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I have been where you are twice. Except I was in the same town. Unfortunately, there comes a time when it is best for our loved one to establish a new home and adjust to it.
As your dad progresses with his dementia and he will, he will need to feel like his new place is home. It is so hard for you to watch, but it will be the best for him.
My mom went two times back to her home because my dad couldn’t tell her “no.” She did okay the first time, but the second time she got really confused after returning to the facility and then threaten to commit suicide. Now, she wouldn’t have, but she got overly confused and couldn’t process everything.
She ended up in a behavior ward for a week. That was the worse week I went through with my mom, she was this 5’1” little 72 year old woman and surrounded by alcoholics and drug addicts. She was safe, she didn’t know why they were there, but it was very heartbreaking for me.
I know this is hard to hear. Your dad could be different and for now he does ok when you take him back.
My concern for you and him is what could happen.
My suggestion is 3 fold. One is to keep him where he is and let him adjust to it.
Two is to continue to do exactly what you are doing, but understand that at anytime it could change. Three is to find a place near you and move him now before he goes down more with dementia. He will have time to adjust before the processing and confusion gets bad. You will be able to see him more and do things with him. Bottom line is no matter what you decide, what he needs most is your love and your friendship. What you need is to know he is safe, comfortable and getting good care.
Since I’ve been though this once with mom then my dad, both have passed on, my choice would be to have him near me.
He may not like it at first, but just talk to him, tell him your thoughts. Let him know that although you know he wants to be at home, you just cannot make it happen for him. Tell him you want him near you so you can be together more. Bottom line, time together is larger than any house. Good luck, I know it is hard. I’ll be praying for you and your dad. ❤️
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Linkabit ;Hello! Wow this is a difficult situation do you have any opportunities to transfer to a company thats not 500 miles away ? I cant even imagine any other way unless you take a different job in the area dad is in what will you do when his disease progresses more It only gets worse and worse ? What if your dad moves out of the NH you move in with him and the money he is spending on the NH you and Dad can live on , thats a pretty penny to live in a nursing home?the two can be comfortable on that kind of money ..good luck to you!!
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Most most of the time I think that monthly visit would just create confusion, but it's been working for you and I think you should continue to try to make it work. I understand what a sacrifice it is to go for a week a month I did that for several months last year before my parents both moved to AL together. I KNOW it would be too hard for my dad to adjust going back and forth between their home and the AL each month but you've proven it to work I think you just need to tell the new director that. Follow your heart.
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It is so hard when someone has Alzheimer's or dementia my mom had it and I regret to this day not spending more time with her back towards the end she had fell and ended up in the hospital and I brought her home her wish was always to live in her house so I quit my job and moved in with her and my dad took care of her till the end which was only about two months after she had fell. Now my dad who is 94 is having troubles and on oxygen and Home Health and I am doing the same thing with him cuz he can't be alone ...so follow your heart do what you need to do for that what you think that they would want or what they have told you in the past cuz you can't go back and change.
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Bless your heart! Follow your heart. My 85yo mother with advanced dementia was in MC, and now in a nursing home. Institutional care is just that--care based on institutional norms, which do not take into consideration individual situations. As long as your dad isn't (or doesn't become) unruly or overly emotionally distraught when you take him back to the facility, and as long as you continue to find peace in doing this for your dad, blessings to you and all your efforts.
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You’re amazing! What a great job you’ve done looking out for your dad! He’s truly blessed to have you. Unless and until these visits either become too hard for him or you, keep doing what your doing. You’ve found a balance that works, so hard for so many, congrats on it!
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If your dad had Alzheimer’s dementia, the MC director would likely be correct about your dad wanting to go to his childhood home. But he has vascular dementia, and that’s what makes this different. He knows where his home is, he knows when he’s there. Sadly, many people with Alzheimer’s, if not most, would still want to “go home” even if they were sitting in the living room they grew up in.

Unless the MC director can give specific examples of how the trips home negatively impact your dad (not them) when he transitions back to MC, then there’s no reason to stop taking him home. His wants and needs are what’s important here and as long as you’re able to meet them, it all works. The caveat here is if his transition back causes him distress and this manifests as agitated behaviors. That’s not a good feeling for him.

If you’re really wondering how it would impact your dad to miss his once/month home visits, you could see how he does with not taking him home for a month.
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It doesn't seem to me that you have to make a permanent decision yet. Is there any reason you can't try taking him home for a couple of months? And then, if he has adjustment problems returning to the memory care unit (which we know he didn't in the AL unit), you can re-evaluate. Unless the memory care director is threatening to expel your dad if you take him for a week, I think it's lovely that you're getting to spend the time with him, and that he gets to continue spending time in the pace where he's happiest.
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Lymie61 Mar 2019
Yes, she can't take him home for a couple of months block because a big part of the success and point here is that he gets to live in his long time home for these excursions. His daughter, the OP, I believe lives and is rooted 500 miles away from his home (and his AL/MC) and while she is able to do her work one week out of every month from a distance it isn't something she can do more permanently or for 2 months at a time. I agree with you that her ability to find this balance allowing her to spend this special time with him and keep him in the place he is happiest as much as possible is a blessing (for both of them) and should continue as long as it works. My guess is this program is and will help him adjust to being in AL/MC full time when the time comes too. It's such a nice gentle way to move him into that, at least it is for him I know it wouldn't be for many patients.
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If you can continue to spend the time, and this makes your dad happy, do it. Sounds like this makes you happy too. These will be the last few moments you get to spend with your dad. At 91, tomorrow is promised to no one. After he's left to be with his wife, trust me, you will be happy you did. These last few remaining days or months will be fresh in your mind and YOU will remember how happy you made him.
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Continue doing what you are doing or are Going to Do, My Angel....I have a Dad who is Alone at His House But a Sister who will Do anything to Make sure he is Happy and Contented and to Prolong His Own at Home Quality of Life of no Strife.
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You're doing an amazing job. I'd say that as long as you can give your dad these one-week visits, do it. It may be harder on the nursing team when he returns, but it's all about him at this point, not their convenience.
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I'm sure their recommendations come from experience with most MC patients and I'm sure for most they are absolutely right. However it sure doesn't sound like the transitions are hard on your dad or you and the 3 weeks in and one week home are working really well for both of you still. I am so impressed and touched by your pattern and can hear how much it means to you as well as Dad to be together in that house so my vote is keep doing what you are doing. He is obviously the exception when it comes to transitions/moves and if you need back up they should talk to the staff in his AL wing since they can confirm it is good for him and not a cause of issues. You are so in tune with your dads needs as well as your own and you will know if and when this isn't a good program anymore. Maybe he doesn't wander at home with you because he is so happy and his mind doesn't have the need to search for anything or anyone else. If this becomes less enjoyable and problematic for you don't feel any guilt about deciding that's the time to stop either, I really believe what works so well here is how happy it seems to make both of you. Keep following your instincts!
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Oh Hi Linkabit!
I answered last night but didn’t notice it was you and your sweet dad.
Last year you were dealing with his auditory hallucinations. At that time it was a radio he heard. You were contemplating memory care then.
I think you are exceptionally tuned into your dad’s needs and I love that your life is manageable with your spending a week with him every month. I wish everyone could manage elder care as well as you have. Such a great balance of keeping him safe and allowing him to spend time in the home he obviously loves.
So good to see you back on the forum.
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Linkabit14 Mar 2019
Thanks 97yom... I feel bad that I don't contribute much here; the consulting business keeps me busy pretty much full time. The support that reading this forum provides is wonderful.
Thanks again.
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Although I want to say keep taking Dad home as long as it's not causing problems, your comment about his wandering concerns me. When he's home with you and you are sleeping, what monitors do you have to alert you if Dad goes wandering outside the house during the night? Or maybe when you are working? As a fellow IT consultant, I can get so focused on my work that an hour or so can pass where I kinda lose track of time unless something interrupts me. Could Dad walk out the door while you are working and you only miss him 30 minutes later? I used a security system that "announced" anytime an exterior door was opened to keep track of young children and elders during my waking hours and always set the alarm whenever I planned to sleep - even during the children's naps. You may need something similar the next time you take Dad back home.
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Linkabit14 Mar 2019
Hi TNtechie. Yeah, sometimes it helps to be a techie. :-) While he was still living by himself, he refused to wear a "medic-alert" wrist band in case he fell. So, I installed door alarms and motion detectors throughout the house, along with security cameras, and used a service that would text me if they noticed anything (like not moving in the bathroom for four hours). Not ideal, but it worked. I left all the sensors, so I get audible alerts and text messages if he gets out of bed or his chair. Also, I can just listen. The house is pretty small. He has never wandered a single time while I've been with him.
Thanks for your reply
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Seems to be working for you. Some people with Dementia don't do well with change and its hard to get them "settled back in". Dad doesn't seem to have that problem at this point, but doesn't mean it won't change. You can voice your concerns at the meeting.
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Really tough call. Try to remember that you do have a long distance relationship with him, not full time. Makes a difference. It is good that you have hired caregiver to be your eyes and ears. You’re a wonderful son. But how often is caregiver there? Still isn’t 24/7. The people in AL are the ones who see him the most and have a clear picture of what is going on the majority of the time. Keep communication open with them.

I can’t speak to ALZ or dimentia like others. My mom has Parkinson’s without dimentia (may happen in future, who knows?). Hard to know how important routines are for your dad specifically. Some say routine in general is important so switching him back and forth is not a good idea. That’s so tough to figure out. Just curious...Did he like routine before ALZ or was he more ‘laid back, easy going’ kind of guy? Still, you and he have to adapt to what is best for him, even if it’s difficult. Not easy to do.

I wish you and your father well. You sound like you research carefully so I would trust your decision.

Has to be hard doing all of this from long distance. Obviously it is important to you to have a relationship with your dad.

I read about placing a camera in AL. Do you see a benefit to that? What does the caregiver do besides report back to you? Is it becoming harder for your dad to manage overall? He sounds fairly independent with little supervision while with you at his house or am I wrong in assuming that?

Is it that he is becoming confused at AL after being home for a week? Is the flip flopping getting to be too much emotionally for him? Is there a quiet area for you to get some work done at the AL? You can still be nearby and he may find comfort in that.
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Linkabit14 Mar 2019
Hi NeedHelp,

The routines don't seem to matter to my dad because he can't remember what happened 10 minutes ago.

The AL facility will not permit cameras in the facility; it's written in the lease. I'm not too worried about his treatment there because my aunt and two of his friends are there. This is a small town, and they all grew up together.

Still, the facility has changed ownership once since he's been there, and there was a lot of resident assistant staff turnover in the AL floor of the place. I've met everyone that works in the memory unit, and they have all been there for at least 3 years. I'm hoping he'll like the memory unit better since he's getting more attention.

Thanks for the reply. Best wishes to you and your Mom.
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What the memory care unit director is telling you is sound advice as far as it goes. It generally holds true for people with advancing dementia that they do better with a structured routine in an unvarying environment. It helps to minimise their disorientation in time and place.

But your concern is not what is generally true, it is what will best support your individual father's quality of life. And you are at a tricky juncture when it comes to knowing what the answer is.

The main drawback is the constant switching. In a perfect world, a genie would pick up your father's house and relocate it to where you live - and staff it with a 24/7 care team, of course. His connections with it are going to be even more deeply embedded than most people's are, given that he built it. He isn't (yet) recalling home as where he grew up.

When you visit him and it's time to set off to the house, is he expecting it? If you didn't prompt him to get up and go, would he remind you?
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Linkabit14 Mar 2019
Hi CM,
You're right about it being a "tricky juncture". That's a good question about if he's expecting to leave when I arrive to pick him up at the AL facility. The last time, I handed him his coat and he asked where we were going...

Then, other times, the first thing he asks me is why he's not at his house, and when am I going to take him home?

Thanks for the reply.
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It sounds like it has worked well in the past. As long as he settles back in I would take him home that week. It’s wonderful you can have that time with him. If he begins to have problems you can always stop.
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I personally would do it as long as he is safe while there.

If he doesn't cause any problems when he returns I can't see a problem.
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