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They are both confused and have difficult time conversing. Promised to take care of each other till end. Still at home with FT home care. Starting to need help with ADLs. Stepfather extreme fall and aspiration risk. Mom is a good fall risk. Both in walkers. Mom pretty much lives in the moment and wants nothing to change. Is getting kyphosis curvature of spine from poor posture abs sitting in chair. Step-father stressing out. Home care already over $100k per year and caregiver company believes we need more hours for care till bedtime each day. Cost is relatively close to memory care when home, prop tax, insurance, car (have to be in own car for appts), utlilities, etc. Don't really get robust program for memory care, activities, exercising as at nursing home. But don’t want to live with other people. Which way to go? They are spoiled now with one on one attention. Worth it to continue increasing costs to just stay at home or introduce them to new place to get settled? They would freak if they knew how much was being spent and would want to cancel all care. But they can’t function without. Feel like we’re one bad fall from their whole world crashing down. Hate feeling we’re just waiting for that and wonder if there's a better way? Stressful!

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So your folks do NOT have 24/7 care in their home as it stands presently, is that what you're saying? Because if that's the case, they're both in grave danger and need to be placed in either Memory Care or a Skilled Nursing Facility immediately, or 24/7 in home care MUST be hired. There is no other choice in the matter.

With your mother at stage 6 Alzheimers and your step dad suffering from PD and dementia, I think it's a ludicrous idea to present them with cost comparisons for in home care vs. managed care!!!!!! That should not be a factor in the decision making process here. The only thing that matters is their safety at this point, not even what they 'want' but what they need. Not wanting to live with 'other people' isn't even a rational statement, and again, expecting rational statements from people suffering advanced dementia/ALZ conditions is unrealistic. Keep their care needs uppermost in your mind and go from there.

That said, it's impossible to prevent falls ANYWHERE they live, even in Memory Care or Skilled Nursing. Managed care homes, however, are set up and designed specifically FOR safety vs. a private home which is not. They also have specially designed showers to accommodate wheelchairs if/when they reach that place of need, which the house probably does not. Many things are in place in managed care that do not exist at home, including teams of caregivers working 24/7.

In a MC ALF or SNF, you will also have the beauty of doctors coming in to visit the folks vs. having to get them into cars and driving them to appointments. That's a big bonus. 3 hot meals a day & 3 snacks.............all sorts of things. I think it would behoove everyone to look into it right away.

Wishing you the best of luck getting your folks set up with the best care and safest environment asap.
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This is crazy. These folks are way beyond living at home. There comes a time when it’s not want elders want, it’s what they need. It’s tough but has to be done. I went through this with my mom and dad. I so wished I’d got them to go to a facility earlier. They could have had a good few years. But they insisted on staying home until they were beat to death. So I finally got them into assisted living, then to memory care. They were safe and cared for but it was just gods waiting room at that point. No quality of life.

Sometimes this is just the way it goes. My folks are gone now. I’ve quit beating myself up as to what I shoulda coulda done better. I did as much as they would allow me to do.
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Are you the PoA for one or both of them? If they are willing to fork out the money (and know how much they're paying) and you are willing to manage the circus, then just ramp up the care and wait for the inevitable. Maybe do some research on facilities so at least you have that decision already figured out. Don't take them with you, just go yourself and take your own pictures to show them afterwards. When you find a great place, get a cost estimate and present the two different costs to them. I'm thinking the thought of them moving will override any momentary freak-out about the money.

If no one is their PoA then there is a very different outcome for them. So, please let us know more info. I realize it is stressful -- many on this forum have walked in your shoes and will have good insights.
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You are "one bad fall from their whole world crashing down." That is why now is the time to be looking for the best memory care facility(that they can afford) for your parents. You really don't want to have to wait until a catastrophe happens, and then have to rush around trying to find a place, when all that can be done now, and you can take your time and do your homework on different facilities. They both will only continue to get worse, and require more and more care, so realistically a memory care facility makes the most sense. And the sooner the better. You and your family are now at the point in your parents journey, where you must do what is best for them and their safety. Best wishes.
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