Mom likes her apartment, but keeps having more and more trouble with normal activities. For example, she keeps showing up at the dining room outside of eating hours even though I have a sign plastered to her frig showing when to go. She gives the laundry clean clothes to wash instead of dirty ones in spite of the 100 times I have told her to put dirty clothes on one side of the closet, etc. She keeps opening multiple cans of cat food because she doesn't remember that one is already open, even though I clearly mark each can for specific days for her. If I have to move her to a higher level of care, she may not be able to take her cat and that might be the end of her.
Get hold of the manager of the AL facility and schedule a sit down or a phone call to discuss more care for your Mom.
Assisted living facilities often have 'levels of care' and she may be at the very bottom tier right now (which is much like independent living).
When my MIL became unable to manage her medications (she was taking the wrong pills at the wrong times etc.); we asked for 'med management'. For a small increase in cost; the facility now brings her all her meds at the right time and dosage. What a relief. Next we asked them to help her dress/undress - this was at no extra cost as it was part of the same tier of care. We got concerned recently that she might need more assistance with toileting etc. so they now visit her every 3 hours just to check on her and see if she needs anything at all (again same tier so no extra cost).
You might also ask the staff at your Mom's place if they provide 'pickup assistance' (my name for it); they will come by to pick your Mom up when it's time for meals and walk her to the dining room.
Talk to management and find out everything that she is currently entitled to; and what the next level of care is and the cost - they can help you!
They can all arrange for room service.
Their pets are often walked or tended to by pet sitters or aides.
Aides can facilitate her laundry sorting as well.
If you are writing notes and reminding her 100 times then I respectfully want to point out that you need to educate yourself about dementia and learn what to expect and how to better interact with your Mom for a more peaceful and production life. I've watched Teepa Snow videos on YouTube and found them very helpful.
I also found this helpful:
Rules for engaging our loved ones with dementia:
1) Agree, do not argue
2) Divert, do not attempt to reason
3) Distract, do not shame
4) Reassure, do not lecture
5) Reminisce, do not ask “Do you remember...?” 6) Repeat, do not say “I told you”
7) Do what they can do, don’t say “you can’t”
8) Ask, do not demand
9) Encourage, do not condescend
10) Reinforce, never force
The overall goals should be to:
1) keep them as calm and peaceful as possible
(because they are less and less able to bring themselves to this state on their own)
2) keep them physically protected in their environment and from predatory people
3) keep them nourished with healthy foods that they will accept without fighting or forcing
4) keep them in as good a health condition as is possible, that their financial resources will allow and within their desires as expressed in a Living Will (aka Advance Healthcare Directive)
5) keep them pain-free as possible and within their desires as expressed in a Living Will (aka Advance Healthcare Directive)
I would sit down with the Nurse or Director and see what kind of help Mom can get but it will cost her more. They will tell you if they can continue her care or she will need to go to MC.
For how long?
'As long as possible' is a good time frame.
For some there is a fall or other crises that means the awful day of 'no longer possible' has arrived.
For others, it is a grey area. I agree with Geaton & the others that adding a personal aide to assist with laundry, cat care etc may extend the time.
I also agree re notes no longer working. The skill of reading may be very intact. Yet this differs from the skills of comprehension & processing the written words, then applying actions & using memory to retain the information. Like being able to pronounce a foreign word but not being able to follow the meaning.
Re the cat - I have seen stuffed life size cats & dogs in MC. Even when residents know they are toys, having a 'friend' to pat & talk to can bring comfort. Hopefully that stage is way off but there is much joy, love & special moments to be had then too.
My mother was in an AL that allowed pets, and she too loved her cat. We had similar thoughts that it would be too detrimental to separate her from kitty. We finally had to remove the cat because during the months of lockdown, it developed anxious and aggressive behavior due in part to my mother’s treatment of it. We later found out that she would forget to feed kitty or give her people food, which in turn caused skin issues with fur loss. My mother would pick at the dander on the cat’s fur all the time thinking she was seeing “bugs” which irritated kitty until she bit or scratched mom. After so many cat bite treatments, the facility rightfully said the cat must go.
We got kitty out and surrendered back to the ASPCA as our situation wouldn’t allow us to keep her. Sadly, when we called to check on her a week later, ASPCA had determined she was too neurotic for rehoming and had put her down. We were horrified to say the least and regretted having left the cat in that situation as long as we did, thinking it was the best thing for my mother and also believing this SPCA was a no-kill shelter.
How did my mother handle the separation? She fretted about it off and on for a couple of weeks until her dementia wiped that part of her short-term memory clean. She’s doing well now, but in hind sight, I would have tried the idea of replacing the cat with one of the life-like weighted dolls or pets to help with the transition.
Best wishes, hopeful you’ll receive some clarity and peace of mind on the direction to take with your mother’s care.
Discuss with the facility, if they have Memory Care if mom can take her cat. Many will allow it. But if mom is unable to care for it is that fair to the cat? If you or someone that mom pays comes in daily to clean litterbox, feed the cat then that might work. Or switch to strictly dry food and allow the cat to eat whenever it wants.
Taking the cat to your house and telling mom that it went "to the vet" and then giving excuses like.."the vet is doing an exam" or "the cat needs shots and has to stay over night" Replacing the cat with a weighted stuffed one is a common thing to do. Some even make noise like purring.
She was a food hoarder, she would go the dining room and stick jellies, butter and so in her pockets, then if she left one little morsel of food on her plate she would take it back to her room, stick it in her refrigerator and there it would sit for weeks. We had notes plastered all over her refrigerator did no good.
She may mourn removing the cat for a while, but she will soon forget and start navigating her new surroundings. She no longer can care for her cat. Believe me it won't take long, that thought and feeling will pass along with everything else.
It is time do the right thing for your mother and her cat.