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Dad is 90 and Mom is 89. Dad needs/wants to move to AL and has secured a unit there. He is very mentally stable, but has physical issues prompting the move. Mom refuses to go. She is 89 with mild to moderate dementia. Her doctor has declared her incompetent, so she has no choice in the move. She refuses to visit the facility. She won't leave the house, even to go to the doctor, and has refused to go to her last 3 appointments (hence another reason to make the move). My Dad, my brothers, and I are trying to find the easiest, kindest way to move Mom to the facility. Her doctor has prescribed medications to help make her more relaxed and less agitated, but they aren't working. If the move is brought up, she gets very angry. Even though she will probably forget what happens on moving day, we would like it to lessen the trauma for all involved. Dad knows we might have to get a medical transport for her, but it's very upsetting for him to think of doing that. I can't think of a way to get her out of the house so the move can take place. She won't go out for lunch or willingly go to anyone's house, even for a visit. Any suggestions are greatly appreciated.

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That is great news. I pray that she finds it lovely and adapts quickly.
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I'm glad that things are moving in the right direction!
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I wanted to update those of you who have replied. My mom's doctor reduced the dosage of her Seroquel and she is now agreeable, although still wary about the move. She even went willingly to a walk in clinic for a tb test and chest xray that is required for moving into the ALF. When my brother had to run in to the ALF to pick up paperwork, my parents stayed in the car but mom commented that the place looked well maintained. Btw, that's a huge compliment coming from my mother! Lol So now she's seen the outside of it. Today, my brother will take my parents to have their tb tests read, but on the way, they have a meeting at the ALF to sign final paperwork and hopefully decide on the move in day. My mom doesn't have to attend the meeting if she doesn't want to, but she'll at least have to go inside the building to wait somewhere. Hopefully she will see how nice it is, meet some of the staff, maybe meet some residents, and possibly even be curious enough to look at the unit they will live in. Amazing how the right dose of meds can help! (The original dose of Seroquel made her sleep constantly, but she was still opposed to the move.) Thank you all for your advice!
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moecam Oct 2019
Maybe tell your mom  that it is for your dad's sake - compliment her on the smallest positive response as that will re-inforce these responses -

Even saying things like "mom thank you for helping us get dad the help he needs ... by the way do you want to make an appointment for the on site hairdresser" - be sure to get her into the recreation activities - my mom did 10 per week + religious ones & she blossomed with the added brain stimulus

She might be worried that she is going to be parked in a NH & forgotten so if you take the spotlight off of her & focus on your dad then she might be more co-operative
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The proverbial fib may have to be used, e.g. going out to lunch at a new place, et al.
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Is there a way to start getting things gradually moved out of the house? Making it look unfamiliar? My mom was overwhelmed with choosing what to take so I made a plan of her room and worked with her on selecting what furniture to take. We discussed which pieces to take, who to give the other things to, what to donate, etc. I think having her familiar things helped ease the transition. I tried to arrange the bedroom furniture in the same positions as her home.
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Don’t talk about leaving the house...call it going out on trip w husband. She will need much more than what ALF can offer...she will need at minimum memory care ..& if she gets violent, then a SNF. But for now, don’t refer to going out as moving out. You might be forced into a decision if she falls or has another emergency. BTW, it sounds like more than mild to moderate dementia, Hugs 🤗
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Oh I so feel for you...we're not facing that, but my mom had neglected her personal care...so we had to figure out a way to get her to the hair appt if for no other reason than to just get it washed and blown. She's at a point with dementia where when SHE wants to go, she'll get herself dressed (maybe slower)...but IF there is an appt and she does NOT want to go (and knows in advance, or someone is urging her on) she will be slow or uncooperative. For a long while the routine was my leaving work, coming home to pick her up, and off we'd go, with dad on the inside urging her to get it together and getting her out the door in time for me to speed so she'd be there on time. But it got to a point of dad being angry/upset/frustrated (at 100+) and I was agitated for having left work, and rushing etc. So we changed the plan...they typically go out to a late lunch on Saturdays...and now that's it...BUT on the way to lunch they go directly to her hair salon. She's fine there, doesn't balk at all goes well. But your situation is a real challenge with her refusing to go out at all. I know there are companies that can move things and set things up exactly as they were...but still not an answer for you. Does she love anything/ any activity, any person? Hoping so much it all goes well for you..
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I’m not sure this is a good idea, but it is another one. Leave mother where she is on the move day, sedated, and move all the things out that have to go, including dad. ‘Home’ won’t look like home any longer. Say that dad is waiting for her, tell her that she agreed to go once it’s all set up in the AL unit. It will be traumatic for her, but less traumatic for dad as he won’t be there to see the problems (including the medical transport that he is worrying about).
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Dad's fear of falling is a primary reason for the move? Chances are likely he will fall more often in unfamiliar surroundings. Even a nursing home or 24/7 home care would be unable to prevent falls. Fall prevention is nearly impossible, turn your back for a second, and....
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Daughter89 Oct 2019
They currently live in a quad level house. Main floor doesn't even have a bathroom, all bedrooms are upstairs, and laundry is on level below main. He's not supposed to do stairs anymore. Unfamiliar level ground will be safer, and he WANTS to move. The heightened risk of fractures is just what precipitated the urgency to move. He tried to get my mom to move quite awhile ago, but due to her reluctance, they didn't move then. It will happen in less than 3 weeks.
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Dementia patients thrive on routine and familiar surroundings. She is letting you know that she doesn't want the changes in either - even if it is better for her and your dad. You have already decided that this is a situation that needs to happen. Stop treating it as if she has a choice and start finding ways to ease the move.

Start by getting the new place looking more familiar: similar furnishings, pictures, linen...

Decide on the "day" and "time" when the move will occur. Plan for it to be an upsetting day. Maybe talk with the doctor about antianxiety meds or sedatives to help ease "moving day". Also, talk with the doctor about how to transfer mom that would be the least upsetting for everyone.

Find out the schedule of the "new place" and start getting your mom used to the new routines there. It will make the "new place" less scary and confusing if she is accustomed to usual activities.

Expect her to have "bad days" initially. She will not be happy about the changes, but she will adjust. Eventually, AL will become home.
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Daughter89 Oct 2019
Yes, we know these things. My post was mostly to find ways to ease the move, as you said. She is on depression and anxiety medication, as well as an additional one to calm her even more (I don't remember the name of it.) That one made her sleep 12+ hours a night and nap constantly throughout the day. Doctor decreased the amount to half, and it is better now. Thanks for replying so kindly.
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Try the taking her out to lunch or to visit your father. If all else fails, you may have to sedate her and then have professionals move her. I would not do it when she is fully alert and will rebel - medication or white lies can help. You have to do what you must and be tough about it. I go for the medical sedation where she is in la la land and won't be able to fight everyone. Just do it - you have no choice.
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Split your parent up as far as the way they are to be transported and put one in one car, and the other in another car. Have your Dad in the lead car and let your mom know that he is up there in front, and that he wants her to follow him to wherever he is going. Be sure she is mellow with the prescribed medications. Do the best that you can to make the move and it will calm down eventually.
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Boy! It sounds like your mother needs the AL more than your Dad does. She sounds angry and scared.
Maybe people's suggestions that you not talk about it but just move them when the day comes are the best idea.
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Daughter89 Oct 2019
Thanks for your reply. Up until very recently, my dad was able to manage cleaning the house, do the laundry, etc. Since he was diagnosed with prostate cancer, we know that his bones are weak, and he should be very careful not to fall. This is the main immediate reason for the move. Usually, mom is fairly pleasant, and they get along ok. (Her memory is getting worse, but she is still able to take care of her personal hygiene. She uses a walker and a chair lift to go upstairs.) It's only when moving is brought up that she gets very nasty and uncooperative. The move will definitely happen in less than 3 weeks, one way or another.
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I don't think there's any 'easy' way to get your mother to a place she doesn't want to go. Therefore, if it were me, I guess I'd give her an extra Xanax, load her up in the car and move her there. Period. There is no 'reasoning' with dementia of this caliber. You are not going to make her understand anything, including the fact that her husband has cancer, so stop trying to use common sense with someone who cannot process ANY information at ALL. It's forgotten as soon as it's spoken, so what's the point?

With that in mind, she will also forget the extra Xanax, the ride to the ALF, and the move. She may wind up liking it perfectly fine over there, and being with your dad, and life can get back to normal in short order. Who knows? In any event, her safety and care is of utmost importance here, not keeping her 'happy' or trying to coddle her stubborn streak. There are times in life when we have to do what we have to do, and so we do. Yes, we'd love to lessen the trauma as much as possible, but in reality, medication will do that rather well.

I had to move my dad into an ALF back in 2014. My mother did not feel like she 'belonged' in an ALF, and was resistant to the move. Poor dad longed for her, and yet she dragged her heels and didn't move in with him for about 5 weeks. When the day finally arrived, he was waiting for her in the hallway, in his wheelchair, a giant grin on his face, with open arms, and she was her usual sour and miserable self, barely saying Hello.

She wound up needing Assisted Living even more than HE did, so it all worked out just fine, by the way. Dad passed away 10 months later and my mother is still her usual, sour, miserable self and still living in the ALF, just in the Memory Care section nowadays.

Best of luck.
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Daughter89 Oct 2019
Thank you!
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Get her in the car, take her to her new home, in the meantime stop talking about it, that does not help her. Sometimes we just need to take the bull by the horn.

If you feel that you need a transporter then hire one. Or move your dad there first, most likely she will want to see him, that may be your chance to get her out of the house and to the facility.

She has been diagnosed as mentally incompetent, you are wanting her to react like a normal person, this is out of her spectrum.
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vicky64 Oct 2019
It really is possible that moving your Dad first would prompt you Mom to want to be with him. My folks were married 67 I/2 years when Dad died.  Mom was in denial that he was that close to  dying.  He Had to be moved, she refused.  Thinking that neither of them would move.  There were no choices.  Instead of making her do against her wishes we left her there in AL w/out him.
She was mad, sad, and lonely.  3 days later we moved her to where Dad was living.  She was so pleased with herself, for 'making' us listen to what she.  She Did Not remember that she refused to move  at the same time Dad moved. this was from one level of AL to another.  The second was rated to be able to care for him, the first was/is a lovely place, they just are not rated the same as the other one.  Best Wished for your journey.  God Bless you all.  I am glad the rest of the family is thinking the same as yourself and you do not have to do this alone, emotionally!!
Let us know!!
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Don’t know the answer but wanted to offer support and a hug. I wish you and your family all the best.
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Daughter89 Oct 2019
Awww, Thanks so much!
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Okay.

Deal with things, then, as they are *now.* If your mother's dementia (you say mild to moderate; but you also say she's been declared incompetent, and "forgetting in minutes" also sounds well past anything like mild) means that she cannot retain information at all, then it is not only pointless but stressful to her to persist in explanations; we're back to the first strategy of planning the logistics but leaving her in peace.

Also, stop telling her about the cancer. Not because she wouldn't care if she could understand it, but simply because even if she gets it in the moment she can't retain the information. It is too much for her to process. Does your father have practical help in the home just to tide him over this phase?

Let her routine carry on as normally as possible, talk about other subjects, hope that the dust settles over the next week or two, and then invite her to get into the car like it's all situation normal. Maybe consider a dress rehearsal - going just for a drive or out for a snack - a day or two before the big day.
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How is being ill a reason *not* to attend a doctor's appointment?

You're ignoring your mother's threats, just taking them on the chin. Good idea. But unfortunately you (you the family, not you individually) have also ignored everything your mother has ever told you about her wishes and her hopes; and then you call her stubborn and worry that she won't co-operate when the time comes for her to be moved.

If somebody told you that you had no choice about where you lived, that what you wanted didn't count, that you were going like it or not, and that what you were being offered is really nice (implies: don't be so ungrateful) - how would you take it?

Your father needs to go to the ALF, he has secured a place there, I've no reason to doubt that his decision is well-researched and correct. I don't even doubt that it will eventually prove to be the right decision for your mother's welfare too. But for heaven's sake! - has anybody tried listening to her at all? Instead of just telling her she's wrong? And nuts!

It's really for your father to deal with his wife, reassure her, and convince her that this move is right for both of them. Your brothers and you had best keep a low profile.

If the medical transport does become the only option, remind your father that they are professionals and they will have dealt with MUCH more challenging situations before. Trust them to do their job, and it will be over before any of you know it.
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Daughter89 Oct 2019
My father has tried talking nicely to my mom about everything. He was recently diagnosed with prostate cancer, which has spread to his bones. That plus his medication to suppress tumor growth is making his bones brittle. He cannot stay in a house with stairs, and is getting too weak to take care of the house, my mom, laundry, etc. This has all been explained to mom. She forgets it all in a matter of minutes. Three times within an hour, we had to retell her about him having cancer. A few hours after we've visited, she has no memory of us being there. Asking what she wants is pointless, as she wants us all to leave her in the house. We've tried giving her choices about visiting ALFs, etc. She refuses everything, even plugging her ears so she can't hear us, locking herself up in her room, threatening to call the police to make us leave her house, etc. We'd love to have her participate in making choices about the move, but she won't even discuss it, unfortunately.
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Well, it isn't just the prospect of moving to the ALF that's bothering your mother, is it? If she won't leave the house to go to doctors' appointments, friends' houses, out for lunch there is something wrong that needs addressing regardless of the move.

Has something frightened or upset her? Did she have a fall or some other bad experience?

I should forget all about the move as far as she's concerned (i.e. carry on with the practical plans but maintain total radio silence around her), tell her to think no more of it if she brings the subject up, and focus on making her feel safe and reassured. Give it a week, see if she's more relaxed, and take it from there.

In the end, she doesn't *need* to know; and forward planning is stressful for people with dementia at the best of times, even if they like the plan.

One more thing: has she always, from way back, maintained that she won't leave her current home unless it's in a wooden box?
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Daughter89 Oct 2019
Thanks for your reply. Yes, she has always said she'll live in her house until she dies. She's very stubborn and I'm sure the dementia is making it worse. She is on medication for depression and anxiety. She says she'll go to a doctor appointment, then pretends to be ill when it's time to go. We'll probably need medical transport to move her, unless she gives up and gets into a car once her things are packed up and moved. We've told her that she IS moving and that we want her to visit the ALF before the move so she can see that it's a nice place (it's top of the line). Then she starts saying she'll disown us, divorce my father, etc. We ignore that.
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Daughter89, my Dad was all for moving to senior living, but NOT my Mom, no way, never, nada, thus Mom won the argument.

Dad was so upset with her as he knew living in a single family house with a lot of stairs wasn't senior friendly for them anymore being they were in their 90's. Sure enough Mom had a major fall and she had to move into a Nursing Home.

Later Dad moved to Independent Living and later to Assisted Living. Dad loved living in a senior facility as the facility did the housekeeping and linen service. Plus he liked having a nurse available 24 hours a day. Oh how he wished my Mom was with him.

I believe some of us as we get older feel comfort of just staying home. I know when I get home from work, I rarely leave the house. Going out if just too tiring for me, and for my sig other, and here we are only in our 70's :P
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Daughter89 Oct 2019
Thank you for sharing your story. We are definitely going to do everything we can to keep them together. Above all else, their safety is most important.
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What a stressful situation.

We had a very recalcitrant FIL (well, I had a recalcitrant FIL and my hubs had a recalcitrant father :) ). Whenever we used a non-emergency medical transport for him, he was much calmer than if anyone he knew tried to take him anywhere. If I were you, I'd just book the non-emergency medical transport now. Also, talk to the doctor's office and see if you can get something a little stronger just for that day.

Overall--and this is something I had to learn over a long time--just realize that if she's that upset, she'll be upset no matter what anyone does. So, now is the time for all of you to make the move easiest on yourselves. If your mom is going to be upset, she's going to be upset. If it were a child, would the parents not move house because the child was upset? Now your mom is the child, and you and your dad are the parents. No matter what her fears are telling her, it'll be best for her in assisted living. Just get through that day the best way you can, and be kind to yourselves in the process.
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Daughter89 Oct 2019
Thanks! I do know all of this, and appreciate every bit of advice and support :)
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