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My mother fell and broke her ankle. She has early stage Alzheimer's, is becoming delusional and is confined to a wheelchair while the ankle heals. She is in a rehab facility for 30 days. The family is divided over whether Mom goes back home after the 30 days or after the 30 days go right to an assisted living. Is it better to return to her own home, with 24 hour care, or to transition directly into assisted living? Any advice?

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A couple of things to consider...how will 24 hour care be paid for? Does she has funds to do this long term? AL is ultimately going to be more affordable long term and will provide your mom with activities and distractions so important in the early stages of dementia. As Blannie points out, more transitions are hard. Also, unless the family members who think she should go back home are going to do the caretaking, I wouldn't listen to them.
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Assisted Living if the funds are available. The sooner the better. That way maybe you can enjoy being a daughter instead of the "caregiver" before she forgets who you are.
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Or you could do what I did. Have her live with you 24/7 and regret that you did not get her into assisted living while there was an opportunity. I am now my mothers assisted living director, medical assistant, personal assistant and all around scapegoat - my life is boring and tedious taking care of a 91 y/o and I really wish I had just put her in assisted living. Too late now.....she is too demented.
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As a registered nurse my fee for 24/7 hour care would be well over $150,000 a year. Maybe I should start charging but as demented as my Mother is she actually expects me to pay rent! She has no idea about money anymore or how much it is costing me to put my life on hold - so I say take the assisted living option NOW - do not make the same mistake that I did because now I feel stuck.
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Another thing to consider; if she's only in rehab for 30 days (not sure why that might be, the bone will take 6 weeks to heal and then she's going to need PT to get walking again), she will need PT for sure for a while, better provided in an AL facility connected to a rehab place than at home. Good PT requires equipment (ramps, step ups, various other implements) that are not easily transported. Also, Mom will need to exercise on her own to practise the moves the PT teaches her; at-home caregivers and not likely to want to "annoy" her with suggestions that she do things she doesn't want to, whereas AL staff can cajole more effectively, also better opportunities for group exercise. Also, is her home handicap-accessible--ramps, bathroom with grab bars, door wide enough for a wheelchair, accessible shower, raised toilet seat? There is a myriad of things that will have to be done just to bring her in the front door. Also, I'm curious about how she fell in the first place, was it related to the possibly unsafe conditions in her home? Just some food for thought.
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Grab the opportunity now while you can because this is going to happen again. The next time she may not be suitable for assisted living-so if she is now go for it. IMO it will save you a lot of heartache down the road.
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This is the perfect opportunity to place her in assisted living. Three yrs. ago my then 87- yo MIL had surgery and spent 2 weeks in the skilled nursing unit of a continuing care community in which she placed a deposit. She was diagnosed with mild to moderate dementia at the time, and from there, on the advice of her dr. and hospital social worker, went right into AL. She hated it at first but after several months has adjusted and now likes her room, the activities and the staff. She is eating a healthy diet and has gained weight. Also, they have physical therapy on the premises which was very convenient. I might add that at the time we looked into 24 hr. home care for her and found that was more expensive than the $4300/mo she is paying now! She does have long-term care insurance which made our decision easier.
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I wish I had moved Dad when he was just beginning his dementia. Then he would have been accustomed and comfortable, "knowing" it was his home. He would have made friends and participated in activities that he might have remembered, now. If at all financially possible do it now. If it doesn't work out the house is still available.
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I would heavily suggest the assisted living for the loved what starts out as a act of love will end up with you being the caregiver. that is where the real problems start your siblings promise that they will help but after it starts will always find a reason why they are to busy or any other reason they do not have to help. I speak from several decades of experience on this issue. I would suggest talking to the assisted living people to see if they had individuals you could talk to that you can 2 different perspectives GOOD LUCK
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An option that you might want to consider is having your mother moved to a respite care option at an assisted living facility. That way you don't have to do any major moving (which can be expensive). She and your family would get a chance to see how she does in the setting, and it would give you some breathing space while everyone adjusts to the changes.

I wish I had done that with my mother after she broke her femur. She was in rehab for eight weeks, and then we moved her to assisted living, which she ended up hating. It was my brother's idea to move her to assisted living. He lives 1500 miles away, so it was easy for him to see that as an option. Since I live close by, all the issues concerning moving and care fell on me. My dad was still living in their apartment, and he missed her very much. We ended up moving her back, which was an additional expense. The bottom line now is she is very, very resistent to trying assisted living again, even though she really needs it.
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