Last year was probably the roughest year for my sister and I since our mom was diagnosed with Alzheimer’s Disease. We moved our parents from their 2nd story house, to an apartment, to a Residential Board and Care, to an Assisted Living Facility, split my parents- Dad went to me, Mom went to Skilled Nursing after a 7th and terrible fall (due to her constant wandering and poor balance) which left her face severely bruised and a concussion, to another Board-and-Care, and then back to a rented home where they have been since Fall of last year with a live-in-caregiver, our beloved Christina. (Who we found at one of the board-and-care facilities. She was a former employee).
If you can only imagine, this was done in a matter of 8 months. We wasted alot of time, energy, emotions,because we couldn’t really make an informed decision on what was best or where to go. It’s unfortunate, because my sister and I were really alone in all of this decision making. Some members of my family were not willing or able to make the commitment to plan for our parents’ care. I’m not bad-mouthing them, but it really is unfair, the burden that was placed on us. Family planning is important and getting EVERYONE on board is even more important for your parents care. This is the main reason for me creating this site. I know there are many of you who are now in the same position that we were in last year. It’s crazy, because we’ve only really experienced all of this in less than 2-3 years, yet we have learned so much about the process, that I’m almost ready to write a book! 
I can’t stress enough how important it is to really think about your decision about moving your loved one outside of your home or their home. It could save you money, stress and distress to your loved one. We feel so bad for our mom especially, because she really went through alot last year with all of the moves. Our dad knew what was going on, so it didn’t really bother him. But she was so confused and scared.
Things didn’t work out, because we followed our “logic” too much and not what our hearts were telling us. I know I’m probably contradicting what many of the “professionals” would say. They would say, that what’s in your heart is not necessarily in the best interests of your loved one. While I agree with that to some extent, I know that emotions can cloud your judgment, I also know that no professional knows our parents more than we do. We knew that neither of them would fare well at any of these places, because it’s not who they were, it wasn’t their “culture”. I’ll explain more in detail.
The Personality and Culture Factor
What is the personality and culture factor? My parents are immigrants to this country. They immigrated here from the Philippines in the late 60s. My dad is a retired electrical engineer, he had no relatives here, no one but himself. When he was invited to work for a company here, he took the job and the chance. My mom followed thereafter, with my siblings, all on her own. Because of this independence, it took awhile for my dad to ask or even want help. Instead of asking for help at the assisted living facility, he kept to himself and stayed in his room and didn’t participate in activities. He also didn’t want to do anything without Mom.
Perhaps if my mom had been healthier, they would’ve participated in more. Problem is, they were separated at this place. It’s very problematic when you have a couple as opposed to one person. My mom couldn’t stay with my dad, she had to be in the Dementia Wing. My dad had no reason to go to any of these functions because my mom wasn’t there to participate. She had her own activities geared towards Dementia patients. The staff tried to get my dad to go, and he would for them, but didn’t on his own even when we showed him the calendar of events. He got more distressed being there, than being at home in front of a TV. Sometimes, people would rather be by themselves than be in big places such as these. You can’t force someone to change or want that kind of life. It’s a major upheaval after years of habit and lifestyle.
Culturally, Asians and Hispanics tend to be more family-centered. That is, they look towards family first before going to the outside. This is why you see fewer minorities in Assisted Living or Nursing Home situations, because it’s almost unheard of. Family always takes care of their elders. It’s difficult blending the American culture with the culture of the immigrant when it comes to later years, I’m sure he expected us to take care of them, which we are, but not in the traditional sense. He and my mom didn’t know about long-term insurance, or how Medicaid would work,the costs of nursing home care. In the Philippines, you just move your parents around through different relatives, not as much here. So of course, my parents preferred to be around us all the time, than a bunch of strangers.
They fared better at the board-and-care. But they had too many staffing problems, and internal problems, that we chose to take our parents out.
Why these homes didn’t work
We moved my parents in a matter of months. They were too dependent to be able to sustain themselves on their own at both their home and the apartment. The assisted living facility was too big and my mom needed constant supervision, that they couldn’t even provide at the Dementia unit. Finally, even the nursing home couldn’t handle my mom’s agitation after she recovered from her fall. They could only give her anti-psychotic drugs, (which she still takes in lower doses),and keep her restrained which made her more agitated. My mom would scream all night, and all day in the hall. The reason nurses kept her in the hall, was so they could keep an eye on her. There were only a few caregivers and about 25 patients on that floor. She fell the first night she was transferred from the hospital. They had to call us to pick her up after a month’s stay because she disrupting the well-being of other patients.
Home Sweet Home
Of course, many people would agree that the longer an aging parent is able to stay in their home, the better quality of life. Sometimes, it’s just not possible financially, or for safety reasons. Every one’s situation is different. My point here is, you really should assess every little detail when deciding which place is best. For us, it was renting a house for them and we were lucky to find someone privately, who we could negotiate salary with. You can’t really do that with agencies. If you depend on an agency for in-home care, that will far outweigh the costs of sending them to an assisted living facility. So far, the situation has worked out wonderfully, and my mom is as good as she can be.
The Best Places
If I were to choose the best scenarios, they would be:
- Home
- Board and Care
- Continuing Retirement Community *if affordable
- Assisted Living
- Nursing Care * only if medically necessary, and only for a short while. I think this really diminishes the quality of life. Spend the money and have home-care instead, with the medical equipment at home and have people visit them if you aren’t able to on a constant basis. Look at your eldercare directory, they have companionship services as well. I think residents are more lonely at nursing homes and big assisted living facilities , than they would be with family at home. If anything, if they are healthy enough, send them to assisted living if they have no family around.
In my opinion, I think you and your family should be the judge of what housing situation is best for your parents. Don’t let any agency, advocate or staff person try to talk you into anything, no matter how good their intentions are. In the end, it is your parents’ well-being, both emotionally and physically. Behavioral therapy can’t change how your parents feel about things, even if they are impaired such as my mom. No amount of arts classes, or gardening can put the smile on my mom’s face, the way my daughter does when she runs in the room and says, “Hi PAM-MA , Hi PAM-MA” (She can’t pronounce “Grandma” so she says “PAM-MA”.
