Help! Dad has advanced dementia, mom is taking care of him. Any suggestions?

Well, there are a few ways to take this, none of them easy. Mom obviously is not ready to send Dad away. Are they able to self-pay? Finances are a huge issue with seniors. Even if they can self-pay, she’s aware soon there will be nothing left. At our age, not leaving anything at all to our kids is very upsetting. Plus, Mom may not be ready to face Dad’s decline. If she claims he’s being “manipulative”, maybe she doesn’t quite grasp his dementia, or want to grasp it.

You can’t force Mom to place Dad until she’s ready. We couldn’t with my FIL. MIL refused. Whenever he’d fall, us kids would get the call, and 911 was NOT to be called. Dad was picked up and sat in a chair. Finally, when our kids were over there doing yard work, Grandpa fell and bounced off the car bumper, cutting his head. My son found him, ran in the house and without consulting Grandma, called 911. La Familia was then ashamed enough of themselves (that a 10 year old little boy wasn’t afraid of Grandma and they were) and Grandpa was sent to a facility.

You can confront Mom with, “Mom, Dad is NOT manipulating you! He’s got dementia! His broken brain doesn’t understand how to manipulate people!” You can absolutely stand up for yourself. You’re a grown up. Do it respectfully and kindly, but firmly. She will deny he’s “that bad”. She will deny that she’s burned out. She will deny she needs outside help from anyone. But, at least, you’ve got her thinking, and now she knows you know.

Have mom's cognitive skills been assessed? In depth?

Sounds like they both need placement.

Motherof3: Any stepping-in that you do is enabling. I’m not judging! Just imparting to you what I learned — for myself & my mom — way too late.

I tried like h*ll to be (everyone else’s definition of) a good daughter. Which was “never enough” because I DO work full-time+ and I DON’T live nearby, etc etc etc.

Respected(?) mom’s proud/stubborn/deceptive/senile wishes to never see a doctor and not tap into her long-term care insurance and leave a maximum amount of her late husband’s assets to his adult children.

So there I was, mom’s little “yes” person. A lifelong role that I played very well. With a knot in my stomach and internally fuming that mom always rejected the “thinking person’s solution.” (Always-always, not just in her late years.)

I enabled mom right into her fatal home accident. She was home alone - as she wished. In her home that was not at all modified for mom’s limitations - as she wished. With no one (other than me in the next county and her dotty 70-something sister that she fought with all the time) checking in on mom - as she wished.

Right? Wrong? Good? Bad? Who knows.

I’ve had people tell me it was great that mom lived exactly as she wanted to. I’ve had people dolefully tell me that I should have (in so many words) taken out a 2nd mortgage so I could turn MY unsafe & unstaffed house into an unlicensed nursing home — while mom sat on 3 paid-off houses and an untapped LTC policy. And everything in between.

Those AARP and Cialis commercials sure portray a fantasy, don’t they?

If your mom and dad went into retirement wanting to remain in their home to the end, it can be very difficult to get them to change their mind later regardless of financial resources. My mother took all kinds of abuse from my dad with advanced dementia and still wanted to preserve his dignity and keep him home above all else. Dad has a pretty good income from SS and pensions that nearly meets monthly costs of good AL/MC just 4 miles from home and rental property could have been sold to finance the difference for several years so there was no direct threat to her home (although she had stated over the years she didn't want to live alone). I believe she considered taking care of Dad a duty and after she had been doing it a while she was too exhausted to really reconsider. Only when her own health started failing and one child tried to take advantage of that to take control did she start to consider maybe he did need to be in MC.

The most effective discussions with my mother were around "what's going to happen when you cannot take care of dad" when you're in the hospital or after you fail from one of the pushes and your mobility is permanently damaged. We also talked about how my father was more cooperative and less abusive with strangers (like the young nursing staff) at the doctor's office and hospitals than he was with the family, particularly my mother. I investigated area MC options and costs, even took my mother on a tour of the one I thought best suited my father. Understand these conversations when on for nearly two years before my mother showed any signs of considering MC for Dad. Although more than one of her children thought Dad needed MC, ultimately the decision was was my mother's. It was her husband, her home, and her health to risk. As long as your parent is competent, there's only so much you can do.

Good Luck!