How to make the move to memory care

kathy632

Hi - I'm new here. My father, 84, has Alzheimer's but is still living at home with my mother, who is now nearly blind and has health issues of her own. She has been looking after him, and trying to cope with his decline for quite some time. They've been together for over 60 years, and she has always relied on him and feels some sense of obligation to continue to care for him. I live halfway across the country, but two of my siblings live in the same town and are completely worn out with trying to help them with their daily needs. I'm frankly worried about them almost as much as my parents. My sister is their POA. We siblings are in agreement that it is time to move our dad to a memory care unit, to take the pressure off my mom, and to give him a more stimulating and safe environment. Currently he spends much of his time obsessing over things such as wanting his car back, or demanding to be taken to a doctor appointment which doesn't exist. They used to be able to take him out to swim laps, etc, but he has become so demanding and difficult that no one wants to be alone with him in a car anymore, and that has really limited his social life. After visiting a few places with our mom, we put his name down at two, and now it looks like a space will be opening this week. Our mom, who was on board before, is suddenly having a very hard time choosing to move him. I don't know if she'll ever be ready unless something drastic happens, which is what we are trying to prevent. So I have two questions, really. One - how do you know when it is time to move someone to memory care? Two - how do you get him there? He would not agree to it. We got him to day care once by concocting a story, and it was a really great program, but he did not want to return. Should we lie to him? Tell him we're going to that doctor appointment he so badly wants to get to? Everyone is dreading this so much, and my mom is uncomfortable with lying. She wants to attempt to get his buy-in, which is never going to happen.

M1

Welcome to the forum. Yes, you make up a story-the doctors appointment may well work-and do not discuss it with him ahead of time. You just get him to the front door, and the staff will take it from there.

harshedbuzz

@kathy632

Hi and welcome. I am sorry for your reason to be here, but pleased you found this place.

I had a similar situation with my mom aside from the vision issues. She does have AMD, but it wasn't that bad yet. That came later. Dad was not and easy individual even before dementia, but in retrospect, some of the hardest aspects of helping my parents was mom's behavior.

Mom had been in denial about dad's dementia for years and fought me on having him evaluated until there was a crisis that nearly killed her. And once he was diagnosed in the mid-stages, she went through a difficult-for-me phase where she insisted on interacting with dad honestly as if he was an equal partner which resulted in me having to drop what I was doing to calm the situation. It got real old, real fast.

Your dad is clearly at a point where kindness is more important than brutal honesty. One thing that helped mom embrace the need for a therapeutic narrative was this-

https://www.smashwords.com/books/view/210580

Mom was quite resistant to placement. It might be worth exploring mom's objections with her. My mom's boiled down to a combination of the societal expectation that women should be caregivers, the generational expectation that honoring her wedding vows meant in home care and concerns about cost. I was worried about her health and his volatility. And, TBH, he was resistant to her caregiving, so he wasn't getting quality care at home.

I tried 2 approaches to gain buy-in for her. Firstly, I assured her that placement could be a temporary/trial. We'd do the paperwork to place dad so that she could travel to attend her sister's funeral in May. Then I had a Come-to-Jesus in which I explained to her all of the ways in which dad's care was harming her and could potentially lead to her predeceasing him as one third of all caregivers do. I assured her that I had an executable Plan B to place him in a SNF near me (he'd been there for rehab a year prior and they agreed to accept him on-the-fly if needed) on the day she died and would place him in the very first MCF that would accept him as soon as she was buried. Therefore, it she wanted to pick his MCF, she needed to do it asap.

We did as @M1 suggested. We told dad he was seeing a new doctor implying that we wanted a 2nd opinion and the best care possible for him. I had arranged this with the director of the MCF who, along with the activities coordinator, took him away to the afternoon matinee and snack activity. I'd gone ahead and prepped his room and delivered clothing and toiletries so as not to raise suspicion. When we visited the next day, we said the new doctor wanted him to have rehab, so we found this nicer place with all private rooms.

I was right to be concerned about mom's health. Despite me being at her house about 5 days a week, shopping for them, bringing meals, handling dad's appointments, and such, mom wasn't taking acre of herself. She stopped taking her daily COPD inhaler because "it doesn't bring much to the party", her BP meds because the prescription needed a refill and she was on hold with the doctor too long (no asking the pharmacist to reach out or me to leave a message on her portal) and her statin because "her sister has "feelings' about them". Dad was only in MC for 7 weeks before he died. Three months later mom was hospitalized for a BP crisis and COPD exacerbation. Several weeks after that, she lost the vision in her left eye as the result of damage to her optic nerve which resulted in her not being able to drive. This means her stage 8 has not been what she envisioned. Nor is mine as she's more dependent on me.

Given mom's vision issues, she may have been more dependent on dad than you realize. Will she need more care and attention is she is living alone. Would a move to a CCRC with her in IL or AL and dad, on campus, in MC make sense? I have seen situations where 2 parents both dementia and sort of prop each other up to function better than even the less progressed one alone would. I'm not saying mom has dementia, more than even a person who is quite impaired can function as a support.

Good luck.

HB

Rob's Daughter

Hi Kathy

We didn't mention anything to my Dad before the day we took him to Assisted Living. Actually a chair that I wanted to have in his room, I lied and said I needed to have it cleaned. We had his room decorated with family photos and his chair was there too. I agree with, just get him to the front door and the staff will do the rest. I was so stressed for that day, but it really wasn't so bad.

It worked out well for a several weeks until my Mom wasn't doing well on her own so we moved her in with my Dad. My Mom wasn't eating nor taking her meds and actually fell a few times. They are together... which is good and bad at times. I think my mom is heading down the dementia road as well. Its so hard to see them both declining... but I know they have GREAT care and are both safe.