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After calling the doctor and waiting for a social worker to come and loosing the first caregiver in the home and trying to get a new one for the interim we have now decided to place dad. Im not sure how this is all going to go, I know he will be upset, I know he will fight it at first, but he sleeps almost 20 hours a day, or just sits in his chair with his eyes closed, he doesn't engage in anything, he doesn't watch TV or even go out to the porch to feel the breeze in the evenings. I want to cry, but also feel once settled this is going to be a major relief and happy thing. No one will visit him because of his current living conditions. I try my best to clean as much as I can when I'm there but it seems in a matter of days the toilet is a disaster and there is dirty dishes and horrible food everywhere. My heart is breaking as this is the most wonderful daddy but I have to do what's best for him. that is the only thought in my mind. He will thrive in the long run. Anyway, comments, thoughts etc.

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Didgens, that is probably for the best. Dad may or may not like the change. He might be very upset or he might notice there are other people his own age that he can talk to, especially during dinner time. Most Assisted Living will place a new resident with someone who has something in common.

What will be hard is downsizing what Dad will take to his new place. My Dad wanted his 200 books but I asked him to sort through them. The standing joke was Dad was now taking 199 books :) He had room for bookcases, so why not, if it made him happy. I let Dad take whatever was within reason.... no, Dad, your workbench won't fit in your room.

Hopefully your Dad will thrive in his new home, mine did. He was happy as a clam and he didn't need to worry about his house any more. I quickly sold his house and made sure he was part of the whole process.
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thank you freqflyer ,, the space in his own home that he uses now has shrunk to a chair ,, the kitchen and the bathroom mostly. The only things I think he will want are his chair, bed, mementos and some kitchen dishes maybe. He hasn't gone out to his garage in months or even the front porch I don't think .... hopefully getting some answers from social worker, doctors, care givers in the next couple weeks will give us direction.
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Your profile says that your dad has dementia. I suppose that is what is causing the problems you describe. At some point, you really do need a lot of constant assistance, when a person has significant dementia. I think that some people adapt to being in AL. It's difficult to say how a person will react. Their brain is damaged, so they may behave in all kinds of ways. I hope your dad does well.

My LO, who had dementia, did pretty well in AL at first, but, soon it was apparent that she needed a much higher level of care than a regular AL.(Have you discussed what level of care that he will need with the AL?) We moved her to Memory Care and it was the right move. That's where she really seemed to fit in and relax. She seemed to sense that she was somewhere where they knew how to care for her and where other residents shared her condition. 

Will your dad accept the care at AL or resist?  That's one thing that we had a problem. With a regular AL, their staff is not really trained or equipped to manage residents who are refusing baths, refusing meds, totally incontinent, etc.  I was getting a lot of phone calls about her need for more care.  I'd just keep that in mind, so that you are prepared.  AL is great for some, but, with some, their level of care may be higher than what they can provide. 

Please let us know how things go with your dad.
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In my family's experience, moving into an assisted living/memory care home was a blessing! My FIL perked up and was the life of the party for the first year he was there -- he actually got "better" during the first 3-6 months because the home's routine was so much more supportive than we were able to provide in his personal home. He missed very little of his possessions, only wanted his "comfy" clothes and his diplomas/art for on the walls. In his quieter moods, he enjoyed the tv much as he did at home - but on his busier days, he helped staff fold towels/clothes and ran the vacuum cleaner on a regular basis. He liked being "busy" once he felt safe/secure, and told us how great the food was all the time. Think positive - and be ready for a couple surprises :)
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Has an AL evaluated him. You need to realize that they are limited in their care. Usually, they are only required to have one RN in charge and an LPN as back up. Neither have to work more than 40 hrs a week even though they may. Most of the staff are CNA's or with a Med tech in charge with the RN or LPN is not around. Which is usually nights and weekends.
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the one place I did go look at today had 3 levels of care and rooms. one was just a regular living space with a "kitchenette". the others were studio and kitchenette with Memory Care ,, boy did that BUMP UP THE PRICE !!! to the tune of 3k extra a month ,, WOW .. so I keep looking.
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This move to assisted living will be a change for everyone. As having worked in an assisted living facility in the past, I have not met a resident who like it at first due to such a living change from home but let me assure you, with time they all adjust and come around. My thoughts are with you in your transition.
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You have to do what's best for your father, especially since he was such a great daddy. At this point I think placement is what is best for him. AL? Memory Care? Nursing home? You will get help in evaluating what kind of care center will work best. And that may change over time. Just keep reminding yourself, this is what is best, and he deserves the best!
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Will there be people who will visit him in a clean, orderly care center? Having visitors is generally a positive thing!
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yes ,, other family members will definitely visit,, and if its on here by my work I would see him even more often then I can now.
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I agree with all of the above.

Let me just add: trust the staff. They have tons of experience with every aspect of this transition.

I didn't believe that my mom would adjust. They told me she would--and she did. She loves her AL now. She also sleeps all day and doesn't do much, won't leave the building. But she loves her creature comforts and that is paramount to her.
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Hi!
The day my father arrived from Canada to spend some time in his Portuguese residence after the passing of our youngest sister (47), the love of his life, he had a severe stroke which left him bedridden, totally dependent and unable to express himself.
During the first year we kept him at home and hired professional caregivers who would come twice a day to do his higiene. Things went more or less smoothly despite the inevitable difficulties.
Things started to get complicated when he started choking with food. He got a respiratory infection and was always going to the hospital for urgent assistance.
My biggest wish was for him to be home with us but by the 15th month it became impossible; his life was constantly at risk.
Finally, we had to put him in a home. It broke my heart to give in to my eldest sister's wish. I felt like we were dumping him and I'm sure that's the way he sees it too. But there is no other way given his fragile health. He has to be looked after during the 24 hours of the day and at home it was impossible.
At this moment, I feel relieved because I know that he is being properly taken care of (I hope) although these meisers don't heat up the place and the houses here in Portugal are like refrigerators.
He's five minutes away from our house which allows us to visit him more often.
Life isn't easy.
Some people reach old age and this is what happens to most of those who are that lucky.
Others, like my poor sister, die young :(
With time things will get easier for you.
Good luck!
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One thing you'll definitely want to do is take down the name and location of the place you're considering. Do a check with the BBB to see if there's been any complaints and to see what kind of rating they have. I personally would not want a place with less than an A+ rating, and if they have less than an a plus, I would keep shopping until I found what I was looking for. Another thing you want to check is the price and even talk to others who have or currently are using assisted-living to see what they say. If they have anything negative to say, use your gut instinct and believe them
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Sometimes finding a place having an A+ rating is easier said than done. My mother's NH has less than a stellar rating but although some of the residents there are seeking better places, the others in the area have (sometimes long) waiting lists. Because my mother is bedridden, she isn't in a position to take advantage of what many of the others offer anyway, and her NH seems to cover the bases. They always have empty rooms and others have only one bed occupied, so short-term people are often placed there, and long-term can essentially "walk in" and get a place.
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It's definitely the right move. Placement in the right level of care is essential, but you can always move up if necessary. My mother has been in AL for five years and she's been comfortable and content. All too often I've observed new residents who definitely require a higher level of care than AL. They aren't able to find their own room or even the dining room and they are placed in SN or MC area. The positive aspect of this AL is that they have a Separate SN next door that also has a MC unit so residents can transition easily. If a resident goes into the hospital they'll return to the SN and if they improve they return to AL. You may want to find a facility that has multi-level care.
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My Mom has been in AL for two months now. It was not without tears on her part at first. We felt so horrible and I kept second guessing myself. She is doing much better now and is making friends. Though she makes it quite clear to those around her that she really does not belong there. But those comments are getting fewer and fewer. She often comments how kind the staff are and that the food is good. She has involved herself in the activities and that helps. Be aware of the extra charges that are not included in the base cost.
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Make sure the place you choose, has several levels of care. From early dementia to late stage.
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Didgens, my heart goes out to you and I will be praying for you and Dad! We had to put my Mom in AL on March, 2016 and she still has not accepted it! Everyone told us not to worry and just give her a couple months and she would come around. Well, I'm still waiting on her to accept it! Between my 2 brothers and myself, we make sure one of us sees her every day. I'm really not sure that's the best thing for her because she constantly badgers is that she wants to go home. I just hope and pray that your Dad will accept it from the beginning!
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My mother also has dementia & neuropathy in her hand and was placed in AL. She was not allowed to bring her bed due to health concerns (bed bugs), but was able to bring whatever else she wanted that could fit in her living area. I found the AL was not the answer when she began acting out and I was finding her medication on the floor, noticed other residents in poor hygiene, being placed in the dining area to eat, but unable to feed themselves and staff did not assist. I moved her out to an adult foster care for the aged. That worked out great. You may consider this as an option.
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When the day came to move my two friends, a married couple, to their memory care apartment from their condo, another friend took them out for breakfast in a nearby town, then to have their nails done. While they were away, we moved their bedroom and den furniture to their new apartment and set it up just like in their condo. At 2 in the afternoon when they came to their new apartment and saw it looked just like home, the husband sat in his recliner with a sigh of relief and has been happy ever since. He was the one resisting the move, thinking everything was the same as usual and not seeing the changes in his wife with her frontal temporal dementia due to his memory issues. He is still happy two years later. He enjoys his new friends at meal time, then goes back and watches TV and reads the paper. He never was a game player, so doesn't enjoy things like Bingo, or art, though he will listen when someone comes to play the piano. But he's happy. I am grateful for the watchfulness of the care givers and ask them occasionally about any changes they might see. Every encounter is recorded in writing and a doctor visits him once a month to check. He is physically healthy and still smart, but without short term memory, cannot function in the outside world without help any longer. Good luck on your move. We used Adult Protective Services to get the ball rolling and when they did the wellness check after my call, I was able to get their car keys and move their car out of their possession since both had lost their licenses but did not remember about that. They were able to live independently another 6 months or so before the wife needed 24 hour care due to her incontinence and wandering. She passed away about 5 months later.  Best of luck with taking care of Dad. Perhaps you could do the same and take him out to eat once everything is in place for the move and not take him back home but to his new apartment.
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Digens, I moved my Mom from her home in FL to a Nursing Home in VA last August. She is only 76. She did not have much money and nothing more than Social Security & Medicare so assisted living was out. I found a nursing home that was a non profit with a max of 90 beds and 1/2 of them are for rehab. so the long term unit is small wing. Let me just say facility care is always hard and the key is families continued presence. Everyone knows my mothers family comes in daily and I follow what she eats, I shower her and take care of all of her personal hygiene needs. I also understand that you might have more difficultly doing all care for your Dad which means you will have to rely on CNA's to bathe and handle the intimate care. It is a tough road and it is exhausting but for my sister and I it was better than traveling 1300 miles round trip every month for a week. The 2 factors that would be critical in my choice would be 1. nurse ratio and the facility rating and inspections and how much they have paid in fines/law suites. 2. location to you so you can be there routinely. I was amazed to find the Medicare website had an incredible user friendly database of all nursing homes and assisted living facilities. It identifies profit and non-profit along with there inspections, the ratio of patients even identifies the percentage of certain medications being used, percentage of UTI's. I was impressed and it guided me in my decision. Good luck.
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Has his doctor had any input? That is where I would start. AL is not for everyone. If he is sleeping 20 hours a day, a NH might be a better fit.
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AL gave my Mom (89 yrs) a place to recover from nursing home. Broke leg in 1 month & 30 days later broke same leg again. AL is like having an apartment but CNA's check on you. Breakfast, Lunch & dinner. They required you come to lunch & dinner, if possible. They will bring your meals but if that turns into a habit they charge. There are a lot of good reasons to be in AL. There is alot of paperwork to handle & you will need to know everything about your person to get these done. Someone with slight dementia (they do not like change) may get by. You will still need to check to see how your person is doing. I finally hired outside help to stay with my Mom 24/7. She would just do stuff to jeopardize her safety. There are extra services usually cheaper to get whole package as more care is needed. Be aware that a law was passed supposedly for ALs & I had to pay a separate company to come in twice a day & dispense my Mom's medicine on top of the already high cost of living there. Someone will want to do an evaluation of your person, determine level of care needed. They are salespeople they sell their facility, services so it will sound great so shop around. Nursing homes are different than ALs. This site is a really good place to get information. Every place, every city, every state is different. It's in your hands to do the best you can to get the best place & services for your person. My Mom is at home but she still has 24/7 caregivers (companions). Drugs from 3 surgeries really did a number on her brain cells. She is doing well. But she is slowly getting shorter on the memory..the old memories are still clear.she thinks she is running her life & to some extent she is, but I handle all her affairs. I am her personal assistant & everything POA. POA disappears after death. So be ready for that also. Sometimes stuff happens so quick.
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I moved into assisted living with my husband. He has LBD with Parkinson's. Due to his many falls, I realized that I needed more help to care for him. Like your Dad, he sleeps 20 hrs a day, but there are a couple of activities that he will get up for. The only thing you have to watch will be his meals and meds. The med techs tend to bring meds at their convenience, not necessarily at the prescribed time. Meals here leave much to be desired -- too high in carbs and low in fruit/veggies. If he has any special diet requirements, it will be very hard. Everyone picks what they want from a menu, not exactly the things they are supposed to have. Make sure you have durable POA in place because you will need it.
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The best guidance I can give; tour several facilities they are all different. Regarding price, some are all inclusive and others have several additional charges - so you have to be wary of that. Money was an issue for us, so I moved mom farther out into the county. The cost difference was significant. Memory care where I live is around $7,000 a month; an hour away, $4,600.

What to consider - do they have different levels of care; end of life care? Are their recreational activities that your dad would enjoy; is the facility and staff appealing at first glance and clean. There are also other options like group homes - which tend to be more affordable. I have heard very good reviews from people who have chosen this route. My mom is at risk for wandering - so she needs to be in a locked memory care unit.

Think about what your dad likes when visiting these facilities. Also get on the waiting list, not all places have vacancies you can always decline if you decide to do so.

Good luck.
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The very first thing that does need to happen is that my dad needs to see a doctor ASAP ,, I have calls in and they are trying to get him on the "Home Doctor Program" but they did not return my calls yesterday. Yesterday I met a New in home caregiver ,, I didn't pull an punches ,, when we walked in I thought ,, gee the toilet isn't that bad so he must be doing a little better ,, but It really looks like things are going downhill fast as I found pajamas that he had pooped in on the floor .. its like the house is his toilet now. I don't know what's going on ,,, I think I may have to call 911 just to get him into a hospital and seen by someone ,,, this waiting is crazy making and I have to work and my son graduates on Saturday and im getting a colonscopy on Monday ,,, I want to scream ,,,, other then the house being his toilet he seems in good spirits,, liked the new caregiver and when I left yesterday was warm and clean ,, I have to keep reminding myself ,, I can only do what I can only do ... ok .. so another call to his doctors office today ,, and the social worker ,, the new caregiver yesterday gave me hope
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You sound so overwhelmed; hang in there. Why don't you consider hiring a geriatric care manager. They can help you with everything and take the burden off. They will also be a strong support system for you.
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Didgens,

Thank you for asking a question that many do not bother to ask. This is a mountain of change in both of your lives.

All that said my words of advice are simple 'follow your nose'. Show up as a surprise to visit. Ask to walk through and have a look for a family member. This will tell you a mountain of answers. First can you smell any unpleasant orders like urine, spit on the floor, unkept areas.  Don't stop there, are people dwelling here smelling or as you walk by an open door is there an order. Another aspect of the visit is while walking around does the food smell inviting. Are there snacks out for the residents to get for themselves at times in-between meals.

One of the best ideas to keep in mind - this is a business. They are here to not only provide assistance, also to make money. And they need your loved one to make money.

Please do not let all of this make you change your mind. There are many ALs out there, it is just that sometimes it is necessary to look a little more closely.

A move is stressful on anyone and when it is due to inability to live at home any longer, the stress level is very high. That said let us make the best decision possible for our loved one.
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Dear Didgens,
I am sorry for your heart breaking situation.Are you able to get your father to a Dr.? It sounds like he may be helped by an antidepressant.He sounds depressed.
If you place him in an assisted living...here has been my experience.My sister placed my mom in one.It was a brand new,beautiful facility.The care was horrible there.The staff were far too young with no experience.No schooling is required to work in one.Every week people were quitting and new workers hired.The care was poor and inconsistent with three different shifts of personal care workers who did very little.They sat on their phones a lot.Some really horrible things happened in the two years she was there.The food was not good.She was not given fresh water daily if there was any in her room.She forgot to drink water so it had to be offered to her.It was not.Her floor was not cleaned.Her room was not straightened.She fell and fell breaking bones in her wrist,hip and a finger was severed completely off.
My advice to you is do some serious shopping around before placing him and be sure to NOT pick a place that is brand new with no history or track record.You will want a facility that has been well established with a history.Brand new,fancy and beautiful buildings are no indicator of the care your loved one will get.Some privately owned facilities are there for nothing more than making money.Not all are that way but do your research before placing him.Will he talk with you to tell you what is troubling him?It really sounds like depression.There is this one assisted living,memory care facility in my town.It was smaller,not so fancy and very homey.I wanted to move my mom there out of the fancy,horrible one she was in because this small one did not like to drug their clients with sedating medication.Their approach was to use an antidepressant to help the clients to get better.Many facilities will give drugs to sedate and make clients sleep or be more manageable thus less care is required but that is not quality of life for the loved one.If I could have done it without harming myself,I would have kept my mom in my home and cared for her but I did not and she suffered greatly at the facility my sister placed her.If you must place him...take much time to select a really safe and good place.I will keep you in my prayers.
Cares.
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It took me two years of gentle prodding to get mom to move into assisted living. We'd visited several, ate at a few, discussed it endlessly. She moved in two weeks ago, and she's done a real 180 turn in her mood, health, energy level, the way she dresses, her eating habits, even her doting on the cats!

She'd come to the point where she really wasn't leaving the house except when necessary - sometimes not even going down for the mail, which used to be a highlight. Her eating habits were awful, there was nothing she liked and ate more cookies that anyone should. She doted on those cats, her entire day revolved around them and what they would eat. She spent 8-10 hours a day - no exaggeration - sitting in front of the computer playing solitaire or online jigsaw puzzles. She'd stopped visiting or having visitors. Her self-esteem was at an all-time low, a lot of it because of the word loss that has come with early Alzheimers.

What helped move things along was having her visit with the resident "ambassadors" there, uber-friendly folks who had a meal with her and talked to her about what life there as like.

Two weeks later: Her new apartment (bedroom, living room, kitchen - with no stove) is sunny and decorated with her own stuff. She has welcomed visitors - family and friends. She looks forward to her meals because of the company at the table and the quality of the food. Normally very shy, she is branching out and facing her fears - taking trips into town with the group, checking out things she used to look down on like beading classes or knitting groups, and had the most delightful time when a group of kids came to visit and hang with the "olds."

This was the best decision we could have made. What I didn't expect is that I am having a harder time with the transition than she is. I'm the one having difficulty letting go of control of her meds, control of everything.

I used to call daily, just to make sure she'd eaten, had gotten dressed, etc. Now, if she doesn't come for a meal, someone comes to find her, and they come find her in the evening to give her her meds. So, at least 4 times a day, someone competent is laying eyes on her. This has been a more difficult change for me than for her on the one hand, on the other, I know she's safe, well-fed, has good company, and is happy.

Hope that is helpful.
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