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My 93 year old father has advanced Alzheimer's, probably at early stage 7. He can no longer independently perform any ADL's, but he can manage a few with mom's constant assistance, cueing and redirecting. He does not recognize family, recalls nothing about his personal identity or history, and has no concept of time whatsoever. He rarely verbalizes, but can (usually incorrectly) answer basic yes/no questions. He has recently moved from only urinary incontinence to intermittent fecal incontinence. He does not wander. Mom (90 years old) functions like she's in her 70's and needs nothing but her hearing aids to live independently. They live with me where I have a realistic sense of their capabilities and daily struggles. Dad is being evaluated for a facility that can provide them either independent and high-level assisted living in the same apartment or memory care support and independent living in two units separated by a few steps down the hall and a locked door. Any thoughts on either arrangement?

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How wonderful that you have options.

It seems like your Mom's preferences should take priority. Has she expressed any feelings? Maybe she feels guilty with the with option of having your Dad live separately, in which case make sure she knows that this would allow her to be a wife again, versus spending all her energy on nursing care. Plus, even if she is managing now, and will have more help, things will only get worse for your Dad and it would be hard on him to have to move twice.

Given the stage you father is in, it seems like memory care makes the most sense. He will only get worse and physically it will become harder and harder for your Mom. But then again maybe there is comfort for her in having him nearby.
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Traveler58 Oct 2018
I’m starting to lean this direction. She’s fine for independent living and then we can add care if and when she needs it.
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I think independent living for Mom and Memory care for Dad. I really think without your help, she cannot care for Dad. If you feel she needs some assistance, like showering, then an AL for her. Whichever, she can enjoy her later years and see Dad when she wants.
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And if she is in independent living, she will have the opportunity to connect with other ladies...socialize a bit...and have that kind of support.
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notsomuch Oct 2018
Yes! This is really important. She is isolated and alone right now.
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I would assess their needs independently, then look at how important it is for them to live together. Don't shelve or underestimate your mom's needs or your own for that matter. My parents reached a point where dad required too much care to stay at home with mom. Luckily, we were able to place him in a facility one mile away. At first, mom could drive to see him. Later, she visited by way of the council on aging van, a friendly neighbor's assistance or me. Was the arrangement ideal? Probably not. But was it the best solution available? Yes. You, like I was, are fortunate to have both parents for longer than many. But the aging process is quite individual and therefore, there comes a time when their needs become disparate and it is tricky to balance the needs of both. Your mom's needs run the risk of taking second fiddle to your dad's. Make sure that you don't lose sight of her needs for "normal" socialization and ordinary living. You need to help her make the best of the rest of her days too. So, just make sure your not sacrificing her quality for his. Last and most important, what does your mother think should happen?
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notsomuch Oct 2018
You are so right. My mom’s needs have been shelved because we are all working 24/7 to care for him and keep him safe. Our PCP is working with the facility to make a final decision about their placement, and I’m fairly sure they’re only considering my dad’s needs.
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Notsomuch ; my opinion is to put your dad in nursing home leave your mom with you.mom will get a well deserved break and dad will get the care he needs.You also need a break if you put them in the same apartment your mom Will just wear herself out still careing for your dad Good luck and I send hugs to you as all ....if your dads dementia is progressed to stage 7 he wont even have to go through any adjustments things will seem as is to him I think your mom deserves a major break .from my experience working as a caregiver when couples move in together at a NURSING facility it NEVER GOES WELL !!!the healthier partner continues on their routine of careing for their partner.... and the stress is unbearable!!! Lots of time the healthy partner becomes sick ,a move will be tramatic to your mom because shes really mentally capable and knows whats going on where a move will not even effect your father .Not to mention the financial burden it would be to house both parents at a nursing facility these Nurseing homes make you sign over all assets. We all have to remember about there being 2 parents that are ageing and not only will dad need care....mom will also....is it possable your dad can go on Like Vitas hospice in their unit ?medicare pays for this? Or if hes a Vet the VA has a wonderful Geriatric unit they really helped me sooo much with my dad ??this way your mom can go on liveing her life as normal as possable ...you all can still have nice peaceful visits with dad without changeing up your mothers routine toooo much the poor thing she must be exhausted ...and you tooo Good Luck to your family
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Traveler58 Oct 2018
Thanks! The facility we have chosen is totally self pay. No signing over assets, but very expensive. The facility has been clear with mom— no helping. She’s exhausted from all the caregiving. and this move is very much for her sanity, too. The whole situation is lose/lose though. She could be living her life if she didn’t have to be tied to him every minute of the day.
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Tho im still working both my husband and i are on the waiting list at a facility with an assisted living section on one side of a locked door and memory care on the other.

We can live together until one of us has to live in memory care and then can visit spouse and dont have to go outside in bad weather.
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Do your parents still share the same bed? Or room? If not, there is not much difference for your mother in having him two doors (and the door) down the hall. This might help her to accept the change to two levels of care.

When you ask for comments on ‘which option’, either of those you are describing sound good. Does it have to be a once-for-all decision, or is it possible for them to start together in high level AL and change to separate rooms later? (You would hope that your mother understands that she can’t take responsibility for him on her own. If she thinks it is possible, get her to think ahead about things getting worse to cope with, for both him and her.)

Your mother sounds very sensible, so her views are important. If she thinks that separate rooms are better, but is concerned about leaving him on his own, perhaps it would be possible for her to have a single bed in his Memory Care room for the first few nights.

Have you taken her to see the facility? It would be a good idea so that it all becomes a bit more real for her. Best wishes – I hope it works out well.
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Traveler58 Oct 2018
They sleep in two beds that are nearly pushed together. He thrashes in his sleep so she wants to be slightly separated. Before his dementia they slept in separate rooms. He can’t be separated from her for more than a few minutes now. She actually chose the facility from a handful I pre selected for her to tour.
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My folks are in a graduated care facility. They started together in Independent living, where there was no nursing assistance other than for emergencies. Mom’s needs have always been higher than Dad’s even though they are both getting progressively worse. When Dad’s needs reached a level of needing assistance (he was falling and could not remember to remind Mom to take her meds), they agreed, slowly and a bit reluctantly, to move togetherto Assisted Living, where they are still in the same roo. Mom is approaching the point of needing Skilled Care. The level of her Alzheimer’s Disease is also taking a toll on Dad. He verbalized awareness of her increased needs, but is reluctant to let go of the care taking he does just yet. When we reach the point where their docs prescribe it, or where Mom & Dad agree to it, whichever comes first, they will live in separate rooms for the first time in their 58 year marriage. But they’ll still be in the same facility, so Dad will be able to visit her daily. I don’t know if this will help you make your decision. These are such tough decisions. I’ll be holding you in my thoughtfor clarity, wisdom and strength as you enter this next phase of the journey.
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Hi Notsomuch. There are places that allow your folks to remain together. If your parents insisted on being together, you’d most likely need to place them both in a memory care area. This will greatly reduce their freedom but will allow them to remain together. IF your folks are ok with being separated at night, you could have one in assisted living and one in memory care at the same facility. There are cost factors to consider with either arrangement. I’d suggest trying whichever option your folks prefer and being open to changing it if needed. Also know that no matter what you choose, there are pros and cons to the placement. We dealt with placing our parents and had many challenges because of different illnesses/ abilities and because our parents insisted they be together in same room. My dad recently passed, and that obviously changed dynamics of everything for my family. So we are dealing with grief and possibly changing my mom’s living arrangements. It’s not fun. Whatever you decide, I’m offering you hugs and strength.
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notsomuch Oct 2018
Gosh, I’m so wrapped up with our current situation that I haven’t thought about what happens when one passes. My dad is so miserable in his dementia that his passing will be a blessing for him, but we will surely grieve. By then mom will likely be ready to move, too.
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You have to consider the effect this might have on your mom. If I were ever in that situation, I would want to be with people who were as active and mentally competent as I am, but that is my opinion. Would your mom be depressed by being in the midst of people who were in much worse shape than she is and unable to provide much in the way of interaction? Just a thought.
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notsomuch Oct 2018
She definitely would be depressed around people she perceives to be “old.” Although she’s 90, she is very active with a very clear and quick mind.
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