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OneDayAtAT1me Asked January 2013

Could dad moving in and out interfere with mom's successful transition to the Alzheimer's Facility or present other issues for her?

Briefly, one month ago Dad recently moved Mom to an Alzheimer's Facility because in home care was too much of an intrusion despite heroic efforts by the Agency to maintain his own independence. Mom is still ambulatory, but very incontinent and very challenged to communicate verbally. She still knows all of us. She has always be a quiet compliant person but recently began to lose her "filter" re: Dad's constant criticism of her in her presence ("accidents", dribbling food, etc.) and would snap back at him. Mom's transition went well. She's asked to come home but doesn't push it. We feel that she's actually relieved not to be under Dad's constant control and judgement. After moving mom in, Dad got lonely and I think is feeling guilty (we pleaded with him to consider the likelihood of this). He has no friends and zero outside interests and refuses to try. Then he had a small stroke and spent a week in a rehab facility. He is leaving with almost a clean bill of health and few restrictions. He initially agreed to a few hours of professional in home help each day and I also offered to stay with him until he was comfortable. I wouldn't say dad is sharp as a tack mentally, but he's darned close. Mom has been asking where he is and not quite buying our explanation that he's not feeling well and will be back as soon as he's better. Mom's new Alzheimer's Home learned of his imminent release and asked if he'd like to move in for 30 days. He's thrilled because he gets to be with mom as he continues recuperating. He will not share a room with mom but spend most of the day with her, meaning she won't participate in as many planned activities (because he won't). She'll be seeing my Dad use a walker for the first time and will know that him living there means something is really wrong. It's a new facility and not even close to full. There are maybe a dozen residents and there is only one that Dad has anything positive to say about so he won't want to be around them. Mom spent a few days this week in the hospital due to a fainting incident with a brief convulsion and her overall strength and activity level has declined in the last month. My dad won't consider a respite stay anywhere else.

I'm wrestling with several things. I would value the benefit of your personal experience: 1) Do you think this will have a positive or negative effect on mom's "settling in" at her new home? 2) Do you think a second separation in 30 days could accelerate her decline? 3) The Director of another facility we considered for dad was shocked that an Alzheimers Facility would allow this, much less initiate it. Does this seem responsible? They haven't been too receptive to us trying to fill them in on dad's behavior toward mom.

It's nice to have some objective opinions on this. My siblings are divided on whether this is a good idea. I'd like to get comfortable with it and feel I need to advocate for mom who doesn't have a vote.

OncehatedDIL Jan 2013
It did NancyH, they had sweet moments that we had never seen in their marriage. The one that sticks out in my mind was when her vascular dementia became worse than his anesthesia induced dementia. We worried as he was never kind to her in their marriage. She was not bright and he never missed a chance to condemn her for it. One day after they were in the SNF together, she and I had been out shopping. She became confused when we returned to the facility and wanted to leave with me. She thought she was back in Mississippi and she still lived in her own home. After she tried to follow me out several times, I sat her in a chair next to his gerichair. I told him that she was confused today and didn't realize she needed to stay.

His dementia had been getting better as time passed. I didn't know if he understood or not.

I headed for the door and looked back and she was starting to get up to follow me and he put his hand on her arm and stopped her. She sat back down, moved her chair closer to him and leaned against him. It was the sweetest moment I had ever witnessed between them.

NancyH Jan 2013
Once, if there was ever anything good about dementia, it's that the person keeps going back farther and farther in their memories. If there was a time in your in-law's marriage that things were actually good, then that could explain why your mother-in-law kept going into her husband's room and sleeping with him. Could be that since they DO have dementia, their marriage might actually get better. Wouldn't that be a hoot!?. ha

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OncehatedDIL Jan 2013
My IL's history may not quite apply, here goes anyway.

When we brought them to Texas all of their siblings made it clear that they strongly felt the IL's should not room together. MIL had been living on her own, FIL had been in a SNF for a year. Her family felt MIL needed space away from an overbearing-LOUD- husband. His family felt that MIL "gets FIL too upset". Both had dementia.

In accordance with their siblings' wishes, we arranged for them to be in different rooms on the same hall.

MIL arrived first with us, FIL a week later in an RV with a nurse and two drivers. The first night MIL left her room and slept in the empty bed in FIL's room. The staff removed the bed for night 2. MIL left her room again and slept with FIL in a bed made for one person.

They hadn't shared a bedroom in 10 years. (Not that there's anything wrong with that, lots of married older people enjoy 2 master bedrooms)

Day 3 the facility moved another bed into FIL's room. The conclusion we all came to is that married people have a right to be together- whether its a good idea or not.

How did it work out? Like their usual marriage, loud days and okay days. Verbal battles and surprisingly enough, they also resumed their sex life. Some of the staff felt he was "bringing her down" others felt they were sweet even when they fought and she would park herself by the front door and announce to everyone that she was leaving him. Some of their marital antics were pretty funny for the staff.

jeannegibbs Jan 2013
Well I hope it works out for your mother and father!

OneDayAtAT1me Jan 2013
Thanks everyone for your thoughts. Dad moved in this afternoon so the train has left the station and the best i can hope to accomplish is damage control. Jeanne, the issues you've raise match my list of concerns to a T. He is paying for the whole thing out of pocket and I don't think he's getting much if any discount. The other place we looked at is an Independent Living Facility with an AL section that he could move between as his needs change. They have transportation. It's much homier and more appropriate for him socially... he might even make a friend or two. He says he'll think about it in a month.

Maybe he'll go stir crazy after a week or two living in a Memory Care Unit and decide to leave despite the $ and another round of adjustment for Mom. Maybe others will comment that their parents have done this successfully despite their worst fears and it's all worked out.

jeannegibbs Jan 2013
pretzel123, I don't doubt at all that allowing a spouse to share a room or a floor in a memory care unit COULD be awesome. Believe me, I would have been an awesome influence on my husband's well-being if he had gone to a memory care unit. But the issue here is would THIS husband be a good influence on her well-being. And that is pretty hard to answer.

pretzel123 Jan 2013
There is a beautiful facility in Oklahoma City that allowed a hubby to share a room with his wife in memory care. It's the first time they had ever done it and it seems to work really well. I agree that if your Dad could be next door in AL that would be awesome. There is a husband whose wife is in memory care that brings their dog up to visit and takes walks with his wife and takes her on outings. Your dad could definitely visit as much as he wanted to once he is stable with his walker. I agree that two separations could be devastating to your mom. It took my mom a long time to find a rhythm in memory care. Months and months till she didn't beg to go "home". Hard decision, i'm praying for you.

jeannegibbs Jan 2013
1) Do you think this will have a positive or negative effect on mom's "settling in" at her new home?

Most likely negative. She'll be back to being criticized constantly. How can that be positive?

2) Do you think a second separation in 30 days could accelerate her decline?

Do you mean when your dad has to leave in 30 days? Change is very difficult on those with dementia. First she had to change from living at home to living in a care center. Then she'd have to adjust to having Dad around all the time again. Then she'll need to adjust to not having around all the time.

Sure, every new adjustment is going to be tough, and could accelerate her decline.

3) The Director of another facility we considered for dad was shocked that an Alzheimers Facility would allow this, much less initiate it. Does this seem responsible?

This sounds extremely suspect to me.

Who is paying for your parents' stay? Are they paying out of their own funds? Is Dad going to be charged the dementia-care rate? He would be there in a rehab capacity. Is the facility qualified to offer rehab?

Could you discuss this with your mother's doctor? Presumably he or she would be receptive to listening to your concerns.

The other place you were considering for Dad's rehab period -- would it be suitable for him? Could they arrange transportation for him to visit Mom an hour or so a day?

It would definitely be good for the new memory care facility to get income for an empty room for a month.

It might be good for your father to be able to boss his wife around again for a while.

It would probably be bad for your mother, for the concerns listed above.

It would probably not be pleasant for the other residents to have someone around all the time clearly disdainful of their condition.

OneDayAtAT1me Jan 2013
Thanks Nancy. This is a brand new Memory Care only facility. He would have his own room a few doors down and use the same dining room and other common areas where all the scheduled daily activities occur. Definitely a My Way Or The Highway kinda guy. He freely admits this is a selfish decision on his part, has been asked to consider the possible collateral damage it could create for mom and said he's doing it anyway. Mom's communication is so impaired that we don't know for sure that she can express how she feels about him staying there or using the walker. It's a beautiful place. Last fall Dad said he also wanted to live there "when the time comes" but later said he changed his mind because all of the residents were "mental patients" and he wouldn't enjoy being around them. I think this may be largely about the guilt he feels for moving mom out of the house and being lonely. It's so hard.

NancyH Jan 2013
Are you saying that the Alz. place your mother is in, will let your dad come live in that SAME unit as she does? I took a tour of one of those units when we were still looking into asst. living OR the memory care place for my mother-in-law. I don't see why anyone with most of their faculties left would ever live there, and I sure didn't know that the people running it would think it's a good idea. Now if there's an asst. living building that has a memory care unit attached or adjacent, that would be fine. Have you asked your mom if it will bother her to see her husband using a walker? It does sound like it's your dad's way or the highway though. Need to keep that in mind when deciding ANYTHING for either of them.

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