How do you deal with parents with different aging progressions?

What does your mother want? There are many couple who are much older than your parents where one is cared for by the other. Yes, some choose AL, but there are many modifications that can be made at home to make remaining there doable.

As for the UTI's, for some reason they can cause weird cognitive effects in older people, unless dementia was already present generally this doesn't last long once the infection is treated.

Would your Mom be willing to go into Assisted Living as well? She would have all sorts of activities to keep her busy and your Dad would have a higher level of care that he needs. When Mom needs help with Dad she can call on staff that would be right there. I say Assisted Living because if they were in Independent then the staff would not be permitted to "help". As Dad declines most Assisted Living Communities have Memory Care on site and Dad could be transitioned there while Mom stays in Assisted or she could even move to Independent Living if she wishes.

UTI's can cause confusion, they do not "cause" Dementia.
I think as we age and so much else is going on we may not notice a UTI and if you are already cognitively impaired missing cues of a UTI is easy. (I am, I think, "with it" but I got a call from my doctor's office telling me to go pick up a prescription, they detected a UTI after some lab work. I had no idea that I had a UTI!) So some may have symptoms of a UTI while other times there are no symptoms.

Just had this argument with DHs cousin. She made the statement my MIL, her Aunt, had Dementia caused by a UTI. I said a UTI causes Dementia type symptoms but it doesn't cause Dementia. Dementia is a progressive disease. Early stage u really aren't aware of the problem. A UTI can make a Dementia worse. UTIs are caused by all kinds of things. For my Mom, it was because she didn't void completely because her bladder was sitting on her rectum. A man, it can be caused because the prostrate being enlarged and not voiding completely.

Did they do a culture. If Dad is worse it could be the antibiotic they are using. Moms had penicillin in it and she was sensitive to it. A change of antibiotic perked her right up. UTIs are serious in men. They seem to get septic easier than woman. If he pulls thru this, a cranberry tablet a day and a probiotic may help. Plenty of water. Also would have his prostrate checked out.

Last year my Uncle was hospitalized, upon arrival one symptom was a UTI, he was 84 years old. With unfamiliar surroundings, unknown people in and out of his room, nurses changing etc. hospital staff wanted him checked out for dementia. As his proxy and POA I declined this evaluation until they could tell me his UTI was cleared up. I also brought in the daily newspaper so he could see today's date. He eventually had surgery and then went to a rehab facility, where he is now living in their long term care area. During his time in the rehab area (6 months, while waiting for a bed to open up in long term.) His room mate changed approximately every 2 weeks and his room changed 3 times. The last room change was to a private room where he started to perk up. When he went to the long term area and started having consistency he is back to his old self, memory also. He didn't have anyone at home with him so this was our only option since I did not have a home large enough to have him come live with me.

To keep your Dad home and safe, do you have any other family members or close trusted friends that can stay with your father for safety while your Mom leaves the house? My Father in law signed up for an Eddy program that came to the house, picked him up and brought him to their facility for the day (like an adult daycare), and brought him home at the end of the day. It ran M-F and he did not have to go every day, but he could if he wanted. A suggestion of options to keep him home and safe if you would like to go that route.

We have had several discussions from people whose parents live in a facility with different levels of care, for example W in AL and H in memory care. They can spend most of each day together. My parents-in-law found a NH with double rooms for married couples (and it also allowed them to keep their little dog). In other cases, one parent lives in and the other still lives at home. Ask around for the options near you.

UTIs do cause confusion. In your dad's case, he probably has also had UTIs that lead to ongoing sepsis (causing those falls and loss of weight). A rehab facility is a good place for him to recover, do physical therapy, and start addressing his discharge needs. He may only need a walker and not need assisted living.

Perhaps you could speak to their town's social worker and see what he or she recommends.

Start him on DManose ( best for bladder and kidney health)in his first glass of water. You will use daily to prevent further UTI’s order online or find at a health food store.

I’m older than your mom, and if my spouse were thought to be permanently incapacitated, I would not be ready to enter residential placement with him just yet.

If your mom is presently totally independent where she lives, she should be the deciding vote in what she will do with her continuing independence.

If by choice she prefers to move with Dad, her wishes should be accepted as her choice.

To sum up- please express your opinions with love and concern, and I’ll consider them, but if I (or my spouse for that matter)is cognitively intact when a decision needs to be made about where we should be, we’ll make it!

Thanks everyone. Really helpful advice. Update: my father started wandering in the hospital at night. They have transferred him to a rehab center but in the mental care unit (without telling us first!). This is so shocking. He had very early signs of dementia before but since his fall it has accelerated quite a bit. I didn’t think that was possible. Here’s still hoping that he will mentally improve over time. My mother is at a loss because she doesn’t want to give up her independence.