Do you include your LO in care plan meetings? If you do, how do you keep it PG while still addressing concerns?

Having a dementia patient in a care meeting is like having the dog weigh in on his neutering surgery with the vet.

I recall one poster, Dorker, whose MIL with dementia was included in a pro forma first bit of the care meetings. Then she would be taken back to her room so that the issues that had arisen could be discussed.

My mother, with Dementia in a NH setting was not included. They would have agitated her.

I would tell the MC that they are free to reduce his supports if they will take financial responsibility for any injuries that occur, including ambulance, hospital, rehab and LTC charges that are not covered by insurance.

My mother was NEVER included in her care plan meetings at the Memory Care ALF, nor was she aware they were even happening.

Your LO is in the throes of dementia, incapacitated, and where he belongs. He's doing well because he's being cared for properly, and that's what's important. If he cannot act civilized toward you when you visit, tell him you'll come back when he's in a better mood. Then leave.

Do what's best for you at this point and stop catering to someone who's dealing with anosognosia and will never likely believe there's anything wrong with him. The goal is to keep him safe and well cared for....if you're the enemy for making that happen, so be it. I was the bad guy for years in my mother's eyes, which didn't stop me from getting her the dementia care she needed. There's nothing logical or sensible about the condition so try not to internalize the angst you're being shown. It's hard, I know. Dementia sucks in every possible way.

Best of luck

My meetings were only 15 min and that was them telling me what they were doing. No time for questions. That was the NH, the AL was better. But neither were my Mom there for. Her Dementia had progressed too far.

Sounds like your afraid they will send him home. You don't think MC realizes that because of their help he is doing well and if it doesn't continue, he will decline because he can't do it alone? I think ur FIL has enough wrong with him he could be placed in LTC if needed. Doubt if he is the only person who has improved. He gets 3 meals a day. Someone bathes and helps dress him. Probably gets some form of therapy too.

I would tell the SW (or whoever is in charge of the meeting) that you have concerns you'd like addressed. That you don't want him there as you talk about him. You need the staff to be upfront and honest with you and your not sure if they will with Dad sitting there who is in denial of his health problems and Dementia.

This is a stage and as his Dementia worsens he really will have no idea what is going on.

In your FIL's case I would not. You might consider keeping him there for the "last half" if he wishes to attend.
My brother, when he was in rehab, was very engaged and engaging, very concerned in his own care, working out whether he should go into ALF or remain in home, wanted information and input and wanted to weigh it all and was engaged, and mentally quite able to participate. He was great at attending the care conference where everyone from PT, OT and dietary were there as well as the discharge planner and social worker. So for him, yes.
You know your FIL best. In this instance you are the expert. You will know if this would be comforting and informative for him or disturbing and anxiety triggering. I leave it to your best expert judgement.

No. A person should not be included in a care meeting when they have dementia.

The care plan meetings (typically a brief 15 min call these days w/COVID) are required by Medicare/Medicaid "no less than every 90 days." Typically, these brief calls are just to provide an update of status (meds, any upcoming tests including minor blood tests) and any psychosocial updates or plans. Once in a facility for a while, much may not change if the care is as well as expected, especially for dementia patients -- not like there are many tests, Rx changes or other things that will greatly after the course of this disease.

My mom has dementia and a host of other conditions, in total denial too. She has been at her facility for over 1.5 years and still believes "she is fine," that "the NH folks do nothing for her," that she "can take care of herself." None of which is true.

She is included on the every 90-day care plan calls as her facility wants to give them as much respect as possible. My mom typically tells them NOT to include me, as I am the devil for "not taking her into my house and providing the 24/7 care she needs." Fine. For the most part when I was allowed to participate in those calls, she could not understand much of anything that was discussed and mostly would just be disruptive.

But certainly if I have any concerns, I call her assigned physician at the facility. The MD will respond to texts too if there is something pressing I need to convey. Ditto for the lead unit nurse, her floor nurse or my mom's assigned social worker. All to say, the care plan meetings/calls can be "pro forma" but just call her assigned/lead physician (not like one calls weekly of course, you get it). But assuming you are "the health agent" or "representative," someone on the outside is the "point of contact" they will speak with you.

And these facilities have seen it all before, especially the loved one saying they "are fine," "they do not need to be there," that they want to go home," etc.

All of this is an aganozing journey. God bless all dealing with this. It just is what it is. Practice self care and if the LO becomes verbally abuse/toxic; as others have said leave, say you'll call later, take a break from the visits/calls, go no or limited contact if that helps. They are in their own reality, if they have made you the devil, then there is no convincing them of your reality, the reality they need to be where they are. I am the devil for my mom, nothing will change that.

I understand 100 percent. I also live in a care facility where there are CPM's every three months. Even though the resident has the right to attend, as the residents family, you also have the right to have a meeting without him there if that makes it more comfortable.
You could call or email the Admin. and explain how you'd like to have a meeting without your l/o present and explain why. You may be able to either have a phone conference or F/T meeting.
You need to make sure everyone, admin, nursing supervisor and anyone else except the aides, involved in his care are present. If you have any notes that has a record of his behavior bring it to the meeting. Also, if they insist that he be there, contact either the social worker at the facility or make an appointment with an APS agent explain your concern and ask them to be part of the meeting.
They'll probably want to meet with him first to get a handle on the situation. After that, they shouldn't have any trouble backing you up. When the rep goes to visit your l/o, don't mention from APS. Your more likely to get a more honest response that way.
It's a sneaky way to go about things, but, I think you'll get the best results this way.

Good Luck.

Don't take his "hatred" personally. This is his dementia and his denial speaking, and also his fear of losing independence. People do lose independence in assisted living facilities. And it's not uncommon for people with dementia to be unaware that they have dementia. He might be functioning well now, but with dementia, and aging, his condition is likely to decline over time. He is in no state to be at home (especially since he is a wanderer) unless he has skilled 24/7 caregivers/nurses who know what to expect with dementia. At some point he might need more than one and special equipment, if he needs help with transfers, bathing, or turning, etc. Would he even agree to 24/7 caregivers in his home? His financial condition would dictate whether this level of home care is possible. More responsibility will fall on you if you have to oversee home caregivers. Are you able to take on this responsibility? His case manager at his memory care facility is most likely very aware of his capabilities (and lack of capabiity) and his denial. You may want to discuss his care without having him present. Are you and his memory care case manager in agreement about his capabilities and what would be the best care for him? Is his doctor aware of his lack of capabilities? Hopefully all of his paperwork is in order with setting up powers of attorney for medical and financial matters, a living will with his medical directives, and a will (if he has assets). You also need to be on file with Medicare and Social Security to be able to speak on his behalf. This can be done with a phone call with him sitting next to you to agree to it. If you can, discuss with him his care options (24/7 in-home care, if that's financially possible, or being in an assisted living facility). People with dementia go through stages; he may get used to living in assisted living. Also, the wish to "go home" is often symbolic. It means that he wishes to be the way he was when he was independent and capable of doing things for himself. Seek grief counseling for yourself to be able to handle a parent with dementia. It is a long "good-bye" and can be emotionally straining.

Anosagnosia, is not the same as denial .. I can swear I did not eat that chocolate cookie even if it’s all over my face .. but I know I did. I denied it !
My Loved One , “IN THE REALITY” he lives in , truly believes there is nothing wrong with him … I am so lucky that he is not hateful . He was angry in the beginning, very upset but never ugly .. He is still home with me and I am still able to tend to things and keep him safe . We are 5 years into to it at this time. He also has a bunch of medical problems. I have
2 1/2 years of Caretakers meetings behind me and I have learned so much . I was truly worried about my own sanity . I realize every patient travels their own path and no 2 paths are the same . My man has lost the ability to comprehend what is happening around him . In the beginning the hurtful things that came out of him mouth were because he was having a rough time dealing with the thing he was loosing . His ability to drive , carry a wallet and credit cards , pay his bills and the biggest thing was playing golf. I took those hurtful things to heart until I know where they were coming from . I related myself to the losses I would feel if it happened to me. . Living in this house is easier now than it was then . When I am no longer able to keep him safe he will also end up in a care center . I fudge the truth when I know it would upset him , change the subject when he gets upset and keep things light . We even laugh at times. I have a DPOA already and would not include him in conversation with the staff when the time comes. If you are not involved with a CareTakers group I strongly suggest you look into it . It showed me that I was not alone and that there was help out there . All I had to do was look for it . , prayers are with you …