Father should be in nursing home but I can't do it

I understand.

Could you at least look into adult daycare through the week?

There comes a point where it really is just too much. You've probably seen posts that say that caregiver burnout is very real. His reasoner is broken. If you do find a place you think he might like, you know there will be care for him 24/7. Something very, very few of us would be able to continue. I see a lot of times where a LO really does settle in just fine. You'd still be his advocate. That wouldn't stop. At least consider it a bit more, both for yourself as well as for him.

I’m trying to figure out why you keep jumping straight to thinking he needs a nursing home when you’ve described him in prior discussions as being in the EARLY stages of dementia. You’ve mentioned the falls. Does he have medical issues that require a nurse to see him every day? Wound care, tubes, shots, etc? Because if he doesn’t - he’s not going to medically qualify for a skilled nursing home.
He will qualify for AL or MC. Although those are mostly private pay. These days a lot of them look like apartment complexes with individual apartments or rooms. Activities, meals, housekeeping, laundry, shower help, medication management. Pkease determine the level of care your dad needs, and go tour places without him. Discuss his needs with the director, find out about costs etc. Have a plan B in place. Whether you want to or not.

There are lots of discussions on these forums about placement and what worked to get the person there and what didn’t. However given that you have already been discussing it with him and are meeting resistance - I suggest you try this: The next time he goes into the hospital, ask to speak to a patient advocate/ social worker. Explain your living and financial situation to them - repeatedly voice that he is no longer safe in your home and you can’t take care of him. Your best bet is if they pursue placement and arrange for direct transport from the hospital to the facility.

You have not mentioned your mother lately. What is her current situation?

A couple of thoughts—

You describe his presentation as "mild"; you mention he's struggling with the computer of late. My own dad was in the early-moderate stage of dementia when I assumed the role of tech support. The repeated questions driving your BSC are a stage 4 behavior per DBAT. It would be highly unusual for a person at that stage of dementia to go into a SNF unless there was some other medical need that required the support of skilled nursing. Someone if stage 4 would normally be more appropriate to a MCF assuming he's ambulatory and self-feeding and doesn't have skilled nursing needs.

If both parents have dementia, placement together might be a good option.

Does he have some other medical issue that is at the root of his falls? If there are, could they be improved by making the home safer or adding PT to improve strength and vestibular issues. We did 4 months of PT after my mom had 6 months of serial falls— I sent her for bi-weekly PT and made draconian cuts to her shoe collection. We also made some adjustments to help with her vision issues. She hasn't had a fall in over a year. Knock wood.

I can appreciate it's difficult to place a LO who doesn't want it. You could hire and supervise in-home caregivers assuming he can pay for it. If your parents didn't want to go to a nursing home, but didn't save vast amounts of money or invest in robust LTC insurance, they made a wish, not a plan.

Realistically, it may not be able to honor a wish without the plan to make it a reality.

As for your feelings of exceptionality, it's not as if the rest of us were raised by wolves. I'll assume you didn't intend the sanctimonious tone. The way I was encouraged to think about this next step— You aren't ripping dad out of his home and into a facility, dementia is.

I hope you find a way to keep dad safe without losing yourself. If he doesn't have any life limiting conditions beyond dementia, you could be looking at a decade more as caregiver.

HB

As the very articulate and wise @harshedbuzz has said in another post, you can’t fight dementia or gravity. Both are unstoppable forces. He will continue to fall, regardless of if he is at home or in a facility. Unfortunately, that is reality. I’m sorry.

@Mav2126

This is how dementia destroys families. You are on the edge of taking steps that could permanently isolate you from your family. Tread carefully here. I've even heard of the POA sibling banning family members who interfered with their plans for care.

Your sister has done the heavy lifting to make his safety a reality and you are set to undermine that because of some rigid feelings unsupported by the heavy lifting to make it a reality.

FWIW, my top choice for dad would have been a state VA home but the waitlist was long, and he passed before a room opened up. I feel like he would have been more comfortable in the masculine setting vs a standard MCF where women vastly out-number men. In a house for 12 residents, there were generally 1-3 men at any given time.

I can appreciate the temptation, as an adult with mental and/emotional challenges, to identify with your dad in this situation but this isn't about you and what you would prefer. Your dad, by virtue of being progressed to the point of needing residential care, has lost the executive function to make decisions of any import.

If you think a PWD (and likely anosognosia) is going to elect to join a memory care community for their own safety and well-being, you don't understand dementia.

HB

If your dad has been approved for VA care and your sister has got everything is ready to go, support the move. Support her. Encourage your dad. Don’t create obstacles to his success. I promise, this is very hard for your sister. It sounds as though she is doing all the heavy lifting. Try to help her. Working with her will help your dad, and you too.

I am sorry for the plight you find yourself in.

Let me just say, if I were your sister, I would be livid at what appears to be you working at cross purposes.

The reason I say that is because my mom has needed to have her living arrangements addressed for years. Her closest family members, knowing that I am an only child trying to do what's best for my mother, (I diagnosed her with dementia an entire 3 years before her doctor finally tested her) gave a lot of support to HER not wanting to leave her house.

They do not live nearby. They were not assuming more and more of her care, while ill themselves. I am here! I was the one shouldering the weight of the world. I snapped. I stopped talking to them. I was livid.

I had to wait for an opportune moment of lucidity to have my mom sign the papers for her IL apartment. Subsequently, she cried. She expressed regret having left her house. She believes it is the worse mistake of her life.

However, I am at peace. There are no more kitchen fires. No more near misses while driving. Someone here said, we should strive to "keep them safe, not happy." My mother is now safe, though she may not be happy.

You can not expect your dad to make a decision to leave his home. Stating you have a moral code and can not lie, implies to me that you are a Christian. If so, take the matter to the Lord in prayer. He will hear and He will answer.

I did not tell you what gave me the opportune moment of my mom's lucidity when I got her to sign her IL contract. She had gone completely blind in one eye for about 10 days prior. She was lucid. She was fearful.

Then, and only then, was she FINALLY open to the suggestion that she was not safe living alone at home. I believe God allowed her to lose her vision for that exact reason, as answer to my prayers. By the way, her vision came back fully, 1 month after she lost it. That's God!

And if he remained in his home and burned the house to the ground with him in it how would you feel? Yes the guilt of putting him in a facility is real, but you need to consider how you would feel if he was left in an unsafe environment and harmed himself in some way.

you didn’t do this TO him, you did this FOR him. Your chief priority must be to keep him safe, even from himself. He isn’t going to be happy with any solution because there isn’t one that allows him to be the person he used to be.

A different perspective: someone I know had moved their parent into an apartment without any AL services (parent with at least moderate dementia based on behavior but no official diagnosis). So this parent was living essentially in “independent living” within a CCRC that had IL, AL (apartment with added on AL services), and a MC/SNF unit. Several of us were concerned that IL was insufficient for this person’s needs. A few months later, the adult child hadn’t heard from this parent in 2 days and asked the nurse supervisor for AL team to check on her. She was found dead on her bathroom floor, probably had a heart attack or stroke and hopefully died quickly. Needless to say, the adult child now feels terrible. Sounds like your father is in the right place for his safety.

My spouse was comfortable in his facility when he started calling me 20-30 times a day. I think it was just something he did when he was bored or when he noticed the phone there. Sometimes I could hear that he was at a meal or activity, so I knew he wasn't bored, just calling on autopilot. Your sister may need to remove the phone, as he can no longer use it appropriately and it is preventing him from putting his energy into settling into his new home and building relationships there.

Sometimes when we love someone and they need help we need to trick them into getting it.