My retired 70-year-old brother lives with his adult son, who works strange hours as a police officer. For various reasons we have concluded that he should not be left alone, including: wheelchair-bound, inability to bathe himself, inability to manage his meds, many chronic conditions and poorly-healed injuries, cognitive issues beyond the already-diagnosed mild memory impairment, and dependent sedentary lifestyle. Assisted living is more cost-effective (and probably better care) than a home care aide. The son is at wit’s end with the situation and wants his dad out of his condo. It would be better care for the dad, and peace of mind with less stress for the son. We have searched for and found a nice assisted living center that my brother’s limited resources can afford. We need a loving way of insisting that he make this move. It’s essentially a loving eviction. His only other option, if he refuses, is to find another living situation on his own, and he doesn’t have the wits or mobility to do so. He has an upcoming annual physical (his first in 2 years) and we have clued in the doctor about the various issues, and asked him to bring up assisted living before we discuss it further. I know this isn’t the ideal scenario for an assisted living discussion in which the loved one feels like he has some choice. It will be a difficult conversation. Any suggestions to make this talk less of a bitter pill for my brother?
This can be repeated until it’s ‘normal’. Worth thinking about this, or another option along the same lines.
I'm back by the way 🙂
Your Brother may not WANT to move to an AL - yet he NEEDS this level of care.
A needs assessment should highlight what care he needs. If he is still resistant to discussing, he may need fuller cognitive assessment into his 'lifestyle decision making' skills. I've met so many who use the "I'll manage" as a coverup statement but cannot manage. Neuro-Cog Ax shows up the big holes in planning & processing skills. Sad, but this is life.
If Nephew asks him to move out, that his care needs are too high for him, he must move *somewhere*, & must arrange his own care needs.
Does he really understand this?
If your Brother has memory loss &/or cognitive skills loss he may lack insight to his situation.
(Medical name: Anosognosia)
It could be a hard spot for you LittleBrother. Caught in the middle in a way. You can see Nephew's point of view but also wish to protect your Brother's rights. I've seen this play out many times now. The folk who come out the other side well, with less guilt or regrets use *common sense*. They avoid getting all twisted up with elder's rights to live how they wish even if this overrides their offspring's lives.. avoid all that putting-others-before-us talk too.
All that gets changed by cognitive decline. By accepting that, accepting your Brother needs more care than can be provided by his son (his son gets the say on that by the way) then you can discuss it with simple honesty with your Brother. That is the common sense of it.
I wish you all the best transistion possible.
Your brother can no longer make informed decisions about his care. Its not what he wants, its what he needs. I do hope someone has POA makes things easier. With my Mom she was probably stage 5 out of 7. We told her she was going to a nice apartment and was going to make new friends. Had no problem with her and she acclimated well. Yes, I was lucky.
Has this AL evaluated ur brother? Usually when Dementia is involved, Memory care is recommended.
Not making light of a difficult family situation although when changes are needed, a person may resist - out of fear, loss of independence, going into the unknown.
It is perhaps unfortunate that the / his son took this on and kept it going for so long. However, it is what it is now - and things must change.
While he is VERY FORTUNATE to be going to a 'good' place, he certainly won't see it that way. So many people cannot afford a 'good assisted living' facility. He is very fortunate he can. (But do not mention this.)
It is understandable he will resist and say 'No."
Clearly, he cannot manage on his own so he does not have a choice.
Talking logic in these situations - whether due to dementia or not - doesn't work. The person wants what they want and will 'kick and scream' their way through it.
I often recommend here - and believe it is a positive, healthy, way to communicate:
Offer reflective listening. You reflect back to your brother what he says, i.e.,
" I hear you saying xxx"
"I know that you don't want to go to xxx" (use his words. PERIOD.
You don't continue on with a BUT - giving logically explanation = adds fuel to the already ignited emotional fire).
You do not agree or disagree. This is the key component of this way of communicating. You are listening to him and how he feels. That is all and this is huge.
At some point, you need to realize that there is no 'easy' way to make this change.
He will resist.
He will be sad / mad, etc.
He will adjust because he has to - or he will continue to scream or let his feelings known to everyone around him. He will respond as he does.
You have no control of this.
I would continually tell him:
We / I love you.
Do not say "we are doing this FOR YOUR OWN GOOD.
Just "we love you" and we are here for you.
I would change the subject and not continue in this tug of war.
No one wins - and everyone is emotionally and psychologically depleted.
When it gets to be too much, take a break.
Walk away or leave for a while.
Do not subject yourself to ongoing sadness and torment - because you want what is best for him, and you love him, and he doesn't want what is needed / best for him.
Trust that he will adjust with time. It would / could hope a lot to get a caregiver / or a friend/care giver is there at the transition period of him moving in - so he has a friendly face / support. This is important.
Perhaps a family member could come in 3-4 a day for the first week or so?
Help him with the transition - so he won't feel so scared and alone. (And expect the screaming / resistance).
Gena / Touch Matters
I have a LO in need of regular respite care. Refuses & fusses. Fear plus loss of control, all that you mentioned.
We had tried many variations of "I know you don't want to BUT..." filled in with logical reasons.
That didn't work.
The logic part held no sway over strong emotions. Even when calm, processing the logicial facts seemed much diminished. Just didn't.want.to.go. Blank looks when asked about other people's needs.
The Doctor said "Arrange the respite care".
Gena, you put it in such a thoughtful & caring way yet practical way.
The end result may be the same: *arrange the care*. But when caregivers BELIEVE in what they are saying & doing, it should avoid any guilt traps. Eg I believed my LO attending respite care was necessary. I feel fine about it.
How about you and his son go pick out two places for him and let him choose, so that Adult Protective Services doesn't have to be called.
He told us - and the social worker - in no uncertain terms that HE was still competent and HE had the last word and that he was going home. As Alva said, you cannot MAKE him do anything that he does not choose to do unless certain criteria are met, but you can make the choice they want uncomfortable or unachievable.
He was 100% correct- the choice was up to him. But we had a choice too. We did not have to facilitate that choice. And we said as much. That we as a family would no longer be providing his care and that if he chose to go home, he would need to hire 24/7 skilled nursing care or that he would be an unsafe discharge - because it was very clear that he was completely unable to take care of himself.
Once we took ourselves out of the equation - that severely limited HIS options. He either had to hire someone 24/7 to take care of him (which was out of his budget) or he had to agree to move to the SNF that we had found for him (a very nice place, that he could afford.) It was still his choice. He just didn't like his choices.
Many times if you take yourself (and anyone else) out of the equation that can facilitate/prop them up and be the solution and remove the roadblocks/impediments to them achieving exactly what THEY want - they are only left with what you want them to do anyway. But they are the ones that make the choice because they don't have any other option. BUT they aren't literally forced into it. Maybe figuratively, but I guess that's semantics at the end of the day.
Frankly, I'm surprised my FIL didn't hire someone for a brief period and then fire them and see what we did. But maybe he finally took us seriously.
Keep it simple, straightforward and honest. Don't argue. Just say "I can't"
Maybe you can use the words: I cannot lift you out of the wheelchair anymore, My job is asking me to be on call 24 hrs, My back is not good, My doctor told me to take it easy, I am tired.
Try not to use the words: You cannot take care of yourself, you are too much work, you cannot stay here any longer.
Try and stay positive about the place, mention the activities, great people that are there, let him in on the choosing of the facility.
You will be getting a needs assessment so we can find a facility that can give you the care you need and deserve.
We love you and know how hard this is but, we know how vital it is that it happens.
Repeat as needed.
Not everything is negotiable in our senior years when disease and dementia set in. I would think your brother can see the toll his health situation is taking on his son and want to remedy it asap. Let's hope, anyway. If not, a legal eviction will have to take place.
Best of luck to you.
I sure wish you luck. The only way is for the son to be honest with his father that he cannot live there anymore, and that if he has to legally evict him, Dad will be homeless or left to his own devices. The father is now a legal tenant whether he pays rent or not. An eviction attorney is the only way to legally remove him. That is the hard truth.
I sure wish you luck and I sure hope you'll update us.
Families can advise, encourage, or make ultimatums (seldom a good idea), but they cannot force a family member to move, hire help, or much of anything else.
For those who may be considering moving an elder into your home, be very aware that older people's symptoms will only get worse. If your elder loved one is stubborn and willful, that will not change when they move into your house, but your ability to say yes or no changes considerably.