Do we tell my dad that my mom has been diagnosed with dementia?

I would think if he was with her he would see both that she needed help and that he could not do for her all that she needs. They are both running out of time. One of them is likely to die before the other. It would be good if they could both move to a care place together soon. Then you only need to go through the move one time. Also, it is often possible in some places, they could get to know other people and not feel so isolated, just the two of them all the time. I notice, even in myself, the desire to cling to the familiar. We like to pretend that we are not diminished and it seems like a big job to make a move. Well it is a big job. We also tend to be in denial as to our condition. I wonder if you could get him to agree on a try out basis. Pack up the stuff that is important to him. Then after they are in a new place together, deal with selling the house etc.

I would use caution about bringing her home for a visit. It may be confusing to her, we brought my FIL home once and you could see he was scared and confused, or she may refuse to go back. How would FIL handle her causing a scene when it was time to return?  It may also be more difficult for FIL to accept that she cannot move home. He may reason that if she can come home for a visit she can come home to stay. Understandably it will be difficult to get him to move from the family home but maybe if is goal is to be with her he may be willing to try it “for now”

Imho, you must tell him very gently, but enough to make him understand.

I was in a similar situation back in 2014 when my father fell & broke his hip. He & mom were living in an Independent Living apartment together at the time, he was 90 and she was 86, they'd been married for 68 years at the time. After having his hip repaired at the hospital, dad went to a SNF for rehab. They did not want to release him because of his mobility issues in addition to a brain tumor, but there was no way I could leave him there in the nursing home and my mother in the IL apartment! He'd pine away w/o her.......and she was a nervous wreck to live alone. So, by the grace of God, I found them an Assisted Living Facility where they could move in TOGETHER, that would do the trick.....get dad the care he needed and keep my mother safe (she was starting down the dementia highway at that time and also having some mobility issues).

My father wound up passing away 11 months later and my mother is still alive, at 93, and now living in the Memory Care building of the ALF. Thank GOD I placed them when I did, too, because it turned out to be more necessary for my mother than my father.

Keep in mind that your mother's dementia will appear MUCH worse right now that she's been through a trauma and is trying to recuperate in a SNF. She can get back to a better baseline once she's back in familiar surroundings, or back with her husband.

If you can get them both placed together in an Assisted Living Facility that ALSO has a Memory Care section, that would be your best bet to keep them together and to address mother's dementia as it worsens. In the worst case scenario, if she begins to wander, she can move into a Memory Care unit and dad can stay in the AL section and they can visit, still.

24/7 in home care is really not viable, cost wise, I looked into it myself back in 2014. Let your dad know the TRUTH about what's happening with his wife; you owe him that and he needs to know. If you can keep them together, come what may, your father's health will probably improve. Keeping them apart is like amputating the man's leg.........he won't be able to live without it, you know?

I will never forget the look of gratitude and peace on my father's face when he saw my mother walking down the hall of the ALF on the day she was finally moving in with him. It brings tears to my eyes even now

Wishing you the best of luck moving forward. This is a difficult time, I know, and I am sending you a hug and a prayer

I think it might actually be helpful if he feels more informed and involved in the decision making but based on experience the way, how and who, it’s presented will make a huge difference. My suggestion would be to have your ducks in order first, does the facility she’s in have apartments or larger rooms for couples and are there others there? Do they have a choice of living situations and what safe options are there for your mom and dad together as well as mom on her own? Maybe even check into other facilities and options at least just preliminarily that have a compromise he might be more inclined to agree with if need be.

Im just guessing but based on your info that visitors aren’t allowed inside I’m guessing you have been having care meetings by video and this is how/when they let you know the results of her assessment and recommendations. Assuming that’s correct or that it could be set up that way, I would suggest communicating with the doctor, caregivers and case manager, everyone involved and giving you feedback about including Dad in a care meeting so they can present the info to him along with you and your wife and any other family members who should be involved or simply might get in Dads ear if they aren’t.

A couple important things to keep everyone aware of ahead of time, first I would be very careful about how the reason for evaluating mom for dementia is explained. Dad might resist joining her or even other medical situations for fear that he will be evaluated or “labeled”. It might even be best to focus on Mom’s current physical limitations as being the reason for keeping her there and you will know best but if he needs to believe there is the possibility they can both move back to the house he grew up in if the doctor is satisfied she has met certain goals it might not be as bad a thing as it feels to allow even though you know she never will meet those goals. Big baby steps. But allow the medical professionals to explain where they feel she is, where she could go and their recommendations basically the way they have already for you. Maybe even ask if they aren’t clear enough for Dad to hear, what will be the challenges and what could happen if she were to go home with Dad and what are the possibilities, advantages if she stays under some sort of full time professional care. Then you as a family can talk about the living options and allow Dad to be part of the decision as to what is best for he and his wife. If being together is best for both of them and having access to 24 hr help/care is best for her maybe he will decide to give up his house for now to be with and support her. Maybe not too, maybe he will want to leave things the way they are or maybe another compromise will materialize. No one is going o get exactly what they want here, everyone is loosing something including you, you want your parents independent in their home same as they do but that’s no longer possible and each of you need your own path to realize and accept that. I would be gentle, caring and honest with your dad, keep trying to put yourself in his shoes, it’s so scary loosing all the things he is right now and don’t take all the difficult news delivery on yourself let the professionals deliver it first while you provide the back bone for helping him hear it.

Difficult times, I know, my thoughts are with you and your family.

MCHSMH The way I understand your problem, you need a good way to tell your dad that he needs to be in a facility with Mom or at least one with varying degrees of Help.  My folks were married 67 years when Dad died.
His dementia was worse than Moms.  She figured she could take care of him with our Help.  Well, We had no alternative.  We got Dad all signed up for the local AL and then to 'visit' with Mom.  Finally, after many different approaches, from....you can't do this...… all the way to many explanations why none of us could take them into our homes.   We Told Her She Would be doing Dad a big favor by going with him.   (She certainly did not want to be left alone!)  And it worked.  Will never know if we just wore her down, if she finally saw that she could not do it 'alone', or if her love for him was so ingrained and true and to do this for him was OK.  I also told her she could go and be unhappy and miserable, or she could go and make the best of it, taking advantage of someone else cooking and cleaning. But there was no other choice. they were going to AL.   God Bless You as travel this road.  When the people we love and have depended on for so many years for so many things....change into someone we hardly know, it is very hard and often frustrating along the way.  Make sure you know that your dad knows how much you love him.  Today!!

Time for a family meeting with her doctor. Your father must be in attendance. Let the doctor explain your mother's medical problems. You can bring up the lack of finances for 24/7 care. It might be time for both of them to live with others who can care for them. Many places allow married couples to share a room.

Your father likely has dementia. He may have vascular dementia. His lack of judgment and saying they don’t need help are indicators. My FIL seemed fine, but his problem solving, and judgment were impaired. So he seemed fine until we really started digging into things and I started going to doctors with him. My MIL had dementia and when I started asking him how he saw the future and what he wanted, he was able to realize they needed to move. They should have gone to assisted living with memory care as an option. They had previously been adamant that they did not want to move. He kept saying, I can’t move. When I finally asked why the reason was not that he was so attached to the house. He said they had so much stuff he could not figure out where to start.
Her LTC policy should cover assisted living for her. Look for a place for both of them. A one bedroom apartment so they can be together. When she is ready for discharge from rehab, she could go there. They are both at risk from Covid if they go into a facility but that will be the case for a year. They really need 24 hour supervision. We paid $10,000 for a 24/7 live in Plus IL for a short while when they were in independent living. He fell and was hospitalized and she could not be left alone. So you could bring her home but if he won’t agree to having someone there, it is only a matter of time before she falls again. She will fall even with care in place. It is a tough situation and I basically lived it with my in-laws. For us, placement for both worked but Covid makes it all So complicated.

I would remind him that they have been paying for LTC insurance for this very scenario.

This was their plan in the event that they became unable to take care of themselves.

That he is resistant speaks for his mental competence. I would encourage him to get tested, just for a baseline. And knowing what you are dealing with does make it easier to stand your ground.

The most dignified way to help is to be honest with him if he is capable of understanding.

IF she could be placed in MC instead of NH (after rehab is done), perhaps you could convince him that she still needs some medical care, but that he can go stay with her while this is being done?

Falls and walkers happen all the time, whether at home, in AL or MC, even in NHs. Mom's MC has residents of all abilities. When she moved in, she was still able to walk on her own. It took quite a while before she insisted she needed a walker (probably didn't but maybe she felt left out?) She now refuses to stand or walk on her own (part of the problem is lack of use, so she is weaker, part of it is weight gain and part of it is due to a few little tumbles she took, so she is afraid), yet she tends to forget she can't/won't walk and ends up on the floor trying to get to the bathroom!

So, if/when her rehab is done, consider a move to MC and have dad move in with her ("temporarily" ;-).) You could keep their house, for now, in the event that she passes before him and he is capable of moving back in. He might be more accepting of the move if he gets to stay with her. You could indicate it is temporary, given mom's falls and the virus. If he has early dementia, this might be a good opportunity to get him settled before the need becomes apparent, and he might 'settle in' easier. It would be good to have him tested at his appointment. IF they do an appropriate test, it could be enlightening for you. Some don't do good testing or pass it off, esp with some who can pull up their socks and appear normal during those brief visits!

My opinion, Mom is passed moderate. And if declining she will need more care than a 90 yr old can give. She needs to stay where she is and as her POA that gives you the authority to keep her there. Your Dad can see a lawyer but she assigned u to make decisions for her. If you feel that his doctor will be no help than ask the SW at her facility if a meeting with the DON and therapist can be arranged. Let them explain to Dad why Mom returning home is not a good idea. They never will believe one of their children.

If your parents finances are low, I would ask the SW about Medicaid. Dad would become the Community spouse. Meaning, he would keep the house and car. Assets would be split to where Moms split would be spent down and Medicaid would take over. Dad would not be made impoverished.

An Elder lawyer versed in your States Medicaid can help.

I hope that this works out. Certainly, mom needs the care in MC. And, if your father is progressing, he may need it too.

I am curious about the visiting though. There is no visiting allowed in the AL's, nursing homes, hospitals, etc. in my state due to covid and I can't see that changing anytime soon. I'd try to get them placed into the same place if possible.

Thank you for all the helpful responses!

You should tell him.
Are there options?
Can she be placed in Memory Care...and can he live with her even if he does not yet require that level of care? Many facilities will do this for couples. If this is an option it might be good for him as well since he is showing signs himself.
If she is not quite ready for Memory Care, and he still wants to care for her as much as possible would Assisted Living with a Memory Care unit be an option? Again he would be able to stay with her, help her and when it became overwhelming for him she could transition to Memory Care and he could still be there for her.
It is very possible that without her he will decline more rapidly.

I agree he needs to be told. During a doctor's visit would be good and perhaps some planning for his future could be done then too. It would be great if the two of them could be in the same facility, This is a huge change for both of them, but obviously they need some help and a safe environment. It would be good to have him evaluated too for a baseline. Do you have POA for him too? This is a time to get all paperwork in order,

Good luck for all of what has to be done. These transition times are difficult. Be sure to look after yourselves too and let us know how things develop.

Since he is still capable of understanding, YES, tell him. Tell him it is NOT safe for her to go home. He can visit her, right? Often? It will have to do. It would be a HUGE mistake for him to take her home. There's just about no way a 90 year old is going to be able to take good care of someone that can barely walk and can't use the bathroom by herself.

Yes, dad, we understand that this is not what you and mom really wanted to happen. But things have happened that no one could have known were coming. She needs to be safe. etc.

Good luck.

I think he deserves honesty. I hope he’ll be able to accept the diagnosis. Be prepared to help him in understanding, perhaps by having a medical professional talking with him about the news and what to expect going forward