My step mom and dad live in a loft in downtown LA. They loved their artsy lifestyle and can’t let it go. Dad is 94 with dementia, plus feet and hernia problem. Can ambulate briefly with cane. Is sometimes physically combative with home aide and step mom. He has a VA social worker. Threatens to throw himself out the window if anything changes in his care. Step-mom is 90 with Parkinson’s and CHF with difficulty walking. She manages my father’s care. They live on the opposite side of the country 3000 miles away. I have visited 1x per year for several years. Step-mom is getting sicker and has been in the ER and hospital a couple of times in the past 3 months. My dilemma is this. If my dad is left alone after my step mother passes or is hospitalized they cannot afford full time care at home at $500 a day. So he will have to be placed in a nursing home. I feel so badly about it because he will be combative and probably have to be wrestled and restrained. Even if I was there he wouldn’t listen to me. They have refused to move into assisted living or nursing care through the VA and now are at the whim of whatever bed is available at the contracted VA nursing homes. Is there anything I can or should do? I feel like if I don’t go out there to help him I’m a bad person. So much guilt, so little help.