. Unless you have done that, you can’t imagine what goes on when family is not present. For example, when a family visits a loved one with dementia, they don’t usually walk in and tell their loved one to take off all their clothes so they can check for pressure sores. But there are places where the staff covers this up, is all cheerful, and never mentions there is a problem. The next thing you know, a pressure sore is finally reported, but it is too late. And the dementia patient can’t tell you about it or pick up a phone and report it. They also can’t tell you when they have been sexually, physically, or verbally abused. But it happens all the time. I’m not saying there are no kind people working in these places. There are. I see those too. But the bad ones can be in the most expensive, elaborately furnished facilities. And they get away with horrible things that you will never know about. I’ve seen countless staff members leave because they can’t take the low pay or the stress or the demands on their time. Unfortunately, they are usually the good ones. The best you can hope for is to get cameras in the room. I have caught both staff and private sitters saying and doing horrific things. And please, check the articles that the AJC newspaper reported in their expose. Carrie Teegardin, the journalist, uncovered a hornet’s nest. Some families don’t want to hear about these awful stories. There was one family here who told the staff and management not to call them unless their mother died. They were just happy not to have to deal with any part of their mother’s needs. I see many other residents who never get visits, phone calls, cards, flowers, food, birthday gifts, nothing. I realize that low pay doesn’t necessarily make a bad caregiver. But honestly, do you really think 2 weeks is enough training? I can tell you it’s disgraceful. And you will never know when your loved one with dementia pushes their pendant and waits and waits and waits. Sometimes 40 minutes to an hour. And the staff doesn’t know if they are having a heart attack or just needs a roll of toilet paper. So there is no hurry. Whether the staff is kind and trained or not, this is a common scenario. You can get a pendant from an outside company that will immediately call 911 in case of a fall. That could mean the difference in life or death. Please don’t try to talk the talk unless you have walked the walk. I know it’s hard to be a caregiver. I was one for 6 years until my husband died. It’s emotionally and physically draining. But I took an oath many years ago that said...”in sickness or in health, til death do we part. “ My husband was my soul mate. And even with me by his side, he suffered terrible neglect, abuse, and a horrible death. So please. Don’t preach, and don’t call me negative. I’m trying to tell you the real truth. Open your hearts and minds and be part of the solution to the huge problem in assisted living facilities across the country.

Dlachica, Your situation is very similar to what mine was a few years ago -- with a very supportive spouse, but just one of many siblings (none in our area) providing any help, and having had to move my out-of-state dad into our home, where I was his in-home primary caregiver for 3.5 years. I agonized for more than a year about whether a memory care facility (and which one) would be best and now, looking back, I think I may have "researched" (i.e. delayed) the move a little longer than was best for both him and me (not to mention my wife).  Anyway, below I've copied an answer that I've given more than once to others on this forum who were tormented by the hard decision to move a parent to a facility:

Everyone's situation is different. But here's what I did after agonizing for about a year over whether, when and where to move my then 95-year-old dad in late-stage dementia to a memory care facility: I didn't tell my dad about the move, instead I just drove him there and he thought we had arrived at a nice hotel like we had done many times in the past. We ate a nice dinner together and I spent the night with him, showered him in the morning, and then we ate a hearty breakfast together. I watched as he ate lunch with his new friends and then I left while he was participating in an activity. Then I returned and observed him eating dinner. After the first day, I rode my bike the 10 miles round trip to visit him at least once every day (and my wife visited him a couple of times weekly as well) for the next 19 months until he died at age 97. During that time, I remained his primary caregiver, but with the facility's small army of aides and my daily bike ride I was a better rested, more fit and much more patient caregiver. An unexpected bonus was that my dad became more social than he had been in many years.

As it turned out, my dad didn't remember living anywhere else over the last 75 or so years, i.e. he didn't remember living with my family for the prior 3.5 years, nor any of the three homes where he and my mom lived for 70 years. However, almost every day he would ask me to take him home, but "home" was his childhood home where he thought his mom was waiting for him (or waiting for us, since he often thought I was his dad). I always told him it was too late today since all I had was a bike, but that we could go "home" in the morning after a good night's sleep and a hot breakfast. That usually satisfied him, but when it didn't, then we would walk the halls together looking for an exit and a ride "home." Sometimes other residents overheard us and wanted us to take them to their homes and I'd tell them the same things I told my dad.

I know the staff at some facilities advise family members not to visit for a while (my dad's staff did not), but you know your mom better than the staff does, and you should do what you think will be best for her adjustment. Like I said, everyone is different.  Kudos to you and your husband for taking care of your mom. Best wishes.

Don’t put her in a facility yet. Just rent a room there for one week together like going to a resort .
OR- ask the facility to let you both visit for lunch and activities for 3 hours at a time . Do that regularly for a few weeks and soon you start to step out and she will be fine because the environment will feel familiar . Eventually you can leave her there overnight . No harsh barbaric shock because it won’t feel like abandonment.

I'm so sorry. I'm heading towards a similar situation with my mum who's 97. She's lived with my and my hub (I'm an only child in my 60s, no children), for nearly 19 years and the situation has at times been exasperating and exhausting. I'm not sure if she has dementia but definite cognitive decline. I'm on anti-depressants which just take the edge off my meltdowns! My hub wants us to have quality time together in our remaining years... and so do I... but the thought of putting her in a care home breaks my heart. It's a terrible decision. Sorry I can't help more, but I'll come back to this thread and read in more detail. xxx

I’m sorry for al that you feel and are dealing with. I can say I have 3 years of experience with a lot of this. My parents BOTH came to live with me and my family. We built an addition and then a year and a half after they moved in that we decided it was time for mom to be in a memory care facility. We did NOT tell her prior to her move, based on her memory and the fact that she was very agitated and angry as an Alzheimer’s patient. The move day was extremely hard but the faculty helped out so much with the transition and within a month and a half mom was settled in. As hard as it was, I can’t imagine either of my parents having made it through this past year both at my house. Way too many issues to try to juggle, way more care and attention than one person was able to keep up with and to see her now, it was the right decision even with all the tough and hard times.
Each family has to decide for themselves. Once I started having health issues myself and realized (& admitted) that all I was trying to do was really affecting me negatively, I knew I would be no good to either of them or my own family if I tried to continue.
It’s so hard and I still shed many tears but I do know in my heart that this was the right decision for our circumstances. The questions and concerns will be there but you have to consider ALL areas and what the current situation is doing and how it could/would change to have a different situation. You can’t anticipate everything but you must make a decision that is helpful and good for everyone. Even if it may take some time to be that.
Best wishes to you and please talk to friends or family who will support you, take even a little time now and then for yourself and know that you have shown honor and love!

If her dementia is advanced enough for you to be considering memory care, it would appear that there is nothing to be gained for either of you by discussing it. I would expect that she won't much like or understand the conversation it will just be upsetting to you both.

This caregiving gig is much more difficult than most of us thought! I didn't think it through very well and would have embarked on a different path if I'd known more.

You're right - your mom is a shell of her former self and really is no longer the person who was your mother. She's gone. You have lost her to this cruel disease. I'm sorry.

While it is hard to let go, sometimes it really is for the best. You and your marriage have to come first. Your mom is going to continue to decline. Look around at places and find somewhere you are comfortable with and move her in. It will be hard. You will be sad. She won't want to go. But it will be best for all of you. You deserve to have a life too.

It's a hard decision, and often leads to one feeling "guilty" for considering placement, but sometimes it's best for all. Dementia caregiving can become overwhelming, esp when it reaches a point that it takes over your entire life. Even with help from siblings, generally it isn't enough - if you get help, it might be dribs and drabs, with you still maintaining the bulk of the care. You really aren't getting much help and it is starting to take a toll on you, your husband, your marriage and life. We take whatever help we can get if we can get it, but often it isn't enough. In my case, really little help initially from my brothers, then really nothing. Often siblings seem to vanish, are too busy or tell you what you're doing wrong without offering to help (or all of the above!)

The stage she's at, as you described it, would be what I described as taking over your life. By the time you finish up dressing, feeding, bathing, it's time to start the next round! Fighting when needing to take meds is common, but just adds to your frustration. With dementia, they forget they take meds, don't want it, insist they don't need it and fight it. Staff at mom's place generally have to coax residents into doing things they don't want to do, but they do it often, so they are more used to it and better at it! Relates to bathing, eating, meds, doc appts, etc - they've seen it all, and in many flavors, as each person's journey with dementia is unique to that person!

"I always tell myself "she raised me all my live and so I should be able to now take care of her""

Yes, if she were just aging and needed some help, this might be doable. Dementia is another ball game, one that we never learned to play, so we have to learn the "rules" as we go, but the rules can change daily!!! It really is something most of us are totally unprepared for and are like fish out of water as it progresses.

"I have looked into facilities but I feel so guilty and my heart breaks just thinking of putting her in one."

Most of us would rather not go this route, but if you take the time to check out all the places you consider (hard to do the full assessment we often recommend, due to the virus) and choose the one that feels right for your mother, you can go back to being the loving daughter and when allowed, you can visit. She'll still be that "shell" of your mom, but you can see her, hug her, squeeze her hand and show her love instead of fighting with her to take pills or a bath!

It is also good that you have the support of at least some family members, and that they have concern for YOUR well-being too. Too often we hear about family who don't support the person asking for help here.

While it is natural to want to explain everything to her, as you are aware she won't remember the discussion. Sometimes a few things said might stick with her, and this could be just the negative emotional feelings she might have. I personally wouldn't discuss it with her, or at least hold off until the day of the move. My mother was still more "with it", mobile, able to mostly care for herself, but it wasn't safe for her to remain there alone and she refused to let aides in. She was dead set against moving anywhere, esp AL, even though her pre-dementia plans included AL! So, there was no discussion. We had to come up with a ruse to make the move happen. Not happy at all, but she went with my brothers (I did all the other work, but chose to stay out of the move itself.)

"My mother was my first best friend and we have had a great relationship all of my 66 years. So very hard to let her go."

It is hard, really hard, but you still have that relationship, in your heart. Remember all those good years! Realize you aren't letting HER go, just the "shell" of her.

If possible, use her funds to hire some help for yourself while you search for the right place. The good ones might have a wait list, so get on those. By the time you settle on one, perhaps the vaccine will be here and allow visits!

Yes but you can’t tell her because she won’t remember or understand why. It will only get more difficult & while you have your strength & health do it. Then you can visit her ... Say something like we’re going out to lunch today...the facility usually has that but maybe not now because of COVID....but tell her that anyway...you can say you need to get some work done in the house & will get her when it’s completed...& then problems crop up with house (just make something up) Please don’t get sick from caring for her...hugs 🤗

Sounds like she needs Memory Care, not just assisted living. I doubt assisted living facility would take her because of her memory problems. Just because she raised you, doesn't mean you can, or should, take the the full burden of all her care now. "Taking care" now means seeing that her needs are met, which you cannot personally do.
Perhaps you can explain to her that you are unable to do for her everything you would like to or that she needs. Thus you need to get some help. She may not fully understand the need to move, but assure her that you will be checking on her frequently and looking out for her safety and well-being..

Do not, for a minute, think It will mean the end of your great friendship! In fact, impaired though her recent memory may be, she will always have past memories, probably quite vivid, that she cherishes...and so will you. It may help to remind her often of the past times you shared. Reliving favorite memories can be a healing and bonding experience for you both.

I know exactly how you are feeling dealing with your Mom. My mom also had dementia. My dad couldn’t handle her easily. He was 90 and she was 89. I have a brother in another state who couldn’t bare the pain to help me with anything! I moved them from their house together in an assisted living facility that offered a memory care unit for Mom, when it was necessary.
My advice to you is she doesn’t need to be told where she is going. The facilities know how to help you with the way to move her there and will give you a lot of feedback. A memory care unit deals with dementia and the residents will have more personal care and attention. You can’t keep up with her needs at this stage 24/7. You don’t need to feel guilty either. I know you will probably, but this decision would be the best for your Mom, first of all; and you and your husband, second. My husband was supportive but still working.
My parents had been going with me visiting facilities for 6 months prior to their move. I wanted them to have a choice, but your Mom is past that point. Visit facilities and enjoy a meal as they want you to experience the daily treatment and meals your mom would receive. Please don’t feel guilty.
I felt the same as you do about taking care of my parents because they took good care of me growing up. Many caregivers that care for their family member receives pay, but I could never except pay for caring for them. My dad wanted to pay me, but I refused. It was my time to care for them. My mom died from end stage dementia exactly one year to the day they moved into their little apt. at the facility. She was needing memory care at that time, but her body began shutting down rather quickly. Her mind also went down very fast. She no longer wanted food, maybe a little water was all she would take. The doctors suggested a feeding tube, but their were many complications with that for a dementia patient so didn’t want to put her through any of that. She was in the hospital for three days and could no longer walk or get out of bed by herself after the first day in the hospital. She ended up being restrained as she was hallucinating and began physically fighting with four nurses( two of them were male and the other two female.) She thought they were trying to kill her. Watching her decline rapidly literally put me into shock. I knew when I took her to the ER after seeing the doctor, that this was going to be the turning point for mom. I talked to the doctor about time for Hospice and he said yes it was. Dad was included in all of our decisions for her. They had been married for 70 years. She was transferred to a Hospice facility where she passed away 4 days later. My dad and I were with her through this and she was medicated because she could act out physically and might hurt herself or others, and they legally couldn’t use restraints. I explained everything to my Dad and he understood but it was painful for both of us to watch her decline. With my Dad’s heart issues, I believed I would loose him before Mom. My Dad missed her so much that he died 2 months and 7 days later. I remained with him too. I took him to the ER for dehydration and 8 days later, his mind was gone. Rescue had transferred him to a facility for Hospice and as he was being checked in he coded. They both had DNR orders. Do not resuscitate orders.
It has only been three years and the pain and grief remains with me. I have been in the medical field all my life, but that doesn’t make it any easier. I am sorry I have gone on so long but I still am grieving. I wish all the best for you as you travel down this difficult path. Making these decisions are difficult, but you will do what is best for your mom. That is what will give you comfort later on. May God give you peace and comfort.

After my parents moved to assisted living, I visited them about three times a week. I didn’t want them to think I had left them so I remained in their lives. Sometimes I ate meals with them, took them to their doctor appointments, took them to the ER when needed. I became friends with the entire staff so they gave me feedback continuously. They would call to inform me of any problem with either of them.
I was pleased with Sunrise Assisted living. Some of the caregivers were better than others, but that would be expected. They were safe and well taken care of. At the end of the day, I could go home and sleep knowing if anything happened they would call me or the facility would call me. I was only 10 to 15 minutes away from them. If I had to do it all over again, I would choose this same facility.