So, last week, we had a little party. This week, we’re back to work.
First, thank you to everyone who took the time to share and celebrate memories of how their own mom’s took care of their respective tribes. I loved the stories! Second, thanks to the lovelies who became paid subscribers when I stumbled into that territory. Your votes of support are hugely motivating! Finally, to my free subscribers, you are supporting me by continuing to read and comment and share. Your engagement helps enormously to further my writing and my reach.
THANK YOU ALL!
We’re Going In
The topic of moving into assisted living may not inspire joy and laughter; but, it’s part of the journey for many, many people, so here goes. By all means, if you have some entertaining, inspiring or interesting tidbits about assisted living please hit that comment button right here and share them!
As mentioned in “At Home or in a Home,” when it came to keeping mom in her own home, I went down swinging; but, I finally realized the best option for our situation was to find a place for Nina that was close to my two sisters where she could get the care and social interaction she needed.
Nina was living with Beatie, and Anne visited regularly after work, making sure she felt her family close. Beatie took her out on daily excursions while keeping her dressed, fed, clean, occupied and entertained at home. The occupied and entertained piece was huge.
Caring for the Master Caregiver
She always, instinctively wanted to help, but had a hard time following any direction. Nina had always kept multiple books in rotation, but could no longer read emails, let alone books. And technology? Even the basic cell-phone we’d found for her was about as useful as a Phaser. Going for walks—something she’d always enjoyed wasn’t an easy option either. She’d developed an unsteady gait that is common with Alzheimer’s, as if unsure where her feet were in space. She could get by with a cane in familiar territory but used a walker elsewhere. (She had the super cool “save your ass” version that converted into a seat when needed).
As much as she needed help doing things, she also needed to feel some purpose (more on that upcoming); and she needed her own space, if only to feel like she was not always being the “burden” she wanted to avoid being. Already, she’d lost her role of caregiver, but to be so totally cared for must have felt unnatural and uncomfortable.
An oddly familiar process
I was around for some of the facility visits that spring and the process felt vaguely familiar, reminiscent of my experiences finding my first grown-up apartment in New York with my soon-to-be husband. Previously in New York I’d lived in places I’d inherited from friends, so this was my first exposure to real estate salesmanship.
Every rental broker contrived a sense of urgency to lure you into writing a fat check with first, last and security deposit on the spot because, “vacancies rarely come up here!” It wasn't hard to see through the ruse, especially when the agent for one particular building said this while multiple wheelchairs were navigating the atrium. “I see a few potential vacancies right here,” I had whispered to my husband. As newlyweds, so full of optimism and eagerness to get on with life, we were prime targets; so too are desperate families, looking for a solution that will feel good enough, if not ideal, for a loved one.
Exploring the Options
Senior living covers a wide range of territory. There is independent living, enhanced senior living (independent living with support), assisted living, then higher levels of care at skilled nursing and memory care. “Homes” accept residents for a certain level of care, based on a comprehensive evaluation of their mental, physical and social capabilities, medical needs, etc. Care levels are based on the number of “ADLs” (activities of daily living) a person needs help with. We’d heard that once in, people tend to recalibrate to the level of everyone else. Consequently, in our minds, the goal was to get Nina in at the highest level for her capabilities, with the most freedom.
I’d read about the dementia-focused living center called De Hogeweyk, aka Dementiavillage), in Holland, a Truman show-like construct where the memory care facility is an actual community, where residents live within a real outdoor village, populated by caregivers under the guise of fellow citizens. There they can wander safely, and interact in restaurants, gardens, streetcorners, hairdressers, cafes and all the usual haunts.
I longed for something like that, a place with a Longs Drugs (with photo dept!), a Post Office and a grocery store stocked with Meal on Wheels; a place that allowed Mom to retain some sense of purpose, natural socialization, physical movement and liberty of her familiar routine. But nobody in our family was moving to Holland. Today, there is a similar concept at an adult daycare facility in Chula Vista called Town Square. The entire facility replicates a small town in the ‘50’s with all the connections, activities and natural interactions you’d find there. Maybe that will catch on. In 2016, in this country, Memory Care generally meant a small, tightly controlled environment. We hoped to keep her out of that for as long as possible.
We (mostly Beatie) looked into about ten places, within a range of assisted living to Memory Care. She received the sales pitches and the assurances that each vacancy was “a very rare opportunity” not to be missed. Never mind that facilities caring for people with a degenerative disease have inevitable short-term turnover. I knew these people were just doing their jobs to fill their facilities, but still, it felt predatory, like they were adding the element of FOMO panic to our mix of desperation and confusion.
Every facility came with trade-offs, some of which were impossible to see until you were fully installed. Some of the places were beautiful inside, but in a location with limited outdoor access. Others were in the perfect location, but were run-down inside, with poor natural lighting or tiny rooms. When the staff was exactly what we did want, the facility was what we didn’t want. Few had great healthy food or adequate exercise facilities or routines. Many smelled like...ah its all coming back to me.
Some features were deal breakers, like the Memory Care place that had half barn doors on each resident’s room. It allowed the residents to have some privacy while being easily monitored, but it also felt like we were on the set of Mr Ed. I couldn’t get by that.
Finding “Home”
Nina, the one who mattered most in the decision, seemed mostly indifferent to the eventual destination. Beatie picked one that was spacious and airy on the inside and perched on a ridge with a nice view. The monthly activity list looked like a sign-up sheet at Club Med, and the feature that really sold us was the fact that there was a Memory Care unit in the same facility. When she did have to go to Memory Care it would be less traumatic, maybe even seamless. It made sense that it was on a ground floor where residents could go out for a stroll in a fenced-in garden. Soon enough we’d see the downside of that particular set up, but for now it was another green light.
The evaluation itself seemed entirely subjective and, not surprisingly, Nina sailed through the interview on attitude alone. She charmed the staff with her smile and easygoing nature. Considering her total dependence at home, we were happily surprised that mom qualified for assisted living vs the much more restrictive memory care.
My sisters, as ever, did the heavy lifting to get her in, and made special efforts to incorporate both functional pieces (like the foam chair that could turn into a mattress for one of us to spend the night), with familiar pieces of old furniture, like our ancient rattan coffee table, paintings from our house, and pictures of family.
The one thing she didn’t have, was what I wished for more than anything. One friend. Just one familiar face in her new world. Shortly after Buck’s memorial in April, Nina moved into her apartment. Beatie offered to stay with her that first night, to ease any anxiety; but Nina was characteristically brave and uncharacteristically decisive. No, she would be fine. She was moving into her own space on her own.
UP NEXT:
We’ll talk about some of the upsides of Assisted Living, which were more than expected, and Nina finding her groove there. And we’ll touch on fake cats because, who doesn’t love those? Well, actually, I can tell you.
This is all very familiar. And so very helpful for people navigating similar waters. We first moved my mom to independent living in 2019. From there she progressed to assisted living and now memory care, each time following some sort of health crisis. Each time I've thought how, briefly, I was an expert on whatever kind of facility I was currently researching. You're doing the smart thing and sharing that knowledge. Well done. And the fake cats! I have one in my closet that I bought for my mom a while back, but my kids and husband declared it was creepy (which might have had something to do with the fact that I turned it on and put on a chair at the bottom of the stairs without telling anybody and it scared the bejeezus out of them 😁)They said she wasn't ready to accept it yet, having just had to revoke her much loved cat. But she's receded so far now, and we're all about comfort measures. I think the timing maybe right. Thanks for sharing all this.