How to help parents transition to new facility

BothDementia

Dad was hospitalized in FEB23 for uropathy. Since then, he has to rely on foley catheter for urination. To date, Dad's dementia(ALZ) went from stage 4 to late 6 within 4 months. Not only was it hard on Dad, it was also hard on Mom. Her dementia (vascular) also took a step down to mid stage 5. It is heartbreaking to watch the both of them decline so rapidly.

For the past 13 months, they have been living at a facility in Fremont, CA that is 30-minutes away. It was an all-Asian centered facility which is why sis and I placed them there and they have become very accustom to this place. Although this facility has a MC wing, but no vacant rooms. Its ALF side has a very low care-staff to resident ratio (1-17) and despite us providing all the daytime supervision, it decided to evict him anyway citing 'needing higher level of care'. We have no choice but to move them.

My husband and I have found a MC facility that is only 5 minutes from where we live so we can visit often and more conveniently. Sis has brought Mom to see the new facility, other than being ambivalent about not seeing any asian faces, she is fine with the facility. Right now, there is disagreement between sis and I - she insists that Dad see the new facility before the move and I don't see the point. She feels he needs to "know" that he will be moving. Is there any benefit to make sure Dad "knows" now that he will be moving and that he sees his new "home" now before the move? A final move-date hasn't even been decided yet! I feel it is more important that we keep things as "normal" as we can AFTER the move by continue to visit daily to help/support them ease into the new environment before pulling back.

Recommendations/Suggestions?

terei

IMO NO, he should not ‘know’ he is moving. Your sister is not seeing that your father is no longer able to process any information logically. Move, give him whatever excuse you need to after he is there that will satisfy any questions he may have. I do not believe any caregivers who have moved their LO will give you any other answer. Your sister is inviting confusion + stress to him that this unnecessary

BassetHoundAnn

No, you should not tell your father that he's moving. At Stage 6 he is no longer processing or remembering any information about where he is. My mom alternately thinks she's living at her brother's house or is in the hospital. She has no memory of any of the AL or memory care or rehab facilities where she has lived during the past 3 years. Telling your father that you are moving him can only cause him anxiety, assuming he can even process the concept or remember what you tell him. Tell your sis that your roles are to keep him safe and to make sure his life with dementia is as stress-free as possible. That means not telling him about the move in advance. It will do no good and serve no purpose.

One final thought. Can the new memory care accommodate his need to use a foley catheter? Some cannot, and will suggest that the resident move to a skilled nursing facility if a catheter is needed.

harshedbuzz

Some random thoughts--

The turnover rate in most MCFs is fairly high in most MCFs. Unless this unit is very small and filled with people in earlier stages, it might be possible to hire outside aides to assist until the move can be made within the facility. IME, dad's facility lost enough folks during the 7 weeks he was a resident that they were able to close off one hall temporarily.

Where I live, a Foley would be an automatic transfer to a SNF for care in which case a CCRC with MC for mom and a SNF for dad in one building/campus might be an option.

Is your sister in a long-distance relationship with your parents? The notion of looping a PWD into a necessary move over which they have no say seems pointless and even cruel. At stage 5, mom would even be iffy around it being an option to include; since you have why not tell sis the decision to move without upsetting dad was mom's choice.

HB

Emily 123

This is more about your sister wanting her parent's approval and buy-in, but your dad is unlikely to be at a point where that's a reasonable expectation for him. At stage 6 he won't be able to retain the information. Keep him in his stress-free routine until time to move.

BothDementia

Thank you all. I feel more assured now. Sis is very protective of Dad and she has good intentions. We lean on each other for support and share caring responsibilities. She has since backed off on showing Dad the new facility so that he knows.....WHEW.

Lately, Mom has been asking about the new facility and wants to know when they can move. She is actually looking forward to the new facility knowing their MC will be able meet Dad needs better than the staff at the current facility; including proper servicing of Dad's catheter related needs. Mom was relieved to know that we are hiring an Chinese speaking companion to visit her 3-4 times a week to assist her with IADLs and provide social interactions.