As many of you know, my dad spent some time in the hospital last week and was released to go to assisted living, not home. He cannot be by himself anymore. We had care coming to his house for 6 hours per day, 7 days a week before the hospitalization. It was about $6000 per month. He insists he is walking out of assisted living on Friday. And I know he will although I don't know how he is getting home. The facility he is in is wonderful and he actually seems to like it but is treating it more like a vacation. Full time in-home care would be over $20,000 per month. That's just not in the plans. And even at that, there are many other things wrong with the in-home scenario and having full time care would not fix them (i.e. he refuses to allow med management, he won't eat properly, refuses bathing, no socialization, lives on a busy street with no sidewalks--going for walks is dangerous, etc - he has way too much control for making unsafe decisions in his house). I am his guardian and we have sent the paperwork to the court for the move so I guess the final decision will be with the judge (dad will contest and we will have a hearing) but I'm not sure how to keep him there between now and then. I need to give the facility 30 days notice if he is going home or he's out over $6000-$7000. I could refuse to allow any in-home care since he's already paying for assisted living but then I'll be in trouble.
Talk to the faculty about this issue. As an AL, they may not be able to keep a person who wants to leave, against his will. You may need to move him to a secure memory care unit.
Have you consulted his doc about meds?
I like the idea someone suggested about getting 'an expedited hearing or a temporary restraint'. I do know that EC attys can request expedite.
One thing I will add - dad NEEDS to be in MC. AL will not babysit him or be there to stop him from walking out the door. The ramifications could be dire if he does walk out. This was my argument with YB, who insisted mom would prefer AL. Sure dude, maybe 5 years before that, but not with dementia! Staff said no to him.
If the AL he is presently at happens to have something like that, the transition may be easier than having to remove and transfer him.
Your first reaction, if you are anything like me, is that he is functioning at a higher level than the other residents of the locked unit, and in some ways that may be true, but if he has been diagnosed with dementia, you have been granted guardianship, and he has no perception of his inability to manage his ongoing needs, you can begin to assume that his need for a secured, structured environment is somewhere on the horizon, and in some situations, it is easier to head in this direction earlier than later.
Under the terms of the guardianship, is there any language that requires you to provide a safe, secure environment for him?
If you place him now, in a locked unit, you will at the very least have a certain amount of time to figure out what to do next.
If his prior living arrangement was NOT possible as a consideration, it is not fair for to him OR YOU, to spend time figuring out ANY REASON OR PLAN for keeping him there, so start thinking forward to other scenarios that MAY work for him and don’t look back.
My LO has been in a well run MCU since last June. I visit often, and whether I leave in tears or marveling over how much she is still her old self, I am content that she’s monitored, safe, and lovingly provided for.
If he walks out they will come looking for him and then require that he be placed in the memory care wing on lock down. Or they will tell you that he needs to be placed somewhere else.
You are in charge, not him.
It is time to do the tough love thing.
Often the facility suggests you curtail visits during this adjustment period because the elder sees you as "a way out" as someone he or she can manipulate, knows, and knows HOW to manipulate.
Only suggestions I have, because if he insists on this then he likely IS looking at memory care. You can tell him that along with being much less nice, it is also much more expensive, and if his money runs out during his lifetime he could end himself in a quite not-nice circumstance that you would be helpless to fix for him. Remind him you know how tough it is to go through this one loss after another thing, but that you will continue to do the best for him that you can, and that you love him, and that you don't EXPECT him to be happy about it, because not everything in life is about happy.
This will not be easy. Think of a toddler that is given too much control and ends up in meltdowns constantly with the fact they can win, then don't know what to do about it. It needs to be more certain for him. More set in stone. No argument. Just the simple loving facts told as kindly as you are able, with sympathy, over and over and over when he goes "there".
As my father's dementia worsened, I became the "only person who can deal with him", primarily because he knew I was as stubborn as he was and would do what I said.
When Dad didn't want to go to MC and told me he wasn't going, I told him yes he was. "You can go the easy way in the car and walk into MC with your dignity or you can go the hard way drugged and strapped down to a gurney by removal attendants. Either way you are going. You need the level of care the MC can provide and I think you will like it there once you get used to it. I would rather see you walk in but one way or the other you are going to MC." I showed up at an appointed time and followed the car while my estranged brother drove Dad to the MC. Dad walked in to his room where he was surprised to find it contained his favorite rocking chair and was decorated with photo collages of family and collectibles. He did adapt and even like being there.
I don't know your Dad's personality or whether his dementia allows him to remember things enough that talking to him would do any good. If you think it would work, I suggest you talk to Dad about what's going to happen if he walks out of the AL. That he has no money and no keys to his house; his picture will be on the news as an elderly dementia person the police are looking for and when the police find him he will be taken to a hospital to be evaluated and held until a locked MC facility can be found, or maybe a NH if an MC isn't available because he won't be able to return to the AL after "escaping". Emphasize that you will have little to no control over what's happening once the police are involved. Ask him to please not do this to himself. You want him safe and someone available to see to his needs and right now the AL is the best place for him. Good Luck.
What will you do when he refuses to leave his home with the caregivers? Have you been in touch with the local police who might need to assist?
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