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My father fell over a year ago. Since that time he has been at a hospital, rehab center or in memory care. He has some issues with early dementia but is mostly of sound mind. He is wheelchair bound now and is unable to do any transfers, so needs constant skilled care. Every day he asks to come home. We CANNOT physically help him with hour to hour activities. He insists that we are holding him captive and that he can walk with a walker. When you offer him a walker to prove to him he can't we all end up on the floor, but he has no "memory" of this. My mother is trying to sell the house and will either move in with him or get a small apartment nearby when it sells. The question I have is this: how can we have this discussion without it sucking everyone's soul dry?. He is always trying to get everyone to help him escape. Is there any line of reasoning to help him understand that he is in the home because we can't care for him and keep him safe?

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What are his feelings toward Mother at this point? Would it be easier to convince him that this is for her sake? Mother can't maintain a large house anymore, and she needs to sell it and move somewhere that she can get some help, too? Build up to it over a few weeks, mentioning how weak or tired Mother is becoming, etc.

Or ... is his memory such that you can keep telling him "we are working on getting you more proficient with the walker -- we expect it will take about another month." (I've heard of people able to keep up this "next month" approach for over a year, with loved ones whose sense of passing time is diminished.)

Have you talked this over with the social worker at the care center? They must deal with this repeatedly. What are their ideas?
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I have tried the it's for Mom's sake approach. Unfortunately then he wants to go home to help, or accuses her of trying to secretly divorce him. Also tried the working on getting you up and around but he tells us that he walks everywhere when we are not there and is just tired when we visit. Half the time in rehab he won't do anything and tells me they aren't helping because they don't want him to get better. It is VERY frustrating, but I hadn't thought about the social worker. I will hunt thm down and see what they say. Thank you for your ideas.
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That is super sad I agree. If he has any money I would hire a live in caretaker and have him come home, I cannot imagine not being able to come home in my old years and hope for a caregiver at home until I die. You can hire some to come for $50,000 yearly from different countries as a co worker of ours did and she is wonderful. If not, I would just visit daily and make up his room in a NH to look like home and he may think it is some day. I feel so bad for you all, best of luck to you.
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PS. A NH doesn't make sure they don't fall either, keep that in mind . Nursing home aides have about 7 patients each to get up and bathed each morning.I feel your pain. My mom was in a rehab and I caught her alone on the toilet, crying, on the floor (mat) with a broken hip, and witnessed no on answering call bells. This is the best rated rehab around and it made me bring mom home also. I Used full-time daycare for her and picked her up on my way home from work. It's a "stuck" feeling as to what to do and what's best isn't it, I hope I die fast in my old age. Bless you, this is tough.
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I've learned to read between the lines of the statement "I want to go home." Many times, it means "I want to be who I was there" – before the decline in mobility and cognition. It's a yearning and a wish that the simple act of going back to a house where you had complete control of your mind and body will restore some of it.
I know a man who has been trying to arrange to leave his AL and go 'home' (sometimes his most recent home, sometimes an earlier address) for nearly three years. He regularly calls cab companies, asks for a lift from other resident's visitors, etc. Fortunately, he doesn't spend the majority of his day in this state and does have some quality of life.
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Assisted Living now offers a high quality lifestyle with lovely activities, a Chaplain, community involvement. They need not be separated no matter her health status and it need not be terribly expensive as much of the quality of the programs and facility depend directly on the Manager/Director and the support the facility received from the community. Do church members visit on a regular basis, do school children go to present programs, do Scouts participate...that sort of thing keeps the facility "open" and daily inspected by the public and adult children of the other residents. Do talk to their doctor and give specific details for his advice!
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If you can afford to pay for a live in aide to help your father return to his home or a small apt that might be best. It is very costly but so are nursing homes and assisted living ( he may be too fragile for most assisted living at this point) so the real choice might be a nursing home or home care. If you can get a power (battery) powered lift moving him from bed to wheechair to recliner might be possible. If his mind is basically sound that is a great help,and some of the confusion with the elderly directly results from both medications and being in unfamilar places (hospitals, rehabs and nursing homes).
If it must be a nursing home men tend to want to be in a facility with other older men to "bond" with. My father was very clear that he would not be happy in any nursing home with to quote him " a lot of old hens". Sorry ladies but the guys don't want to be the only sane male in the nursing home. At Least mine didn't and for that reason I was checking out veteran homes in our state as they tend to have more men residents.

Remember whatever you decide he may not want to be moved out of his home. Sometimes it is needed but never a happy event. It reinforces that they are nearing the end of their life and to your dad's credit in his own way he is trying to hold on as best he can.

Good luck.

Elziabeth
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"Isnteasy" made the same point I want to... it's almost certain that dad associates being at home with a younger and healthier self, and wouldn't be as happy there anyway, as he thinks he would. After his stroke at age 88 and until he died at 95, my dad was constantly wanting me to take him to more and more doctors who could make this that or the other body part work again.
After a few years of frustration and trying to explain and his anger, I finally learnede to just briefly acknowledge his concern and then change the topic. "Ok, dad, I'll make some calls after lunch.. What do you want for lunch..."
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