They indicated it is time to move to the community based residential facility. This is the first this has been mentioned, his hospice nurses have not indicated any issues with him, residents have shared with me they do not like how he is treated at meals (he is "yelled at"). I know his dementia is progressing and he is becoming more demanding. He wants his food now, somebody tie his bib, etc. Since no staff has ever shared concerns with this, I haven't been able to tell them things. Like this is my dad's personality - he tells/doesn't ask, likes to be the first to get anything, doesn't always thank people. But I have lived my entire life with this and could perhaps give them some ideas. I am afraid that by moving him, his death sentence will be signed. It took weeks before he adjusted to the facility - besides the dementia he has macular degeneration both eyes so getting around with so little vision is extremely challenging. He now has his routes memorized and I'm very concerned about how this change will impact him.
Thanks for any help.
My plan is to meet with the administrator, listen to her concerns and do what is best for him. If it's safety concerns, I can certainly support that. If it's staff not liking the extra time he's taking, I'll have issues.
Often, at my bro's place, they try really hard to keep people out of memory care and in the ALF portion of the place because it is almost twice the cost. Many cannot afford it. But the staffing is so different in each place that this cannot go on for long.
I would speak with them at the facility, ask for a one on one consult with those in charge. Explain that the bump up in cost may force you to look at other facilities. Explain that it is crucial to keep him in AL as long as possible. Understand that eventually, the move may be necessary.
I cannot tell you, after one year of watching carefully, how much I admire the ALF that my bro is at, how hard they try for residents, how hard they try with staff. Just how hard they try, and for many this is an avocation. They truly love seniors, and work and study on them on their own time. It is so hard to find a good facility and we feel totally privileged to have found this one. But again, it is difficult for all involved for so many reasons.
Change in general is never good for a person with dementia, and creates more confusion. Perhaps you can convince the ED that your dad should stay where he is, especially now that he's on hospice, but that may not work. In the end, it's the ED who gets to make these decisions based on a variety of factors.
Wishing you the bet of luck.
How long has your father been at this ALF?
Just for light relief: this afternoon I asked a client how he'd been today. He said "How am I? I'm bloody fed up!" He went on to explain the frustrations and boredom of not being able to do what he liked; so, so as not just to have asked him a routine question and then not listened to the answer - such a common habit in society that drives me personally up the wall - I asked him what he'd normally be doing of a wet Sunday afternoon. He claimed he'd "oh, have a couple of pints..." but he didn't get much further because his daughter and wife intervened and hotly denied that he ever did any such thing.
I don't know many men born in the first half of the last century who didn't occasionally go to the pub for a modest ale or two. And as far as I know Sunday lunchtimes were peak periods.
Then while I was out of the room I overheard both wife and daughter round on him for swearing "in front of the nice lady."
Be that as it may. The point I actually want to make is that a good facility a) should be able to accommodate rough manners as long as they do not cross the line and become personal verbal abuse; and b) does not tolerate any member of staff "yelling at" a resident. Though please distinguish carefully between yelling TO (e.g. across a crowded lunch room to explain that they're being as quick as they can) and yelling AT (e.g. arguing back, reprimanding, issuing orders to a resident).
So while I think you're right to be concerned about the possible drawbacks of moving him, I think you should perhaps first investigate how things are going more generally. You don't have to wait for staff to approach you - are you able to spend enough time in the place to start up a few conversations?