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Hi, My dad has moderate Alzheimer's and has had a few falls this year. He broke some bones in one fall. I have read that Alzheimer's patients are more prone to falling. He currently lives in a nice facility but my brother is trying to convince to move into his home. The problem is that my brother lives in a very old house with steep stairs, so that my Dad would have to walk up and down that stairs. I am concerned he could trip and fall. It doesn't seem like the safest environment for him, especially considering that he is in a good environment that is safe. I also do not think Dad will get the mental stimulation at my brother's home that he would get in the facility where he's at, because my brother and his wife both work. The facility offers many daily activities and lots of opportunities for Dad to socialize. It seems like Dad would be sitting at home alone a lot at my brother's place-- and what about if he fell down the stairs while they weren't there? Where do I voice my concerns about this possible move? Are there authorities who check out the safety of living arrangements for elders? My brother won't listen and Dad doesn't have the cognitive ability to understand.

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Have you discussed it with his doctor yet?
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He probably wouldn't change his healthcare POA because he gets confused when processing decisions. The thing about the verbal abuse is that he has forgotten it already. Others were horrified but he doesn't actually remember it. I have reminded him a couple times, but do not want to keep on about it. If he doesn't remember, he doesn't remember. He is pretty easily manipulated into doing things and is his own worst enemy in that regard. I was just thinking that if I could tell someone, like his doctor, that he shouldn't live with my brother because of the APS reports and stairs, that would make a stronger case. He could live with me but I honestly think that he would be better off where he is because it is a very nice facility with lots of wonderful activities.
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Would your dad be willing to change the healthcare POA so that only you have authority? It sounds like he can still make his own decisions (?) -- does he want to go to brother's, knowing the verbal abuse he now gets from his DIL? His own decision is enough to keep him where he is for now, but as dementia progresses decisions will need to be made for him, and for that reason it would be good if you were his primary healthcare POA, with brother as a backup (in case you are incapacitated).

Even if Dad can get along on his own all day now (which sounds pretty iffy) he will not be able to as the dementia progresses. It really sounds like he should stay right where he is.
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CTTN55 - I honestly do not know why he wants to remove my Dad from the facility, but if I had to guess it would be because he and his wife are not very popular there. Witnesses have seen my sister-in-law screaming at my Dad and badgering him. An APS report was filed and I think they may be upset about that and would prefer Dad to be in a place where they can verbally abuse him without witnesses.
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Hi JeanneGibbs, My brother and I share healthcare POA so we are supposed to be making decisions about his healthcare jointly. Dad is still able to do a lot of things for himself so that he does not need around the clock care, however currently he is in a very protected environment where there are people around if he were to need help right away. The facility has assisted living options that we have begun to utilize. He needs reminders to take medications and to eat and go to activities. There is a dining room so he doesn't have to prepare his own meals. My brother does not have plans to hire anyone to be with Dad while he and his wife are at work and they are in denial about the severity of his dementia.
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Cascadian, stairs can become an issue for anyone as they age... even for myself I find I don't like walking down stairs, going up is ok. If I plan to stay in my house any more length of time, I would put a second set of handrails on the stairs, as it does give one a better sense of safety using two handrails. We have that at my office, and it works great.

Aging can cause falls, when you think about it, if a parent wears bifocal glasses, they are looking through the reading lenses when looking down, thus everything is blurry. It's hard for them to look through the distance lenses as they would need to put their head further down to the chin and that doesn't help with balance.

If that was my Dad, I would keep him in the facility as he probably has made friends there, likes his room, likes the meals, etc. Pulling him out would cause more confusion that might not go away. Being home alone is a bad idea. Your brother needs to think what is the best interest for his Dad, not to use him as a pawn to help save money [unless money has turned into a real issue].
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What is the reason your brother wants to take your dad out of the facility?
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First, from what you say I agree that where he is may be the best choice for your dad.

But who gets to make that decision? Who has Power of Attorney? Who is Medical Proxy? Are these documents in place? If not, is your father still lucid enough to understand what it means to give someone authority to act on his behalf?

Has a doctor advised that Dad needs 24-hour supervision? (Most people with dementia do at a very early point in the progression.) Does your brother have plans to hire someone to be with Dad while he and his wife works?
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