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I would keep her at the memory care facility. She likes it there and that says something about the place. I would look into hiring a reliable person to sit with her for 3-4 hours a day. Visit your mother at different times so you know she is getting best possible care . This seems like the best option for all of you. What if the caregiver friend is no longer able to care for your mother, you would need a back up plan. Are you and your sibling willing to take care of your mother until other arrangements can be made in case of an emergency? Do not stress too much on the teeth, that is a minor thing ,but changing her is definitely a priority and I would talk to the nurse in charge of the unit about it. I would make sure staff walks with your mother, she is fortunate she did not fracture her hip. She is a fall risk and staff should all be aware and take the necessary precautions to keep your mother safe. We all would like to be in our own home in the last stages of our lives but sometimes it is not possible. This is a difficult decision that both you and your sibling have to make. It is a difficult journey ahead and you will need all the help you can get. Pray about it and God will direct you in this decision.
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I'm with the other responders.....since she is doing well there I wouldn't rock the boat. I have been after my parents for years to consider IL.....and now that mom has dementia (exact stage to be determined soon), AL would be preferable. Mom is extremely stubborn, difficult and demanding (always has been) and my dad is beginning to show signs of burnout. I wish she would be more cooperative for both their sake.
Moving your mom back home is an unknown.....and to depend on 24/7 permanent private care is precarious at best. Also, with dementia being progressive, you would most probably need to move her back at some point. As MsMadge suggested.....hire a companion to visit with her a few days a week to ease whatever loneliness you think she might be experiencing. If that doesn't work, then nothing is lost....whereas a move would be an upheaval and could impact her dementia. Decisions concerning our LO's is not for the faint of heart.....best of luck with this one.
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Is the house she would be returning to set up properly?
* No stairs
* Large bathroom for a wheelchair or other equipment? NO lip on the shower that she would have to step over or that you could not roll a shower chair into?
* No carpeting?
*No thresholds to get over going between rooms?
* Wide halls and wide doorways?
Just a few things to consider there are plenty others.

Are you ready to loose a friend?
How long will she work?
Who will care for your Mom when she is off? You can not expect someone to work 24/7/365 with no break.
You do not say how old your Mom is nor any other physical problems but this could go on for 5, 8, 10 years is your friend ready to commit to that? And are you willing to maintain the house for that length of time as well.
You will still have property taxes as well as all the household expenses (include added insurance for your friend in case she is injured, because she will get injured).

Personally I would leave her in Memory Care. She is with staff that is trained, she is in a facility that is set up for proper care.
If your friend wants to do something for you, and get paid, have her run all the errands you would have to do, bring Mom to the Dr, get any shopping done that she needs stop in for a visit on a few days you can't make it in.
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cherokeegrrl54 Jul 2019
Excellent advice!!
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The idea is to make the best decision for your mother, not to be concerned what your siblings think. If she is doing well where she is at, then, leave her there, her needs will continue to increase and eventually she will have to go back to MC anyway. As for hiring a friend, I think that is a very very bad idea, your friendship will be under too much pressure and most likely be broken. If the worst thing that is happening where she is, not having her teeth in, I would say they are doing a pretty good job, 6 to 1, is a good ratio, and if she cannot even put her teeth in by herself, that might be a sign that she needs to stay where she is.
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Since it sounds like mom is doing very well where she is, leave her be. Every move for those with dementia causes further decline.

Live-in would become mom's employee. Taxes, Medicare, disability, all deductions would need to be paid for caregiver by mom. You would need a caregiver agreement prepared by an elder law attorney. You would need an accountant or payroll service to take care of salary. There is also consideration needed to labor law. Will caregiver be 24/7 or will there be three shifts of caregivers to provide breaks for the live-in?

If you were to use an agency, that would require three shifts of caregivers, 40 hours a week times three, 120 hours at $20.00 an hour or more. $2,400.00 a week plus expense of being in home with utilities, etc? Excess of $12,000.00 a month, easily.

Then a friendship that could be lost. Never hire a friend. She will not, necessarily, do things the way you want, then what? Or mom, with dementia, could decide she hates this woman. Leave mom where she is. 6:1 ratio is very good.
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kdcm1011 Jul 2019
Great response! Outlines all the practical requirements necessary for this situation.
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I don't think any of us would opt for a facility but finding reliable 24/7 home care is nearly impossible

mom has been in memory care for 3 1/2 years - she is no longer mobile and while I would prefer she be comfortable at home, I know it isn't possible
wheelchair wouldn't fit
no way to shower her
caregivers get sick, have their own family emergencies etc

with dementia, things only get worse, so you will need a plan beyond just the near term especially around mobility and incontinance

6 to 1 is a very good ratio
i have private caregivers with mom in the facility
if mom has funds, maybe you can find someone to spend some time with her at the facility and provide those extra touches that staff can't
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kdcm1011 Jul 2019
This is what we did — private caregiver for a few hours a day + our visits on the other days — made all the difference when Mom was in AL & then NH.
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Have you discussed this with your friend who would be doing the caregiving? Is she very experienced in caring for people with dementia? Since Mom is also a fall risk, your friend would need to be extra vigilant. Would she be on 24/7 duty or would you also need an aide during the night, since many dementia patients wander and can leave their home. Your friend has experience, yes, but even professional caregivers with lots of experience can get burned out. If Mom can be difficult, this would increase the possibility.

To be honest, since Mom is doing so well at the facility, I would hesitate to uproot her. Even though the care ratio is 1-6 ( which truthfully isn’t that bad), there is staff on duty all the time. Moving from place to place, even back to a familiar home, can be confusing and upsetting.
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