Last weekend was very busy. We moved my mother into a memory care facility. For the last several years, she has  had a caretaker of some sort living with her in her home of 65 years. About 6 months ago, her doctor decided she needed 24-hour care, so we arranged for that. Her cognitive ability seemed to be declining steadily. Since she is 95 years old, I figured that the decline was simply par for the course. But about a month ago, my sister visited her for a week, and I noticed that her cognitive ability improved considerably. This told me that with increased stimulation and participation, she could do better. Her caretaker was seeing to her physical needs but not her emotional and social needs. She needed a more stimulating environment.
That bit of information prompted me to look into mem ory care facilities. My brother first checked out a place up near them in Portland that looked good, and they told him they had facilities near me as well. While he was checking into places near him, I was searching online for places near me. Mother has a lot of friends that would come over to visit her or take her out to lunch, so a place near me would still allow those friends to come and visit her. I happened to fill out a query on caring.com about memory care near me, and they immediately called me and set me up with tours of several centers in my area. Over the following several days, about half a dozen other places also called me from that same referral. I toured both private homes and larger facilities. While the private home was more cozy and personal, it had no more stimulation than Mom was getting at home. The larger facilities were more geared to keeping the residents engaged and participating in various ways.
I ended up liking a place called Brookdale up in Citru s Heights, only 7 minutes from me. I started the process. It is not like you can just drive up and drop your parents off. There is a process. First, I took my mother there to check it out and talk to the nurse on duty there. She filled out about a 10-page questionnaire on my mother. The next step required her to have an appointment with her personal physician so he could fill out another 10-page state-approved form called a 602a that the facility had to have. It turned out that she also needed another form from her physician that involved him actually approving her move into such a facility. Fortunately, they were able to fax that form over to him so he could specify what foods she could or could not eat and list her required medications. Fortunately, Mom is not on any meds, so that was easy, but he wanted her food well chopped up as she does tend to choke on stuff as she swallows. And like me, she has to be gluten-free.
A word about pricing. I don’t know if other places are the same, but this place has an interesting pricing schedule. There is a base price for her 10×14 empty room space (you bring you r own furniture) and basic food service, laundry, care personnel, and activities. Then there is the personal care pricing. It is like an à la carte menu – the operative question is just how much care do you need? If they have to dispense your meds, that is a flat $852 a month. Help with your showers might vary from $187 to $600 a month. Special diet needs like my mother has are $585 a month. Assistance with dressing or grooming is additional. There are 3 pages of possible additional care fees. There is even a $669 a month fee if you are a pain in the butt (resistance to receiving care). The contract states that they will constantly adjust your fee schedule as your needs change. It all makes sense, but it was weird for me to see it laid out like that.
Each time I went back to Brookdale, everyone was v ery friendly and helpful. Our move-in date was to be August 30th. Fortunately for me, my brother Daniel drove down from Portland a few days before the move to help my mother pack. Since she needed to bring down her bed, we had to rent a U-Haul truck to move her stuff down from her home in Colfax down to Brookdale. And since there was lots of extra room in the truck, he loaded a lot of her other furniture up as well to bring down here to store in my storage space. While he was loading up the truck, my sister Jennifer arranged for a real estate agent to come over to the house to give an appraisal and a list of what we needed to do to prepare her house for selling. There are a few things that need doing, but potentially the biggest might be a need for a new roof. We have to get a roof inspector over to check things out.
While loading was happening, I went over to Brookdale to get an accurate measurement of her room to see if her furnit ure would fit. As it turned out, her headboard was too big and would have covered up her emergency call button. So I had to order a new bed frame overnight so I could set it up the next morning before they got down with Mom and her stuff. She was scheduled to arrive between 10:30 and 11:00 Saturday morning. Sure enough, I was out there at 9:30 assembling a new bed frame. They arrived right on time, so the chaos could begin. The bed was the easy part. Unpacking all the boxes of clothes, linens, personal supplies, and so on took a bit of time. At one point, I had to run home because we had no hangers to put clothes on. While I did that, Mother had her first meal at Brookdale.
Transition like this is very confusing for someone wi th memory issues. She has been in the same house for 65 years, doing the same things every day. Now, suddenly, she is in a new place. She has no idea what to do or when to do it. The when is especially difficult for her. Her time sense is completely gone. At 3 in the afternoon, she was asking me if it was time for her to go to bed. Ten minutes after she has eaten a meal, she will ask me if it is time to eat. Her historical memory is fine, but her ability to track the passage of time here and now is completely gone. She can read a clock, but she has no idea what it means. As a consequence, she is constantly asking “what am I supposed to be doing now?” Unfortunately, this environment is new to me as well, so I usually don’t know the answer for her. I did remember from the initial tour that the main activity room had a daily chart of activities for the day posted by the front door. I took her down to that chart and said that this is where to find out what she is supposed to be doing. 9:00 breakfast, 9:30 exercises, 10:00 puzzles, and so on.
One of the things the tour guide told me the first tim e I visited the place that impressed me was that with memory care patients, they have to have stuff to keep them engaged all day long. So they keep them busy from 9 in the morning till 5 at night. This was just what I was looking for. She can, of course, trundle back to her room if she gets tired. But stimulation is available for her. She will have a structure that will answer her constant questions about what it is that she is supposed to be doing. Of course, that did not stop her from calling me a dozen times the next day. Plus, I had to come up with a suitable dirty clothes hamper, which I took over the next day.
My brother and I visited her for a while the next day. She was having issues with her hearing aid. Apparently, she ha s been unable to replace the batteries for over a year. Her caretaker in Colfax had been doing it for her. By the time we got there to help her, one of the staff had replaced the batteries, but I was told that if they had to do that regularly, there would be a new monthly charge for that service. Most of the residents had rechargeable hearing aids to avoid this fee. So now I have to look into getting Mom new rechargeable hearing aids.
My brother spent the night at our house and headed out at about 2:30 in the morning to drive back up to Portland. It is a long drive. I am back at work today. Mother only called twice while I was working on patients. Ellen tells me she called the house about four times. I think the transition might be a little harder for someone who has no short-term memory to use to make new memories with. It is almost as though every day is a new day. A little bit does make it into long-term memory, but not much. A new adventure for both of us!
Take care,
David
It was cloudy and a bit chilly this morning, so when the  sun came out in full strength, Ellen rolled out into the driveway to soak up some sun.
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