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My mother has lived with me and my wife for the past 5 years, with my wife being her primary caregiver. It’s come to a time where my wife is experiencing health issues and we can no longer give her care.

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Welcome, RCaldwell!

I am going to assume that it's your WIFE who is 61 and that your mom is older. Your profile also says that mom has dementia.

The first thing you need to do is figure out what level of care mom needs. This can be done through a "needs assessment". You can ask her doctor to order one or you can contact your local Area Agency on Aging and ask them to schedule one.

You only want to move mom once.

Are all of her legal documents (will, POA for healthcare and finances) and end of life wishes (POLST, MOLST, living will) in place? Get those done if she is still competent.

Folks with dementia often have lost the ability to think logically. So saying, "mom, we need to get you into a NH/AL/MC place because DW (dear wife) has had a heart attack may not register with her.

In that situation, you utilize a "therapeutic fib". "Mom, we need to go to (destination) to see X who is having a baby". "Mom, DW has to go to the hospital and I need to work, so you're going to stay at X for 2 weeks". Or, "Mom, the plumbing has just blown up and we need to evacuate for 2 weeks; you're going to stay at XYZ facility".

You've done a good job caring for mom; now is the time to care for your wife.
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You speak with her clearly, gently and honestly. Do not expect her to take this well. She will mourn and feel grief. YOU will both mourn and feel grief. Tell her how sorry you are that you cannot go on. Tell her you will visit, you will try to find a good place, you will never abandon her but that your limitations have been met now and exceeded and you cannot go on.
Again, don't avoid GRIEF, but do not go there where guilt is concerned. Guilt belongs to felons and evil doers, and they never give it a thought. You are human beings, and good human beings at that.
I am so sorry for the grief. Allow yourself the tears. Allow them for your Mom.
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I had to tell my mother that both she and my father were moving to assisted living.
I had run out of gas and was on the verge of losing my family. So I told her in a kind but direct manner that they were moving. My father was in the next room sobbing. It was not an easy thing to do but I would do it again.
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Your wife's health issues are the place to start. You look for a facility that offers respite care and/or trial periods. You explain to your mother that it is imperative that your wife takes a month to stabilize her condition, and that plans will be developed from there. N.b. this does not involve any lying, which you must avoid because you cannot be sure that deception or falsehood will not be detected and destroy your mother's confidence in you.

The move to the facility then takes place, and you see how she does. If she takes to it, well and good. If not, then you will still be free to consider all of the available options. It sounds as though returning to your and your wife's home won't be one of them, or at least won't be a sensible one, but there may still be plenty to choose from. Have you had any opportunity to research what's available within reasonable visiting distance?
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