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My father has serious mobility issues and our home, though a bungalow, has stairs he cannot escape. My husband and I care for him as well as for his dog. We are in our mid-thirties, working intense career-paths that require a lot of hours and attention, and we cannot physically or emotionally continue to provide the care he requires. Dad's neurologist as well as his day-program rehab team and some community nurses have all expressed concern about his living arrangements with us and have strongly suggested he investigate other living options that would be safer as he deteriorates. I've started exploring this talk-track with him and he is aware that I am dealing with some burnout from our current situation. He is so sad. He has reached out to my mom (his ex-wife) to tell her how sad he is and how he feels terrible that we would not want him - he doesn't understand why if we haven't had any fights.... some if it is his inability to process due to frontal lobe damage.... but it's breaking my heart and I feel horrible and awfully guilty. BUT... I'd like to have a baby before it's too late and have put starting our family on hold to provide care and support to both of my parents for the last 5 years. I'm rambling, but my question is... how do you manage these feelings of guilt and such deep sadness when taking a hard line on decisions that will protect both you and your loved one in the end?

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SarahK - I agree with many of the prior posters who have said that it is important to make your dad know you love him and care about his well being, but that you need to be able to live your own life as well. My (now) 95 year old mother, with moderate dementia and living in AL since August, 2015, told me at 65 (just about my own age now) that "if I ever become a burden I don't want you to feel guilty about looking into assisted living or nursing homes for me." Of course, this was said when she had full cognitive and physical abilities, and that perspective changed when reality set in. I say all of this because my husband and I weren't much older than you when I'd had this conversation with my mother, and we, like you, were in the prime of our lives and wanted to be able to enjoy that time together. The bottom line here is you are young, in the prime of both your career and lives, and also want to begin a family. It may sound selfish but we all only get one time around the block, and while you are young and able to do so, you should give yourselves permission to live your lives to the fullest. As long as you couple that with the compassionate approach you are taking with your father, and perhaps tour some possible facilities together in order to find the best fit, you are doing everything you are called to do as his daughter. Sending lots of hugs to you and your husband, as these responsibilities are not easy for you now and are only going to get harder as your father ages. Good luck to you all!
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I'm going to be the first to suggest a few "fiblets" to tell your dad to help ease the transition for him. I tell my mother that there are now laws that say that when people reach a certain age, it is no longer safe for them to be alone in the home, and that I have to work, and if something were to happen to her while I was at work, I could go to jail, and she would be a ward of the state, with no one to be there for her. I tell her that once I retire we can consider moving her back home to my house (she lived here for four years until the dementia got to the point that I had no other choice but assisted living for her). They reach a point in dementia where they cannot process logic or reason.

He will make friend there, I notice that most of the men at my mothers facility adjust very well. You can go back to being a daughter, and enjoy your time with him when you visit.
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One approach might be to talk to Dad about how much you want a baby, and your own biological clock. Tell him that you feel (the doctor has told you?) that you will have to choose between keeping Dad at home or never having a baby of your own. Say that you feel torn between the two, and just don’t know what to do. It might help Dad to feel that he was doing the right thing and being brave, not that you are making him leave against his wishes.
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When you’ve reached the point of ultimate caregiver burnout, you just don’t care...all you want is relief from this caregiving situation. It wasn’t hard for me to bring it up at all, but I also thought it was in my mother’s best interest if she went to assisted living since she constantly wants socialization and companion of other elders. I quit saying it when I found out how much assisted living costs. So still,,,I caregive!
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Did the doctors talk directly to Dad? If not, next appt have the doctor look Dad in the eye and tell him he is not safe in your home. You r not set up for the care he needs. I feel their reasoning power goes first. No amount of explaining why gets thru. They no longer can process. I found this out early in Moms Dementia. We told Mom she was going to a nice apartment where he will meet people and have things to do. At Moms AL I heard a CNA say "they waited too long". She was talking about a new resident who was constantly trying to escape. If they had placed him earlier in his Dementia, he would have had time to adjust to his new home and except it as that, his home. Then he may not have tried to escape.

You Dad health will only worsen. To the point that you will not be able to care for him. I feel for your generation. Two salaries are needed just to have the basics. Healthcare is expensive. You want a family. Going to be hard to juggle Dads care, a job and a baby. You would have to give something up, probably the job.
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You don't need to feel guilty. His present living arrangement is no longer safe for him.
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Thank you all, I'm welling up - this support is lovely. I want to assure you all that I am expressing to him and everyone involved that his safety is my biggest concern. His reduced insight and inability to see implications makes it tricky, but I am constantly telling him that I love him and want/need him to be safe. Your advice has been great and I will continue to see my wonderful therapist, talk with you all and to care for his dog - she will never be taken to a shelter, we love her almost as much as we love him. Frazzled - sounds like we're living parallel lives my friend - hang in there and I would love to talk further by message etc as it has been rare to find someone in my demographic who is experiencing the same. My dad is also insulin dependent with neuro-deficits. xo Thank you all!
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Do what you need to do to live your life. Nobody tells us at some point in our career and life path that our parents will drop a big bomb in the middle of it. There is no way to plan for that. You are young, in the prime of your life, and deserve to live life as you have planned. Hopefully your dad can understand that. Please do take care of the dog no matter what - elder's dogs that end up in shelters often get overlooked and then euthanized.
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"Dad, we've loved having you here but this isn't working for either of us any more, you need to be somewhere that is more handicapped accessible and we are hoping to start a family soon, I think we need to start looking at our other options. Do you want to talk about this more right now or take a day to think about it?"
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my mom and dad both had to be moved to assisted living. while my dad had advanced dementia and could not understand who/what/where...my mom could understand. my mom wasn't really happy with moving, but I think she understood why.

they both constantly asked about their old home. could they go back etc.

my dad is passed now(2015). and my mom has adjusted. (both moved 2011)

anyway just regarding my experience in the assisted living where they live(d)

it seems most of the residents. (Even the ones with memory problems) seem to be fairly happy. they get to see lots of different people all day every day. every where you go, from the beauty salon, to the dining room, to the TV room, bingo/piano room, outside porch, hallways....there is someone who is there with a smile and a hello.

friendships and conversations during meals. music and singing. exercise in the morning. crafts. sometimes a bus drive to see wild flowers growing in the mountains.

yes its a big expense. but it has been good experience for me. has it been hard? YES.
i feel assisted living and their experience dealing with dementia, is something i just cant easily deal with myself. its an entire village, not just one person doing everything.

i think the only thing I don't like is that they charge a resident 6$ for each meal delivered to the residents room. if the resident not feeling well and doesn't feel like being in the dining room. I don't know, it just seems wrong. the facility is on the smaller side so its not that far to walk to a room.
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I know where you're coming from...my mom just recently moved into a facility after staying here with us. I too am in my 30s and raising a family with my husband, and it was taking a toll on all of us. I felt tired and spread thin all the time, and was barely sleeping.

My mom said she felt that we didn't want her here when I first brought up exploring other living options, and now she seems to be adjusting well where she is, but I know she wishes she could just live with us forever. Living at home alone for her is not an option either due to her mental health, neurological issues, and insulin dependent diabetes.

You have done the right thing by being honest and explaining to your dad how this is affecting you, and that it's just not feasible for the long term. Let him know you love him and will always be there for him and will make sure he has the best care possible, even if it's not there in your home. Plus, tell him his doctor and medical team recommend exploring alternative living arrangements in order to keep him safe.

Sounds like you are making the right choice. It will be a big adjustment for your dad once you find a place, but it will likely help him to socialize more, and will be better for you and your husband as well, especially if you are wanting to start a family.

A good therapist can help you deal with the feelings of guilt and sadness that come up, it's definitely an emotional experience for us too when our parents lose their ability to remain independent and/or decline mentally.
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Geewiz is right. Somehow you have to carefully choose words that will not give Dad the impression you are throwing him out. He may also fear that if he has to go to a facility, he will have to abandon his dog. That’s a real fear of mine, too, so I understand. You’ll need to constantly reassure him that you love him and worry about his safety in your home. You would be devastated if anything happened to him because your home is not handicap accessible. It’s ok to be honest with him and tell him he requires more care than you can provide. It’s not his fault and not yours, either. But it’s the truth. Let your mother know what you’re telling your father so she can tell him the same thing. Make sure he is super-involved in choosing his new place but tell him he has to choose a place. A lot of assisted living places allow seniors to keep their pets, too.
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Sarah, I know your time is limited but I believe you would benefit from attending a support group for caregivers or dementia patients. Alternatively, seek a counselor that can help you work through these feelings. They can also help with how to address the subject with Dad without hurting him OR you. A few sessions can guide you through this path. Every discussion with Dad needs to mention his safety and your concern for him. good luck.
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