Dad refuses to move from AL to EC

Gobellago

Hello, my dad has Alzheimer’s/Dementia and has been in assisted living a year. He needs more care for his diabetes and heart condition and we need to move him to Enhanced Care. He is not ready yet for Memory Care. I would put his current stage as “middle”. He absolutely refuses to make the move from one side of the facility to the other. Caregivers will be the same, room is similar, and they are allowing him to continue to go to the AL dining room for meals to help ease transition. But he’s still dead set against it, and his reasons “why” vary a lot: he doesn’t want to change rooms, the people who work there are “people I don’t like”, the people who live there “I don’t like”, he thinks it will cost more (even though I told him it wasn’t an issue), etc. I just can’t get him to budge. He doesn’t agree that he needs more help even though he can barely walk and falls often, and has completely stopped all hygiene. He smells awful but tells me he doesn’t smell when I ask him when he has last taken a shower and becomes angry. I told him I love and care about him and want him to be healthy and safe, but he doesn’t seem to care about us or himself any more. I could use any help or ideas you have!

M1

Welcome to the forum. This may sound harsh, but the choice is not his to make. You probably need to present it as a fait accompli and just say, "we're moving down the hall today.". Make up an excuse if you have to--Painting/remodeling project, gas leak, whatever. Don't offer any other explanation about the level of care.

H1235

Sorry I know it’s probably not what you want to hear and it’s really hard, but I agree with MI. He is not able to understand reasoning(#2). By coming up with an excuse for the move ( they need to paint???) you avoid an argument(#1). You can sympathize with him and agree that the move is inconvenient. If you try to convince him it is only going to upset him more and probably you as well. Change is hard. If his memory is not good he may just settle in and adjust very quickly.

Gobellago

OK. I’m letting this approach sink in. Thank you both for sharing your experiences! It’s not what I expected, but it absolutely makes sense. Dad and I have not had a discussion based on logic for a while now. And he is not able to maintain a thought long enough to speak it in a full sentence. Yet he still has all the feels and emotions, and can’t remember why. I’m trying to play this scenario out — so I will say “we are moving you to a different room next week, I’m here to start packing some of your things.” And he will say “why? Did you decide this without me?” I’d like to be able to say “because this room needs to be repainted”, but he is aware enough to know he is being moved to the area of the building where the “crazies” (his word, not mine!) live. He still has enough memory to realize he is going to a place he doesn’t want to be. I’m not sure how to help him at this part of the interaction.

M1

You dont tell him until the day of the move. No time to think about it. Move his things after the fact, not before. ask the director for help about how to accomplish this.

I moved my partner from one MC room to another two weeks ago and did not tell her until the day of the move We did not have to move furniture; if you do, that's where i would enlist the facility's help. I was able to move her things in a couple of hours.

H1235

Is he still able to get out for things? Could someone take him for a drive or lunch, anything that would get him out of the room for a while. Maybe someone at the facility could find some way to keep him occupied while you move him. Could you blame the move on the facility. He is not allowed to stay in AL any longer(probably somewhat true). They say he needs more care than can be provided. It’s not a decision to be made it’s just the way it is. Good luck. Think on it and get creative, you will come up with something that will work.

harshedbuzz

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

If your dad is resisting hygiene, I would put his stage at "Moderately Severe Dementia" per the DBAT staging tool and sounds more appropriate to higher acuity care. He risks being ignored or not tolerated by others in AL if his dementia is apparent and he's unable to socialize as well as a person without dementia. My aunt was actually bullied in AL because she couldn't keep up with conversations or their activities.

As you noted, while dementia comes with a loss of empathy and the ability to reason, along with memory loss, it does not blunt emotional intelligence nor the ability to experience the full range of emotions. Long after dad had forgotten something he was told, he held on to his emotions around it.

You need to make it happen. It's probably easiest on everyone involved to create a false narrative for the move— aka "fiblet"— and just do it. Make it something that doesn't ascribe blame to him in any way. In your shoes, I might tell him there's a problem with his current unit— they discovered mold, there's a plumbing leak so the water is turned off, they're upgrading his suite— so he'll need to stay "here" temporarily. This allows you to validate his unhappiness by saying you feel sad too and that it isn't fair. If/when he asks about moving back, you can create a story about waiting for a plumber or part.

HB

H1235

https://alzconnected.org/discussion/comment/211505#Comment_211505

You are absolutely right. Suggesting it’s his fault he has to move was not a good suggestion on my part.

M1

One other thing to reassure you: within a day or two of moving my partner had absolutely no memory of having ever been jn any other room.

Gobellago

thank you all for your help! You have given me a whole new way to approach this and it makes so much sense for where dad’s at. It also feels right… I know if I continue trying to “talk him into it” it will fail spectacularly. I feel much more equipped to manage this!