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My parents are on opposite ends of the aging spectrum. Mom is 90 and dad is 93, mom functions completely on her own while dad has very late stage dementia and requires complete care for ADLs. They are in a wonderful small facility that has allowed them to remain together in an apartment where she receives very little assistance, and he receives the highest level of care. He is completely incontinent and relies on my mother to feed him in the dining room. He has had two serious falls requiring trips to the ER this past month The medical staff at the assisted living facility is now requesting that we move him over to the memory care unit which has a small staff to resident ratio. Mom would be able to walk over and visit anytime she wants. I agree that my mom is under an incredible amount of stress trying to help my dad navigate in a world that he no longer understands. Any suggestions on how to ease his adjustment? They’ve been together 75 years and this will be tough on them for different reasons.

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How wonderful that they can both get the care they need in the same building! If you think that your Mom would still like to help him with his meals, I would suggest that she only go over for lunch and/or dinner and let the staff take care of the other meals. This way she will get the “respite” that everyone on this forum is searching for, and she will be able to do some activities and outings that perhaps she couldn’t do with him always present.
Reassure them that they’re still under the same roof...it’s just a bigger house, and they’ll be exactly where they need to be.
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notsomuch Mar 25, 2019
We've been lucky to find a great, small facility that was willing to work with us. If we don't take this rare opportunity for an opening in memory care, who knows when we'll get another chance. They both desperately need this as my mom only gets to grab a few minutes here and there to socialize. She loves to play games and chit chat with all of the women there and she just can't with him. Great idea about bigger house-- I'll try that.
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My mom and dad were married for 70 years. About five years ago, my dad required an emergency surgery that started a downward spiral of his ability to live independently. He did not have dementia, however. Much to his dismay, he could not remain at home but instead required nursing home care. My mother, who had valiantly managed his healthcare (that ramped up after a brain injury/acquired seizure disorder) for 25 years, could no longer care for him adequately and they did not have the resources needed for assisted living or enough help in their home. So, for two and half years, mom lived at home and dad at a nursing home in the same town. I believe that each realized it was the best option, and overall, it worked fine. I made sure that they were able to enjoy as much "normal" experiences as possible, taking them out for meals and drives in the car together. We had a wonderful 70th anniversary/90th birthday party for them at the nursing home. Mom could visit often since he was nearby and when she couldn't drive any longer, would get a ride from me, neighbors, and the council on aging van. Your mother has shaped her life around your dad's for a lifetime and knowing what I know about caregiving for the elderly, this shaping is even more so now. When your dad passes, it will leave a gigantic hole in her heart and life. By moving him to memory care they will provide the care he needs and she will be able to gently reshape her life to include a little more independent activity and retain her health. This is a difficult time in one's life, especially when a couple has been together for so long. But this is the inevitable part of growing old together. It is not for the faint of heart, but obviously your parents are strong survivors to get this far. There is no perfect solution, but more the lesser of difficulty. He should move to memory care IMHO and you should give them love and support on this journey. Talk to the memory care people to learn what you can and can't do in terms of activities/outings with mom and dad, and be creative. My parents and I picked pumpkins (meaning I drove them to the farmstand and brought two uniquely different nursing home sized pumpkins and had them chose one each) and we had picnics (meaning we bought take-out/or drive through food and ate in the car at our favorite quiet vista). You get the idea. When they can't go out any longer, just try to enrich each parent's lives the best you can. I brought music into dad's room, and took mom and my daughter for pedicures....anything to enrich their lives in a positive way both together and apart. Use your creativity and mostly imagine yourself in their shoes and ask yourself what you would like. I'm getting teary eyed now, because mom and dad have passed. But as I did, you can make their last years and experiences better as they maneuver through this process. Love and hugs to you.
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notsomuch Mar 26, 2019
What a beautifully thoughtful response. Thank you. "There is no perfect solution, but more the lesser of difficulty." Perfectly stated.
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Hopefully it wont be as hard on either of them as you fear and my guess is much of that, in particular for your mom, will depend on how it's approached. I would have a talk with mom about the move to this other section of the facility is for his safety and her's as well. It has nothing to do with how well she is caring for him and in fact is what needs to happen to care for him the best way possible, even if you were living with and caring for him this move would be best as he's beyond your abilities too. If you think it might help you could even say they are sure the next step in his mental decline will be wandering and possibly violence (without meaning to) and moving him now will prevent the first event of either of these symptoms from being major. You all picked this place for just this reason so when he needed the safety of MC they would still be in the same place and able to live together just not sleeping in the same room. He can't go to her (or anywhere else) but she can always go to him without the restriction of having to every moment of the day (and night). She will also be key I imagine in making the transition seamless for him.Once she is on board it might be helpful for both of them if she plays a big part in the move, maybe someone else could have dinner with dad or visit with him in the dining room or common area while you, mom and attendants set up his new room. Maybe move his specific belongings in as well as some of their joint belongings, his chair for instance, family photo's...set the room up as similar to the one they share now as possible so it looks familiar to him and he looks "at home" in the space to her. Then just walk him back there from the dinner/visit where he will find her and she can help settle him in and acclimate before bed or whatever seems best in his schedule. Also this way when she goes to spend time with him there it's comfortable and familiar/welcoming to her. This helps her in a couple ways, making the space hers as well as his and giving her responsibility a "job" caring for him to focus on during the adjustment for both of them. Also depending on how important it is to them maybe you can set up a way for him to ring or call for her if he's looking for her. Kind of the way you might at home if there was a big house or lot's of property...walkie talkie, Alexa or Google device that triggers with voice, cell phone, call button....whatever might work best for them and in the facility but not needing to ask staff and have them find her so it takes out the trigger that "others" have to facilitate his access to her and her availability to him?
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notsomuch Mar 25, 2019
Thanks for the great reply. He is so far into his demential that he won't be able to use a button or know what to do with any communication device. He's basically like a 200 pound toddler at this point, constantly asking for his mother (my mom). I think he'll be a mess for a while and a real challenge for the staff, but it'll get better. In the past month I've had to sit with him in the emergency room and he's not been asking for my mom at all. I'm holding my breath and hoping the facility has the staff onboard to help us over this.
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It will take a little while to adjust but this might not be as traumatic as you fear, the hard part might be getting your mother to allow the staff to help - just take it one day at a time and deal with things as they come up.
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notsomuch Mar 25, 2019
Yes, getting mom to let the staff help was the hard part when we moved them in to assisted living. However, she quickly got exhausted from his constant needs.
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Help your mom set-up his room in the memory care unit. Little personal touches that she knows best to help him ease his transition.

Is there enough space for her to have a comfortable place to sit with him in his new room?

How far away is the memory care unit from their apartment? Can your mom walk it?
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notsomuch Mar 25, 2019
Yes, there's a nice sized room available. There's space for a bed, recliner, and a dresser. It's a small, lovely facility with a stairwell up the middle. Independent and assisted living is on the left and memory care is on the right, separated by only a few feet. She's very mobile and would be able to move about the facility between activities, memory care, dining room, common areas, etc.
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Will your Dad really know the difference if he is moved from one area to another as long as he gets all the attention he needs? To make the transition easier, your Mom can sit in the room as he is fed by the staff, gradually diminishing her mealtime visits over time. Then she can visit him anytime she wants without the stress of having to be there at mealtime and feeding him. Right now, she is sacrificing her own well-being, which is not good for her, your Dad and your family.
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notsomuch Mar 26, 2019
This sounds like a good idea for where he is. He can still feed himself, just not in a way that's socially appropriate for the assisted living side of the house so my mom feeds him. I ate with them last night, a delicious fish dish, and hers was basically ruined because she fed him first and then ate hers. She took a few bites and said, "I'll bet this was good when it was hot." Sad.
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Dad may not have that much a problem since he is in late stages. Especially if Mom can visit. Mom maybe the problem, being without Dad. What will be nice is being able to eat a meal without having to feed Dad too. Ur Dad's needs are now more than the AL can give. As long as Mom can see him, I don't see too much of a problem.
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notsomuch Mar 25, 2019
Agreed. She's wearing out trying to keep him "socially acceptable" in the dining room. Here's hoping this isn't going to be much of a problem.
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Caring for you father may be putting your mother under a lot of stress. She may be relieved to know that he will receive the level of care he needs and that in the process she can visit him daily. My mother lives in an AL that has a SNF in an attached but separate building. Several residents have spouses “next door” and they are very content with the arrangement. I don’t think that you have a choice as the AL won’t continue to let your father remain there as he requires a higher level of care. Your mother realizes this more than you know.
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Ask your mom, "What do you think?" Unfortunately, it's about money, and liability. Separating your parents, when done, is likely irreversible, and statistically he has a high chance of rapid decline into death in memory care. Memory care units are security based, when "elopement" is a risk. If you decline memory care the facility might push you to enter him into long-term care. I would talk to your mom......agree to nothing, yet.
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notsomuch Mar 25, 2019
Well, I've been meeting with the nursing director who has offered either 24/7 care or memory care. My dad is simply too far along to be able to function in assisted living any further. The staff has been great in providing a higher level of care than could be expected of them. He's fully incontinent and requires a major cleanup at least once a day. He can no longer feed himself, and needs constant monitoring. I'm sure if we move him and it doesn't work after a couple of months we can move him back and bring in 24/7 care. I'd hate to burn out their resources if I don't have to though.
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Yikes. This is a tough one. How does your mom feel about it? Is there any way possible that she could get more help with Dad at the apartment? Would that be feasible? Other than that, it’s probably best to do the “bandaid” thing and just move Dad over there quickly and then deal with the fallout afterwards.
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notsomuch Mar 25, 2019
They're requiring 24/7 one-on-one care, which is financially insane. I'm thinking bandaid and bracing for the fallout. Sigh.
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