To tell dad or not tell dad about nursing home?

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My 91 yr old dad is in a rehab; his former ALF has evaluated him twice and finds that he needs a higher level of care than they can provide and they recommend a nursing home. The rehab facility is a nursing home as well. The question is, do we tell him that he cannot return to the ALF where his wife resides or keep him living on false hope that he is in a rehab temporarily and 'might' be able to return home? we fear that telling him the truth will be his demise as his only wish is to return to his wife, but he needs too much help and his wife cannot help him - she has dementia and his return would cause her to go down hill; she is not fit for a nursing home at this time. I think the truth is the better way to go - thoughts?

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Top Answer
YVM, I had the same problem...I haven't dealt with it yet either. I just kept saying, "Well, you can stay here as long as you need to in order to get stronger..." that's been 5 months...of course, it is a long term care NH situation. I decided NOT to tell Mom point blank that she isn't going home...I keep offering some light hope, but don't over do it...just day-by-day...the NH staff kept bugging me to "tell her" but I still haven't. I did not want to take away her hope...I don't think you should tell your dad either...just tell him "well see how it goes this week..." Good Luck to you...I know it's hard...
Same here. Mil isn't progressing in rehab and will be moved to the NH wing soon. We've decided not to tell her straight out. Since she has to vacate her current room, we've told her she'll be moving to a bigger, private room (all true) with different therapists from the outside that the doctor will send in for her (also true). She loses track of time and thinks she's only been at the center for a few weeks when in fact she's been there nearly four months and maybe that's not such a bad thing. Does your dad have any forgetfulness?

Like Pumpkin, we tell her 'maybe when you're stronger' or 'when this new medicine kicks in', etc. It seems to work for now. The slightest upset sends her mental state downhill, so in her case, the stringing along is probably the kindest thing to do at the moment. Very hard, I feel for you.
I tend to agree with Pumpkin and Lisabeth. Does he have any dementia or memory loss? It would be harder if he is still sharp mentally, but seems to me to be unkind to remove all hope of being reunited with his wife, even if that is the reality. I agree with the "light hope" and just moving from one day to the next. If he still is sharp mentally he will probably figure it out for himself eventually, when he is ready to accept it. Good luck and prayers - Joan
Pumpkin, Lisabeth and Emjo, thank you all. It certainly isn't easy, but hearing of your experiences and handling helps a whole lot! Thank you! My brother and I are supposed to break the news to him today. Pumpkin, like you, the NH keeps on prodding us to tell him, but even his wife with dementia thinks its a bad idea. He is sharp mentally, and he keeps asking when he's going home, but lately he hasnt asked that too much. I also think the 'light hope' way is the way to go. I suppose we can keep telling him that "right now, he just needs a higher level of care than his ALF could provide", and NOT tell him "when he gets better". I think he is starting to accept the reality. He will be moved from his private room to a semi-private room when one becomes available, and he's started to make friends with the other gentlemen there, so as you all say, I think 'taking it slow' is the answer - one day at a time. It does seem awfully mean and hurtful to remove all hope he's not ever going back home to his wife even though that is the reality. Thanks for your responses and your prayers!! Hugs and Prayers to all of you!
Who at NH prods you? Why do they say he needs to be told? Do they have a therapeutic reason? Or is it direct care staff worrying about how to answer his ?'s. It seems family, maybe w support from SW, should be handling this the way THEY Feel is best...this is my feeling, I'm not vey experienced w NH's too much. Sorry your family is facing such hard decisions n circumstances. If cna's r suggesting, discuss w SW or DON. someone may be prodding/talking out of turn? Good luck, kimbee
The only solution I have known is home care. Children wanted to keep parents together for their remaining time possible and set up situation with add on living space and live in 12 hr shifts. Lucky to have responsible agency and loving regular caregivers. Continued after mother died. Maybe some institutions are flexible. It is one of the hardest situations to face--almost impossible to find affordable happy solution. Needs more consideration.
At age 91, is your father cognizant? If so, you must tell him of your plan to put him in a Nursing Home, even if it's in the same place.
Whoa, you "must"? Nobody outside your situation can give you a black-and-white answer -- including the NH. Kimbee's suggestion to find out what the NH's issue is, is a good one.
For your own sake you want to lie outright as little as possible -- lying is hard and confusing and painful and saps your energy. So Lizbeth's way of saying things are that all true is helpful.
Now, here's something that's true: you don't actually know the future either. Maybe he'll go home in the end. Maybe your mom will join him. Maybe you'll figure out something you haven't figured out yet. You know more than he does, and you think you know what's going to happen, so there's some decisions being made and thus some "news" to consider telling or not telling. But there's no need for any one of us to act like we have a crystal ball and we just plain don't have one anyway. So this is what's actually TRUE: "I don't really know how this is going to play out, Dad, we've got to take this a little bit at a time. I know the way things are isn't what you'd like -- there's a lot about this that we all wish were different! For now, you and Mom are both best off if you're here. We're trying to get each of you the best care we can."
I think it is best to give your father hope of getting stronger. Unfortunately most rehabs aren't set up to exercise the elderly if they are over 85 yrs old. PTs tend to write the 85+ crowd off. If I had a dime for everyone that told me my father had "plateaued" I would be a wealthy woman. The exercise rehab must be paced with their stamina level but they tend to have a "schedule" of 3 hours a day of exercise and it is seldom broken up. This type of rehab doesn't work with the 85 yrs + crowd. With proper exercise, your father might improve enough to return to the facility with his wife.

I brought my father home from his second rehab because they said he was nursing home material. I knew he didn't want to be there and mentally it would have depressed him. He came home and lived another 3.5 yrs. Of course, it took lots of money, work and having a trained "exercise lady" who had experience with the elderly above the age of 85. But they can improve slowly with proper combinations of rest and exercise.

Nursing homes may be needed but let's face it the majority are not good for the elderly person's mental health. My father's mind remained sharp to the end.

Is it possible to take your Mother to visit your Father once in a while? If so, that might help him be more content in the NH.

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