My mom fell and broke her hip in March. She is 86 years old. She went to rehab at a skilled care facility. She is nearly strong enough to walk, but she must use a walker. The facility tested her for dementia and has diagnosed her with moderate dementia. She has fallen three times in the past two months at the facility because she doesn't call a nurse and tries to walk without a walker. My wife and I as POA totally agree with the facility staff that the safest place for her is at the facility.
The problem is with my dad. He is 90 years old and they have been married for 65 years. They have really never been apart. We believe he may have some dementia (he has never been diagnosed), but if he does, it is mild. He simply cannot live with her being at a skilled care facility. He insists that she must come home.
We can see that her dementia is getting worse. She confuses dreams with reality and even before she was at the care facility she didn't take care of the house, the cooking, the finances, etc. We are certain that if she came home she would fall again and may take him with her. They cannot afford 24x7 at home care and he insists that they don't need it - even though she can't even use the bathroom by herself.
Now my father says he is going to call a lawyer and get her out. Should we tell him she has dementia and the facility is the best place for her? His own health is worsening as a result of this episode and we are concerned that telling him this might make him give up.
My father wound up passing away 11 months later and my mother is still alive, at 93, and now living in the Memory Care building of the ALF. Thank GOD I placed them when I did, too, because it turned out to be more necessary for my mother than my father.
Keep in mind that your mother's dementia will appear MUCH worse right now that she's been through a trauma and is trying to recuperate in a SNF. She can get back to a better baseline once she's back in familiar surroundings, or back with her husband.
If you can get them both placed together in an Assisted Living Facility that ALSO has a Memory Care section, that would be your best bet to keep them together and to address mother's dementia as it worsens. In the worst case scenario, if she begins to wander, she can move into a Memory Care unit and dad can stay in the AL section and they can visit, still.
24/7 in home care is really not viable, cost wise, I looked into it myself back in 2014. Let your dad know the TRUTH about what's happening with his wife; you owe him that and he needs to know. If you can keep them together, come what may, your father's health will probably improve. Keeping them apart is like amputating the man's leg.........he won't be able to live without it, you know?
I will never forget the look of gratitude and peace on my father's face when he saw my mother walking down the hall of the ALF on the day she was finally moving in with him. It brings tears to my eyes even now
Wishing you the best of luck moving forward. This is a difficult time, I know, and I am sending you a hug and a prayer
Im just guessing but based on your info that visitors aren’t allowed inside I’m guessing you have been having care meetings by video and this is how/when they let you know the results of her assessment and recommendations. Assuming that’s correct or that it could be set up that way, I would suggest communicating with the doctor, caregivers and case manager, everyone involved and giving you feedback about including Dad in a care meeting so they can present the info to him along with you and your wife and any other family members who should be involved or simply might get in Dads ear if they aren’t.
A couple important things to keep everyone aware of ahead of time, first I would be very careful about how the reason for evaluating mom for dementia is explained. Dad might resist joining her or even other medical situations for fear that he will be evaluated or “labeled”. It might even be best to focus on Mom’s current physical limitations as being the reason for keeping her there and you will know best but if he needs to believe there is the possibility they can both move back to the house he grew up in if the doctor is satisfied she has met certain goals it might not be as bad a thing as it feels to allow even though you know she never will meet those goals. Big baby steps. But allow the medical professionals to explain where they feel she is, where she could go and their recommendations basically the way they have already for you. Maybe even ask if they aren’t clear enough for Dad to hear, what will be the challenges and what could happen if she were to go home with Dad and what are the possibilities, advantages if she stays under some sort of full time professional care. Then you as a family can talk about the living options and allow Dad to be part of the decision as to what is best for he and his wife. If being together is best for both of them and having access to 24 hr help/care is best for her maybe he will decide to give up his house for now to be with and support her. Maybe not too, maybe he will want to leave things the way they are or maybe another compromise will materialize. No one is going o get exactly what they want here, everyone is loosing something including you, you want your parents independent in their home same as they do but that’s no longer possible and each of you need your own path to realize and accept that. I would be gentle, caring and honest with your dad, keep trying to put yourself in his shoes, it’s so scary loosing all the things he is right now and don’t take all the difficult news delivery on yourself let the professionals deliver it first while you provide the back bone for helping him hear it.
Difficult times, I know, my thoughts are with you and your family.
His dementia was worse than Moms. She figured she could take care of him with our Help. Well, We had no alternative. We got Dad all signed up for the local AL and then to 'visit' with Mom. Finally, after many different approaches, from....you can't do this...… all the way to many explanations why none of us could take them into our homes. We Told Her She Would be doing Dad a big favor by going with him. (She certainly did not want to be left alone!) And it worked. Will never know if we just wore her down, if she finally saw that she could not do it 'alone', or if her love for him was so ingrained and true and to do this for him was OK. I also told her she could go and be unhappy and miserable, or she could go and make the best of it, taking advantage of someone else cooking and cleaning. But there was no other choice. they were going to AL. God Bless You as travel this road. When the people we love and have depended on for so many years for so many things....change into someone we hardly know, it is very hard and often frustrating along the way. Make sure you know that your dad knows how much you love him. Today!!
Her LTC policy should cover assisted living for her. Look for a place for both of them. A one bedroom apartment so they can be together. When she is ready for discharge from rehab, she could go there. They are both at risk from Covid if they go into a facility but that will be the case for a year. They really need 24 hour supervision. We paid $10,000 for a 24/7 live in Plus IL for a short while when they were in independent living. He fell and was hospitalized and she could not be left alone. So you could bring her home but if he won’t agree to having someone there, it is only a matter of time before she falls again. She will fall even with care in place. It is a tough situation and I basically lived it with my in-laws. For us, placement for both worked but Covid makes it all So complicated.
This was their plan in the event that they became unable to take care of themselves.
That he is resistant speaks for his mental competence. I would encourage him to get tested, just for a baseline. And knowing what you are dealing with does make it easier to stand your ground.
Falls and walkers happen all the time, whether at home, in AL or MC, even in NHs. Mom's MC has residents of all abilities. When she moved in, she was still able to walk on her own. It took quite a while before she insisted she needed a walker (probably didn't but maybe she felt left out?) She now refuses to stand or walk on her own (part of the problem is lack of use, so she is weaker, part of it is weight gain and part of it is due to a few little tumbles she took, so she is afraid), yet she tends to forget she can't/won't walk and ends up on the floor trying to get to the bathroom!
So, if/when her rehab is done, consider a move to MC and have dad move in with her ("temporarily" ;-).) You could keep their house, for now, in the event that she passes before him and he is capable of moving back in. He might be more accepting of the move if he gets to stay with her. You could indicate it is temporary, given mom's falls and the virus. If he has early dementia, this might be a good opportunity to get him settled before the need becomes apparent, and he might 'settle in' easier. It would be good to have him tested at his appointment. IF they do an appropriate test, it could be enlightening for you. Some don't do good testing or pass it off, esp with some who can pull up their socks and appear normal during those brief visits!
If your parents finances are low, I would ask the SW about Medicaid. Dad would become the Community spouse. Meaning, he would keep the house and car. Assets would be split to where Moms split would be spent down and Medicaid would take over. Dad would not be made impoverished.
An Elder lawyer versed in your States Medicaid can help.
Totally agree he will not believe his children. I've seen similar posts from others...apparently this disbelief is common in the elderly.
I am curious about the visiting though. There is no visiting allowed in the AL's, nursing homes, hospitals, etc. in my state due to covid and I can't see that changing anytime soon. I'd try to get them placed into the same place if possible.
Are there options?
Can she be placed in Memory Care...and can he live with her even if he does not yet require that level of care? Many facilities will do this for couples. If this is an option it might be good for him as well since he is showing signs himself.
If she is not quite ready for Memory Care, and he still wants to care for her as much as possible would Assisted Living with a Memory Care unit be an option? Again he would be able to stay with her, help her and when it became overwhelming for him she could transition to Memory Care and he could still be there for her.
It is very possible that without her he will decline more rapidly.
Good luck for all of what has to be done. These transition times are difficult. Be sure to look after yourselves too and let us know how things develop.
Yes, dad, we understand that this is not what you and mom really wanted to happen. But things have happened that no one could have known were coming. She needs to be safe. etc.
Good luck.