How to force moving elderly people from home to assisted living and they have dementia?

Unless you have been given custodial custody of this couple by a judge, you can not force them to do anything I'm afraid. What you can do though is contact senior services in the city/town where they are and ask them to get involved as it sounds like the wife, especially, could be in real danger. They should make a visit to the house and assess the situation and you can go from there.

Good Luck!

You don't mention your relationship to them but if you have influence over the I would exercise that influence in a firm way and tell them you are concerned about them and that you are going to have a Geriatric Care Manager come to assess them or call adult protective services if the do not proceed with plan for assisted living. If they do not proceed having a professional visit them will help. If they want to stay at home maybe work with them arranging for companion care for 3-4 hours a day to drive them and to help prepare meals and arrange meal delivery.

It isn't good to force any elderly to leave their home for a nursing home or assisted living if it is against their will. Both of these two people could live another 10 years without much difficulty at 75 and 83 years old. A decade is too long to be in either an assisted living or nursing home.

They probably can be happier at home with support. If driving is not advisable, then they need to be driven to appointments, social outings, church. If they need someone to shop for them or have their food delivered (consider paying for meals on wheels for them).
If they are not able to manage cleaning, hire a cleaning lady for them. Do their laundry weekly or pay a friend to do it for them.
Get the mother in a daycare program for people in the early stages of her disease. This will give the older father a chance to rest while she is being looked over.
If Dad can still do the check writing fine, if not get the POA and write the checks for them so their running bills are paid. I would get a home health aide there daily to help get them bathed etc. If not done already, get the home set up for handicapped especially in the bathroom to reduce the likelihood of a fall.

Bottom line assisted living isn't for people who can be cared for better in their own homes with help. The last 2 or 3 years of life should involve nursing homes and assisted living ---not decades of it. We are living longer, and we can support elders in their home.

If you get a POA remember, you need to assist them to do what they want for their care. I think their cancelling out on the assisted living tells you they know they are not ready for that type of placement yet. When I had the POA I did what my father wanted and we reached "agreement" on the home supports he would receive. Forcing the elder (like forcing a teenager) generally leads to rebellion--you want their last years to be cheerful and you having their respect and love. It can be done. Yes it is more difficult then a transfer to assisted living where the elder is left to deal with strangers meeting or failing to meet their needs. Many assisted living facilities do not offer much support and are ill prepared to deal with your mother's illness or any mental health issue. Don't
listen to the sales job when they say they do it all---investigate.

Good luck---this is aging, it is a normal part of life not a crisis.

I agree that you can't force them to move. They may do much better with in-home assistance.

You could call your local Alzheimer's organization as see if a social worker can come to your home to evaluate the situation. They can be very helpful and there's no agenda to sell you services. This person may be able to suggest in-home services available in your community, as well.

Take care of yourselves and please let us know how this progresses.
Carol

We experienced the exact same scenario last year. My father has dementia and his wife has Alzheimer. He did the exact same thing, one day he was agreeable then the next day was adamant about staying in his home of fifty years. He would drive every day to BK for lunch and KFC for supper. After his third car wreck we decided we had to force him to move into ALF. Even after putting a for sale sign in his front yard, he would go out and take the sign down and he even called the real estate agent and told her to cancel the sale. We knew it was dangerous for them to continue to live alone. He would not allow home health care to come into his home saying that he could take care of his wife but the fact is he was not taking care of her or himself. He was making mistakes with their meds and was not bathing her. As upset as he was with all of us, we knew we could not back down. We finally moved them into ALF last November. The only thing I will tell you is pick the facility carefully. We have had numerous issues with the one we chose. Make sure the one you choose has attentive staff and also make sure the meals are catered to seniors. Stay strong and know that you are doing what is best for your dad and mom. Good luck.

Lauramc, I'm glad that worked! It had to be hard to get your parents moved but somehow you convinced them.

In the end, many people simply can't manage at home and in-home care isn't enough. In-home care can often put off the move, so it can be worth a try.

Your advice to choose the home carefully is wonderful. Even if in-home care works for awhile, it's good to start the search for AL early and put the couple on a list. They can always be moved lower on the list or taken off if in-home care is effective.

I have known people who simply wither when they are forced to move from their homes. I've also known many who thrive once they've adjusted to AL or even a nursing home.

Often we have no choice but to go with what works at the time and hope that time will help with the rest.

As you say, stay strong. Something needs to be done.
Carol

It was not all uphill once we did move them into AL. My dad experienced hostility and depression. But with constant contact with his physician, we were able to work through those issues granted medication was given. I have to admit there were times we (me and my siblings) did feel a little guilty, but bottom line he is in a better place. It was not possible for any of us to take both of them into our homes so this was the next best thing. I have learned that there is not right way or wrong way to care for your aging parents. You just have to do what feels right in your heart and in your mind.

Might have to go thru Guardianship/Conservator ship process in probate, we don't know the relationship you are (son/daughter, niece etc.) That process has many unpleasantness, can be a very high expense, and may have surprising or disappointing turns.
Another question is involving private pay: how much income and assets do they have to sustain the 'assisted living'?

another consideration is that they likely (if they decide to move to an assisted facility), they would not be happy in a 1 room arrangement. It may require a 2 bedroom suite, with a living area.. again cost....

I got a live in for my mother. It's cheaper in the long run than assisted living and it makes her happy. Her caregiver is chatty and involved. They are doing well.

My mom's neurologist was a huge help. I kept him informed about the specific things mom was doing via email, which provided a diary the nurse read and passed on to the doctor. Mom did very badly on Demenia test they gave her at her next appointment and HE told her she need to be in an ALF. She argued, cried and refused. He told her he would have to inform the State that she posed a danger to herself and they would place her in a facility if she refused. She stopped arguing and was very mad at the doctor, but that did it. Our parent's generation believe what doctors say like it's gospel.

My aunt's doctor had her driving license revoked when she was about 90 yo. She rebelled and went down and took a competency test and driving test. Needless to say, she fired her doctor. Her license was restored. She died alone in her bed at age 98 from complications of pneumonia.

I have been in sales and marketing at many senior/assisted living/health care communities. May I say that you are stating all of the reasons why the need is absolutely necessary (and it is). But in my ebook, "Bold Actions for Helping Older Parents" there is information on this very common problem and yet I advise that it may take a serious disaster to get him to move on and make the right move for the mother's sake. Men just can't handle the fact that they are no longer in charge of handling the lifestyle because they can't look at the real today facts. I would definitely consult Adult Protective Services and a good elder care lawyer. Seems to be a Type 6 and 7 by the description and guidance I give in my ebook. Please waste .99 and read over to help you the caregiver.

In some states (at least in California) you can contact the DMV and have them call your father in for a driving evaluation. The only problem is that, if they pass, they can't be called in again for some time (I think it is 18 months although I haven't checked recently). 18 months is a long time, and things can get a lot worse, of course. However, if you are fairly confident he won't pass, you might try to contact the DMV. The other option is to contact his doctor. His doctor probably won't tell you anything, but will listen to what you have to say.

I have said it once and I will say it again, you cannot force people out of their home, truth is dementia and Alz are also disabilities, disabled people have rights to live in their own home.

A facility never really is like your own home, no matter how good it is, your memories were not made there, and to some a facility of any kind is a holding cell for death...

Some value their privacy how can you be private with so many people, some people value their independence, they want to eat what they want, when they want it...many restaurants cater to seniors, they take home enough for another meal. They can share a meal, because of how large the portion is...

I am not going to say you aren't worried, but right now it is their life until, they cannot manage anymore...and it sounds like they are coping and have a plan in place...some seniors do drive and maybe there will be something with that, they still have to take tests, eye exam, etc, there is something in place to try and catch them if they are too old...

Also if your seniors have an ethnic issue like they eat old European food, going into a facility that only offers American food is also a problem.

In our case, the POA's were quick to make decisions that affected their mother and I the unofficial caregiver (the mother's choice of caregiver, not theirs), she wanted in her own words to be carried out, like my husband and we had every intention of helping her to the ed in her own home, a two flat where one youngest sibling was the caregiver along with his mother to the father and then now the son alone with his mother. They couldn't wait to exude their power, it was biting at them, in a vengeful act, they removed their mother from her home and tried to do what I was already doing, they could not within four months they had her in a very prestigious, nursing home in a small maybe 8X12 room, where they promptly spent her life savings, to the tune of $6,500.00 per month she was in AL but needed more and this facility handled changing circumstances, the other siblings were older and still working (god bless them they take after her, 82 when she retired with ALZ) they didn't want to be stuck, so they tried to do it "their way" and their way was removing her from her home she lost 15-20 lbs in 11 weeks, we were lucky we got her out, but no one got her stuff out... fast forward they paid for three more months forcing the sale of her home by the Guardian at litem and the judge to pay the attorney fees for their lawyers to oppose us who wanted her to live in tht very home. The sale of her home has provided us a rental home and her living expense but no compensation for care-giving, living with the people she felt very comfortable with, able to have her old friends of 50+ years still see her, doing everything in her power to live life on her terms for as long as she can...that is what she wants isn't that what we all want...

@lwentanon: I hear what you are saying, but the poster said that her parents' "plan" -- to the extent they have one -- is not "working". For example, they aren't eating on a regular, or even daily, basis. And, if her father is dangerous on the road (my mom is scary and I'm worried about her causing a serious accident), that needs to be addressed.

While forcing someone out of their home may not be the best solution in many circumstances, they clearly need more of a plan, perhaps in-home help.

I have had to deal with my elderly parents for the 1st time this yr. My dad, while clear in mind, can barely walk with walker and mom did everything for him and around the house. She paid the bills, everything. When she got Parkinson's and started to become confused they tried to hide the problems they were having from us but soon we found bills not paid, stove left on, door left unlocked,etc. Then dad had to go to hospital with CHF and mom was left at home. Dad wouldn't approve to hire sitters or live in sitter which would have been around $275/day. So, we tried to go and watch over her but couldn't be there all the time and 1 day she wandered from home, locked herself out and police found her. She had to go to hospital and then when she was going to be released we knew she couldn't go home because we couldn't afford sitters around the clock or the live in help so we were going to put her in respite care at a local facility while we figured out what to do because my dad by this time was in rehab. Neither could take care of themselves or each other and we finally put them both in respite care at the same facility with my mother on the memory care floor. He had not seen her since she wandered off from home and didn't understand that mom was different now - we don't know what caused her to go from confusion to dementia in a day or 2- so we had to talk to him about staying n the facility because going home was too expensive, there was a good chance she would walk away again and she couldn't take care of him anymore. He didn't know his meds, hadn't paid a bill in over 15 yrs so it made more sense andwould be safer for both to go to assisted living with them on memory care floor so mom couldn't wander away again. He didn't like it, we argued, he's still mad about it but he's finally seeing there was no way they could manage at home and while he hates not being home this was best decision for my mom. It's a very hard, trying time. I will pray for you and God bless you and your parents.

Meals on Wheels, Salvation Army, Hosipice, social workers, adult day care, etc....

Try to explain to them it's the best thing for them. Do not let call and cancel. That maybe doing more harm than good at this point. Try even a nursing home if you think that would help them. Also you could personally try to call the Agency of Aging or Social Services and see is they could help getting in-home care services. I work for one of those companies and that really does help keep the clients in their own home for longer. Hope this helps!

Sherry1Anne, I HAVE to ask -- you wrote that having a "live-in" is "cheaper in the long run than assisted living." How? Where? :-)

I would LOVE to hire a live-in (i.e., full-time, 24-hour) person to come and just be there in case my Dad needs anything, and to make sure he doesn't wander, or set a fire, or fall. As it is, I am paying approximately $2200/month in Southern Oregon to have caregivers come in to supervise and support him for 3 to 4 hours every day ... and his need for support and supervision increases steadily, as he has a progressive dementia. His regular living expenses (e.g., housing, utilities, food) run about $3500/month. Formal memory care facilities in the area start at about $5500/month, so we're already spending more (about $5700/month) to keep him at home (where he really wants to be) than moving him to a facility. And that cost is going to go up as his need for daily supervision and support increases.

Hiring a live-in caregiver through the agency that supplies our current caregivers, according to my calculations, would cost us somewhere around $11K or $12K a month ON TOP OF his regular living expenses ... just not doable over the long run, given that he is only 75 and in reasonably good health, aside from the dementia. Hiring privately would save us $5 or $10/hour over the agency caregiver rate, but raises a whole host of additional risks and problems ... including the need to provide worker's comp insurance, withhold taxes, pay into Social Security, etc. And now that labor laws have changed so that personal care employees hired by individuals like us must now ALSO be paid overtime for any work over 40 hours a week, as if we were small businesses ... this would mean I'd have to hire three or four different caregivers to fill the "round the clock" care without going into the overtime rate I can't possibly afford.

How are you doing it for your Mom? Did you find a private person who is willing to work for minimum wage? Are you not withholding taxes or paying insurance or overtime? Do you just live in an area where in-home caregiving rates are way cheaper than in southern Oregon (we're paying $20/hr currently, up from $18 three years ago)?

Believe me, I'm not asking idly. I would really love to be able to hire a live-in person for my Dad. That would ensure he could stay at home (and not be lonely!) for years to come. But I haven't found any way to make "live-in" care come out as costing less than two or three times the monthly cost of a 24-7 memory care/assisted living facility ... and it sounds from your post as if that hasn't been your experience. If there's a solution to this that you've found to this scenario, I sincerely want to learn. Please share! :-)

Paula K:

I had an aide for my father while I worked for about 3.5 years and added an aide (live in ) for the last 6 months when he could no longer walk etc.
The first 3 yrs I was the aide from 3 pm to 7 am the next morning when I went to work full time. On only home health aides (with having a small LTC insurance policy) I paid approx. $150,000. ($40,000. the last 6 months when more care was required). However nursing homes in my area (NJ) ran $90,000 per year and that was the basic cost, lots of add on costs --it would easily have run over $100,000./year for the nursing home.

The added plus was he enjoyed being in his own home and was the only person the home health aide had under their charge.
It can be done, not easily done and I lived with my father so I was ever present to supervise him and his care.

I know some of the local agencies have live in aides for approx. $180./day.

Also my father did not have to pay a mortgage as his home was long paid for, I covered the other costs as needed since I was living there. He had an adequate pension and being a union worker he had good Medicare supplemental policy and dental/prescription card and eyecare policy. These are very needed for the over 85 year old elderly--many lack these benefits from their former employers which leaves the elder with a very big problem.

I would suggest looking into "live in aide" costs, and if he is a veteran see if he can benefit from the VA's aide and assistance program which grants the veteran funds for home health aides and expenses to keep them out of the nursing home system.

Good Luck

I completely agree with Lizann. I have a helper who is an angel. She is becoming a member of our family. She needed a home and we needed a helper. We pay $250 per week and an apartment. We cook meals together and I buy the food. It's a wonderful arrangement. My mother has a VA pension that pays for that much + we put an inlaw suite in our home in anticipation of my mother living in it. She has been in it for 4 years, but now our helper is living in it while my mother lives in my downstairs master suite. It's as though we've been blessed with an angel. I was about to lose my mind with all the responsibility as my mother grew increasingly confused about things. I could no longer go to work and run my business, but now it's a different life. I can actually go out to work and shop with peace of mind. This helper is the best thing that ever happened to us. I had tried an agency and they ripped me off, charging $18.00 per hour and the sitters were undependable or dishonest. One even stole my coat and a lamp from my living room.