I guess I'm just venting frustration on rapid decline after moving to assisted living. How can you tell if it's the right place for your LO?

The update is that he hasn't fallen again but he's just sitting all the time or sleeping a lot. He is using his walker and has seen the staff physician who said he now is just very afraid of falling to an extreme.

we brought him home yesterday (Sun) for dinner and he seemed far weaker than he was on Friday for the doc appointment. I don't think he's eating as he didn't eat much of his favorite dinner last night either.

He had an "episode" I caught on camera which he doesn't know that I know about. He s*** all over himself because he didn't make it to the bathroom. That never happened before either. I'm wondering if he is withholding food from himself because of fear of that happening again. The caregivers helped him get all straightened out but I'm sure he found it embarrassing.

I've called the doctor to see if he could maybe prescribe an appetite stimulant or something, at least temporarily.

I'm still working on getting myself hired as a caregiver so I can come and go (assuming they don't say no, because I AM circumventing their rules for family). I have to have fingerprints, background check, pass my CPR/First aid class, Get a physical and TB test and take the agency's class on personal care assistants. So it will take time to accomplish that. I'll write back if it works because then maybe others can do the same if they are as frustrated as I am.

I KNEW this was going to be hard on him, but I never imagined it would be so hard on me too. It's way more work and worry, however my husband really doesn't want him here permanently so there isn't much option.

I see where you are questioning why the facility cannot get your dad to activities and such. I know at my mother’s, the staff is stretched. Is the facility a bigger one ? How is the staff to client ratio?
If your father is refusing to go, they cannot make him. I so wanted my mom to have a better outcome with where she lives. She refuses to be involved , all the while complaining of being lonely. I cannot help her.

can you find a different in home company that can work with you and your fathers schedule? I had very good luck with an independent company...maybe they can only go twice a week ,or once a week during the schedule you would like, it would be a start.. then your dad may acclimate and want to go....just a thought...

We finally got my dad out of his house to AL at age 93. We hired familiar caregivers 3 days a week for 6 hours and he insisted on having one of his cars there for the caregivers to drive. They took him out and about and he was still using a walker. He had previously had issues with dehydration and enjoyed the fact they had a full beverage bar. He made a couple friends, enjoyed eating in the dining room, and liked to sit in the lobby and people watch. Fast forward to Covid. No more eating in the dining room, no more caregivers, I couldn't visit, and he had to stay in his room. He grew weak and fell constantly, causing compression fractures in his back. He was moved to skilled nursing in May, can no longer walk, and he was just transferred to memory care. I never found that there were enough eyes on him at AL. I was paying for a good buy-up plan but I'm not sure I was getting my moneys worth. I had noticed he seemed to be weaker even before covid hit so maybe all of this would have happened anyway. I would definitely check on the dehydration thing. That can make a big difference. What you are seeing may also be what might have happened anyway, with or without the move.

Nothing is better for an elderly loved one than being with their family. Routines are familiar to them, as is the location of everything so it seems as if they are functioning well. However, when elderly people are moved, they get completely disoriented. Yes, in time they can acclimate. That said, It doesn't sound like this is the right place for your dad. 4 falls in one week is courting disaster. You are literally monitoring him with cameras and paid caregivers and he is still falling and not participating - so despite it being a high end facility - it clearly isn't providing your dad with the care and companionship HE needs to thrive.

My sure to be unpopular opinion:
1. Your father is 93, and at that age, things happen very fast, and folks can go downhill in a matter of a week. Accept this because you can’t change it.
2. You state in 1 of your posts that “no matter what I won’t be satisfied with the care”. You are a problem...you love your parent, but your expectations are ridiculously high and you can’t buy your way out of it by expecting the facility to literally babysit your father 24/7 for a higher payment. There are others in there that also need care, not just him.
3. Assisted living is just that. It sounds like he needs a nursing home for 24/7 care.
4. You made a really ugly comment about you should get a job for minimum wage at this place so You could take him to activities., Please don’t “put down” the caregivers in these facilities....these folks work very hard for low pay and they have duties and responsibilities to carry out as they are issued. Does it occur to you that you don’t get to choose what your duties are in a facility? If you want to do everything for him, and won’t be happy with care in a facility, then bring him home and become his caregiver, because it sure sounds like you will do a much better job. Let us know if you do this and how it works out.

I’m not trying to be mean,,,my dad is in LTC and I’m just grateful he has people there that do care, and do their best every day, He also would not use his walkers.,,would not listen,,..wasn’t deaf... wasn’t sick...etc etc. His own stubbornness caused his rapid declines. I do not hound his caregivers, and i do watch for any mistreatment. We are all doing the best we can, as are many on this forum.

Thank you everyone. He fell again last night and now tells me he will be a "good boy" and use his walker all the time! Yeah, we'll see. I have cameras so I can see people from AL coming and going but it's "all business" and no one chats with him and he's not met a soul. They don't take him to activities but it's because he says he won't go and he can't hear anyone (he's nearly deaf) and everyone has a mask on so he can't read lips. I still asked if they would take him to activities even paying for a higher care plan and they said no they couldn't?!!!

I have PT coming in 4 x a week (people he was familiar with) but that only covers 4 hours. I have paid caregivers coming in 4 x a week (who he knew from before) and that covers 12 more hours. I did this because I wanted him to have familiar people around and because I can only visit for 1 hour per week. Still, they can't be there to bring him to the activities because their schedules don't coincide. So I may have to hire more caregivers!

It's ironic because the things he needs help with appear to be different than the "standard". he can dress himself, and yet the caregivers keep trying to dress him. He can put in his hearing aids but he sometimes forgets to close the battery door or change the battery... they OFTEN dont' think to do that for him (EVEN THOUGH it's in the care plan). He puts on his CPAP at night but sometimes forgets to put it back on after he goes to the bathroom. I asked them to check on him, wake him up and have him put it back on. It's taken nagging daily (and a camera) to prove they aren't doing it!

I am glad to know that the confusion MAY get better as he gets used to the place. I'll give it more time. While he has some dementia, the problem is more his hearing and so I really don't want him to be in memory care until it becomes a MUST. If people take the time to talk to his good ear, he can have an intelligent conversation. I know that won't always be the case and that memory care is only a short way away.

I just really am shocked that even when I said "let's up the care plan" they said they can't do it!

Your description of the AL sounds so good, it is too bad your father is having trouble there. Definitely get a medical check up, and perhaps check blood labs. Maybe he is dehydrated.

Imho, he could be suffering from a variety of issues - low potassium, dementia worsening or forgetfulness among other things. Perhaps it's best that his physician give him a full health check up.

Before you do anything you should read this. before you think of nursing home and assisted living
This will tell you how seniors were not taken care of in nursing home
Not Just Cuomo: These Other Democrat Governors Also Jammed COVID-Stricken Patients Into Nursing Homes
MARCH 11, 2021 By Tristan Justice
New York Democrat Gov. Andrew Cuomo went from liberal hero to embattled emperor of the Empire State in the fight for his political life within just 12 months.
On Tuesday, the governor’s book publisher cited a federal inquiry into Cuomo’s deadly nursing home cover-up when it announced a halt to the promotion of his pandemic manifesto touting his “leadership.”
While conservative media has been consistent in highlighting the disastrous March 25 nursing home policy from Cuomo that jammed COVID-stricken patients into the state’s long-term care facilities, the New York governor was promoted to celebrity icon among leftists in the corporate press for his aggressive pursuit of draconian lockdowns. All along, Cuomo’s state has led the U.S. with the highest coronavirus death rate in the country, a feat accomplished in no small part by Cuomo’s nursing home policy, which is estimated to have sent nearly 6,500 patients to an early grave.
New revelations related to the governor’s early actions on New York nursing homes have now provoked a long-anticipated reckoning on Cuomo’s pandemic leadership. According to data unearthed in a Freedom of Information Act case brought by the conservative think tank Empire Center, Cuomo was manipulating the numbers on nursing homes to underestimate the devastation of his nursing home policy while he paraded around the country to brag about pandemic triumph. Subsequent reporting from The New York Times found the nursing home death toll in New York at more than 9,000.
Yet Cuomo is far from the only U.S. governor who implemented a deadly nursing home policy forcing coronavirus-infected patients into close contact with the population’s most vulnerable. And it’s become clear that the reason for this policy is money: “The hospital lobby directly engineered this approach, and these governors obliged.”
Michigan Gov. Gretchen Whitmer
Michigan Democratic Gov. Gretchen Whitmer, who shared in Cuomo’s media glory as an aggressive lock-downer throughout the pandemic, signed a similar order that forced COVID patients into nursing homes on April 15.
“A long-term care facility must not prohibit admission of readmission of a resident based on COVID-19 testing requirements or results,” the spring order read, which was renewed repeadedly throughout the summer until it was finally rescinded in September.
The true toll of the Whitmer order remains unknown to the public, as the governor’s Department of Health and Human Services (DHHS) stonewalls Freedom of Information requests for information to determine COVID deaths in long-term care facilities. The Mackinac Center Legal Foundation filed a lawsuit on behalf of Pulitzer Prize-winning Michigan investigative journalist Charlie LeDuff to unearth the data hidden by Whitmer’s public health department.
California Gov. Gavin Newsom
On the west coast, California Democratic Gov. Gavin Newsom, now facing an imminent recall election, signed an executive order on May 15 that “patients hospitalized, or receiving treatment at an alternate care site, with COVID-19 can be discharged to a [skilled nursing facility] when clinically indicated.”
According to the Los Angeles Times COVID tracker, nearly 13,000 have died in California nursing homes. Newsom now faces a recall effort that picked up steam after he was caught violating his own lockdown edicts that prohibit indoor dining.
Organizers for the movement report having collected more than 2 million signatures, far above the nearly 1.5 million needed by Wednesday to force an election, likely to come late this summer or in early fall.
New Jersey Gov. Phil Murphy
New Jersey Democratic Gov. Phil Murphy gave the green light for an order from NJ state

Before you do anything you should read this. before you think of nursing home and assisted living
This will tell you how seniors were not taken care of in nursing home
Not Just Cuomo: These Other Democrat Governors Also Jammed COVID-Stricken Patients Into Nursing Homes
MARCH 11, 2021 By Tristan Justice
New York Democrat Gov. Andrew Cuomo went from liberal hero to embattled emperor of the Empire State in the fight for his political life within just 12 months.
On Tuesday, the governor’s book publisher cited a federal inquiry into Cuomo’s deadly nursing home cover-up when it announced a halt to the promotion of his pandemic manifesto touting his “leadership.”

While conservative media has been consistent in highlighting the disastrous March 25 nursing home policy from Cuomo that jammed COVID-stricken patients into the state’s long-term care facilities, the New York governor was promoted to celebrity icon among leftists in the corporate press for his aggressive pursuit of draconian lockdowns. All along, Cuomo’s state has led the U.S. with the highest coronavirus death rate in the country, a feat accomplished in no small part by Cuomo’s nursing home policy, which is estimated to have sent nearly 6,500 patients to an early grave.
New revelations related to the governor’s early actions on New York nursing homes have now provoked a long-anticipated reckoning on Cuomo’s pandemic leadership. According to data unearthed in a Freedom of Information Act case brought by the conservative think tank Empire Center, Cuomo was manipulating the numbers on nursing homes to underestimate the devastation of his nursing home policy while he paraded around the country to brag about pandemic triumph. Subsequent reporting from The New York Times found the nursing home death toll in New York at more than 9,000.
Yet Cuomo is far from the only U.S. governor who implemented a deadly nursing home policy forcing coronavirus-infected patients into close contact with the population’s most vulnerable. And it’s become clear that the reason for this policy is money: “The hospital lobby directly engineered this approach, and these governors obliged.”
Michigan Gov. Gretchen Whitmer
Michigan Democratic Gov. Gretchen Whitmer, who shared in Cuomo’s media glory as an aggressive lock-downer throughout the pandemic, signed a similar order that forced COVID patients into nursing homes on April 15.
“A long-term care facility must not prohibit admission of readmission of a resident based on COVID-19 testing requirements or results,” the spring order read, which was renewed repeadedly throughout the summer until it was finally rescinded in September.
The true toll of the Whitmer order remains unknown to the public, as the governor’s Department of Health and Human Services (DHHS) stonewalls Freedom of Information requests for information to determine COVID deaths in long-term care facilities. The Mackinac Center Legal Foundation filed a lawsuit on behalf of Pulitzer Prize-winning Michigan investigative journalist Charlie LeDuff to unearth the data hidden by Whitmer’s public health department.
California Gov. Gavin Newsom
On the west coast, California Democratic Gov. Gavin Newsom, now facing an imminent recall election, signed an executive order on May 15 that “patients hospitalized, or receiving treatment at an alternate care site, with COVID-19 can be discharged to a [skilled nursing facility] when clinically indicated.”
According to the Los Angeles Times COVID tracker, nearly 13,000 have died in California nursing homes. Newsom now faces a recall effort that picked up steam after he was caught violating his own lockdown edicts that prohibit indoor dining.
Organizers for the movement report having collected more than 2 million signatures, far above the nearly 1.5 million needed by Wednesday to force an election, likely to come late this summer or in early fall.
New Jersey Gov. Phil Murphy
New Jersey Democratic Gov. Phil Murphy gave the green light for an order from NJ state

Any time you see a sudden change in condition, you should have a medical evaluation by his medical doctor to discuss medical reasons. If his level of care has changed, then you should have a care plan meeting to discuss it and what is in his best interest. A good Assisted Living facility would recommend these things to you as well as initiate a care plan meeting.

Although we care for our mother, my sisters and I are also very aware that our age is also creeping up on us. We all say, "I will never do to my children what Mom is doing to us." I think that one advantage of taking part in this forum is learning what the progression is going to be like for us. This post and others like it warn me that the best thing to do for my children is to watch for signs that my time is coming for downsizing or moving to a care facility. When the time is coming, I will take my time to make the right choices, but I will also make the move early enough to handle the change better.

I can see in my mother, now 96, that her ability to adapt and learn is becoming extremely tenuous. She really should have moved to residential care at least 5 years ago when the change would have been easier for her. Even then the choice would not have been assisted living, but some range of nursing care. In our state there are specific behavioral guidelines regarding the type of care each level involves. "Assisted living" behavior looks like someone who could manage well enough at home, but benefits from a little help now and then. I think Mom wouldn't have qualified for that much past 85--and at that age she was adamant that she wouldn't go. Of course, that decision would not have lasted long if she didn't have daughters to fill in where she was no longer able. The longer it goes on, the less she is able to see that she really can't manage. That will become part of the problem of adjusting to a new place when the move absolutely must be made.

We all wonder if we have made the right choice in enabling Mom to stay in her own home for so long. The worse she gets, the harder the move will be. It is so very difficult trying to make the right decisions in caring for the elderly. Each is so different and the "right" decision is never very clear. The fact is that the end of life is a really difficult time and we will probably always doubt the choices we make, however good our intentions.

You say that he was walking 1/4 mile prior to admission? I am wondering if that was accompanied? It is much different than being mobile on your own. MUCH! I know the main reason my brother, newly diagnosed with probable early Lewy's dementia, moved to his ALF was because of his wonky mobility and balance issues. He actually was a bit better at ALF than he had been in his small home with decking and some few stairs in some few places. But mobility continued an issue. I think that your Dad was failing, as otherwise, why the move to your home, and then the placement? You describe him and yourself as both being pleased with the facility, so unless there is carpeting when he was used to flooring (much easier to negotiate) I can't imagine why this would happen in a week and suspect is it coincidental, and a part of some failure in general. I am sorry, whatever the circumstances, and suspect we on Forum can only take a guess. My bro thrived after his move, and much of that was, he said, a feeling of confidence that people were always nearby, and that any financial concerns had been taken over by me (bills and etc). But he was 85, he did become ill in a year with cellulitis, which went septic, and he did die.
I guess you, your Dad's docs, and the place itself would know more and have better guesses than we might. I suspect we are as puzzled here as you are. I sure do wish you luck.

I have worked in assisted living for 23 years. Assisted living is for people who are still able to push an emergency button if they have fallen or need help with something. Doors are not knocked on to remind them of activities or to go to meals unless it is a scheduled, paid, service. Was he assessed before going there? What I find a lot is families think their loved one "only has a little dementia" only to find out when they are here, they have a lot more challenges than the family thinks. Then the family gets angry with us as we suggest more services to help the person, or even a move to memory care. We truly don't do this to make more money, we just want our communities to be a comfortable place for their loved one. I also see families not wanting to pay for additional services to the detriment of their loved one. Memory care is a whole different story. Residents are encouraged to participate at activities and meal time. And I do tell families the first two weeks can be tough, and with someone with more challenges it can take up to a month. Plus this last year has been tough on everyone.

I love the biography idea. We do that for every new move in and share it with staff. It gives us a chance to know them more.

Hopefully time will help. And hopefully you can do inside visits. We are able to do that now with essential caregivers.

Since he is "weak" and "falling", ask them to take his vital signs. If he is not drinking enough fluids, his blood pressure will below and that will make him feel weak or black out. If his heart rate is very low, the same can happen. If either is a problem, he needs to be evaluated by a doctor.

Another question, did he go off his prednisone "cold turkey" or was it tapered off. If it was the first, he probably needs to go back on prednisone on a tapering dose.

We moved mom from a 3 bedroom 2 bath house into an efficiency apartment in Assisted Living.  I chose the efficiency for several reasons.  The apartments with bedrooms were small and everything was boxed in.  I thought it would be confusing for her.  The Efficiency is roomy and she can see everything from any spot in the room.  Once you move them from their familiar routine, it becomes very noticeable how much they have declined mentally.  My mom can't remember that she has a call button on or what it is for.  My advice is to make sure there is MINIMAL furniture in his apartment....nothing he has to maneuver around. A chair, a bed a TV...if he has a side table, make sure it's against a wall and not in the middle of a room where he has to walk around it, etc...  Make sure his shoes are not catching on the carpet and tripping him.  Give him some time to get used to everything.  My mom has been in assisted living for almost 8 years and still has days where she gets lost going to the dining room.  Hopefully your dad will make a friend or two and he can have some companionship.  It gives them hope and they fair better when they have a friend.  Stay on top of the activities schedule and try to get your dad to attend things...our place has a church service, sometimes they have entertainment, they have bingo, stretching classes, etc... try to get him to participate or just watch.  I would just give it some more time and visit as often as you can.

When a loved one has AZ or dementia. A move, even one they want to make, is a big deal. It throws off the routine they previously followed and can cause anxiety and confusion. If sleep is disrupted your Dad may have been more tired and off balance. My dad suffered 5 falls in an 18 day period when we placed him into a high end MC. Two falls he actually slid out of his wheelchair, but still- where was his staff? I came unglued and told the facility there was neglect for the fact they always responded After a fall; they weren’t proactive. In my dad’s case, it turned out he’d blown out his ACL and torn his MCL. Knee replacement wasn’t an option given his age and medical condition. More falls were a certainty, so Dad’s Dr. wrote an order saying he could only do transfers with a 2-person assist. I let the facility know I’d better not hear about how they can’t spare two folks, esp. overnight. Things improved, but the damage to his knees was already done. Be sure your Dad’s ok.
a camera can’t hurt! Best of luck!

I will scream this to the rooftops. Everyone who has a loved one with any minor to advanced dementia needs to have a camera in the room. Please do not have blind faith in the promises and feedback from staff and management in any of these facilities. I have had my mom in 3 high end facilities and here are the cold hard facts: they do not have the staff to care for the amount of residents. They may meet the "required" staff but it isn't enough to properly devote any reasonable time to individual residents. Your father probably spends his entire day alone with very limited social interaction. If the dining room is open that is great but even with a camera my mom would sit in her room and never be taken to a meal (yes, it is in her care plan). The "activities director" does not go around and grab all the residents for activities or do one on one activities if they are not interested in group activities. They will say they do but put in a camera and get the real story. This is not isolated...this goes on in most facilities. What I see with my mom having a camera is pretty crazy so I can't even imagine the isolation that other residents have felt during the pandemic. He is declining because he is not receiving what he needs from staff. Whether it is medical or mental, they are not present enough to even interpret a change in behavior. Wondering what leads you to believe that care staff is in and out all day. And if in fact they are in and out all day, what type of interaction and how long are they with him? Everyone...get a camera whether you pay $4000 a month or $10000 a month, it is all the same care.

"Assisted living" assumes a certain level of independence in a tiny apartment. It is NOT a "nursing home" where people will be constantly monitored.

It's possible that he has experienced a small stroke, which is why he is having balance problems and disorientation. I would recommend a medical evaluation.

It's also possible that he may need a higher level of care now - but he should be evaluated medically first.

Wow, your story is exactly mine! It’s all I think about everyday . My mom was in and out of the hospital after she fell and broke her pelvic bone and my dad died previously in May unexpectedly on their 63rd wedding anniversary , this all happened in 2020. She declined so much after the fall and after being isolated. Now she had had both her vaccines and hopefully can start seeing people but , I’m telling you right now she’s a totally different person. I would love to hear more about your dad and how you are feeling and dealing with it🥰

I don’t agree with others saying that he needs to move immediately to LTC or NH. To go from being ambulatory without falls and then such a sudden change in falls indicates something has contributed to it. If he has vascular dementia, he could have had a step down occur due to more brain bleeds or TIAs. Medication can also contribute to loss of balance. Does he use a walker? That would be helpful. If not have his doctor order a PT visit and they will assess him him and teach him how. I will tell you, most elderly will just sit all day watching TV or reading, and that will decondition them very quickly. My dad felt he deserved to sit after over 90 years of working around his home and that was the beginning of the end to his independence. Nothing I said could get him to walk or participate in activities. An occupational therapist can assess his apartment for fall risks. One thing came to mind was to have his phone where he can easily get to it, even if that means multiple cordless phones,
I would approach this from a methodical manner and don’t rush into moving him again. Moves are hard on them and usually take 3 months to adjust to them.

Sort out the prednisone-related issues first. Namely: why was he taking it, why was it stopped, who is monitoring the condition he was taking it for, and what is the plan for management now?

Until that's all cleared up it's impossible to say - and more especially after only one week! - whether the ALF and his care plan are right for him.

New onset confusion could be a uti.

As for the falls, has anything been added to his meds? My mom was given muscle relaxants for spasms (it was really shingles onset) and this caused her to fall 3 times in 4 days at her ALF. She did not use her call button, either. At that time she also had an undiagnosed uti and was dehydrated.

I have had her home with me for 11 months now bc of covid. She has just received her 2nd vax and will be returning to her ALF. She has declined from when she left and I, too, am wondering whether the care will be enough.

I think rule out medical causes for your dad’s falls and give it a little more time and make sure he has and uses a walker.

Wishing you both better days.

He needs a higher level of care. With each fall, comes more decline, unfortunately. Does he have a walker? Did he get evaluated by dr or go to hospital for X rays?

I don’t know if getting off prednisone contributed to falling...

When I saw the nursing home put button in my mother’s hand, I told staff she will not know or remember what it’s for or how to press it.

He Probably needs nursing home facility. Hugs 🤗

Question - why was he on the prednisone?

Concerns:

Lookup says this medication suppresses the immune system and has withdrawal issues:

"Prednisone withdrawal: Why do I need to slowly taper down the dosage?
(from mayoclinic)
If you abruptly stop taking prednisone or taper off too quickly, you might experience prednisone withdrawal symptoms:
*Severe fatigue
*Weakness
*Body aches
*Joint pain
*Nausea
*Loss of appetite
*Lightheadedness
Prednisone is similar to cortisol, a hormone naturally made by your adrenal glands. If you take prednisone for more than a few weeks, your adrenal glands decrease cortisol production. A gradual reduction in prednisone dosage gives your adrenal glands time to resume their normal function.
The amount of time it takes to taper off prednisone depends on the disease being treated, the dose and duration of use, and other medical considerations. A full recovery can take anywhere from a week to several months. Contact your doctor if you experience prednisone withdrawal symptoms as you are tapering off the drug."

At least 3-4 of the withdrawal issues they list could lead to falls. How long it takes to wean off depends on what it was for and probably how long he was on it and the dosage.

Since you had been "working" with him at home, getting him walking and active, it might be a good idea to have a good checkup and perhaps get OT/PT in to help him build up more stamina and strength.

Good checkup should include blood work and a urine culture. Since this is an immune system suppressor, he could have picked up a UTI or other infection. If he isn't eating and drinking enough, it can cause imbalances in the blood. Even drinking too many fluids can lead to issues - my mother managed to do that and end up really looking ill and confused! Once they stabilized her with an IV drip bag, she was back to her grumpy old self!

This is very, very, VERY, normal. Moves disorient elder's minds quite a bit. Moving him to another facility would just set him back even more.

It’s a major change. Any change in environment is an adjustment.

Wishing you and your family all the best.

My mother, who had NEVER fallen, fell three days after moving to her memory care place and got 28 stitches in her head. Since she arrived at the place in a wheelchair (the walk from the parking lot was too far for her), the folks at the MC didn't realize she could walk, and she tried to get up to go to the bathroom without her walker. It was a miscommunication all around, but of course, I was livid. (Why would I bring a walker if she was wheelchair-bound??) Still, I came to realize that it's an adjustment for the staff as well. They have to get to know him as much as he has to get to know the place.

It is a huge upheaval for them, especially with dementia, and yes, it takes time to acclimate. They also probably won't acclimate to a level of what was "normal" before, because when someone has dementia (at least in the case of my mother), any shock to the system like a move, an illness, or an emotional shock (my dad's death) results in a step down in her ability to bounce back. The bouncing back also takes a LONG time once it does happen.

One thing I did for both the nursing homes my mother has been in was to write a short biography of my mother for the staff. It gives them an opportunity to know a bit about who she was before she came to live there, plus I also put in important information I felt they needed to know. For example, she has macular degeneration and can't see faces, so I asked that they identify themselves when talk to her and don't touch her without speaking to her first, because she may not see them coming. I also gave that biography and the notes to the hospice people when I signed her up with them as well, and they were thrilled to have it. They meet their clients for the first time at the end of their lives, so it's been very good for them to understand what kind of person she once was.

Consider writing a biography for your dad to share with the staff. Be in touch with them, let them get to know him, and obviously stay in close touch with your dad as well. Remember to be part of the team that cares for him, not an adversary.

It is a huge change and very normal to see sudden decline following a move, it is very disorienting for them. You are right that a week is not enough time for fair evaluation. Ask the staff whAt they commonly see for adjustment. Try to be patient as adjustment needs much more time.