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My mother has been in a facility that is @ an hour from I live for the last 8 years. She and my father started in Independent living and then each made the transition to assisted living and eventually to the skilled nursing unit. My father is an Alzheimer's pt. as well but was diagnosed much later than mother and his disease had not advanced as rapidly as hers....particularly in the last heart. She has been on Excelon since her diagnosis and I really do believe it served the purpose it was prescribed for by giving her at least an additional year of a better quality of life. It has become clear over the last is to a year that I is no longer doing anything beneficial and she has become combative one minute and non responsive the next. She has lost the ability to walk and communicate and while I sometimes see a glimmer of recognition in her eyes when we are together, I know she is no longer aware of our relationship. It is time to begin weaning her from the Excelon and the neurologist has been very helpful explaining what the process from here will most likely be. I tried for 2 years to never her transferred to the Memory Unit attached to her facility, but the wait list moves very slowly since there are only 8 rooms on that unit.
Once most of the Excelon has cleared her system, it's possible that her decline from that point will be the quickest and most significant of all. The nursing unit she has been in is typically average: beautiful, clean, bright with a patient to staff ratio that is ridiculously high. I have hired a sitter for when I can't be there because I am not satisfied with her care. I am her Attorney in Fact and HCPOA. My brother was POA for both parents originally until I discovered he was living a very comfortable lifestyle by just using their money as I it was his own. Even pressure from the attorneys involved convinced him to resign as POA for my mother, but my father is still competent and refused to revoke my brother's position as his POA (theirs is am extremely co-dependent "boys club" sort of relationship.) I did sue my brother but every dime of the tens of thousands of dollars he took from mother was already from my mother.......with my father's knowledge was gone.
When she was first diagnosed with this hideous disease we talked a lot about the things she as feeling and what she wanted moving forward. My selfless, fiercely protective mother asked made one request......... That when her death was imminent, I would be here with her if I could and that feels like a tremendous honor. I would also like for her to be closer in proximity to where I live so I can be with her as much as I can and would like to transfer her to the Hospice facility where I live.
Given all the animosity I have felt from both my brother over the last several years, I anticipate a lot of anger from both of them about my decision.
I don't want to be cruel to my father by making a decision that he will likely have great difficulty adjusting to since they presently are just a few rooms away from each other. I have made the round trip from my home consistently for almost 10 years (starting with moving them from their original home). I want to be near my mother in her final days and near enough to be there with her when she dies. I don't feel as if my decision is a cruel one but others seem to think that I should be more concerned with my father's feelings and the effect it may have on him since he is till aware of his surroundings,etc. I don't know exactly the effect it may have on him. He has not taken any responsibility for her care or he's interest even when he was both physically and mentally able.
I would be interest in what others think.
Thank you!

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* Hospice will call you when death is imminent so you don't have to worry about that. Our hospice transfers the patient to their own facility when there is a week or so left so you will have warning. If you can get hospice involved, you may be able to discontinue the sitter and keep her where she is close to dad. Don't worry about offending your siblings.
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My mthr's hospice visits the patient in her home, no matter where that is, house, apt, or facility where she pays rent on the room. She's in a memory care unit and there are 8 others under our specific hospice's care who live there. Everyone, not just hospice patients, benefits from the harpists, the guitarist, the vocalists, and the game people from our hospice! Our hospice has a strong presence at our memory care home.
Iif you see someone in the nursing home who is wearing a nametag with a hospice name on it, be sure to stop them and ask for their card so you can call them! You can also ask a nursing home administrator if there are hospices the can recommend who serve people at the home. Because of confidentiality laws, they can't reveal who is on hospice, but they can let you know who they think is appropriate.
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