# My Grandma is getting "Evicted" from AL/forced into Memory Care



## Wild1 (Jun 10, 2019)

So, my grandma (92) is facing eviction from her assisted living place (for non financial reasons) and being forced to either move to another facility, or into "memory care". The reason being that she has started falling a lot and supposedly needs a higher level of care than the place offers in this facility. Now she has a lot of problems but I would say for her age, memory is not really one of them. 

The staff are trying to force a move into a Memory Care unit, because she has fallen more than Y times in X days......   Someone please enlighten me on this point as I wasn't aware that old people fell because they forgot to keep standing? I always thought it was a loss of BALANCE (probably caused by loss of strength/flexibility)???

Anyway, my grandma has no real signs of memory loss. But the staff claims she has Alzheimer's/dementia.... And interprets ALL of her behaviors as "early signs" of this as justification to push this move. However, most of us who have known her for years know the real cause of these issues. For example, they say the fact that she comments on peoples weight is a sign of Alzheimer's. (She has always been hypercritical of people!) Also, one thing that happens a lot is she will ask the same thing over again in a conversation. But she is horribly hard of hearing, and has never been a great listener but a good "teller".. Of course, the hearing loss now has gotten more severe (you can't even call her because she cannot HEAR the phone ring) and she usually has CNN blaring at max volume as well. Omg. 

She asks the questions repeatedly because she has gotten used to "acting" like she is listening, (eye contact, nodding head etc). And will reply with generic responses like "yeah" or "uh huh" but often times I think this is because she can't hear and doesn't want to admit it or interrupt.

I have caught her doing this many times (my grandpa, who is still living independently and doing great also does this from time to time). 

The nursing director, as proof of his "memory" argument, claims she needs it just bc she doesnt remember his name. I disagree! I think it's entirely possible she JUST DOESNT GIVE A HOOT about who this guy is.... Is that so bad? I doubt the level of interaction they have really necessitates the learning of all these peoples names. I have excellent memory, am young, and I don't always remember the names of people I am introduced to particularly if I dot have frequent contact with them or expect to.

One issue she does have is auditory hallucinations that sometimes happen frequently for a whole and then don't show up for a few months. she does occasionally complain about sounds that aren't there and attribute them to things/people that aren't there  (this is one of the reasons we moved her in assisted living in the first place, as she was insisting that my grandpa call the cops on the neighbors for constantly playing loud music, a song from the 40's (they obviously weren't). But I attribute this more to the severe hearing loss and being on depression meds with this as a potential side effect. 

Ok so....
I guess what really worries me, is this move is not only going to be stressful bc at her age, everything's stressful . ... But it will put her into nearly total isolation, and I feel that's not mentall healthy for her. 
-(it will remove many of the benefits she has had from being in Assisted Living, particularly social interaction with friends she has made; and others she knows from long ago, if she has to be separated from the other residents; 
- if she is put in memory ward, how the heck is she supposed to make new connections with people that legitimately honestly cannot remember anything? 
-to make matters worse, she will have NO PHONE? That's just cruel! 

NO PHONE? This worries me also on a personal security level..... So you put a person, a vulnerable person, in a situation where they are physically trapped, staff in and out all day and night, you have already labeled them to have faulty memory, and then they have NO WAY of contacting the outside world at will or in private.... I see "Unsafe Situation"/ripe for abuse/coverup written all over it....

What other options do we have? 
Any way to get her more care without leaving her "home" ? Or getting a phone in the room? I would think for $5 GRAND a month they could at least figure out how to get a contractor in there to install a phone jack and then remove it for when they have a person move in who really has the issues where they should not have a phone.... 

Sorry that was a long rant .... Just feeling very sorry/scared for her right now.


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## RadishRose (Jun 10, 2019)

Can you ask to see their "Patients Bill of Rights" with regard to phones being disallowed?

This doesn't sound right to me.


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## treeguy64 (Jun 10, 2019)

When all else fails, give the reliable line, sure to make the powers that be, who run these types of facilities, shake in their boots: "I'm going to be contacting my attorney, and he'll be in touch with you, within the next few days!"

When my Dad became late, his luxury AL facility kept stalling on refunding his $70K deposit.  They told me, repeatedly, that they needed to rent out his unit before the refund was issued.  Thing was, they were pushing the priciest units, at the time.  This was an absurd situation.  After a month of being stalled, I gave them the line.  Less than twenty-four hours later, they called me to let me know that the refund check was on its way.


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## GeorgiaXplant (Jun 10, 2019)

Wild1, is it possible that you're in denial? I speak from experience with my favorite aunt. She's 94 now, and for the past few years I just refused to believe that she was declining one bit. Ten years ago after my husband died, I moved to Georgia and she stayed in our home town. When I moved here, she was fine, still driving and even the one who picked up "old" folks to take them to appointments, grocery shopping, to church. Four years ago she sold her house and car and moved to Georgia to be near her son (at the urging of both him and his son), and that's when the decline started...when she left "home." Just before she moved, there'd been a problem that affected the one IP available in our hometown. She was convinced that she was the only one who had no service, but said she'd just cancel her access and wait until she got to Georgia. A little house had been leased for her, but my cousin wouldn't let her move in because "she has to be watched 24/7." My thought at the time was that nobody "watched" her before she got here, therefore, nobody needed to "watch" her now. He'd mention odd behavior from time to time, but I just wouldn't believe it and insisted that he misunderstood something she said or did.

She became very frustrated when she got here to discover that my cousin didn't have internet access and no plan to get it. So exit communicating with the outside world...

I live about 175 miles from her and would drive down frequently for the first few years, and she was always the same as ever when I was there. We'd go shopping, I'd take her to get her hair cut, we'd go to lunch...absolutely nothing to make me think there was anything amiss at all. From time to time, she'd call and complain about my cousin, how he wouldn't "let" her do anything, verbally "abused" her, and that all she really wanted to do was to get away from him and live on her own. 

After she'd been back in Georgia for about a year, she asked me to help her get back to our hometown and to look into senior housing on her behalf. She chose a date that she wanted to move, asked me to reserve a U-Haul truck to take her furniture back (which was in storage). All the arrangements were made, truck reserved, apartment leased/deposits paid, and THE DAY OF THE SCHEDULED move, she decided she wouldn't go after all. What? Her reason was that it would "hurt" my cousin's feelings if she left "and besides, he's all alone and would be lonely." Oy!

Another year went by with me visiting every 6-8 weeks, and she announced that once again she'd made up her mind that she just was too miserable away from her friends and wanted to go "home." I was VERY leery but told her that if SHE'D make all the arrangements, I'd help her get there, stay with her a week to help her get settled, etc. Once again, she decided at the very last minute not to go.

In between visits, my cousin would relate things to me that were clearly not normal, but whenever I was there, she was just fine. Didn't repeat herself, didn't "forget" things, knew where to find things in the kitchen...that kind of stuff. He, his son, his ex-wife, all tried to ease me into accepting that she was declining, but I wouldn't acknowledge that there was anything different at all.

My cousin happens to be a marathon runner and wanted to do a half marathon last summer that required being gone overnight. He didn't want to leave her alone (a half day, overnight, another half day) so asked if I'd be willing to stay. Sure! That would be fun, we could cook out, visit with the neighbors...

It. Was. A. Nightmare. After he left she had a tantrum, started emptying out all her dresser drawers and throwing the contents in the middle of the living room floor, refused to eat, soiled herself and refused to clean herself up or let me help her, wanted to know where "all these damned dogs came from." They have three...hers and two that belong to my cousin. She has always looked forward to church on Sunday morning but refused to go. I took a cup of coffee out to the patio, she went out the front door and walked around the side of the house to the fence gate, started yelling at me "I don't know who you are or what you think you're doing here, but get the HELL out of my yard or I'll call the police." Visit with the neighbors? LOL She complained long and loud about how awful "those people" were and she wished they'd move so she could live in peace and quiet! Cook out? Nope. She wouldn't hear of it.

My aunt has a hearing aid and until the past couple of years, never had one bit of trouble carrying on a conversation, responding appropriately, or asking relevant questions. When she doesn't want to hear, she removes the hearing aid or simply doesn't replace the batteries when they wear down.

So...what I'm telling you is that unless you're there all day and night every day and night, what you observe isn't necessarily what's happening. It's entirely possible that your grandmother is calling on her resources to always behave appropriately when you're there, and in a sort of reversal of acceptable behavior, "relaxing" when you aren't.

Another thing: there are degrees of memory care as there are degrees of dementia/Alzheimer's.

Try to keep an open mind. The caregivers at her assisted living place now observe her all of the time; you are only there some of the time. Believe me, acceptance wasn't easy; I wanted my dear aunt to be just the same as she ever was. Unfortunately, it doesn't work that way.

I should mention that my aunt has fallen a number of times, once hitting the back of her head so hard that it apparently knocked her unconscious, also made a wound serious enough that she had to be taken to the ER for sutures and was kept there overnight. She refuses to use a cane or a walker. Usually her "reason" for falling is that she didn't see that one of the dogs was underfoot. Falling has nothing to do with memory...you're right...it has to do with balance, but if she falls and breaks bones? She'll be in acute care, then rehab, then...memory care.

Hope I haven't offended you. This just my own experience. Maybe there are some things that will resonate.​


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## Aunt Bea (Jun 10, 2019)

I tend to agree with GeorgiaXplant.

It sounds like your grandma does have some significant issues that could impact her care in an assisted living facility.

I also don't believe that the management of an assisted living facility would evict a tenant with a dependable payment history unless they honestly believed it was in everyone's best interest, what do they have to gain.

At least check out the memory care facilities being recommended.

Have your grandma evaluated by an independent physician not associated with the assisted living or the memory care facility?  It's hard to believe but some of the problems you have mentioned could be related to something as simple as a UTI.

If she is not allowed to have a phone try to find the reason and look for an alternative such as an emergency response pendant that will list you or another family member as a secondary point of contact if she has a medical emergency.

Good luck to you and your family.


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## GeorgiaXplant (Jun 10, 2019)

I didn't see it because I didn't WANT to see it.

I have a friend who's father is living "independently." She sees him once a week to take him shopping, but talks to him at least daily. Her sister, who until now has only seen him on holidays or at family gatherings, has his POA. She just retired a few days ago and will start taking him to do his shopping every week. My friend has seen, heard, and documented his decline and tried to explain it to her sister, who refuses to believe any of it. The sister finally took him to a doctor to be evaluated after my friend tried to convince her sister that he needs to be in memory care. Their father aced every test, was pronounced fit, and the next day (the day my friend takes him shopping) insisted that they'd gone the day before and didn't need a thing. A case of rising to the geriatric occasion!


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## Wild1 (Jun 10, 2019)

RadishRose said:


> Can you ask to see their "Patients Bill of Rights" with regard to phones being disallowed?
> 
> This doesn't sound right to me.



Thank you! Right now she has a phone in the regular AL unit she is in, but if she moved into MC, there would be no phone. Not even a hookup for one. (Still at $5k+ A month I would think just about anything should be possible?) I totally get the "no stove" thing for MC (obvious safety reasons) but I can only really understand the "no phone" thing for the absolute most severely memory impaired patients, I guess. 

Also curious about the other levels of MC available. 

Also GeorgiaXplant and treeguy64 and AuntBea for the helpful and insightful comments!

Although I must say, she does over-rely on the phone and calling my grandpa. It is getting to be overbearing for him but he handles it like a champ. She calls my grandpa (who is still on his own and driving and lives 12 miles away) to do things she is supposed to "press (her) BUTTON!" (Pendant) for. Stuff the staff can totally do for her (and should do, because at 95 he's not exactly a strapping young lad, and never was a huge guy to begin with). 

Sometimes she will call him multiple times per day asking him to do things the staff would normally help her with (and should be the ones helping with).. Its unclear if this is her forgetting and calling him again, just misses him, or refuses to learn the button thing (when he is there, she even asks HIM to press the button FPR HER to bring her to get the staff person to bring her to lunch!!) so I see it more as a "refusal/stubbornness/missing him" thing than a "forgetting" thing.  (I will have to ask him more questions about this!)  (but after all, I can't blame her - she doesn't feel good, is in pain, and although He sees her almost every day, but obviously that's not a replacement for living with your spouse of 60+ years. (She has been in AL for 3 years or so now, and this arrangement overall seemed to be a positive change for her mood wise, until she started going downhill this winter/spring).

Speakif of ,.. Thanks for bringing up the UTI's issue ---- please tell me more about how this works)??? This is seriously interesting .... Because: 

1) UTI's --- she got a really bad one this winter and was on multiple courses of maybe 2 different antibiotics....then, whaddya know, (now that I think about it', the auditory hallucinations started around the same time she really started having more severe UI).... 

2) March/end of Feb: she got hit with a really bad GI bug.... The worst kind.... It sounded like  PURE HELL....(no surprise since antibiotics wiped out all her gut flora). 

3) can't remember when the falls started but she had obviously some crappy stuff going on.

4) fell, compression fracture in back, 

5) back brace that annoyed her,

6) more falls, falling falling and more falling.... That's when well, obviously I understand why she needs MORE care (and I do realize she has declined significantly, but just I don't think the memory is then main issue). 

Now, if say this was someone less stubborn and more open to learning new things (which is not my grandmas cup of tea!) I would think something like VOIP would be an option or a cell phone like Jitterbug. But folks, I can tell you that ain't happening unless it looks and talks like a real phone. Zero computer skills. 

As much as I get annoyed by some of her negative attitude and demanding ways (she was born this way!) I want the best for her and more care, and when she moved into AL, overall she seemed a lot happier. I see this to be due to the increased social contact she didn't get when living at home. I just fear she would be really scared w/o a phone and shut down as it would cut her off from the world too much.


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## Lethe200 (Jun 12, 2019)

One issue with virtually all senior facilities is that the residents/family have very little legal recourse. Nobody likes to read the "fine print" but for most facilities it's "their way or the highway." Even high-end facilities run this way.

If your grandmother is overusing the phone, that is right there a reason why Memory Care units don't allow one. You're making some good points why she may not have dementia, but the behavior she's exhibiting is clearly making it difficult for the AL staff to deal with her. 

You do not want your grandmother to be the resident known as "the one needing 80% of floor staff time every day" along with the staff doing the behind-your-back eye-rolling.

I think your choices are either find another AL facility to take her, or move her to the facility's Memory Unit and see how she does. If the latter, keep a close eye on the situation and if she doesn't do well, don't hesitate to move her out to somewhere else.

It doesn't sound to me like you've spent any time vising the Memory Care area. Have you? When we chose a facility for my MIL, we not only toured it, we attended one of the daily classes and several facility events where everyone, including MC residents, were attending. 

You may be imagining difficulties where the spectre is more ominous than the actual reality.

If you take her to another AL facility and it also develops issues with her behavior, you will have to face the fact she cannot manage in AL, and take steps from there.

HTH. It's never an easy time for caregivers, even when the senior isn't living with them any more.


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## StarSong (Jun 12, 2019)

I'm mostly going to echo Letthe and GeorgiaXplant, having gone through the shift from AL to Memory Care units twice.  Once with a parent and once with a parent-in-law.  

While falling is a sign of poor balance, cognitive losses can be behind those balance losses.  Memory Care units provide a higher staff to resident ratio, meaning more eyes and help for each resident.  The two facilities we used permit transitioning MC residents *who are not disruptive to others or a danger to themselves because of falling danger* to use the general population's dining room and some other common areas, but have "home base" in apartments within the MC area.  

AL facilities are communities.  Staff including caregivers, med techs, maintenance, and cleaners serve as the communities' eyes and ears.  They report behavioral changes (and other residents' complaints) back to administrators at which point various residents' statuses are reevaluated.  Hard as it may be to face, it your grandmother may be losing some of her social skills and filters.  

Deterioration is often part of the cycle of life as we get much older.  Sometimes it's our bodies that betray us, sometimes our minds, sometimes both. 

I wish you and your grandmother well.


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## StarSong (Jun 12, 2019)

PS  One of the reasons Memory Care units often disallow unfettered use of phones is that confused or paranoid residents may call 911 or family members to report that they're being held hostage, that there's been a murder, and various other delusional beliefs.


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## Wild1 (Jun 12, 2019)

Wow, thank you for all the continued thoughtful responses! I am amazed at how thoughtful people are here to help me through this and explain things! 

I have to say, I have become more open to memory care. However, in my stubborn Finnish fashion, it is not necessarily from the convincing of anyone here, but a changing reality. My grandma just took a MAJOR turn for the worse  

Yesterday, I called Grandpa on my way back home from work. I asked how she was doing. I was coming up on a stoplight and I had a bad feeling, I wasn't needing to get into the right lane to turn to go home....and he told me right then that she is doing really bad. He told me that she was saying that she thought someone wearing a blue gown was using her shower. She was so convinced that someone was in there (even after they showed her no one was) that she called 911. Uh-oh....BAD. (Up to this point, her delusions were limited to thinking people were playing music that was not there, and while this was problematic and fear inducing when she was living at home, she had nice things to say about the "music" that "they" were playing "upstairs" at her AL facility and almost seemed to enjoy it).

So.,.. I continued North and headed up to see her (over an hour's drive). When I got there, a staff person was there at the door, waiting for me, and knew exactly who I was. "Thank God" she said. She said that (Grandma) had a REALLY bad day today; and was being very cooperative and very aggressive with staff, and was swearing and tried to hit her.  She said, that she has never been like this at all before. And has also been very energetic and they couldn't get her to go to her room. (it was just after 8, and she normally is in bed by 7). 

Wow. Crazy just got crazier. While she always had the tendency to be stern, stubborn, and critical, never in my life have I seen her act AGGRESIVE. I think they even said she said the F-Word. I didn't even know that word was around back then! Holy ****.....

So, I went in. I sat with her. She was very happy to see me (thank God) and tell me all about:

-the shower curtain ordeal and the unauthorized woman in the blue gown who was using her shower! For a while, I thought: in her defense, she cannot hear well (and often listens poorly to boot). She probably misunderstood that staff had changed the shower curtain, which they pulled to the side and cinched in the middle, and did have the shape of a dress, from the peripheral vision of a delusional/ suggestible old woman....
Then she said, "Well, you know what I did? I CALLED 9-1-1." 

-Then she went on to say how staff are trying to scare her, making fun of her,
-the men who are physical therapists who come to bring her to therapy, are "salesmen, trying to sell her something". She said, "I've seen them before at the ____ Hotel, and they were wearing masks and dressed up all goofy in costumes, they are trying to scare me." 
-went on and on how it is so terrible the people here try to scare people 
-She kept saying she was going to "Quit School" and "I'm not going to go to school tomorrow". When I reminded her, that she's been retired (from school teaching) for quite some time now, She replied, "well yes, but this is sort of like a class, for teachers; they teach you about teaching methods". Whoa.... 
-Then she told me about a woman, on the staff, who is "Very Artistic" and made beautiful things, but who is giving her trouble, and said "I am going to tell her off" (this character came up several times throughout the night."  She claimed this person left miniature "puppets" (maybe like ornaments?) all over the apartment (she doesn't even have any nic-nacs in there). I asked her to describe this person, (something I did with several of the hallucinations; and she drew a blank. Asked "what color hair?" Nothing. This was the case for all the hallucinations and seemed to confirm to me there was no one who was abusive or anything... 

Then she wanted to go out in the hall. At this time; it was late, (honestly I don't know why I allowed this) 
-she said that there were girls at the other end, wearing blue (it was a water cooler).
-She then said that they were setting something up, at the other end and that there was going to be some kind of a "show." 
-she started "heading for the show" and told staff all about this. (This was all the way to the other end, staff tried to turn her around but to no avail (very inconsistent with her behavior - she usually just sleeps). (Frequently in her earlier years she and Grandpa would travel to places like Las Vegas and Branson, and went for the shows). 
-She told the staff persons she was going to the other end to see "the show" (oh boy). 
-so claimed "caravans" were coming in, and asked several staff members how they got the "caravans" in, and if they had big trucks to take them in.... 

The list goes on and on and on.o have gone on too long, sorry..../

A few observations/patterns I picked up on:

1) Paranoid ideation, and fear and anger dominated her thinking/discussion, when we were in her room. 
2) when she was out of her room, she was equally if not MORE delusional, but she was not upset, just "tripping balls" (as my generation would put it - a borrowed drug reference)..... As we settled in to the chairs at the end of the hall, she was telling "the show" "at the end of the hall" how great the singing was and all that.... 
3) a confounding variable in the room versus public space comparison, is the presence of staff and others walking through. 
4) all of her falls have taken place in her room. Not dining room, or on her way to lunch or other places. I suspect they are when she gets up from her chair or bed. 
5) she is always on her best behavior for doctors, and to a lesser extent, staff. 
6) I was informed by staff that she DOES NOT push her "button". Whenever she has fallen, it has Ben staff who have found her, because the resident next door will press HER button. I have also observed her say that she can't get the button to work, and asks my Grandpa to do it for her, when he is there. 

Today, she had an appointment and was given a diagnosis of Lewy Body Dimentia. (I can't say I agree as I don't think she met all the criteria, and they didn't do the sleep tests); -- and she meets ALL the conditions for delirium of which supposedly close to 15% of people >85 experience. They are giving her some meds. Regardless of the diagnosis, I am happy she is getting some help. Grandpa was relieved. 

Sadly, I received a call today that she had another fall. And hit her head. This was "Strike three." So, she is moving out .... Either MC, or another AL/MC sort of place. Given what I saw today I am less opposed to the MC idea. It's just that I think this is an acute , sudden onset delirium, and not necessarily how she will be everyday. Normally she is pretty well functioning for how old and frail she is.... 

Any in-between solutions? After what has happened yesterday, I am less opposed to taking the phone away, obviously. But what I am scared of is that she will have no one to socialize with. I am also worried about Grandpa as this means the only contact is in person, and this will could mean, even more driving ... Sigh (but at least she won't be able to demand he come right away, over the phone?) 

Thanks all for listening, I am privileged to have you; to read through all this. This forum is amazing; you all have so much knowledge and kindness to share it with me. THANK YOU!!!!


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## StarSong (Jun 12, 2019)

Wow does this sound familiar.  My mother had similar "confabulations" as they were called.  She had vascular dementia and was never diagnosed with Lewy Body or Alzheimer's.  

The doctors quite accurately predicted that my mother would eventually be cognitively unable to construct the complex (and quite bizarre) scenarios that she was imagining.  
Should your GM go to Memory Care she will be able to speak with you and your Grandpa on the phone, but the caregivers will connect the calls when she is able to manage them, meaning when she isn't agitated.  


I wish you and your family well.  Cognitive declines are not easy to manage by the people suffering from them, their loved ones, or their caregivers.


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## Butterfly (Jun 12, 2019)

I really don't have anything to add to what others have said, but I do know how difficult this kind of thing is, and I wish you peace in dealing with it.  It is so hard to watch a loved one slip away, whether physically or mentally.


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## Wild1 (Jun 13, 2019)

StarSong said:


> Should your GM go to Memory Care she will be able to speak with you and your Grandpa on the phone, but the caregivers will connect the calls when she is able to manage them, meaning when she isn't agitated.
> .


 this makes me feel much better, that she will be able to connect calls. And I guess there will be more interaction with staff too maybe, because there are more of them!? This could also be a positive thing as it should limit the number of frivolous calls she makes to my Grandpa. 



Butterfly said:


> I really don't have anything to add to what others have said, but I do know how difficult this kind of thing is, and I wish you peace in dealing with it.  It is so hard to watch a loved one slip away, whether physically or mentally.


Thanks for the kind words of support Butterfly!


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## Wild1 (Jun 30, 2019)

Update: 

Grandma got moved into memory care last week. (Grandpa had some troubles of his own (unrelated) during this time, which is why I haven't updated this). 

Anyway, grandma is doing better in memory care. She is at least more comfortable, not saying crazy stuff, etc.

I can't say she is really getting "better" as being waited on hand and foot, and not doing really anything, she will probably slip away on us faster. But, I guess part of this process is realizing that maybe for her, getting better doesn't mean recovering (because I don't even think she wants to) for her, getting better means being comfortable. 

She loves the attention from the staff in this unit, and thinks it's the best thing since sliced bread. She's not bothered by the small room and lack of bathroom door, and less privacy, and no phone, either. She has transitioned well. Way better than expected! 

I guess, in the end; I think it was the right choice for her even though it wasn't really a choice at all. 

I think she is accepting being there, and likes it. She feels comfortable and safe now, and is not agitated or complaining of pain. And for her, maybe that's all "getting better" needs to be at this stage in the game.

Thanks all for your support.


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## RadishRose (Jun 30, 2019)

@Wild1, I'm so happy to hear what a great transition she made and how at ease she feels now.
Wonderful news!


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## StarSong (Jul 1, 2019)

I'm both glad and unsurprised, Wild1.  My mother and father-in-law, both of whom swore they'd rather die than go into a "home", adapted quickly and nicely to Assisted Living. 

Finding acceptance for the natural rhythm of life and death is the challenge every generation must face.


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