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Old 03-24-2012, 05:37 AM   #1
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Should I tell Dad he's moving to assisted living

Dad was diagnosed with Alzheimer's Disease several years ago. The progression has been slow until now. He also has poly neuropathy in both legs and is an insulin-dependent diabetic. Three years ago mom and dad moved to independent living. Mom was his caregiver. Six weeks ago she passed away. I'm feeling so overwhelmed since I'm the only family member to take care of him. I have completed guardianship for Dad so I can advocate for him but I've been terribly worried about him in independent living. Some days he hates me, other days he thinks I'm wonderful and take such good care of him. He's not wandering but he has a dog that he walks several times each day, sometimes as far as 2 or 3 miles. Though he can take care of his personal needs and get to and from the dining room, he has no idea where he lives, what day it is, month, year, etc or what state he lives in.

His social worker strongly recommends moving him to assisted living. She suggested we have dinner there on a Sunday (Easter) and move him in on Monday.... no discussion. I can't even begin to think how to explain this to him. The SW reassures me saying he'll be upset for a few days, but once he begins to settle in, he'll forget his anger. His caregiver/companion will be his familiar link while he's getting used to his new home. Because he becomes easily agitated when advance notice is given about simple doctor appts, that there's no reason to talk with him ahead of time and create unnecessary stress when he clearly needs to move. Having no experience with any of this, I don't want to make him worse. I've learned that his disease can accelerate with trauma.... and we've seen that since mom passed away.

Anyone have any feedback? I would be so grateful for shared experience in this area.

 
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Old 03-26-2012, 12:00 PM   #2
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Re: Should I tell Dad he's moving to assisted living

My first thought is that he needs to be moved to a memory unit or a memory impaired home. The area would be locked securely and he would not be aware of that. The staff would know how to treat someone with dementia. The activities will be dementia- friendly. Esp. given that his wife just died - he would get worse.
Later on he will be moved to a memory unit again when he reaches moderate/late stage. It is safer that he goes to the memory unit now given that he forgets where he is and the date/time or the season. It is moderate stage.

About telling him about the move: I would say yes/no. No, you don't need to tell him the fact which he will forget anyway. Also if he is too confused, the facts don't help and will only confuse him. However, it is not wise to shock him by the move. Make sure his old peers and friends are still nearby. If it is the same building, make sure he is in the familiar public area so he is not aware of the particular move. Say white lies such as the new room is better or larger. The new room has more light. The old room is taken away. Say any excuse. Don't just be mute about it as he will for sure have questions. Comfort him and tell him all the good reasons for the move.
Do not say he is sicker so he has to go there. Just comfort him and assure him everything will be fine. He will have the same food, the same activities/outings and etc.
When we moved my FIL to a home for memory impaired, he assumed he was to come to "work with" his son. It was not true. Anyhow, he later loves the home and thinks of this home for his "work". He never accepts retirement so he does not think of this home as a nursing home. The funny part is he loves to be cared for by the nurses when he gets sick. He trusts them. However, he has his own reason to like this NH (it is all about work.) So I am not sure about your Dad.

I am sorry that your Mom passed away and Dad got worse and has to be moved.

Take care,
Nina

Last edited by ninamarc; 03-26-2012 at 12:10 PM.

 
Old 03-26-2012, 01:10 PM   #3
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Re: Should I tell Dad he's moving to assisted living

Nina, thank you so much for responding to my post. I wish he could stay where he his, but this community is only independent living, so a physical move is necessary. His social worker has suggested I take him there for lunch a few times prior to the move so the surroundings will be familiar. The staff there will help by referring to mom's "previous visits" to prepare for the future when they need it. Perhaps if he hears them invoke her name, it will help take the trauma down a level. I'm also going to talk with his doctor and ask him if he will see dad and communicate the time has come for this kind of change in living arrangements.

Dad can't go straight into secure memory care as his is not yet an elopement risk. They are, however, a sister facility to where he is going. I'm not crazy about the potential of having to move him twice, but there doesn't appear to be any other options. There are no facilities here that house both assisted living and secure memory care under the same roof.

I am looking forward to June when I know all this will be done and he will be well-used to his new home. If I think too much about the actual move, my stress level jumps through the roof. I think the social worker helped the most when she told me that no matter how long I waited, he was not going to get better, that he's not going to ever like this. My heart breaks for this once-vibrant, larger-than-life man stricken with such a mean disease.

Any other suggestions you have will always be welcome.

 
Old 03-26-2012, 02:24 PM   #4
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Re: Should I tell Dad he's moving to assisted living

I can understand why he needs to go to AL now instead of memory unit. Where my FIL is also only accepts people with mid-stage dementia or later.
I noticed the stage progresses and there are different needs. My FIL had had home care starting from 1 hour to part-time, full-time, to live-in and finally 24/7. The home care expenses were too much. But the advantage was that he could go to the lake behind his home.
I can imagine that your Dad wants to walk his dog. The memory unit has pet therapy also so they will still have pets once a week.

There are some NH that have 3 units - independent, AL and memory unit. But I prefer a smaller one. Given Alzheimer's, my FIL only needs a memory unit so this place has only people with dementia. (64 units; 32 units each side - the other wing is for sicker people.) It is a residential care home as well as a nursing place.

I sure hope AL will help. But note that when he gets lost in the AL, it will be a little hard to deal with. However I understand he needs to go out on his own with his dog. Make sure he is supervised.

Hugs,
Nina

Last edited by ninamarc; 03-26-2012 at 02:26 PM.

 
Old 03-26-2012, 04:21 PM   #5
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Re: Should I tell Dad he's moving to assisted living

I agree with the theory of not making a big deal out of the move. Telling dad that his room is being cleaned or some pipes broke , you get the point, and then just make the move. Reasuring him that as soon as it is fix he will be back but it will take some time. Myself I would not have the doctor tell him, I think it would just cause stress and to make sure that he thinks that some of what is going on is his idea. Include him in on your little desiption buy asking him his opinion of how long he thinks it will take to replace the floor or fix the heating or whatever you desire. Our loved ones need to feel needed and they need to feel like they have some control over things. I am so sorry about your mom, I also just lost my mom just over 4 weeks ago, and both my dad and I are still reeling from it. One day at a time right!!

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Old 03-26-2012, 04:42 PM   #6
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Re: Should I tell Dad he's moving to assisted living

Rene, if your Dad can take care of most of his ADLs and is not an elopement risk then he should be ok in AL. I am not surprised that you have seen a down turn in his cognition after losing his wife. And I want to extend to you and your Dad my condolences. It is difficult enough for us but even more so for those with short term memory loss. Yes the move is going to be another new situation for him but it is unavoidable since he can not continue alone in IL.

Your social worker is giving you good advice. Since your Dad gets anxious about a simple doctor's appointment, imagine the anxiety a physical move will create. Taking him to his new unit several times is a good idea so there will be some residual memory. Take him for lunch and let him sit in the unit living room and relax. Let him met some of the people there and make it a positive experience. I would do this as many times as I could. If you try to explain the move he might get upset about it. He might remember enough to remain anxious or he might forget it all. If he forgets you have to do it again and again.

When we moved Mom and Dad to AL they stayed at my sister's while we did the physical move. When they walked in it was "just like home". We did the same thing when we moved them from AL to the locked unit. If possible bring his favorite chair, set the room up similar to the one he has now. Use the same spread on the bed. Take pictures that he recognizes. Don't forget his favorite things. These will help give his room a feeling of familiarity.

Dad being upset with you one day and grateful the next is normal. They are in the moment. They don't remember yesterday and tomorrow doesn't exist. What is happening right now dictates their mood. The social worker is right. He might get upset but as he settles in that will usually fade. Just make sure that he has plenty to do. Arrange with the staff for him to be busy. This will help. If he is let in his room to brood you will have more problems. Time your visits to let him stay involved in the facility activities.... even going with him. You want him to get into the rhythm of the facility and not be dependent on you o a daily basis.

I do hope he does well in this move. I am sure you are overwhelmed at the moment but know there is a light at the end of the tunnel. Dad will be ok and therefore you will be ok.

Keep typing and know we are here to listen

Love, deb

 
Old 03-26-2012, 04:54 PM   #7
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Re: Should I tell Dad he's moving to assisted living

Oh my goodness, it is so incredibly wonderful to "talk" with other women in similar circumstances, i.e. we have become our parent's parent. I have felt alone in a very leaky boat for several weeks now. I can't begin to thank you both, Nina and Judy, for responding and sharing your experiences and suggestions.

I understand Dad's need to feel included and part of the process, but I'm not yet sure how I can do that. The repairs idea is a good one except his community is almost new and his awareness is heightened by his paranoia, especially when he's feeling fearful. His new home is 5 miles away and I'm hoping that telling him it's the place mom chose for both of them as the next step will help allay many concerns.

I spoke with the director this morning and he's going to talk with a couple gentlemen living there who are WW2 vets and also love all things John Wayne. Dad watches westerns from morning until night. They'll be paired up during meals in an effort to help Dad begin to feel a part of the community. My husband and I are going to walk the area this week to find a direction he can safely traverse (with his caregiver) that will allow him to let his dog run loose for a minute. I'm not sure what else we can do to help him acclimate. If only he knew how many are involved in trying to make this as comfortable as possible.

I just wish I could remember to breathe.....

 
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