When we speak of assisted living to MIL, she forgets she agreed to move one day, next day she agrees? How do we follow through?

Has she been "formerly" diagnosed with dementia? (and I see from your profile she probably has been)
With the "formal" diagnosis there would not be a problem getting her into a facility particularly if the doctor states she needs 24/7 care.
I would caution you though that AL might not be the best place.
AL she can leave and go on an outing without supervision. She could sign out and go for a walk and not return.
Memory Care would be a better option. She could not leave without you or some other family member or facility staff.
If you do place her in AL as she declines she will have to move to MC and moves typically result in a decline shortly after.

I agree with Grandma re a formal dx. Alz or Vascula can have a long time frame & depending on the AL & what care is offered (they seem to vary a lot), it may work well for quite a while.

But some other dementia types have faster progressions & may need more support sooner rather than later. Esp if other medical or mobility issues.

It is a continuum care place ie AL with NH & MC?

Who has POA? If she has been diagnosed with and declared incompetent to handle her affairs, then u don't need her permission, you do it.

It depends on how far her Dementia has progressed whether she needs to be in an AL or Memory care. Some are not progressed enough for MC. The AL u choose will evaluate Mom to see if they r the right fit.

I will add, if this has to happen then you just have to get it done. Whether you use the honest truth, small fibs or outright lies it may break your heart but still has to be done.

You could suggest that as SIL is going on holiday, MIL will need to stay there a month - just for starters? Thank her for doing this to help SIL & you.

I know people will diss me for fibbing & I would try honesty first, but I have seen so many families struggle & struggle with this. I think it really comes down to the elder's personality & if they are willing to accept change or not.

How I reconcile it is although it's never nice to move people out of their home against their wishes - the effects of neglect leaving them unsafe at home can be worse.

Best of luck to your family through this transition.

First of all, kudos for recognizing SIL cannot do this anymore. Rather than how to physically “move her”, I’m going to approach this from a different angle.....
- does hubs have DPOA & MPOA that is legal for NJ law?
- does MIL have significant assets to pay on her own totally for AL for 3-4 years? Say 200k-300k available between her existing savings & her monthly income (like her SS $) over time?
- if not, is her $ interdependent on her selling her home.? & if so, what realistically could sale bring in deducting $ to make it market ready, Realtor & Act of Sale costs? Is SIL owed $ from mom for paying for house stuff over the years? Or you & hubs owed $ from mom? Like maybe family paid her tax assessor bill.
If she still has her home, is anyone expecting to have it given to them? Or lives there right now?
- if AL doesn’t work out, does she have $$$ for MC or NH? Or will you & hubs pay her costs to stay in NJ? Even if it should be that she actually needs skilled care @ $8-12k mo? Wherever she is, will, I’ll bet a case of a Prosecco, want y’all signing off on some sort of financial responsibility agreement as she has no well established history as NJ resident (so not easily onto NJ LTC Medicaid should stuff go awry should you have her in a facility that even takes Medicaid).
- are you assuming Medicaid (not MediCARE) will be covering her costs on NJ? Not perhaps Initially but eventually she will need MedicAID.

- has she had a “needs assessment” done? If not, please get one done ASAP. You do not, again DO NOT, want the new AL saying “we just so love your mom but she needs a higher level of care & here’s your notice to move her out within 30 days”. Happens all the time. Needs assessment is not a note from her MD saying she needs AL. It’s a 1-on-1 done usually by a geriatric RN & SW team at her home. Personally I’d be wary of any facility who blithely tells you she can move in without a faxing & review of her current last 6 mo of medical records AND some sort of last 30 days evaluation in advance...... whether it’s a 1/2 day “play date with lunch & activity” at the place or a needs assessment; aNd all of these done before the place accepts her as a resident. She’s coming in from living at home, if SIL & her family have been doing oodles of stuff that enables her to live at home now for 14 years of caregiving, it may be that MIL is not at all suitable to be AL resident. Needing help pulling up a zipper or transitioning in & out of the shower might be ok for AL. But She’s going to be expected to get cleaned up, dressed appropriately, take her meds & over to dining & activities on her own for the most part.
Did you spend better part of a day at this AL & can your mom on her own do what the other residents easily do???

- what’s her health like? Does she have diabetes or other chronic diseases? Have you set up a whole new group of NJ MDs for her? In new AL, is she expected to be able to go see her docs on her own, and do her daily RXs? if she needs help with these then she’s probably going to be billed as a seperate fee for medication management & for an aide to accompany her & transportation costs. Unless this is an $$$ AL with concierge medical, all these are added on costs for AL & remain a mystery till she’s actually a resident.

- will her current health insurance transfer to NJ? Original Medicare does but the supplemental secondary to her Original may not; if she’s on Medicare Advantage plan, those don’t as they are tied into provider network for her section of NC. So what have you set up for her health insurance?

Physically moving her, I’d suggest that you move her via a large SUV tag team driving so no overnite hotel stop, the smallest possible clothing & personal items for basically a dorm size room. “Belongings” need to be jettisoned, 86’d, Goodwilled. Maybe take chest of drawers, bookcase & lamps. Maybe box up & ship soft goods. A lot depends on facility allowing outside furnishings.

why not stay in NC?

Daughterinlaw56, sounds like a good plan is in place.

Break for SIL. Temporary stay with you. Medical look over coming up.

Yoir MIL is in good physical health & with such a lovely supportive family has the best chance to transision to an AL where she will be a bit safer going forward. To do this before the memory issues get worse is your best ally. Good job! 😊

EVERYONE’S parent “has always been a difficult parent”, and very rare, VERY RARE, is the docile, peaceful, agreeable, self sacrificing parent who AGREES with entering residential care.

If HER SAFETY, SIL’s wellbeing, YOUR HUSBAND’s ability to provide the best circumstances FOR ALL OF YOU, FOCUS ON DOING WHAT MUST BE DONE.

Whether she is “mean and accusatory” or not has NOTHING to do with doing the best you can for everyone involved.

NO ONE in your situation will be completely happy with how this goes down, but at this stage of her care, compromise among less than good situations becomes the best you can do. If her cognitive assessment reveals anxiety/depression, a small dose of carefully chosen mood stabilizing medication may help, and it’s worth a try.

You have all thought this out kindly and fairly. If the assessment of her cognitive functioning does not reveal that she is not safely living in her present setting, that time will occur soon. You all know that dementia is progressive. There is no strict time line of course, but also no question that it is irreversible.

If she qualifies for Memory Care it will most likely be the safest, considering your concerns about her potential attempt to leave. The residence you are working with will typically help with that decision, but with Covid 19, many no longer have the luxury of too much mutual decision making.

Choose the simplest method of getting her out of her current situation, ignore the hostility, rage, threats, ignore “changes her mind”, bring small familiar possessions that will make her feel more at home in her new setting and move larger pieces when she’s settled and you have a little time to make those kinds of decisions.

Although this feels as though you’re all alone in this, her pattern is tragically familiar to many (probably most) of us. Hope you are able to make some sound decisions, combining love and safety to come up for what is best for her.AND FOR ALL OF YOU.

When we first moved Mom I to assisted living, she not me, signed the contract lease agreement. If there is no dementia documented, you cant sign the papers for her and drop off and leave. She also had to have a meeting with the RN to do cognitive and needs assessment.
So the only way we got mom on board, was to say she could try it for 2 weeks, then she could give 30 days notice if she didnt like it, and she would only be out a month rent and a small administrative fee. She said she just wanted a few things moved, I think she finally said ok, so we would shut up about it and she could point out she tried.

Since then her dementia increased and shes had to move to Memory Care. One thing that we did is that they allowed her to do 2 covid tests, one 48 hrs prior, then one day of move in. She got results next day for both of them, negative so she did not have to be quarantined when she moved in.

I would present this to her as a done deal. I would not ask her if she agrees, I would just proceed as if she has. And she did agree, but then she forgot. Just proceed that this is temporary to give SIL a break. I would not define how long the "break" will be. Bring what you can of her personal items but not furniture; that could be moved later; rent furniture if you need some, or buy it online.

You just keep moving forward; this is a good plan. It does not matter if she is mean to SIL; she has dementia and maybe is mean all the time. My mother is mean; so what, I know she has a broken brain and I don't get offended or upset.

You are overthinking it now. You have the plan; just decide how she will get up to NJ and do it. My mother did not want to move; she thought we should take care of her at home. We had MD report stating she could not live alone so we blamed the doctor and placed her. And just so you know, when she was placed, she was happy for about 2 hours and then she started calling for us to come and get her out. That lasted for 2 weeks.

For now, baby steps, just get her in there. Good luck; this is no fun.

I'd suggest packing all of her belongings in a portable trailer to attach to your vehicle and have it ready to go on a moment's notice. On a day when she's cooperative just go for it. If there are any sights to see on the way where you can stop so as to make it like more of a vacation that might help. With that said, all you need to do is to get her there physically. She certainly isn't the first person who arrived and was resistant, fearful, or hesitant to accept this new living arrangement. Will a family member be living close by to stop in daily for a while until she is settled? On the other hand, is she appropriate for assisted living considering her memory problems? If you can't get her to agree to stay at the assisted living facility then you may need to look at long term care. She'd be required and they'd be responsible for keeping her there at the facility. The most important question is does one of you have POA for her? If not, I'd get it before attempting this family adventure. It will make your lives a whole lot easier. Best of luck!

Put a big sign on refrigerator with date of the "move". Have everybody sign it. It will be a visual reminder every day that she is moving. Expect some fussing, but continue with the plan. You are doing this for her safety and health - and the health of every one involved. Ask SIL to "help" her sort through her belongings for her new home (usually the management can give you guidelines of what to bring). Have SIL pack items and either mail to you or arrange for them to be shipped. There are transportation companies with all different types of shipping. PODS and similar services drop off a huge container that you pack with boxes and they move it to the new location. Some places will do the packing, loading, moving, and unloading into the new home. Of course, U-Haul is an option but it requires somebody driving the distance.

I feel so badly on what I am reading about people who are caring for parents with stages of ALZ or dementia. It has been 2 + years that I have lost my husband to stroke/fall while in assisted living with ALZ/dementia. He had told me years ago he didn't want to go that route. Okay, so being a loving wife, I said I wouldn't do that. BUT, when the time comes, you can't ask your parents or your spouse if they would go, you just do it and take them there, don't empty the trunk with their stuff until they are escorted to their room, and then empty the trunk with an aid from the facility. This is TOUGH LOVE. You would have already signed papers long before that move in date, plus all the medical reviews and signatures from doctors on agreeing this is best for loved one. I'm reading almost every post here that you all don't want to upset Mom, Dad, spouse, aunt, by asking and sometimes pleading with them that you can't take care of them anymore. Don't feel badly that you can't. It is too difficult, heartbreaking, and sad that you yourself endure, your own health at risk for theirs. If you get incapacitated because of your own illness and can't take care of them anymore, who will.
When it came time for me to make this decision, I just did it. I had to have a hard heart and do the job. Got paperwork, got doctor's exam, signatures, already had the health care directive for my husband's wishes, in hand, made all the arrangements and drove him there. Don't you think after 58 years with only one year apart, when he was in Vietnam, and for 57 years, lying in bed with him and waking up to a caress and kiss, that I wasn't wrenching my gut that this was wrong, sick of me not to care, regretting getting papers signed, lining up the movers to deliver his bed, favorite chair, favorite painting, favorite family pictures, a good bit of his clothes, and walking him to his room? It was the right thing to do. But, lucky for me, that my husband didn't disagree, he didn't know any better by this time, he just was a danger to himself by leaving the house, and you've heard this from me before, crossing 6-lane boulevard on a Sunday afternoon when there was barely traffic. Don't you think my heart bled that I had to face facts, he wasn't getting better? My sister and brother had this problem with my Mom; she and her husband had their own apartment, thought she didn't need assisted living, drove my sister crazy with bank statements, called my sister a thief, when there was no such stealing from my Mom; called the manager a thief for stealing her load of sweaters my sister gave her, only to be in her drawer where she put them. When the time came, my brother drove from Delaware to pick up my Mom and step dad, drive them all the way to Delaware. On the way there my brother had already arranged for their room in assisted living, and he brought them there, all while, telling them during 6 hour trip, he wasn't taking them to a home. But he did, for their sake and safety. Oh, yeah, my Mom was blazing mad, using every cuss word she could think. Slapped my brother and tried more, that she was p___ed off, she hated him, didn't want to see him. He had to have tough love, as he saw how my mom was keeping house, her husband making a sandwich and eating it with molded cheese and meat. That was the little clue. My brother stayed away the required time, as I did with my husband. My Mom fought like hell, but she was safer than her own apartment. My family wished they had done it sooner. I was not living in the country so could not leave my job overseas and help. I only agreed with what they did. Sometimes grown children of demented parents have to have TOUGH LOVE. For the safety of their loved ones, no matter what they said about not ever wanting to go to a nursing home, wanting to stay in their home, have tough love and take care of what has to be done--for your sake as well as theirs, just get it done.

Do what is in her best interest and make sure you take Covid-19 threat into consideration on investigating what facility you want to send her. Today decision could be a matter of life or death and possibly when.

I’m not sure if this will be helpful or not if your MIL is “difficult”, but here’s what we did with my mom: humor. After a couple years of her living alone after my stepfather passed, and her falling into a deep hole of depression, me and my 3 sibs began talking with her about moving to the state where 2 of us live. If we put pressure on her, she would dig in her heels and refuse. We tried to keep things light, but never missed an opportunity to point out times when it was obvious that she couldn’t do things as well as she used to. We’d use sarcasm and humor, pointing out as she would say, “old age ain’t for sissies”. It was very helpful that both her daughters live in the city we wanted to move her to. She visited with us a couple of times, and both times we introduced her to 2 nice facilities we picked out for her, therefore giving her some say. Same thing, she loved the facilities while here, and when she returned home, didn’t remember and balked again. Finally, we convinced her to move after she suffered a UTI, because she was not able to consistently take care of herself. Three of us visited both facilities with her again, and we all played up how nice they were and she agreed. We held her to it, packed up her stuff as quickly as possible and “struck while the iron was hot”. We made a fun time out of the move, (as best one can!) driving 900 miles together.

Once in her new home, she was confused, and shortly after, was diagnosed with dementia, which we kids all knew. That diagnosis was very distressing to her, as her mom died of Alzheimer’s and my mom was terrified of having Alzheimer’s. So we now refer to it as CRS, “Can’t Remember Sh*t”, which seems to be ok with her.

My point in all this is, even though bottom line you are having to step in and play the adult role, doing what is best for your MIL, there are ways to lighten up the process, being firm (about the decision), yet gentle (about how you make it happen). Good luck to you!

Other people have said: stop talking about the move or the facility for a few weeks, let her forget about it. Then plan a "vacation" with you in your state, where the new facility is. While she is on vacation with you, someone (or a hired company) must move her things from NC to the new room in NJ. Obviously this requires weeks/months of preparation. When the vacation is over and she wants to go home, take her to the new assisted living in NJ.

If her memory is that bad, she doesn't belong in AL. You'll just be moving her again.

Move her to a memory care place.

Imho, she quite likely requires a higher level of care than an AL. Best to do just one move to an MC. Then when an MC is found, just say to her that you're going on vacation. Prayers sent.

Can you bring her to the AL for a trial stay? Have you considered what to do if she does require Memory Care; instead of AL?

After reading all of your answers, my heart goes out to you.my thoughts agree with what Ricky6 said, have you checked out any memory care homes?
My mom is in assisted living and her dementia has just exploded because of covid19.i can sit on the porch with her and thats it, because i cant come in and visit with her shes gotten stir crazy, always telling me she wants to go home.i recently tried to move her to a different facility, id previously showed her pictures explaining the facility to her, she was totally for it. When i got her there, she was totally confused, acting like a deer in headlights and absolutley refused to stay.
I get the tough love thing, but you have to know they're really ok. If a parent cant remember certain things, they at least deserve to know they are loved.
By you explaining things to her is a respect thing, how i see it.
Dealing with a loved one that has dementia and changes gears every time you talk is a really difficult thing, just making a decision for them, ive seen with my mom, can leave them worse off being left confused i dont know if anything I've said here is helpful, but my heart truly goes out to you, and if you ever need to talk or vent, plz shoot me a message. isnt that what this website is for?
The support?
Best of luck to you, I'll definitely pray for you,

From your narrative, no one is able or willing to care for your MIL at home and she is not able to live independently.

Accordingly, there is no choice for her to make.

Make all the plans and have furniture, etc. in place. Go and take her to "lunch" or to visit and then just bring her. Sounds like she has dementia. Tell her your sister is taking a vacation and will return, etc. (little white lie). Let the staff handle it from there. Do NOT let her refuse - just get help in getting her then. And I would let your WIL out of the move. She needs some peace if she is not tough enough to tell her off and force her to stop her behavior. Just do it. let her rant and rave - she'll forget the next day. They are trained to handle this.

not sure a good answer but maybe a little "white lie" in telling her that the doctor suggested a short stay while SIL goes on a small vacation.  This place will take care of her until SIL gets back.  Then take her there (and explain that situation to the staff-they will understand), tell her that you will be back, make sure she is settled in, then leave.  I wouldn't go back then for at least 2 weeks.  give her time, she might enjoy the other company of others and their activities.  And when you do go back, tell her that you are repainting or something and it will be a little while yet.  sooner or later, hopefully she will forget about wanting to go home.  And if she does put up a fuss, tell her that the doctor has to approve first........and then drop the subject.  Wishing you luck.  My dad had fallen and went right from hospital to NH,  he would mention about wanting to come home and I told him that the doctor had to approve it first.  He definitely had dementia and we never told him that he was in a NH, just another place like hospital until things were approved by doctor.  God will forgive you (or whomever you believe in).