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Has she been evaluated to see if medication could help with her anxiety, agitation,etc? It sounds like she is in a lot of mental pain. I would explore this with her doctor. Please know that the delusions and false accusations are common and in no way your fault.

Can they get on her meds while she's in the hospital?

Will her kidney problems require her to be in a skilled nursing facility? Does she have an advanced medical directive?

I know that you said that she could return to her previous AL, but, have they discussed with you how they would handle someone who is disruptive and resistant to care? I had that happen with my cousin and it's not a good situation. When the dementia is of a certain level and they are not able to give her one on one attention, it might be that her level of care would be too much for a regular AL. I'd ask them about it and how to evaluate what type of facility she would get the attention that she currently needs.

In NC, Memory Care AL's provide care for the resident for as long as they live, unless they need skilled nursing care. They can stay there even if they are bedbound, incontinent, handfed and on hospice. So, I felt comfortable placing my cousin there. Regular Assisted Livings in NC have other rules and a resident has to have be able to meet certain abilities like being able to transfer with the help of one person, cannot be double incontinent, etc. So, at Memory Care, there is some peace of mind knowing that they aren't likely to have to go to a nursing home. I'd check the rules in your state to see how they apply to help you with the planning.
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The agitation, paranoia and aggression are mainly in the evening, which they are attributing to sundowners. She was not doing that in AL. She did this the last time she was hospitalized, so it is typical behavior for her when in an unfamiliar place. Right now, I'm not inclined to add to her list of meds but I will keep that in mind. The kidney problems will be resolved in the hospital. It is her unwillingness to eat that I think will cause her current AL place to not want her back. They don't deliver meals to rooms unless you are ill and she is refusing escorts and reminders to go to eat. So, they probably will think she is a liability. They do wheel residents in wheelchairs but she could STILL refuse that. I will check into the Memory Care rules for Illinois. I was not aware they might have different rules.
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And thanks, Rainmom for the list of questions to ask. The nurses at the hospital said to NOT make an appointment for the first visit, just pop in. That's what I did with her current AL place and what I saw on that visit is exactly the way it is.
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ALG - the other thing that comes to mind is hospice. If when the time comes you are likely to want to use hospice - which I highly recomend - ask if the NH will allow outside hospice care. Most do as its additional help. My brother and I were determined that this last move be - my mothers last move, so hospice could have been a deal breaker if not allowed. I really like my moms NH - it's only a few years old, is privately owned and is small-ish in terms of residents - about 35. The married couple that own my moms place are both RNs and therefore the place is very medically oriented. They have two Drs with one or the other being at the place most days. An interesting detail that helped swing my decision was that the mother of one of the owners is a resident there. All the rooms are private and all have their own bathrooms - which would have been a deal breaker for my mom, had it been different. The only negitive is that it's all private pay - you have to prove three years worth of resources to be accepted there. However, if a resident runs out of money after the three years they will allow Medicaid rather than force a resident to move. That flexibility showed me that while a business - they were caring and understanding.
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08/25/16.... since I past posted on this thread, which probably was back in June [the date/time stamp is now gone from the postings], I moved my Dad into Assisted Living from Independent Living, same complex.

Where my Dad lives, Sunrise Senior Living, an Aide comes to his room and gets him ready for the day, and later returns to take him to the main dining room if Dad hasn't already started to head that direction. Same for lunch, and same for dinner.

Whew, what a relief as when he was in Independent Living, I would call him at 4:30 to remind him to start getting ready for dinner. Then I would call back at 5:15 to make sure he wasn't in his room.... if he answered, my heart sunk, as he hadn't gone to the dining room yet. Now I don't need to worry.
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Freqflyer, that's exactly the situation I was in. Calling mom at mealtimes, making sure she went and upset when she would answer the phone because she chose not to go. And she has a thousand excuses so it's not always the dementia. "I'm not dressed, didn't have a shower, nothing sounds good, not hungry..."
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