I have made the incredibly tough decision that it is time to put my dad in assisted living. He has been in a rehab facility for about two months now. Not that it has been any easier since we have had major issues with this facility since day one. (I recently wrote about my "caregiver burn out" as I get no help from my family.) My question is, do I tell him before he is transferred? As POA, can I make this decision without his consent? He may not question the move at first, because I had mentioned I was going to try to get him moved because of all the issues we were having with the current place. He has been diagnosed with dementia and aphagia. It is getting worse and I work full-time and have two children to take care of. He cannot be left alone all day as he is a fall risk and this is now a safety issue. Since he has been in rehab for so long, he has lost his in-home care through the VA and would have to go back on a wait list when he comes out...this could take weeks to months to get services back and it only cover 4 hours a day 3 times a week. Anyway, to get back on topic, my brother, mother, and I had planned to sit and talk with him. Then, at least two people told us not to tell him till the transfer was done. The assisted living director said they could have one of their doctors sit with all of us (after transfer) and tell him that he needs to be there for his safety. The AL place sent over all the paperwork to the rehab place, but that director at rehab is saying she cannot fill out the paperwork because my dad has not been told yet. Can she force our hand here? I am so torn. He will be upset either way. He may refuse to go if I tell him now. I know he will be very mad at me either way. I guess I am asking what is the best way to handle this situation? How do you handle telling a person the time has come for him to be cared for in assisted living when he doesn't want to go?
We did something like this when we moved my mom, post stroke, to a really nice AL ( she had been livingi,in an IL at that point). We needed to tell her she was being discharged and where she was going.
It didn't really help. I took her in my car ( don't do this, I would use medical transport if possible) and she became hysterical, tried to grab the steering wheel.
My heart goes out to you. Nearly all the caregivers in my local support group have had to place their loved ones in a care center of one kind or another. It is truly a heartbreaking decision to have to make.
Yes, this will be a hard conversation, and likely he will have 101 reasons why he won't go--but when we had this talk with hubby's father--he finally said, Ok, he'd go. He really didn't want to be a burden, he knew enough to know he was not capable of even walking up/down stairs and he couldn't feed himself.
I did most of the talking. Hubby sat on the couch in trembling fear. It wasn't a "here's your choice, dad" kind of conversation, it was a "this is your only option, we're so sorry" kind of situation.
Had he been in better health he would have fought us, I'm sure he was simple exhausted.
I wish you luck in this difficult task. Make sure you and brother are ON THE SAME PAGE!! My brother will routinely tell me he's got my back over something and then caves in when Mother kicks up a stink. Talk beforehand and rehearse what you're going to say and make sure you support each other in this.
Until your father is deemed to lack mental capacity, the decision of where to live is his. You have POA for him, which is good, which means you can act on his behalf. But what you can't do is act without his consent until he is formally recognised as being unable to consent on the grounds of his (legal) incompetence. A dementia diagnosis on its own won't cut the necessary mustard.
So you either have the difficult conversation with him - which I hope will be a lot less difficult if you adopt some of the sensitive approaches others have described - or you go through the process of having his mental competence assessed.
If the worse comes to the worst and he flat-out refuses AL and his doctors won't agree that he lacks capacity, how much time in hand have you got at rehab and what other in-home services are available? The same director who's digging her heels in might like to go through his options with you, if she can't support this one.
Please don't think I don't sympathise with your position. You have every right to make it clear how much his staying at home has depended on your commitment to date and to make it equally clear that that can't continue. Just not (not yet, anyway) the absolute right to decide what's good for him.
I didn't tell my mom when I made the decision to move her to memory care straight from the hospital - she fought tooth and nail going into her room - it was agonizing for both of us
Do the best you can to reassure him he's not being abandoned and make his room as pleasant and familiar as possible with some of his favorite things
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