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So, they've both reached 90. She has severe dementia, and mobility issues. Not taking care of herself, barely anyway. She's been told by numerous doctors that she either needs 24/7 care or to move to a facility. Dad has mobility issues, cannot hear, and is beginning his own decline mentally. They've gone as far as they can with the PCA's, visiting nurses, help from family and neighbors, stairlift, Medalert, meals on wheels etc. But now it's time to go. The house is unsafe, my mom yells at the nurses because she's jealous they're going to fool around with my dad (hence no more in-home nurses for us!). Dad's going to a brothers house and mom's going to a facilty. We're investigating all our different options and he as renovated his house for them. We've been talking about this gently for a while now, gradually getting more insistent but now we have essentially created a deadline for which we will move them. We've tried to spell it out as simply and kindly as possible numerous times in various ways and tried to present them with various options to help them feel in control. Mom's mad and confused and he's sort of accepting but is beginning to talk about reasons why he can't go, so we think he will outright refuse when the day comes or at least continue to stall and procrastinate. They most certainly will not pack their own belongings or make their own preparations. We will have to do that. Neither one of them will be driving out, will have to ride with us and she will get medical transport. So how's this going to work? Our resolve is strong because it's all become a logistical nightmare and the whole situation is so unsafe for them and we have professional backing to move them out. It's going to be really difficult when the time comes next month, I know it.

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try to keep ma and pa together if they are compatible.

find a place close to a family member, at least someone can visit.

get them involved in community as much as possible.
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Keep them in same facility. One in memory care & the other in assisted living....which may quickly be graduate to memory care...Same facility...Don’t separate them. If & when one becomes violent, then Nursing home...Hugs 🤗
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Please, please face the fact that there comes a time when you have done all in your power to handle the situation but it is not going to help and it will get worse. So, do you want to continue and be slowly destroyed or are you going to get tough and tell them like it is and what the rules are now. YOU are in charge now, they have proven they are no longer capable. YOU must seek where to put them and how and in what kind of a place. Do this the instant you see things happening - be prepared - think out of the box - be prepared at all times. You cannot wait. Seek help and take appropriate action whether they like it or not - you have no choice.
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I don't think it is a good idea to seperate your parents. They are bookends. Find a facility where they can be together. Take them to the facility and let them chose between the rooms available. Choice goes a long way to reducing resentments. If they can take personal items, help them select and move the items.
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MAYDAY Dec 2020
They are bookends :)
If at all possible, try to keep them in same facility..
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well, there seems to be a lot of answers...but . do what deems better for your family... is there are right move or answer? no telling with dementia, etc...
hope they are ok and the decisions that are made for them..no right or wrong... make sure family visits them often.
make sure they know they are not alone.. visit often, laugh talk, smile. read to them... play music eat fun food.
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Since there is dementia as part of their health concerns, neither will remember your prior conversations about moving. You just have to move forward, I would suggest:

1 - Start by streamlining their home to bare essentials. Empty guest rooms, storage closets, extras of anything. Streamline the kitchen to 1-2 pots, 1-2 pans, 2 sets of dishes to eat off of...

2 - Streamline their clothing to about 2-3 weeks' worth of everyday clothes and 1-2 nice outfits for seasonal outings (some for spring/summer and some for winter/fall). Donate the rest and get those tax receipts for mom and dad.

3 - Create a calendar with count down to move on it. Put it on their refrigerator and mark off days. Place pictures of the place(s) they are going next to the calendar.

4 - Start moving things they will need into the new place(s) or into storage or trunk of care EARLY. Every time something gets stowed, it is a reminder that their is a move coming.

5 - On move day, handle outbursts and hesitations matter-of-factly and steel your emotions. Put everything that needs to be moved into vehicles first. Place your parents in last.

6 - Respect the facility(ies) guidelines about settling in. Most facilities require2 weeks of COVID quarantine when visitors are not allowed. Afterwards, expect "distanced" visits via phone, window, or porch with no physical contact allowed.

Question: Why don't you have mom and dad moving together into the same facility. They will be happier being together and settle in sooner into the facility's routines. I have known of many married couples that share a room in long term care.
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The first thing is to try to understand that they have been independent and co-dependent for many years. Dementia is a horrible thought stealer. Try to find out a few things that mean the most to each parent before you begin to remove items. My suggestion is to get them moved where they are going to be before you do anything to the house if possible. See if you can have a family meeting using zoom and their physician. See if you can get them to tell the folks that their safety is important to the family and that this is the way you can repay them for all they have done for all of you. Then remember it will be like the first day you sent your kids off to kindergarten. Mine cried hysterically and it was the hardest thing I had to do as a mom. As to your mom going out alone, please be at the new place to meet her. You may think she won't know or doesn't remember but her life will be changing drastically and a hand to hold may ease the move. Be well and the scariest thing is that we will all eventually get to this place later on. Hope it goes well.
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Don't take anything of value... good clothes will disappear, unless you wash everything yourself. They even stole Mom's rosary beads from her jacket...elder lawyers are good and very helpful... check them out...
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We took Mom to the ER... she was admitted and then sent to a nursing home. That's the only way to get in a nursing home here. She had dementia and wasn't happy... Didn't talk to us for 14 months, then she passed. She got much worse as time went on. Sometimes you just have to do whats best for them. Take care of yourself.
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Wow. I am in the same situation with my 90 yr old parents and they refuse to talk about options because, it has become obvious, that they'd rather let me and 2 adult sons crumble physically and emotionally. Mom has been bedridden since 2017. Dad's Chronic Lymphacytic Leukemia, 6'1" 125lbs and he jumps to her aid. They will not consider anything other than staying in their home with 3 rotating caregivers and our unyeilding consistent support. And now they are having to ask for $$.

Is it me??? Doesn't Dad get a chance to relax at 90? Creating a Nursing Home in their house for 3+ years. It's unbelievable considering my mother's parents were tossed into a nursing home by THEM at 85. I need a plan....
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Imho, keep your strong resolve. These moves are for their own well being. Prayers sent.
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Who is poa? If she has severe dementia the poa takes her to care. I wouldn't explain. What is the point? Won't remember 5 mins later. You say you are going there, or will you go to nursing home? Of course she will say no. Thats a given. If you said lets take a shower/will you take a shower? She'll say no too. Just get them in car & go or get transport to take her. Stop explaining. And stop counting down the days till they move. No point. Your gonna work dad up into a full out panic or tantrum attack that he is adamant he is staying. What is the end goal in that? Make them feel bad? Is dad going to go room to room to say goodby to a house he's lived in probably for decades??? How cruel!! Mom's brain isn't working right. Paranoia is part of dementia. Its common. My dad did same when my mom went to store. Very cruel to keep reminding them your days are numbered here.
Get them in the car and go. Period. Your overthinking this. They will pick up on your demeanor. Get their belongings after. Or when they aren't looking get a night kit and put it in trunk of car. Like toothbrush, nightgown, change of underwear. Dont show it to them. Dont do it in front of them.
Stop making a big build up about it, or dad will never get in car. Heh dad were gonna for a ride. Act like normal day. Then go. No big production. Only 2 mins before you leave.. not an hour production out of it. No lets have a last look at house. None of that. Point is to get them there not freak them out. Don't feel guilty. You took them as far as they could go at home. Nothing to feel guilt over. You can't do more. Later go back for a suitcase of clothes. Stop making this a gigantic production. It won't help. Thats your guilt taking over. Can have a good cry that eve. Then go visit them the next day and be upbeat for their sake.
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canonlylaugh Dec 2020
You got it right Jasmina, that's what we gotta do. I'm trying to keep it as low-key as possible until the last minute.
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Check with an attorney first. From your description I would agree with you and the doctors that residential care is indicated. However, unless you have legal authority to over-rule your parents' wishes, their rights to determine their own lives might mean an ugly court battle, particularly in your dad's case. I have a great deal of empathy for your situation. I would have liked my Mom to move into residential care several years ago. In her case, though, she would be able to "hold it together" long enough to get a judge to rule her competent. So, even though her ability to physically care for herself is on the wane. Until she agrees or her condition deteriorates to the point where we could get guardianship.

I think that what I would be telling my Mom at the point where you find yourself with your Mom and Dad would be reassuring things like, "I know this is hard for you. It is hard for me/us, too. I wish you could live as you have for the last 20 years. It just isn't possible anymore. We will do everything we can to help you get used to your new home. I am sure you will like it, once you get used to it." Say "new home" not "memory care" or other words that will arouse fear. I would stress that they will see me just as much and that our visits will be even more enjoyable because we won't have the stress of managing the housekeepers, etc., as someone else will worry about those things. You can count on them having a hard time adjusting. The longer that they have lived in the same house, in their own way, the harder it will be for them to adjust to a new place with new rhythms of life. Be patient with them, please. I know this will be harder on you than you anticipate. Acting as the parent to your parents is so very difficult.
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What and why are you 'we've tried to spell it out as simply and kindly as possible numerous times...' with a person inflicted with severe dementia? Their reactions are expected. You've needed to TAKE CONTROL of the situation long ago - by realizing they are unable to cognitively make any decisions for themselves. Don't the medical team tell you this?

There is no 'gently' talking about when dementia has taken hold. Of course it will be difficult moving / adjusting to a move. This is to be expected. What needs to change is your awareness about dementia and how to interact with - and communicate - with your loved ones. Only you can change, they cannot due to brain chemistry. It isn't "will' or 'desire' or 'decision making'. It is how the brain has changed.
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canonlylaugh Dec 2020
Well, she has the severe dementia, but he's a lot more lucid. I don't know if he technically has dementia yet, so he understands what's going on, or at least it seems to me. But I agree, nothings going to reason with him at this point. Even if he does intellectually understand, emotionally he might not be able to process or he'll forget in a few days. He's hard to read sometimes.
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If they want to be together, there are memory care facilities that accept couples. You might want to consider this if your father is beginning a mental decline, or prepare for that as an option for later. Moves will be difficult for both your mother and father and it will take them time to adjust. You can't really prepare someone with dementia for a move. They don't understand and remember what you tell them, and I think it just causes anxiety. I think it's best just to do it. Tell her that she needs to move to a place where she can get more care and this is her new home, and she'll be safe there. Unfortunately if you move her during the pandemic you won't be able to visit her as much as you'd like. Be sure that the memory care facility has her end of life directives (living will). With my mother, we also changed her care to hospice-type care (no hospitalization, paliative care only). My mother got agitated in the hospital, didn't understand what was happening and acted out by biting the nurse.
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If mother has severe dementia and mobility issues, I would just physically take her to the care facility with no discussion.

If father has some cognitive ability, I would tell him that if he does not move to a better environment, that senior services may get involved and they will tell him he has to go. Ask him if he wants others to choose for him or if he wants to control his own destiny. I have just gone through something similar with my 85 yo sister. She had neighbors and friends waiting on her hand and foot and even taking her to the toilet. I told her that one of these days one of them is going to be out of neighborly kindness and call the authorities because she can't take care of herself and they would force her to go to a care facility. I said you can pick one, or they will, which do you want? I had ready choices for her, and she went. Reluctantly, but she went. We had to have her taken by ambulance, that's how bad it was. My brother and I are dealing with this as she has no husband or children, and we are both in our 70s and live in a different city. We will have to deal with all her finances and figuring out what to do with the semi-hoard of things in her apartment, while driving back and forth from our homes.
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canonlylaugh Dec 2020
Sounds like we're very much in the same boat OldAlto. Actually someone did notify APS and we had a long conversation about them. We will in fact be giving my dad a choice, Mom's leaving and you can either come with, or stay home. I have a feeling I know what he'll choose.
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It’s hard to be put in this position, but you are doing the right and caring thing to insure their safety. With both of them in cognitive decline, I would suggest you not keep telling them of the plans. It may sound cruel on the surface but if it creates agitation and anxiety it is not helpful Plus you can not expect them to understand reasoning...that ability flew out the window a long time ago. Make your arrangements and drive them there. Have her room unpacked and ready. Will it be easy?...Hell no...but not everything involving this type of situation is. The business A Place for Mom paints a lovely picture but it’s not reality. Also know that there will be months of adjustment and begging to "go home." That too is normal, just know that going into it. Be strong and best of everything. You are loving and brave.
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When I moved my husband to memory care facility I told him he was going for a doctor’s appointment. Otherwise there’s no way he would have gotten in the car but he was used to going to the doctor. He didn’t notice the packed suitcase because I had put that into the trunk before he came out to the car.
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Is dad not wanting to go because he will not be with his wife?
For a couple that has been married many many years separation can cause anxiety, depression, some confusion. Is there a way to move both of them into Memory Care together?
If you are taking furniture for mom take what she will be comfortable with and will know is hers. Dresser, a favorite chair. Clothes all easy to pull on, pull off. Easy wash and dry. A lot of her clothes can probably be packed away or donated. (any vintage items you might want to check value and if of no real value ask at the local High School or Community College if they want items for Theater Group. Same with dad's clothes. And same with his furniture.
Expect slight declines for both of them. It is confusing to get used to someplace new.
You, the family are making the right decision to move them out of their house. It sounds like it is the safest thing to do. (I do wonder if male nurses or Aids would make a difference, would your mom be more accepting of that?)
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If your parents own their own home, and you think a live in care provider is your best option for them, perhaps you could offer the live in -0- rent, WiFi, utilities and a small salary?
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Grandma1954 Dec 2020
You still have to pay appropriate wage.
As we have seen posted many times "room and board" is not adequate for a caregiver.
And there are legal limits as to how many hours a person can work.
And taxes for wages must be paid. could be a paperwork headache.
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Tell them the house has termites and that it's going to be tented, so they have go somewhere for a week or so. Move them into the new place,
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After mother-in-law was officially declared incompetent to live alone. We moved oldest daughter in with her while she attended college around the block. That lasted over a year. After three incidents;
mil left on heat to high in the summer( 95), oven on broil all day and paper towels left on top of hot stove, we decided she could no longer stay in her condo. Mother-in-law said she would when older/sick go stay in the reformed presbyterian Home(IL, AL and LTCf). After encouraging a move over several months it became clear to us that that was never going to happen if it was left up to her. I spent many hours setting up her life there trusting that it would be fine once we got her there. MIL was told we arranged for a weekend visit as she was acquaintances with several people in assisted-living. On the last day when she thought she was returning home to her condo in Michigan, we explained to her that the doctor said this was necessary for rehab purposes. At this point mother-in-law was probably between stage four and five dementia so still occasionally with-it and always frustrated that she was with such old people ( she was 75), threatening constantly to return to Michigan and wait till she was older to go to the facility. We sold her condo to use the proceeds to pay for her care and it became apparent, we had to sell her condo in 2008 when the market crashed, that her monies would run out way before she expired. So after her condo was sold we took those proceeds And added a first floor room where she had access to laundry, bathroom and sitting area in her bedroom. We did all this and were able to keep her for two years in our home, till she started wandering, keeping up with the eight children while she was wondering became impossible. We moved mother-in-law to a small care home with only 10 residents. She was placed on hospice shortly after. She then broke her Bone just below her pelvis. We declined surgery for that bone as her dementia was already in the late stage 6 to 7. Since she was no longer mobile and we we’re helping her pay to live in the care facility we decided to move her back into the room we had made for her. She lived with us in her room with hospice care, her son my husbands care, my children’s help, and mine, for over two years before she passed. Looking back I might have done things differently had I been aware of the difficulty getting her on Medicaid after spending her money on the room. Knowing what I know now though, I’m glad I did it! I’ve learned a great deal. 2 years after her passing We were blessed to be able to house her sister-in-law who had Parkinson’s the last four years of her life. saving sIL from being put into a nursing home, she was on hospice for the last full year of her life in our home. Both these experiences have taught me so much. I’m contacted often by total strangers to help them navigate how to care for their loved ones, truly I would do it the same way but with a better attitude, understanding the gifts that I’ve received knowledge and compassion. I say all the above to encourage therapeutic fibs, they resolve anxiety for both parties. Emotional outburst are normal for anyone confused and out of control of their life, so be quick with your fib to lessen their stress. Also, in both situations with our loved ones who lived with me I thought each decision I made would be a final/ only decision about how they would live out their last days. those decisions were changed several times to accommodate life for everyone at its best. It was an incredible wake up call when I realized that both would be like children for many years and need total assistance. I think many people that come to this board do so hoping they will receive a different answer than that reality, that there’s a different way, that there is an escape. Sorry, many families will deal with years of care for their parents or spouses. So the learning and growth are there for all of us.
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I feel really bad for both of them, at this late stage in their life, that they can't continue living together and in their own home until they die.

Your mom is going to be so lost, unhappy, confused, loney and feel betrayed and more than likely will get depressed and lose the will to live.
You should re think this. Senior Homes are only easier for the Adults putting their love ones into. They show you nice pretty places and tell you what you want to hear but in reality, they are not loving caring homes and are most always understaffed. If your love one gives trouble then they will be given Rx which in turn will sedate them and they will be as a vegetable, not able to communicate, just sitting in a wheelchair strapped so they won't fall out and bedridden where they will end up with Bed Sores. Loss of weight and probably fall trying to get up.

If anyway possible, unless mom needs to be on Life Support, she should stay in her own home, that would be the best place for her.

They could both stay in their own home and hire 24 7 Caregivers. If your mom gets upset with the female caregivers, then hire a male Caregiver for your Dad.

set up a Camera where you are able to check in any time by cell phone or computer.
Or move them both in to brothers home and hire a Caregiver.

In the end if your mom has to go to a home, install a camera in her room to help keep her safe and so you'll be able to view somw of what really goes on, especially with Alzheimers and Dementia patients with short term memory because the loved one can't remember what was done or happened to them to tell you.

I have a 96 yr old Dad that I promised I would never send him to a home and he's got 24 7 Caregivers and I had Nest Cameras installed to be able to check in 24 7 to see what really goes on when I'm not there.

Another idea and less expensive is to hire a Live In which I'll be checking on that in the new year and it would be half the price.

But right now my Dad sleep schedule is off like he sleeps all day and has problems sleeping at night which is fine for 24 7 Caregivers but not for a Live In as they are supposed to be able to get some night time sleep and they have to have their own bedroom and a bathroom they can use.

If your Mom and Dad mostly sleep thru the night, a Live In would be the best option.

Of course 24 7 Caregivers or Live In's are both costly but if your parents have a retirement/savings fund and can afford it, then they will be happier and Live out the rest of their life together and in peace like they should.

Of course theur wojld be No Inheritance Money because it'll all go for their Care.

One more thought, wuth the Corona Virus out they are safer in their own home.

Your Dad can move in with your brother if your mom dies first.

Prayers
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cherokeegrrl54 Dec 2020
This is NOT helpful at all. Did you even read the OPs full post?? And you also pile on guilt to people who are trying to navigate whats best for their parent(s)....
your answers are not positive at all!
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Isn’t there anyway they can both go to the same facility? It might make it easier for them if they stay together.
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Contact the National Association of Senior Move Managers at nasmm.org
They even help staging the home to sell it! They do much more than you even imagined you needed help with!
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Spounds like you have done a great job with preparing them for this transition. The physical move itself, especially packing up a house of memories is really hard!
I live in central NY and there are several local companies that specialize in senior moves. You might ask a local retirement community or assisted living facility if they know of one.
This company not only packed belongings but were also very good at helping to determine what to keep and move to the apartment. They took care of donating useful items like furniture and home decor and even clothing to local charities. (My parents accepted their verdict about what was junk much more readily from them than they did from me!)
Mom and Dad had lived in their home for 55 years, raised their children there and enjoyed their life. Leaving is very emotional and the staff at this moving company was very experienced with handling not just the physical moving, but the emotional burden that comes along.
Best of luck to you all.
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You sound so confident that I'm sure you have all of this sorted out, but I need to ask - on what authority are you moving your parents, especially your father, out of their home?

You mention "professional backing" - what is it, please?
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canonlylaugh Dec 2020
They're my parents, and it's basically doctor's orders. I am one of the health-care proxies also. They are mentally imcompetent and not able to care for themselves. They're unsafe and unable and unwilling to deal with caretakers living in their home. It's not complicated.
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Canonlylaugh, Dad won't be visiting due to covid restrictions. Make sure he understands this or that brother is able to help him adapt to the reality of complete separation. The best they can do is video chat. Separation in the time of covid is total separation, probably for the next year. Mom may be vaccinated earlier next year based on current medical guidelines, but visitors will not be allowed for a long time.
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cxmoody Dec 2020
Here in Florida, we are allowed Compassionate Care Visitations. In our case, in my Mom’s MC, we are allowed twice a week, in-person. Other than that, we can do window visits and Zoom calls. It may be different where the OP is from.
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I've said it here often enough that the regulars are sick of it, but...

Tell them the house has termites and needs to be tented or the water heater is broken and needs to be replaced, or come up with some other plumbing issue that would drive normal people out of the house for a while.

You mom in particular doesn't need a lot of explanation because she has dementia and pretty much any excuse will work -- or not. The point is, try not to stress about how to do this in a logical manner that will make sense to your folks, because literally nothing will make much sense to them. You just do what needs to be done.
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canonlylaugh Dec 2020
Excellent point MJ- logic really isn't a thing here. It just needs to get done.
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Ann Reid’s comment is an excellent primer on how it’s done.

I would add a couple things from my own experience.

The first few days I would wait until mom and dad were in the dining room for dinner and take stuff to their room, unpack, fill drawers and hang pictures. Just a little at a time until I had the place fixed up nicely. They hardly noticed.

I also had to pull back on visits. I was the complaint department and my presence reminded them of all things past. So I would sit in the lobby and watch them in the dining room at mealtime, chat with staff and putz around working on the room.

Dad was pretty easy to divert at the point but mom started to figure out this was not temporary. No end of tears and yelling at me. I had to have a come to Jesus talk with her finally. Mom....Things are reversed now. I have to take care of you and dad. I have to do what is best and you’re not always (never as it turned out) going to like it but that’s the way it is.

It’s the hardest thing I’ve ever been through. I was the last person on earth to care for them. No help and doing it long distance. Put 70K miles on my car in short order.
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