Mom has been in an AL for about 19 months. All in all it's been a good thing. About 5 weeks ago she had to move from her more independent setting to the secure unit. We opted to have her stay in the same AL community as we wanted the continuity of care.

Last 2 weeks have been a disaster! We are working with the staff, her PCP and the Dr's at the Memory Clinic as well - but we are thinking that we may need to consider a move to a smaller, quieter setting.

Has anyone ever moved from an AL to a Group Home? Would appreciate your thoughts, suggestions, cautions and tips.

Bz

There are some foks here who have had a lot of success with moving their LO's into smaller care homes, Raven is among them. It's more homey, more quiet and less stressful for a lot of folks.

Yes, we did this.

My mom moved from her home with 24/7 in-home care to a large locked dementia-care ALF for nearly a year.

Then I moved her to a 9-person Alz-certified and licensed group care home, also locked. The CG to resident ratio is generally 2-3 caregivers for 9 residents during the day.

For her, it was a great move.

She is Stage 5/sometimes early 6. The dementia-care ALF was chaotic and disorganized, partly due to the resident mix and partly due to incompetent administration.

My mom is still aware enough to be very disturbed by the dementia behaviors of other residents. They would reach out to touch her, come up to us when we were doing a project and just stare, a male resident kept coming into her room to use that bathroom, and then there were several "wailers" and moaners.

Yes, they had lots of group activities. But my mom really needs one-on-one attention in order to participate and enjoy activities, and she definitely didn't get that.

They also couldn't adapt their caregiving to her individual needs, and the result was a perpetual low level of frustration and agitation on her part.

The group home is calm, orderly, and quiet. Much better and happier setting for her. They know all her little foibles and accommodate them without hesitation, so Mom is now extremely contented, much to my amazement.

There are eight other residents at various stages and they all coexist peacefully. There's one "wailer" but when she's wailing nonstop the CGs whisk her back to her room.

The only two possible downsides are:

1) no activities to speak of.

If my mom were less confused that might be an issue, I guess. I considered it ahead of time and figured if that was the only problem, I would be able to find a solution (like paying someone to come in and do things with her, or getting a church volunteer to visit her).

But as it turns out, her days are pretty full what with ADLs, meals, dozing, "reading", etc. and I'm not seeing any negative impact from the lack of activities.

2) more difficult to handle doctor's visits.

The dementia-care ALF had nursing staff 24/7. An internist and geri-psych both called in weekly and a dentist and podiatrist called in periodically as well.

The group home does have a doctor who calls in, but he is on probation for cocaine use so I don't want him to care for my mom.

I was able to get my mom signed up with a great geriatric house calls service, but that's not available everywhere.

If it weren't for that, we wouldn't have any doctors or nurses that called in at her group home and I would have to take her for office visits. Not fun.

On the other hand, I still have the same mobile dentist visiting her that saw her at the ALF, and the group home does have a podiatrist that calls in.

So it's all worked really well for us (knock wood).

Oh, and it's cheaper. Less overhead!

How does a doctor on probation for cocaine still practice medicine? I guess I shouldn't be suprised. My parents first doctor had some issues being sued for wrongful deaths after prescribing counter-indicatory meds, something like that.

HI:
When mom's ALF didn't work out after the first three-to-four weeks, we moved her to a small group home. There are only three residents, including my mom. It's the best thing that could have happened for her, and I thank God every day that we were paired with this particular home. It is more expensive than the ALF, there are few activities provided, but the care is absolutely top-notch. And I visit three to four times per week, at all different times of the day. My mom is always well-groomed. Her hair, nails (hands and feet) are trimmed and polished, she is clean, she is toileted every two hours to minimize the incontinence. The meals are all cooked from scratch, using fresh food, a huge contrast to the cafeteria food at the ALF. Even though mom is fed, her meals are beautifully presented.
Her Medicare Advantage insurance provides visitng nurse services, who recently gave her her annual physical.
The cost is $4,000 per month, it is private pay only. I know there are other group homes which are licensed for 6 people, and some of them will accept medicaid.

I'm thinking that we too may be in this same situation soon. I have a question though.... what did you tell your Mom? How did you present the move to her? I'm anticipating a real problem when this move comes and a whole lot of confusion.

I really want this option for my mother when she gets out of the behavioral SNF. The problem is that the homes we have found have 15 residents, plus respite and daycare. Yes, there are less activities which my mother doesn't do anyway. The problem is that I want to find a SMALL group home. These places that I have found and have wonderful reputations will be too overwhelming for her.

1) as far as telling my mom - keep in mind she was already in a dementia-care ALF and not happy. i said nothing to Mom beforehand. i waited as long as possible to tell the ALF she was leaving bc I was afraid a CG would say something to her.

I had a friend pick her up the morning of the move, take her to lunch and "shopping" while I raced with her stuff from the ALF to the group home and got it all set up. We were able to move in a few pieces of furniture ahead of time, but not her clothes, pix and toiletries until the day of the move.

I met them at the restaurant, friend handed off Mom to me, and I drove around for 15 minutes getting up my nerve. Then I said "Mom, I think we'll spend tonight with some friends of mine. We'll be closer to home that way and I know you don't like (name of ALF)."

And she said OK. So I immediately started talking about another subject and headed over there to get her settled.

Seriously. Total non-event to her. We've never talked about it again.

Of course, YMMV (your mileage may vary).

2) to find smaller homes - marjk, have you checked your state dept of aging website? they will list every licensed LTC facility in your state, including residential group homes.

i know TX has a PDF report of every facility you can download and I believe it includes how many beds they are licensed for.

quote:

Originally posted by Grassflower:
2) to find smaller homes - marjk, have you checked your state dept of aging website? they will list every licensed LTC facility in your state, including residential group homes.

i know TX has a PDF report of every facility you can download and I believe it includes how many beds they are licensed for.

The problem is that the group homes that are close to my sister are just too big. There are NONE here in Manhattan. The smaller ones are way too far away for either me or my sister to be able to visit regularly. I'll still look into this more. Working closely with a social worker now. At least we have a little time now because my mother will be heading to a behavioral nursing facility for a good six months, although six months FLIES by at the blink of an eye.