How do we move my father to AL when he insists nothing is wrong with him, etc.?

Shelbybud

My 92 year old father has dementia.  He currently lives  in an independent living apartment (for people age 55 and over). The  facility has an AL facility next door to his building.  He was evaluated for AL last week.   We (my older sister, myself and my younger brother) have been told by the director of the facility that Dad can't stay in independent living and needs to move.  We have been looking at moving him to the AL facility next door.  Dad insists there's nothing wrong with him and that everyone is lying about him having dementia, etc.  He says he's not going to move.  Gets very angry when we mention moving to AL.    The AL people said they have some people there with dementia,but it's not really a memory care facility. I'm wondering if we should be looking at a memory care facility so he won't have to be moved again as the dementia progresses?

Also,we are wondering how other people have moved their loved one when they aren't going to move willingly?   Any ideas?  We are really struggling how to get Dad moved.

M1

Hi Shelby. I hope one of you has his power of attorney? If so, then the decision is yours not his. If not, that's the first thing to pursue. It may help you to read up on anosognosia, which is the inability to perceive his deficits- it's much more than denial, and some 70 percent of folks with dementia have it.

You've come to a good place for advice and support. Good luck.

Iris L.

Anosognosia is a characteristic of dementia that causes the PWD to truly believe he is fine.  He sees no need for doctors, medications or changes in his routine.  If you try to make him see reality, he will resist and become upset.  This is what you are seeing.  You will have to learn work-arounds from the members.  They are knowledgeable and are willing to share.  Don't mention dementia to him again.

Iris

bozowing

Have exact same problem with my 93 year old dad, major proud and stubborn.  This week the judge signed an order for a 3rd party law firm to become his guardian.  So, we have some help with the legal aspects, but as the family there's no getting out of the emotional side.

Fib bit, going on short trip (voucher for the luggage).

Lindsay22

Hi Shelby, 

Second the POA, you will need it.  When I moved my mom to MC (against her will) I set everything up before hand but said nothing about it to her in the days and weeks leading up to it.  On the day of the move my husband took her to breakfast and a "doctors appointment" which took some doing because she was barely compliant with appointments of any kind at that point.  Once they were out of the house I went in an packed a basic bag for her, pillow, favorite blanket etc.  Using the advice of this board I did not bring sentimental items or pictures.  I then went to the MC facility and set up her room.  My husband arrived to the "doctor" and we said something about being there for a short time for some tests and left.  The facility advised that I not visit for 10 days to 2 weeks to give her time to acclimate.  I did speak to her on the phone after 3-4 days and by day 10 she was doing well enough that I visited.  She did ask about her cat and wanting to go home with me but that has gradually lessened.  It has been 3 months and they have adjusted her meds and she doesn't ask about home anymore.  It was incredibly difficult but I knew she needed 24 hour care and that her mental state prevented her from ever being able to see that or agree to moving.  If your dad would agree to the doctors appointment ruse with one of your siblings I would suggest that route.  

SusanB-dil

Hi ShelbyB - welcome to our little corner of the world.

Also agree with POA - and the anosognosia. Sounds like you will have to use fiblets - in his best interest.

and Lindsay22 - good job!  sounds like it went best as could be expected.

Shelbybud

My brother has POA for health care and durable POA. So that's not a problem.

Shelbybud

We have thought about having someone take Dad out for the day while other family members move his things to the new place.

Shelbybud

Lindsay, did your husband go to a doctor's office (or where)???   I'm not sure I understood that part of your reply.  Thanks for the reply. My siblings and I have discussed having someone take him out to eat, etc. for a day while other family members move his things to the new place.

MN Chickadee

He probably has anosognogsia, which is common with dementia. The brain is damaged to the point where it can't recognize its own deficits or process logical thought. This means no amount of reasoning, providing facts or evidence, or argument will work. It's time for therapeutic fibs - the only response and information you give him is that which brings comfort. 

Many of us have to find the right fib about moving to AL or MC. Sometimes we blame it on the doctor (the doctor wants you to stay here a few days to get stronger, or maybe monitor some other problem like high blood pressure, diabetes or a bad hip.) Sometimes there's a problem with the originial residence (there's no heat or water at the apartment so you can stay here until it's fixed.) Maybe there's a covid outbreak there if that is on his radar and he can stay here where there is no covid for a while. We almost always call it temporary. The transition may be hard but eventually he will settle in and stop asking to go back to the home. 

I'm not sure AL will go well. If he is to the point he doesn't know he has dementia, he will probably be an exit seeker trying to get out of there. AL is not usually locked meaning he will wander.  And the AL staff won't be experienced with this like MC staff, in MC they will definitely be used to dealing with someone who doesn't want to be there. AL is not usually staffed to the same ratio of MC and do not have the bandwidth to deal with dementia behaviors. If a person who already lived in AL develops dementia they may be able to handle it a short while, since the person is already in familiar surroundings, but generally it just doesn't work or is a very short stay before another move. The activities will likely be over his head because they are geared for cognitively normal people. MC activities are adapted for dementia. And the world in MC is just designed for dementia. So much more structure, routine, and oversight both medical and just day to day living. AL can often mean the person just doesn't show up for activities or meals, and gets lost in the extra time and space they can't handle. Place him based on his worst days not his best, and remember it is a progressive disease and it's only going to get worse. Whatever you decide, it is indeed best not to involve him in the decision or process. Taking him out for the day and having someone else pack up and move is probably wise, and then take him to the new location and start in with the fiblet you think will work best. If he is highly anxious or agitated or angry you might consult his doctor and/or find a geriatric psychiatrist to find the right meds to improve quality of life and make care more successful and reduce anxiety. Many of our LOs are on something for anxiety around the time they move to MC. I do know how hard it is, this stage you are entering is very difficult and forcing them to move is very difficult. Moving my LO to memory care was the hardest thing I have ever done and the most stressful time of my life so far, but couldn't be helped and in hindsight was the best possible thing we could do for her. She has thrived in MC getting the care and support she needs. Hang in there. 

Shelbybud

MN Chickadee:

I totally agree with what you said.  Well, today my brother (who has POA's for Dad) said they (he and my older sister, they both live in Nebraska near Dad, I live in Colorado) want to move Dad to the AL facility that is next door to the independent living apartment building he currently lives in.  Well, the main reason he wants to move Dad to AL is because Dad has a "girlfriend" who lives in an apartment in the independent living building.  He's very attached to her.  I knew this.  

If Dad moves to the AL facility nearby, there's a hallway that connects the AL facility and the independent living building, so Dad and his girlfriend can go back and forth.  

I understand my brother's hesitancy to move Dad away from his girlfriend, but I really believe Dad is really needing to move to a facility that has MC.  I've tried telling my brother and sister that AL won't address his dementia and he can take off, wander, no eat meals, etc.  Not a good thing.   We need to move Dad somewhere where he'll be safe and healthy.  

So, I guess we'll see what happens at AL. 

My brother said they will downsize Dad's belongings and furniture when they move him to AL so that if they have to move him again (to MC) he won't have as much stuff to move.  Yikes!   I really think he won't last long at AL and they will tell my brother and sister that he needs to move to someplace that has memory care.

Wish us luck!  Not my idea for Dad to go to AL!