Finding Memory Care in Long Beach That Will Say Yes

Secured means two completely different things here

In a larger community it usually means a separate wing with its own locked doors, its own staff, its own dining room, and residents who all have dementia. Your mother would not be in the main building. She would be behind a door that needs a code.

In a six bed house it usually means the doors are alarmed, the yard is fenced, and somebody is awake at night. That is a smaller, quieter, more homelike version of the same idea, and for a lot of people in the early and middle stages it works better. There is no dining room to get lost in and no corridor that looks like every other corridor.

Whichever you are looking at, ask to see it rather than be told about it. Walk to the front door with the administrator and ask what happens if you push it open. Ask whether the home holds the state approval it needs to secure a door that way, and ask to see the paperwork. Any home doing this properly will have it to hand and will not be offended that you asked.

What actually gets someone turned down

Nobody tells families this list, so here it is. These are the things that make a home say no, and knowing them before you call saves you a week of rejections you will take personally.

• Leaving with intent. Not confusion at the door, but genuinely trying to get out and get somewhere
• Hitting, grabbing or shoving a caregiver or another resident, even once, even understandably
• Needing two people and a lift to transfer, which a house with one caregiver on shift cannot do
• Being awake and active most of the night, which a house with one overnight caregiver cannot absorb
• Oxygen, a feeding tube, or wound care that needs a nurse
• A weight far outside what the caregivers on shift can safely move

So describe your father accurately, even the bad week

The instinct is to present the good version. Everybody does it. It costs you time, because the home comes out to assess, sees the truth in twenty minutes, and declines. Then you start again three days later with a discharge date that has not moved.

Say the worst of it on the first call. A good home will either say yes, or say no and tell you what kind of place would say yes, which is information you cannot buy. The homes that take anyone without asking a single question are the ones to be careful of.

If your parent is currently in hospital on medication for agitation, say that too, and say whether it is new. Homes need to know whether they are meeting a settled person or a person in the middle of a change.

The four o'clock problem

Late afternoon is when dementia gets harder. Light changes, the day's staff are tired, shift change is coming, and a person who was fine at eleven is now packing a bag to go home to a house they sold in 1998. That is when a home either has a plan or does not.

Which is exactly why your visit should be at four, not at ten in the morning. Ask what happens here at this hour. Ask what they do when someone is trying to leave: do they redirect, do they walk with them, do they call the family, do they call the doctor. Ask how often they call a doctor about behaviour. There is a real difference between a home that walks a resident round the garden for twenty minutes and one that reaches for the phone.

How to read a visit

Look at the residents, not the lobby. Count the staff you can see on the floor, not the ones in the office. Then ask the questions the tour is not built for.

• How many caregivers are with residents at two in the morning
• How many people living here have been here more than a year
• How long has the person doing this tour worked here
• What happened the last time a resident got out, and what changed afterwards
• Do you take someone through to the end, or is there a point where we would have to move again
• What does a day look like for someone who cannot follow an activity any more

Cost, and the bill people do not see coming

Dementia care costs more than assisted living in the same building, because it is more staff. In a larger community that usually shows up as a higher care level. In a small home it is often a flat rate that is simply higher than the rate for a resident who sleeps through the night.

We are not going to publish an average, because an average across this market would be meaningless. Ask each home for its own figure in writing and ask what would change it. The bill families do not see coming is the private caregiver hired on top, hour by hour, when a home will accept your mother but only with extra help for part of the day. That can quietly double the monthly number, so ask early whether it is going to be required.

Where to get the call list

The state register tells you which homes exist, how many beds they are licensed for and their licence numbers. It does not tell you which ones run a dementia programme, because that is not a field the state publishes. So use it to build the list, then ask each one the questions above. We keep the whole thing on one page: all 50 homes licensed in Long Beach, plus the 109 more across the Gateway Cities.

Then let us do the ringing. We already know which homes in this catchment are taking exit seeking right now and which are not, and that answer changes month to month depending on who else is living there.

When the answer is not a move yet

Sometimes it is not time. If your mother still knows her house, still sleeps, and the real problem is that you are exhausted, a move may not be the thing that fixes it. A few hours of caregiving at home, a day programme two or three days a week, and a proper conversation with her doctor about what is driving the agitation will sometimes buy a good year.

The Alzheimer's Association runs a helpline that is staffed around the clock, and it is worth a call even at two in the morning when you cannot ask anybody else. We will tell you when we think you are not there yet. We do not get paid for that, and we would rather say it than have you move her twice.