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My father is in assisted living after having 2 heart attacks and dementia progressed aggressively to about stage 5/6. He has coherent moments and wants to know how much the facility he is living in is costing him. I try and change the subject and re-direct as much as possible, but sometimes he is just adamant and feels like he has lost all control. I certainly don't want him to feel that way but he hasn't understood finances in a few years and I don't want to stress him unduly. Any ideas on how best to respond to him?

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It’s really impossible to predict how any person with dementia will react to anything. My mother spent years saving up enough money to leave me an inheritance when she passed. I know she went without things to do this, including living in a tiny apartment. However, when she had to go to a facility, all the money she saved went to self-pay/ spend down for Medicaid. She wasn’t familiar with costs for nursing homes because she never had to deal with it. When she asked me about her money I was truthful. She never asked about it when she was delusional. I was honest with her. I know she was upset that I’d be left with nothing. I told her it was alright and I thanked her for saving all that money all those years because the cost of her care would have fallen on us. She was satisfied with that explanation.
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Since, as you wrote " he hasn't understood finances in a few years", then I would not go into detail, but give a general answer that he is paying his way and has enough to continue to pay his way. If he keeps answering, I would use the broken record approach of repeating my answer.
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Money and the bathroom. The two things all Dementia people worry about. Just answer him. Its costing you ______. If the amount upsets him fib a little. I say this because $5000 back when Dad was young could have bought a nice little house. If thats not enough for him, then tell him you are taking care of it all and he doesn't need to worry. My Mom would start the conversation "We need to talk". In the AL, she wanted money. I asked her what for and she would tell me someone said they needed it for this and that. Once Mom was in the AL, she never went on outings. She was a fall risk and couldn't take direction. There was no need for her to have money. She would have either given it away or someone would steal it. It usually was someone else needed it. I told her when she needed it I would get it to her.
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Annekeating Aug 2018
Thank you JoAnn for your words of wisdom. My husband had a stroke 16 months ago, left side affect. But what’s more difficult to deal with is the vascular dementia that has set in. He worries constantly about the bathroom and becomes almost paranoid to leave the house. No matter what resources I can help reduce this high anxiety , it does not seem to help.
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You could say.."let me think...what do you think it is? Ask this while you are looking through a check book or notebook When he comes up with a number you could say...Hmm think it is a bit less than that. That might please him to know he is paying less than he thought.
If this is not acceptable to him you can tell him (if he was in the Service) that the Army, Navy or what ever branch he serve with is paying for it.
I do not consider a fib like this a problem if is reduces anxiety, lessens stress or reduces an argument.
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We tell my father-in-law that insurance pays for everything at his Memory Care facility. We also allow him to keep six dollars in his billfold. There are times when he does not know where his billfold is, but when it reappears he is always glad to see he has some cash.
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My answer has changed through time. I've told my mom different levels. This is what I found has been most soothing for her. I tell her that Assisted Living is free. That her health insurance pays for it because she has dementia. She loves that, and it gives her relief.
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I only tell Mum half the story. We’re in Scotland, her care home costs £900 a week, social work pay £250 and I pay the rest from Mum’s bank account. When she asks, I tell her that social work pay and it’s like being in hospital (she knows NHS is free) so she doesn’t have to pay anything. She’s accepted that explanation. She would be horrified to know how much it actually costs.

One problem I do have is that she asks for money. I tell her, if she needs anything, I’ve got her money and I’m keeping it safe for her. She gets agitated and wants to have some money in her pocket, but any I give her disappears, both loose money and a wee purse I gave her. I’m not sure if it’s stolen or ends up in the laundry. I haven’t managed to solve this issue, my only thought is to just keep giving her a little amount and just accept it will disappear.
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disgustedtoo Aug 2018
Get some "play money" - I entered that as a search and there are several places that sell these, many looking almost real. Example, for $8.75:
https://www.amazon.com/Learning-Resources-Play-Money-Pieces/dp/B01LZS1L48
Even saw a Home Depot link and Michaels

She most likely won't know the difference and who cares if it gets washed or stolen!
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My mother occaisonally get on the "finacial roll" and starts asking questions, too. While she is not deep into dementia, she has not been able to cognitivly process numbers, much less finances for quite a while. Since it is her money, I am honest with her. I tell her what she wants to know and then assure her that she is doing just fine. That calms her for a month or so.

I have found that our parents simply want to be assured they are not a burdan on anyone. My father was the same way before he passed from Alzheimer's. As you mention, they like to feel like they still have some control in their lives, but it is being taken awy from them. They know it, but they don't have to like it.

Our parents do not like being lied to and we would get caught in the lies anyway, so don't. Be factual, but assure he is comfortable with the answer. Details are not needed. He only want to be treated like the mature adult he is.
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Hi all - another vote here for fudging numbers a little. Mom insists on hearing some number, not just ‘youre fine.’ She always asks what I’m paying the visitors that go to her house, and if I say $17 she loses her mind. She has a skewed sense of what anything should cost. She refused to let me pay someone regularly - any amount - to take her walking, because ‘they should do it for free because they’re getting to walk, too.’ That was when she still could go walking, which she’s unfit to do now because she refused the visitor to provide regular practice. (Yes, I used to take her myself but it wasn’t enough.)

Tell your dad that it’s usually X amount but because he’s a special X and did X in his life, it only costs him X. Give a monthly amount, then say how much him living at home used to cost a month and that it’s more economical.
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You might try telling him that you did a comparison of his bills and expenses at his previous home, and the AL is w-a-y less money. This is probably true if you factor in hiring the in-home help he would need to live elsewhere. If he asks for actual numbers, you can say you don't recall exactly, but it was about $xx a day cheaper, so he's "saving" $xx a day!
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