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My Father is in Assisted Living Plus at a great facility. He has been assessed at the edge of moderate cognitive decline, one "point" from severe cognitive decline. I moved him here to Kansas City from Milwaukee after a stroke. He lived with us for awhile and then he fell resulting in a compression fracture. The recommendation was to no longer go the flight of stairs to the bedroom. So, after rehab, he moved to Assisted Living Plus at the same facility.He is focused on getting an apartment back in Milwaukee. I know that Milwaukee is home to him but there is no other immediate family in Milwaukee. I have had multiple physicians tell him, he can no longer live on his own. We have told him that. He does not believe that he can't live on his own. Per him - he can do everything he used to do. I have tried the physicians say you cannot live on your own? I have tried everyone you know, says this is the best place for you. He has said - it is not what I say.I have POA, so make the decisions and I know this is the best place for him. I have not told him about the POA but he still says...you cannot make decisions for me. It is just super hard, when all he talks about is moving back to Milwaukee. Any thoughts on how I should respond when he goes down the path of moving? I am not always able to redirect to what he had for lunch or what is on the tv. Do I say no Dad, you need to be here? Do I ignore the question. He is past the point of being able to reason, and I do not want to go thru the list of things he is no longer able to do. Any thoughts/suggestions would be appreciated.

One of my neighbors had two parents over 100 years old who moved themselves out of assisted living and into an apartment.

They were life long dairy farmers and did not like the food at the assisted living because things were not buttery enough and fried enough for them.
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Reply to brandee
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Anxietynacy Sep 25, 2024
Well I can't say that I blame them, everything is better with butter. 😊
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Many WANT to go home.

SHOULD they? CAN they? They are different things.

I would ignore should & can for now. Focus on what Dad says. He's not making defined steps & plans - this could be more about his FEELINGS. How does he feel? Sad. Fair enough too. It's a lot to lose.

I would try councelling for your Dad. Doesn’t have to be a top expensive cognitive behaviour type. More pastoral care. A councellor that works with *life transistions* as they call it. Social Workers can do this.

Basically, someone to listen (often non family is good). Someone to hear his GRIEF at losing his home in Milwaukee. While no-one can fix his grief, sometimes expressing it can help.

Worth a go?
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needdirection6 Sep 24, 2024
Thank-you. The life transitions social worker is a good idea.
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There's just no easy way and NO one size fits all approach to how you deal with this. Anosognosia is the inability for a dementia patient to recognize his deficits, or to acknowledge them. My mother had severe dementia, lived in Memory Care Assisted Living, but she was fine. All the rest of the residents were "crazy" and "nuts" and she had no business being there. If I told her her doctor said she needed to be there, then her doctor "was a dirty liar". Sometimes I'd tell her she could "ride the subway home" to see her (All deceased) family members "when the doctor said she was able to." Sometimes it worked, other times it didn't. Ativan always helped calm her down though. In a way, it doesn't matter WHAT you tell dad because he'll forget about it and ask you 100x in a week anyway.

I agree with you that all of this is super hard and drains the soul. When mom started insisting on talking to her mother on the phone, I'd come up with a story du jour about why she was unavailable (deceased 30 years and would've been 137 yrs old). One day she got furious and yelled, "YOU'RE FULL OF SH!T" at me. So I said, mom, grandma is dead and has been for many years now. She said Oh Ok. Sigh. As I said, you can't win. You try to spare them the anguish, and that doesn't work. You tell them the truth and that doesn't work.

Take your choice of how you want to handle dad on any given day, and best of luck with a difficult situation.
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Reply to lealonnie1
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While he still has barely enough cognitive mentation to understand you you must be honest with him. He will keep repeating this as he sees you as his only chance of rescue. You are his POA. He will not be discharged from care without your knowing it. So it is as simple as:

"Dad, I will tell you this, and if you need it repeated in your doctor's office the two of us will go there so it can be. You are no longer safe on your own. You need to be in care, and that is where you are. You need to be near enough so that I can use the POA to manage your care; and that is where you are. I know this is a road of constant and painful losses and I understand you still have dreams and fantasies that you can return home and live on your own. But you are no longer able to do that. I am sorry to have to be so brutally honest with you, but this is where we are. I am so sorry it hurts you and it hurts me to see your pain, but I hope for your own sake and mine too that you will try hard to adapt".

He may. And he may not. No one likes to see this for our parents. It is a loss of control of their own lives. Try to imagine that. But this is the honest truth about where you are. Not everything can be fixed. You aren't responsible for the losses of aging and you can't fix them.

I am sorry for all this grief, but these losses and the pain that goes with them are the norm. You'll know that if you stay and read up on AC.
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Reply to AlvaDeer
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I would ask him what his plans are for moving. What size apartment, what neighborhood, furniture, etc. Obviously he can not facilitate a move on his own, so entertain him with getting all the information that is his dream. Doesn't mean it will ever happen but, he can still dream about it.

Best of luck, dealing with dementia is grueling. Finding ways to let our loved ones still have their dreams is difficult when they are kinda in outer space and are things that stress us out. Learning to listen with half an ear and appropriate acknowledgement is beneficial to us.
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Reply to Isthisrealyreal
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We tell my MIL (who is bedbound in LTC but sometimes insists she can walk) that she can leave when she can show her doctor that she can perform all her ADLs, which are required to live safely on your own. Then the burden goes back to him and his doctor, not you. Then change the subject.
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Suzy23 Sep 24, 2024
I used the same tactic when my dad had dementia. Mad that you can’t drive? Convince the dr that your mental faculties have improved enough to take the drivers test. Mad that you can’t handle money anymore? You’ll have to convince the dr. Furious that you can’t climb a ladder onto the roof? You will need to convince the hospice nurse this is a good idea first. Furious that we moved you to a hospice facility after 4 major falls in 3 days including a blow to the head and a lot of blood? You’ll have to gain enough strength to walk steadily and use the walker before you can be released. It's not safe for you at home otherwise and mom can't get you off the floor nor call an ambulance to help multiple times per week.

It’s really sad and difficult. But it’s the reality.
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First you can't reason with a broken brain, so save your breath.
I would just tell him that when his doctors say that he's well enough to go home, that you will consider it. And then drop it.

But more concerning to me is that fact that you say that you are your fathers POA, yet you "have not told him about the POA" to which I will ask, how can you be your fathers POA if he himself did not appoint you as such as that is not legal?
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needdirection6 Sep 24, 2024
I probably used the incorrect wording. He had a POA created years ago, there was a requirement for multiple physicians to agree that the POA is needed and for it to be put in practice.
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Either tell him you’ll move him back home when he gets better (obviously will never happen), or at some point in the future that you can endlessly drag out (say he can move “next month” indefinitely).
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