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Dad has been in his new ALF for about a week, and for the most part, he seems to be doing...OK. The staff has been able to finally get him to have breakfast and dinner in the dining room, and they are all REALLY nice. He's found some table buddies, but when I say he literally seems to have declined overnight, that's no exaggeration. Daily, I physically show him where his clothes are (he picked out where he wanted to put them), but he insists that his clothes are gone. I will show him where they are again, and it's like we never had the conversation. Despite his home oxygen tank being right in front of him, he says he can't find it, so he hasn't been wearing it in the room. The staff will come by and help him put it on, but means he's without it for several hours a day. I'll show him where it is, but he forgets as soon as we have the conversation. Things that he was doing at his former ALF seem so foreign to him, and he's frustrated, and I feel awful. I feel like it's my fault because I moved him. I expected a transition period, but nothing like this. Any tips?

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We all pray we die in our sleep before we get in terrible shape. I agree with you, I hope things work for the best for you both.
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MACinCT, I'll ask hospice about that.

Dad transitioned to a new team since moving to the new ALF, and they actually reduced his visits to once a week because he seems to be "thriving".

I guess they don't see what I see (although he was convinced I was his wife yesterday).

Is it bad that I kinda hope this is nearing an end? This is stressful on both of us. I hope I don't live to get into that state... guess that's a pretty mean thing to say, but he's a mess...
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I thought your dad was on hospice. If this is still true, he may be experiencing the end stages. Perhaps it is time to start "comfort care" and help him control symptoms. If he is not experiencing discomfort when off of oxygen then it may no longer be important or it may be time for medications (opiates) to help him stay comfortable.
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Thanks everyone. I tried to put Dad's stuff back in similar locations as his old room, but this room is much smaller, so Dad lost the queen sized bed that he never slept in. Instead, we kept the sofa and the recliner that he finds more comfortable. I can always buy him a twin hospital bed if the need arises.

All of Dad's things have been essentially flipped, however. Everything is on the opposite side of the room due to the new layout.

Dad is legally blind. He lost his tunnel vision so he has to constantly move his eyes to focus on something and be very close to the object. We have a chair directly in front of the TV so Dad can see it. If he's on the sofa or in the recliner, he can't see the large screen.

I will have Dad checked out just in case. I'm hoping this is just a matter of him not knowing where things are. I just keep showing him where everything is on each visit.

As for the oxygen, Dad has lost the understanding that the canula must be in his nose in order for it to work. He keeps saying "the machine is on at all times". As a result, his shortness of breath has been a nightmare.

And for the person who asked. Dad is legally blind with end stage COPD and dementia. Sadly, it would be so much easier if Dad could see. At least then, we could write him reminder notes.

An ironic turn... Dad seems to have forgotten about the button on the phone that speed dials my cell phone. Is it bad that I find that a relief? Now if we can just get him to remember where the phone is...
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Many people feel that a change in environment does confuse those with dementia. (Does your dad have dementia as well as lung disease?) I'm sure it does for some people, at least initially. On the other hand, when my husband didn't know where he was when he was at home, did it matter that he didn't recognize someplace new? Our neuro doc encouraged exposure to new things and approved of travel. That is a little different, because I was with him, but he adjusted to each new hotel room just fine.

I am so glad your dad is going to meals now. That is moving in the right direction!

Here is the thing, Tinyblu. You can't control the progress of your dad's disease. You just aren't that powerful. You gave it careful thought and then did what you thought was in Dad's best interest. What else could you do? Feeling guilty is only appropriate if you deliberately caused this increased confusion, or if you made the decision on a whim without really giving it thought. Continually thinking you can/should be able to prevent health problems for your dad just increases your anxiety without changing anything (except perhaps conveying some of that anxiety to Dad).

CM is right that any sudden changes should be reported to a nurse. And the staff is likely to notice the change also. Do what you can. Don't fret about what you can't.

Generally a sudden decline for a dementia patient might be caused by
1) reaction to a new medicine
2) the result of an illness or infection
3) progression of the dementia

The first two are temporary and the patient will go back to his baseline (or close to it) when the cause is corrected.

Relax a little. It will be good for you both!
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Tinyblu, when my Dad moved to Independent Living facility, I also had his caregiver scheduled to be there to help him just in the mornings. At home Dad was just so use to my Mom being there picking out the clothes for him to wear [or Dad would be wearing plaid shorts, a checked shirt, those heavy black socks up to his knees and wearing sandals]. And he was use to my Mom having the table ready for breakfast and lunch, all Dad had to do was sit down.

Dad could figure out the most complex physics problem but he couldn't figure out how to make himself a sandwich.... [sigh].

Later my Dad had to move to Assisted Living/Memory Care, and yes, the move did make the "sundowning" he had worse.... but I was no longer on pins and needles worrying about Dad getting outside and wandering in the middle of the night. The Assisted Living building was locked at night, no one in or out except by code.

Tinyblu, were you able to set up Dad's bedroom similar to what he had at home? I found that that did help my Dad find some of his clothes because his highboy dresser was to the left of his bed, like it had been for over 25 years.
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Tiny, isn't your dad blind?
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When my mom was in an SNF, she got moved around a lot. During the three years she was there, her room changed 4 times at least. Sometimes it was her fault, sometimes it was there’s. But the last move, into Memory Care, she was so far gone she barely even noticed. I agree that you should speak with the floor nurse and get him checked out. He might benefit from a psych evaluation as well as a baseline.
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Tiny I don't want to be alarmist but you need to get him checked out. I'm thinking especially of his not seeing things which are, essentially, under his nose; or remembering from one minute to the next what you've told him - this is quite an abrupt change and you want to rule out stroke or infection.

It could be that the move is either a complete coincidence or only an aggravating factor rather than the actual cause; or, once you've ruled out anything worrying going on, it could just be that he's feeling ruffled and it'll take him a little more time.
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