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My mom has Moderate Dementia, but lives Independently. It was a 2 year battle to get my mom to move off the top of a mountain & into a nearby community. She has moderate dementia & doesn't take her medications on time, sometimes not at all. She's down to about 105#, I know she forgets to eat sometimes. She needs more help than I can provide, (Money very tight). should I move her to Assisted Living while she is mostly capable of caring for herself or do I wait til she isn't capable at all? Is being comfortable with her surroundings better or is getting the right help better? She has very little savings, I help when I can but I have 2 kids & not much either.

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Sounds like she is past assisted living. She needs a much higher level of care.

Your #1 concern is her safety, not where you would be more comfortable if you were her. This causes a lot of people a lot of grief. It's very simple. You are obligated to put her in a place where she is safe from herself and the world, where her changing care needs can be accommodated, and you won't find yourself having to relocate her with no warning because the facility can't handle it.

What mom wants and what mom needs may be two different things. There comes a time in our lives where we have to do the responsible thing even if it's not what mom wants. Mom can't make good decisions anymore, so it's our responsibility to make sure good decisions happen on their behalf. We don't let children eat candy for supper or stay up all night, without question. A lot of folks have trouble accepting that the time for their parents to be in charge is over, and it's on their shoulders now.

Safety First. Always.
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About costs & money:

Yes, their funds will be used up by old age care and when they run out, there's a Medicaid application process. Running out may mean down to their last $2,00-$3,000 in cash/checking. It varies by state.

A hard reality of this time in history is that the idea of an inheritance is something for the very wealthy. Unless your parent arranged their finances 5+ years in advance of a Medicaid application and locked it all up in annuities or irrevocable trusts, it's going to be used to pay some or all of the room/board/Rx costs.

It's their money anyway, so it should be used to on their care.

Quite frankly, I'll be content if there's nothing left at the end. I'm fine with not having to go through any more legal processes and pay attorneys & death taxes any more than I already have!
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I think it all depends on the cost of Assisted Living in your area. If you can, find how much net worth your Mom has, and if she can afford $2k to $5k per month for assisted living. Then try to estimate how many more years does she have? And if the assisted living facility will take a Medicaid waiver [depends on the facility and if the State offers such a program to help with the payment].

If the money situation looks good, then try to get Mom to move as soon as she can.... that way she would still be able to make new friends at the Assisted Living, learn her way around the building, and learn who is the Staff.

If you wait until she isn't capable to take care of herself at all, instead of Assisted Living she might need a higher level of care such as nursing home.
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I would be concerned, because if she isn't taking her meds on time, there is also the chance that one day she may decide to take all of them at once. Once you are out of the early stages, not having constant supervision is a risk, IMO. I'd be concerned with more than just the medication issue too. Forgetting to eat is also concerning.

Does she have her Durable Power of Attorney and Healthcare POA signed? I'd make sure that I had those in hand.

I think I might determine two things: What are her current needs and anticipated needs for the future AND what are her financial resources.

Does the state she resides in assist with the cost of Assisted Living and/or Memory Care for those who are deemed in need? Some states do and if she is deemed to need daily assistance by her doctor, she may qualify if she meets their financial requirements.

I would determine if she does qualify and then locate places that may be a good fit for her, in light of what the assessment recommends.

I would be wary of moving to a place that is not strongly supportive of dementia patients. Some patients may be okay with reminders for daily care, but often with dementia the resident needs someone to bathe, dress, comb hair, cut their food and even hand feed them. Memory Care offers that kind of support, so I would really look into that type of facility.
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This is right. Trying to keep a dementia patient happy can be exhausting and futile. They often are anxious, scared and paranoid. These feelings may intensify as the condition progresses. The independent life they describe is often illusory. They are often unhappy anywhere they live and regardless of the circumstances.
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SoMuch - please, please get a realistic handle on what moms ability is. Yes, I know she has been living on her own but often so much of daily tasks is rote memory by default. Add to that, that our parents can "show-dog" when we visit. Family often fixates on the finances so AL always looks like the better decision. Keep in mind that Medicaid waivers for AL isn't always available BUT there will be a NH somewhere that takes Medicaid & will take her Medicaid pending from day 1.

If you can, visit both a AL and a NH that you like and be there for about 3 hours - to be there when an AM activity is done (10/10:30) and then go to lunch and then to the beginning of whatever is planned for after lunch. Will your mom fit in? AL are very much social hives with planned activities while a NH is not quite so much. Can mom do what the majority of the other residents are expected to & can do? I'd guess that she will not be at the ADL ( activities of daily life) level that most AL residents can & are expected to do but is more at the NH level.

If mom has been somewhat isolated in her home (I don't know if this was an actual mountain or not!), an AL could be just overwhelming. She may not be able to follow along the pattern of daily life at AL. They don't have to be all sorority social to live in IL, AL or NH. But if they are very antisocial, a NH will be more accepting of their personality.

Moving them is hard but moving them from their home to AL only to get a "we do just love, love, love your mom but she needs a higher level of care and this is your 30 day notice" a couple of months later is a panic & crisis situation both emotionally and financially.
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I know it's tough when the loved one is adamant and they seem sure they know what is best. I would keep in mind that she is not thinking clearly.

What I did, and I did it because I had no choice, was to look at the reality of the matter. Is she safe not being supervised and cared for around the clock? They are at risk not only from exploitation, but also from wandering, accidents, falls, etc.

One of the main reasons my cousin's doctor recommended assisted living was due to her inability to take her medications. The doctor told her that she would NOT let it go. I knew what that meant and that my cousin would have to agree to go or the doctor would report it.

I convinced her to go by saying that she was going in for rehab, physical therapy, medication administration, nutrition, blood sugar monitoring, etc. AND that she would return home when the doctor saw that she was better. Of course, she soon forgot all about that. She is now in Memory Care and has no memory of any of that. (Progression of the dementia caused me to have to move her to Memory Care. She also began wandering and became double incontinent in a few months.) That's why I say have that extra support with Memory Care.

Have you visited the Memory Care unit you refer to? I would do that and ask questions, so that you can understand why they are set up the way they are.
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Somuch2learn, You cannot let your emotions and feelings get in the way when you are dealing with dementia patients. You have to be sure she is safe and safe from others. She will be mad at you when you move her to a home, but she will get over it. She will adapt and you will have piece of mind.
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You said, " have found a "local" Assisted Living place that also has a memory care facility. They require 2 years of private pay before moving her onto Medicaid, which will wipe out her savings & require a few months from me but not to much." As someone who has a mom with advanced dementia, it only goes one way.. which is much worst than what your mom has now. She'll need care for everything ...for years. It sounds like financially you don't have much maneuverability and need to move quickly. Otherwise, you'll have to do it which will make it almost impossible for you to work. Then, where will you and she be? I'd move her as quickly as possible so she can make friends and adjust.
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As cwillie has said, you can't force anyone into a facility if they refuse to go. Until she's diagnosed to not be able to make her own decisions, she can decide for herself.
I'm facing the same problems with my husband. I'm taking a chance next month and putting him in a facility ho will do respite while I need to be away for a few days. If he refuses to stay I don't know what I'll do except give up my plans and bring him back home. Also, you'll need her to get a recent physical from her doctor as he will need to complete a health form before she can be admitted. Best to get some of that done asap. It's what I'm doing right now myself.
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