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I'd say he's in the wrong type of care situation. He belongs in memory care, not AL.

A friend of mine had her dad in AL, and while he has Alzheimer's, it isn't terribly bad. Nevertheless, she was visiting daily, calling him to remind him to go to this activity or that, sitting in his room while he showered because he was afraid to otherwise, and generally doing much of what you'd expect from the caregivers. The problem was that that isn't what AL caregivers necessarily do.

Her dad was very anxious when she didn't show up or call exactly when he expected, so her life was chaotic as she tried to maintain this pace. (She also works full-time.)

Her dad fell and broke his hip, so the decision was made to move him to memory care when he got out of rehab. Now he's very happy where he is, his needs are being cared for by the staff as they should be, and my friend has been freed up to just be his daughter again. Your situation sounds very much like hers.
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The problem is the AL is not allowing activities OP says. Until restrictions are lifted not much can be done concerning socializing.

I lived 5 min away from Moms AL. I stopped in everyday but for no more than 30 min. She had gotten to the point she couldn't hold a conversation. We sat out in the Common area so I talked to the lucid residents. I occasionally took my 3yr old grandson. One of the residents loved playing wit him. If I had something to do, I wouldn't go that day.

I think since we are still in COVID and you want to do it, visit that one or two hours. As restrictions are lifted, cut back ur time. When the Common area is opened up, visit out there so he gets used to socializing. There was a woman who visited her husband. She knew my Mom and we would talk. She would turn to Mom and say "what do u think Peg" or "don't u agree Peg". Always trying to make Mom part of the conversation. Loved her for it.

Have you spoken to his Dr. about an anxiety medication.
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Part of placing a parent in AL is a goal of getting them to socialize and interact with other seniors every day. If you're going to be there every day for 2 hrs, how will he get a chance to make friends and adjust? Now, with the virus wreaking havoc on normal life, it's prevented a lot of regular activities from happening in AL anyway, so your visits have probably been a life saver for your dad! Now, with the vaccines going out, life should be getting back to normal in your dad's place, right? I know it is for my mother in her Memory Care Assisted Living place. So think about cutting down your visits a little at a time and encouraging dad to join the other residents for stimulation.

I go visit mom once a week for 45 minutes which is the max allowable time for the moment. It's plenty bc she's got advanced dementia and visits tend to be difficult due to conversation being limited and her having no attention span. We talk on the phone daily. She does activities with the other residents daily, and eats 3x a day with them too. There's only 23 residents in total, and Covid hasn't restricted them TOO badly, fortunately, bc dementia residents can't BE restricted to their rooms like regular AL residents can. It's a different kettle of fish in MC.

Don't feel badly about backing off a bit and see how dad reacts. Hopefully a spot will open up for him in MC soon. It's a shrunken world for them in MC where they have less to worry about in general. Fewer decisions to make and life is easier and less complicated.

Good luck with everything.
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It is for YOU to decide how much time is to much.
If you can handle 1 to 2 hours a day 5 days a week then that is your time.
If you are feeling stressed, drained, exhausted, frustrated, angry and all the other emotions that go with caregiver burn out then the 1 to 2 hours, 5 days a week is more than you can handle.
Would it matter to your dad if you only stayed 30 minutes? Or would he realize you were cutting your time short?
If you skipped a day would he notice? I can understand not wanting to skip 2 days and the stress you would both experience.
You do need a break from caregiving. Even if you are not a direct caregiver you are still very much involved in caregiving.
Can you get someone to visit him as well? A volunteer from your church, check with your local Senior Center and see if there are volunteers that can visit. I know the Hospice I volunteer with has volunteers that will visit patients in facilities. And there is also the option of a paid companion from an agency. You can even check with the facility where he is to see if they have something like that available. Or since he is in a facility it should be their goal to make sure he is engaged and not left alone so that he does not get anxious
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Is dad adjusting to life at AL? Making friends, going to activities?

Is his dependence on seing you part of a larger pattern of general anxiety?

The problem that I see is that at some point, you will need to take a vacation, visit a new grandchild or have surgery. If dad hasn't adjusted to his new environment, or if he has overwhelming untreated anxiety, then your absence provokes a crisis that YOU can't be around to help manage. Where does that leave dad?

Make sure that he gets comfortable enough being without you NOW; if he is having panic attacks when he doesn't see you, he needs to be seen by a geriatric psuchiatrist. If he is simply being demanding, set some boundaries and a new schedule.
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On the one hand you say you are retired and that "1 to 2 hours a day, five days a week, isn’t that much", but you've also tagged your post with burnout, so which is it? Enough is whatever works for YOU, it doesn't matter what your sibs say about it, but you can't go five days a week and then complain to them that it's too much for you either. Step back a little, start by dropping one day, then two. Pop in and stay less time. And if I were you I would take him to any activities provided by the AL so that he gets more accustomed to taking part and less focused on you.
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Louise315 Apr 2021
Good ideas! Unfortunately, due to the Covid restraints, I wouldn’t be able to take him to activities. I need to remain isolated to his room only, and I am only allowed to visit him because a hospital doctor gave me permission. He is not a hospice patient, but because of his needs, which are many, the last time he was in the hospital the doctor wrote me a note. Covid also makes this very complicated. Dad has only been in this place for five months, and three of the weeks out of this time he was in the hospital. I shared about this in a post below yours. So he really hasn’t made much of a connection with the residents there, he has a little better connection with the staff, but not much.
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There are caretakers here with way more experience than me who will have a great deal of excellent advice! But I'm curious - why have you never had him assessed formally? If he actually has vascular dementia, perhaps assisted living isn't the proper placement for him, perhaps he needs memory care instead. You mention that leaving him without contact from you for extended periods of time leaves him distressed, do you know this because you have tried?

It doesn't seem as if the amount of time you spend with him is a problem for you, and if not, that is fine. The amount of time that YOU spend is entirely up to you. What we think is irrelevant unless the amount of time is causing you stress or problems in your life. If you are happy with it and you get joy out of spending time with your father, then there is really no reason to change what you are doing. However I would caution you that things could change on a dime and that hand full of hours could be 5 hours a day or 10 hours a day or suddenly you don't have the first clue what happened but you are spending every moment of your time caring for your dad and you start to resent that you don't have a moment for yourself...and then you start wondering for real....when is it enough.

The real answer is that only you can answer that. You mention that you retired early to help care for him because you knew he was going to need that help. Which gives me the impression that he already needs more help than assisted living affords him. In which case it may be time to consider that he needs to be fully evaluated and decide if he needs next level care. Maybe your immediate family sees what you are too close to see. For some, even an hour is too much time. For others, they will sacrifice their entire lives, and even the lives of the rest of their families, their relationships, etc. But you have to look at the big picture.

What is best for your dad? What kind of care does he really need? What is he really able to do for himself when you aren't there? Does he need care that you really can't provide? Will his condition worsen? Will he be able to recognize you? Will you be able to be there every time he needs you?

My best advice? Get the full evaluation. Find out what is really going on and move forward from there.

Good luck! You sound like you love him a lot, but remember that loving someone does not mean that you have to be the one that provides the hands on care for them. In many cases being a good caregiver means that you handover the caregiver reins to someone else so that you can be the loved one.
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Louise315 Apr 2021
Thanks for you thoughts and suggestions. Dad probably should have been placed on the memory care side of this home. There weren’t any rooms available at the time, so he was placed in the assisted-living section. He is on the list to be moved to the memory care side as soon as possible. So yes, you are right he probably should be there. We never had him formally assessed, in part because he is rather frightened of doctors. His mother was hospitalized when he was three years old with schizophrenia, and spent the rest of her life in a mental institution, so he has a great fear of hospitals and doctors. He is the kind of person who does not feel like he has any problems mentally, or any issues with his memory or dementia. Just trying to get him to take the quick test that a general practitioner gives was like pulling teeth. He also had several physical problems that occurred over the last two years: Including colon cancer, aspiration problems with eating, and kidney disease that caused him to be in continent. He also caught covid from another resident in January. I just didn’t have the heart to drag him in to a neurological psychiatrist to get a specific type of dementia diagnosis. I do think spending less time with him is an option, and I’m looking at ways to make that happen. I was just curious what others thought.
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