My father had a severe fall in June 2011. He has recovered from the physical injuries very well however the fall included a head injury which has uncovered his ability to mask dementia. The dementia is well established. My step mother, who has been married to my father for 5 years (and the marriage was deteriorating rapidly prior to the fall) refuses to accept him back in the marital home. My father wants to go home. He spent a long time in the hospital and has now spent the past 6 months in a carehome - which he has seen as the next step in getting back to his house and which she has seen as the final destination. She has 'moved on' in her daily living; she has established new routines and they simply do not include having him living with her any more (I should mention there is a sizeable age father is 75 and step mother is 64. My natural mother passed in 2002 from cancer.

My wife and I feel very caught in the middle. We want to advocate for my father but also fully understand that step mom simply isn't capable of caring for him. We have tried to softly suggest that for the costs of the carehome she could obtain significant respite and help in their home but that just doesn't seem to be an option in her mind. We have 3 children (11, 9 and 7) and have discussed bringing dad to live with us but that is less than ideal also - he can only manage 1 - 2 hours in our home at a time before he is simply exhausted and asks to get back to the 'lodge' (his carehome). We have purposefully lived such that our kids friends are constantly around - there is a lot of activity in our home - intended so that we have the 'luxury' of knowing what our kids are doing.

The fall dad took in June 2011 was down the stairs in his house. Those stairs are still present and, in my mind, still represent a physical risk for him. Living at home is not ideal either, not for him nor for step mom.

His dementia has left him somewhat confused for certain, but he is still high functioning. He recognizes people and connects with them readily - he might confuse names but he still knows people. Confusion is present of course, and short term memory loss is prevalent - one might have the same conversation several times in a row. There are also some physiological side effects from meds taken post head injury, such as incontinence and a disrupted gate in his stride - balance is off on occasion too. Which reminds me of the risk presented by the stairs in his home.

I am really not sure what to do. He obsesses about getting back 'home'. Originally I thought 'home' just represented someplace other than where he was but he definately associates home with his house. We have now taken him there (in the co-ordinated absence of step mom) and he definately associates that house as his home. And he wants to go home.

The carehome he is in is not ideal socially, but he is safe and very well cared for there. He is simply bored. Most of the other residents are far more advanced in their various dementias. We try to stimulate as much as possible but both my wife and I work and of course with three children we are somewhat on the run. Our kids come first in our world but we are torn about how to best contribute with my father. Through the winter we would have him home at least once a week and visit him 2 or 3 other days as schedules allow. The spring and summer have been much busier with activities for us so our visits have dropped to once weekly many times.

Any suggestions would be most welcome.

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Mac, looks like your dads wife has moved on without her husband, so forget that one I guess. Makes me doubt the whole marriage in the first place, otherwise where's the 'for better or worse, till death do us part' idea? I sure wouldn't reward her bad behavior by letting her have your dads house (if it is) and make him live somewhere else though. If he has to move, then she should have to move too. If your dad can afford it, I would vote for a retirement/asst. living place for him. The good ones are always having social stuff and making things interesting for the seniors that WANT to talk and visit with their peers. I doubt he would get bored there, unless he chose to. Also, what your dad might be saying when he says that he 'wants to go home' is that he wants things to go back to 'normal' again like it was before his fall. Not that he actually wants the physical house anymore. If that's the case, you may have to have a serious talk with him and let him know that it will NEVER be business as usual. His wife has seen to that I'm afraid.
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You sound like a very caring an very careful individual. That is a great combination. Your father's situation is very sad, but he is lucky to have you looking out for him.

It sounds like you are trying very hard to be realistic, and not base anything on wishful thinking. Good.

I don't think that you are going to be able to acheive an ideal solution, or even an ideal solution for a person with dementia. A goal of the best possible solution under the circumstances is more realistic.

He is not going to be able to go "home." Since this was a late-life marriage, perhaps all the financial details are taken care of. If any of your father's assets need protecting or if any joint assets need attention, I hope you can act in his behalf. Do you have durable power of attorney? Health care proxy?

It doesn't sound like bringing Dad into your home would be ideal. In fact, it sounds like a way to maximize the misery. I'm glad you are not letting feelings of obligation or guilt cloud your vision on this one. I do hope. however, that Dad will continue to be able to visit for limit periods of calm family time.

The care center he is at now is in many ways suitable, but you find it lacking in social stimulation. What about providing more social stimulation right where he is? What about hiring a personal care attendant for a few hours each day, to help him work jigsaw puzzles or play cribbage, or just look through picture magazines? In addition, I'd urge a little more interaction with your family, even in the busy summers. Cutting back just slightly on all the frentic friends activities and making a smidge more quiet time for Grammpa could pay dividends for everyone. There is no do-over for ths period in your family's history. Take advantage of Grampa time while it is still available.

I hope you find the best solution in the circumstances, and that you keep tweaking it to keep it the best.
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I'm sorry to hear about your situation. It's quite unfortunate that step mom is unwilling to accept your father back into his home. However, you may come to a point where you find it best that he stays with you despite the fact that it is not his home and that you have a family. With four children, my husband, and my mother who I care for, my home is pretty full, but we've each learned to adapt and manage, and having the kids around to keep mom company at times helped her, and maybe having your children spend some time with your dad will give him a little more social stimulation that you mentioned he craves.

If it is at all possible to reason a bit with step mom, by all means try it. If he is able to move back home, a monitoring system would be a lovely option to ensure his safety and allow step mom to continue her new routine if she really wants to.

I hope this helps even just a little.
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