I moved my Dad (who just turned 90) to an assisted living facility four months ago because his memory problems are to the point where his doctors, our family, and I don’t think that it’s safe for him to live alone in his house any longer. He has not “adjusted” as the facility staff said he would; instead he is becoming more depressed.
I’m his only child; I moved to another state right after school because that’s where my career took me. We both lost our wives at about the same time ten years ago. I don’t have kids, so both of us live alone, 500 miles apart.
Dad had a mild stroke two years ago. He fully recovered physically, but he started having memory problems shortly thereafter. Last year he was diagnosed with vascular dementia. I started paying his bills and convinced him to stop driving. Up until this spring, he had no problems living by himself (with some help from his neighbors and family who live nearby). He sometimes gets confused about where he is, and the neighbors told me that on two occasions he was out wandering around the neighborhood in the middle of the night. They got him home safely, but it is still frightening. Dad doesn’t remember any of this. I used technology to the extent possible to support him at home (set alarms to remind him to take medicines, monitor the pill box, monitor his movements throughout the house to detect falls, etc).
His memory has degraded to the point where he forgets that he’s on medication. The neighbors suspect that he only eats when they bring him food each evening. This resulted in him being hospitalized for a week this past May because of high blood pressure and dehydration. He could barely walk when he was in the hospital. When he was strong enough to be discharged, the doctors said it was no longer safe for him to live alone and recommended that he move to assisted living. He refused at first; to get him to agree, the medical staff at the hospital told him that it was only for rehabilitation so he could recover his strength. I signed him into a facility near his house where he has stayed for the past four months.
I visited two weeks ago to pick him up for our fall fishing trip. Because of the care he received at the facility over the past few months, he is much stronger. He had no problem walking a quarter of a mile to the dock or climbing stairs at the ball park. He still likes housekeeping—he cleans up the kitchen, made his bed, and cleaned the cabin where we stayed on our fishing trip.
He did not want to go back to the assisted living facility. His neighbors and I had hoped that he would adapt to his new community, join activities, and make new friends. It’s been four months now and it’s not happening. Dad says he likes the people there, but he misses his tools and home projects. He does not believe the “rehabilitation” story anymore. Every time his friends or I stop by to visit he wants to know if he is going home. He says that he should have the right to decide where he lives.
I’m certain that if he leaves assisted living and I leave him alone in his house, he will wind up in the hospital again, or worse. I want him to move in with me, but he doesn’t want to move out of his house and give up the frequent contact he now has with his friends and remaining family. I can’t move in with him because I’m not in a position where I can fully retire. I quit working full-time right after his stroke and took a consulting position where I can work remotely some of the time. This allows me to visit him one week a month. He won’t let me hire people to come to his house because he is determined that he can live by himself. He’s really upset that I’m spending money on assisted living that he says is “unnecessary and unwanted”.
We’re planning another trip when I visit him next week. I’m not sure that he will get in the car when it’s time for him to go back to the assisted living facility. I am heartbroken that I can’t do more to help him. He’s a “Greatest Generation” father—WWII veteran, mentor, and best friend. I want his remaining years to be as happy and comfortable as possible for him; I’m trying to balance that against concern for his safety.
I read “Being Mortal”, a very good book on this issue by Dr. Atul Gawande. It helped me understand the medical community’s point of view. Dad’s doctor says the enforcement mechanism they use to ensure patient safety is the state’s Adult Protective Services, but he said they are only called for extreme cases.
I’m considering letting him come home and take the risk, although I would still hire people to visit him for at least a few hours each day to make sure he eats and takes medicine. I’m worried about the wandering though, but it has only happened twice.
I would appreciate hearing how anyone else has solved a similar dilemma.
Thanks for reading this long post.