How do I help dad adjust to his new living arrangements at an assisted living facility?

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First of all, here is background information on my Dad's living situation. About 5 years ago, both of my parents' health declined to the point that they needed caregiver assistance to remain living at home. We started out with a part-time caregiver and by last year, it was necessary to have a caregiver (paid and family) at the house 24/7. Mom and Dad did not want to move to a facility so we did everything we could to make their home safe and secure. They seemed content all in all.

Mom passed away on October 31st, 2012, in her own bed with the help of hospice. Since that time, Dad's mental health has deteriorated and his Dr admitted him to the hospital with the diagnosis of "failure to thrive" in February or March. He was transferred to rehab for a 6 week stay and seemed to be happier and more active. He agreed to move to an assisted living facility on a trial basis. The trial period is up mid-May and he now wants to go home.

My sister is POA and said he cannot go home. I don't yet know why not except that it might be against Dr's orders. I will find out more tomorrow when I visit Dad during his counseling appointment at the facility. Since that seems to be the case, I am wondering what I can do to make it easier for my father to accept the permanent nature of the situation. Whenever I have gone to visit him the past couple months, he keeps asking when he will be able to go home and I think he may find comfort being at home surrounded by my Mom's things.

Has anyone here arranged to have their parent or parents live in assisted living part-time and home part-time? Or, do you think it would be ok to pick Dad up and bring him back to the house sometimes? I wonder if that would be too stressful for Dad to go home and then have to leave again. It just seems so cold to say you never get to see your home that you lived in for 40 years again. I don't know how I would cope if that happened to me.

For what it's worth, it is a very nice facility where he has his own "apartment" that includes a bedroom, bathroom, living area and kitchenette. Besides talking about going home all the time, Dad talks about Mom every time I see him and I hate to see him in such emotional pain.

One more thing, I read somewhere that the average life span for someone that goes into a facility is 18 months. Has anyone else read that? It's definitely cause for concern because I am hoping to have many more years with my Dad.

Thank you for reading my long post. It has been therapeutic to write all this out --it is weighing heavy on my heart and mind. Looking forward to reading what my fellow caregivers have to say :)

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Some good ideas, sunflo2.
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I think you should leave him in the AL. If you must, tell him some white lies and or get the counselor and dr to corroborate "saying, Mr. Smith, you are doing great here, we 'd like to evaluate again in 6 months". This should satisfy him to stay somewhat.

I would bring his favorite chair, pictures, books -- even his favorite cup and saucer, rug, etc to make it more like home. Second, you might take pictures of each room, their garden, favorite shopping places or restaurants, street, neighbors, neighbor houses, like an earlier suggestion and put on one of those digital photo frames. This won't make him sad like you thing, but reassuring.

Do you still have some of moms clothes or favorite sweater? Can you bring a couple pieces and hang in his closet? Would he let you cut them up and make a nice quilt or wall hanging for him? To many of is it might sound morbid, but for some it is comforting to open the closet and hold, smell their spouses clothes for awhile. Only you can decide what your loved one will be most comfortable with.

Hope some of these suggestions help.
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For what it is worth, in our family Grandma would have been better off if we HAD strong-armed her. The last few years at home she had been laying in bed all day looking a the ceiling doing NOTHING. She started to hallucinate about seeing small children that had been dropped off for her to babysit, hearing the cries of children abandon in the park next door, the caregiver's "fiance" was hiding under the bed, or in the closet, or "using a device to look through the wall" when she was on the toilet (caregiver was 70-year-old family friend of 50 years...no "marine boyfriend" more is the pity!). Hallucinations have all disappeared now that there is real activity going on around her. She is in a 6 person board & care, so she doesn't get lost in the crowd. Has regained badly need weight, doing MUCH better.
Personal opinion - if you can keep the house for awhile so your father can "check on it" it might really help him. He has lost so much, it might be nice if he doesn't have to lose that too. I'd guess his visits will get fewer as time goes on. Unfortunately we didn't have that option for my Grandma, and she mourned losing her home of 40 years. We were able to take her back for one visit before it was sold. We sold to a friend of the family (full price), who offered that she could come visit anytime, though she hasn't taken him up on the offer. The sale to someone "sorta" in the family helped her deal with the sale much better. She did feel a huge loss that her things were disposed of without her there, but we had no real choice (she was in hospital/recovery when everything had to be taken care of). I've been interrogated numerous times about where different items went, & have been able to tell her that this went to this aunt's house, that went my bro's house, or "I don't know, but I think it went to so-and-so's house", which satisfies her most of the time. She doesn't want the stuff back necessarily, just to know where it went.
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I just finished a rather lengthy post and then my computer crashed on me. Augh! I wanted to thank everyone for their responses and just give an update on what's been going on.

Dad is still adamant about going home. However, my sister visited him this past weekend and told him if he goes home, she will quit as his POA. From what I understand, he told her that he'd stay.

We've been discussing his living arrangements in counseling, that is, my Dad, the counselor and I. My sister lives in another state and visits infrequently. For me, it's upsetting to have a family member strong arm another family member. That's what it feels like --- I plan to continue the conversation with Dad about options, concerns about living at home and what the possibilities are for another POA. I think, though, he's actually afraid of losing a daughter with a threat like that.

Whatever he chooses to do, for whatever reason, I will stand behind him. It just makes me sad that she is doing things without his input.
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You don't. "THERE'S NO PLACE LIKE HOME"
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Regarding the average time frame people spend in nursing homes, ALF or with caregivers in their own home, it normally is about 3 to 3 1/2 yrs according to insurance companies who provide long term care insurance. Most LTC policies have a certain # or visits by a home health aide, or day care facility and it does work out to about 3 or 3 1/2 yrs. Most people do not need help for 10 or 20 yrs if they were fit or not disabled in their earlier life.

As far as when a family decides an ALF or NH is appropriate I think it depends
on the ability of the elder to care for themselves and the willingness and financial ability of the family to keep them safely home. Further, the family support must increase to keep them safely in their home with or without home health aides. The adult child of an elder makes lots of sacrifices to keep the elder home and unfortunately as a society we do not help these adult children financially or emotionally. Medicaid pays for NH placements but Medicaid does not pay for the home health aides when needed for custodial care at home. Hopefully as a society we will make it possible for support at home.

Elizabeth
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I have heard no statistics about only living 18 months in assisted living. That seems ridiculous, except for the fact that most folks wait too long to go and they are on the decline, anyway.
My mother and MIL are both new to assisted living facilities. Both need help rising up from bed, so they are where they need to be. They are safe, eating, are bathing and are around other people.
Many elderly ask to go home, even when they are home. So, I think that it would be worse to let them move home.
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I would figure out a few things: 1) Is your father able to manage in his home with caregivers? 2) Does he have the money to provide caregivers? 3) Was his not eating simply part of the grieving process following the loss of your mother?4) Have his spirits picked up enough that he will eat at home and sees a life without his wife?

If he can stay in the ALF it might be easier on the family. However, if he doesn't like it, it may not be best for him. It also may be too much change at once. He just lost his spouse a few months ago and now to move him from his home of 40 yrs --it could be too much emotionally.

As far as how long people "live or exist" in an ALF or NH, it depends on their age and overall health. Most people go to these arrangements at the last stages of their life. If you suspect, your father may well live another 8 or 10 yrs then it may be too early for him to live in a facility where everyone he connects with declines in health and dies. In his own home the positive thing would be his neighbors are younger and he sees the full range of life (children, teen, young married couples, middle age as well as 65+ folks. My parents never wanted to be in a facility with only elderly and basically the fragile elderly (over 80 yrs) even when they were in the fragile elderly.

I think your father is grieving the loss of his wife, I would watchful about making him grieve his home of many yrs. Home is home.

Good luck

Elizabeth
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Carol,
I am so glad you posted this question. My sister and I are facing the exact same issue right now with my mom who has dementia. We moved her from Arkansas to Oklahoma suddenly, and she is having a very hard time adjusting. She wants to check on her home but it is 250 miles away and I work full time. She has an apartment at a independent living faciltiy and we did bring photos, linens, dishes, etc. to give her a sense of home. However, every day, she wants to go home. This has been one of the hardest things we have had to do as a family. We know it is the best for safety, but it is so very sad. My question to others, does it get easiser? Will she stop asking to go home?
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In my line of work, I often see people having to go thru this.
1. take pictures of the home they are in room by room.
2. when setting up new place try to make it as similar as possible to the pictures
these steps make the transition not so traumatic, I've work with a women who does just this. She stated that not only does is make the move easier but is safer as things are so familar and they are less like to fall or injury themselves.
And remember when they are moving into these facilities, that it acknowledgment of thier decline adn loss of independence.
Stay strong.this is a difficult time for all.
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