Just found this site, and I am so glad because I am really struggling about what to do for my dad, and I have a variety of questions. My mom died over four years ago, and he still cries every day. He lives in their home and is determined not to leave. He also has macular degeneration and is easily confused and overwhelmed by small things. I would not say that he is incompetent, because he can definitely make decisions about things that when he understands them, but he also seems to need help with day to day things and is in total denial that things are starting to confuse him. There is a trust, living will, planned POA, etc, but I am not sure if it is set up the best way. My half brother (so my dad's stepson) lives about a half hour away and is currently set to be the trustee if somebody takes over, and I live in another state (currently visiting). So here is what I am struggling with...

I think alot of my dad's stress is caused his poor eyesight, but he is also just really easily confused. An example would be that he forgot to cross out Friday on his calendar this past week, and I had a terrible time convincing him it was Saturday and that he was done with the drops he takes for 4 days after his injections. Even when I added the black line he uses, somebody had made a squiggle on the box, so it looked like something was crossed out, and that confused the heck out of him. So I made another line, and that seemed to confuse him even more. He is supposed to have cataract surgery next week, and we are all hoping his vision will greatly improve. What I am wondering is, does the progression of dementia sometimes reverse when stress is lifted? (He is also freaking out about getting his taxes done at the moment). My husband thinks it is not going to change his mental state that much, but I really don't know much about it.

I am having such a hard time deciding if he really should not be living alone. He also does stuff like leaving milk out for long periods, but seems to have a good sense of smell. He will seem fine for a long stretch, but then just one bill or other item of mail will have him in tears of confusion, but I am not sure if it is mainly because he can't see it well. Of course the first thing is to see how he is after surgery, but I think sooner or later he is going to need help, and that is where he is opposed to all the options, or somebody else is.... I laid out the options for him:

1. Go to assisted living - he is COMPLETELY opposed to this and really dislikes new people and situations.

2. Move to an apartment near my brother so he can help more - also totally opposed and living with my brother is not an option as his house is to small and he doesn't want to move in with my dad. He would really rather not handle his affairs either, but is willing to do it for the sake of practicality.

3. Move to where I live - I know his preference would be me for his caregiver (I am named as who will be conservator and POA), but again, totally opposed to leaving the house or going to a colder climate.

4. Hire a caregiver - he is also opposed to this as he doesn't like strangers, and we have concerns that he refuses to lock up his bank statements, etc.

5. My family move back to CA - I know this would be his choice, but he also would feel bad because he knows we don't want that, and my husband is VERY opposed to it. He has a good job and my children and I have a strong and close knit community of friends, and we don't really want to raise our kids where he lives.

So yeah... there is just no good choice. :( When I ask him what he wants if he gets sick and needs help, he just keeps saying, "These are hard questions," but refuses to pick one. He just keeps joking that he is going to find a young wife. I don't think he ever expected my mom to die first. I said to him, "This is your life, I want you to decide," but he just won't do it, and somebody is going to be very unhappy with any of the choices.

Sorry this is so long! Thank you in advance to anybody who reads it all and has feedback!

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Thank you for your thoughtful replies. I agree that moving him to where my family is is the best option, but I think I would have to drag him kicking and screaming, at least at this point, and I also strongly feel a similar way about the familiar surroundings. He really only has ONE request, which is to stay in him home, and he has done so much for me that I would like to honor that unless he changes his mind. After turning it all over, I think bringing a caregiver in when he needs it, is going to be the best option. He has agreed we can take all his financial papers out of the house at that time. I just don't see him in assisted living, but maybe he would get used to it. When I talk about living with me, he says over and over that he doesn't want to be in some "dinky" place. He also seems to have major concerns about how is body is going to get back to his prepaid cemetery spot next to my mom. We told him that would be handled, but I don't think he conceives how or remembers I said so. As it is, he asks me what "online" means about 50 times a day because he keeps seeing it about paying his bills. I picture him worrying about that every day, and it makes me so sad. :(
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I forgot to add that my mother does the same thing about poo-pooing all options.There are always reasons that we can't do almost everything to make a positive change. When my father was alive, she used to say we couldn't do them because of him. Now that he is gone, she uses other excuses to oppose all changes. It can be frustrating when they paint themselves into a corner using "yes, buts" and "no can dos." My mother is to the point now in her dementia that I really don't want to make any changes until I have to. I believe the familiar surroundings help her stay oriented at the present time. The golden opportunity to move my parents passed years ago, so the next move will either be to the NH or to the hospital during her last days.
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neomia, I agree with the things that Jeanne wrote. Your father sounds like a good candidate for assisted living. Moving him near you sounds like the best option. To me it sounds like your father has some dementia (or at least senility). The inability to make decisions, the confusion when there are too many words, and being overwhelmed sound so much like my mother. The confusion your father feels is probably made much worse by the shock of losing your mother. I feel so bad for your father. Nothing is ever the same after a long-term spouse dies. There is a huge vacancy.

Chances are that your father will enjoy AL because it will help him get away from the memories and let him fill part of the vacancy with new friends. He might even do well with Independent living in a senior community, since he is still capable. These senior communities provide transportation to the stores and doctors as needed, so are very nice for people who don't drive. They are also less expensive than AL, which your father may not need until on down the road a way.

I hope you can talk him into moving near you. And I agree with what was said about not moving there. After uprooting myself years ago, I still have the same resentment about why did I have to uproot my life so my parents wouldn't have to move from their house. Really... this house is no shrine and they could have moved as easily as I did. In your case, your father can move a whole lot easier than your entire family can. The impact of your father being the one to move will be a lot less. So be selfish here and stand your ground. (Take it from one who knows.)
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Cataract surgery should result in greatly improved vision. (Though of course he will still have macular degeneration.) Reducing stress improves outlook and attitude, generally, and his confusion may seem reduced.

If he has dementia, that will continue to progress (get worse). There are things that can help manage symptoms (very worthwhile doing) but no cure.

Please take option #5 off your list. Giving your father a choice that your husband hates is simply not realistic. If you were both eager to pull up roots and start all over, hey, this would be perfect. But you are not, so take it off the list. (If you need convincing, look up the many posts on this site where moving to care for a parent has disrupted all family relationships and turned out to be a disaster.)

I'm also a little skeptical option #2. If his stepson would do it if he has to, I'm afraid you would sooner or later come to another decision point, when stepson decides he really can't do this any longer. He can do financial management without being geographically close to Dad. It sounds like more than that might not be realistic.

So that narrows it down to 3 options. Maybe that would be more manageable for Dad to think about. (I vote for a combination of #1 and #3 -- ALF near you. Do you think your dad would be influenced by my vote? :D ) Your dad is right. These are hard questions. I suggest that you make a decision. Tell him what it is. Say "Dad, I would really like to know what your preference is, in case you become unable to live alone. But if that is too hard to think about, know that I will do my best to act in your interest. If I had to decide tomorrow, my choice would be __________. You think about that and see if it feels comfortable. If you come up with a better plan, please let me know."

You are really smart to be thinking of this ahead of need. (At least we assume it is ahead of need at this point.) But it isn't easy no matter what the situation is.

Is Dad on or eligible for MediCal?

I certainly hope the surgery goes well and at least relieves some stress.
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Oh and he also does not want anybody to take his bills over. As much as they seem to upset him, they seem like the only thing he has to keep him occupied these days.
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