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I've read many comments here regarding getting a loved one transported to a facility. I cannot even picture what that will look like for my 93 year old mom - strong personality, confined to wheelchair, mid-stage dementia.


I am the only relative/influencer who will oversee this process.


Taking her to lunch as a distractor while getting her moved in is not an option.


She has good days and bad days. Not sure what to do if moving day turns out to be a "bad" day.


Honestly, I picture a scenario where she will be tied to the roof of the car and transported to the front door of the facility. (Just joking!!!) But you get the idea. I really cannot envision how I am supposed to pull this off.


Help!

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Hire medical transportation to convey her from wherever she is now to the facility.

My mom grabbed the steering wheel....once.

From then on, she was transported by professionals.
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Babs75 Nov 2019
That's what we did with my dad from the hospital to the facility. There was no way I wanted anyone to have to deal with him in the car. As I said above, it has been 2 months now and he has finally quit asking to go home. He had what we think was a blood sugar incident (he's diabetic) at the AL yesterday but luckily they recognized he was having a problem and called the paramedics. All is fine now but another reason that he can't stay on his own.
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Different people have different approaches, but, you are justified in your concern, because, if things break down, you may be limited in your options.

With my LO, the only way I was able to get her to agree to get into the car, go inside, and stay at AL, was that at that time she was able to process what her doctor said. Her doctor told her that she HAD to enter AL. (Reality was that she was not able to live alone due to significant dementia. If LO refused to go, she would have reported it to APS. Doctor told me she would not let this go. So, I worked on the plan, while I cared for her. ) The spin that I put on it with LO was that she was entering for rehab. That she would stay there while she got her medication adjusted, physical therapy for mobility and balance, nutrition on track, (she had lost a lot of weight), etc. And, I would take care of her cat. She didn't like it but, she went. I sense that she secretly was scared and knew she needed AL. She did get all of those things at the regular AL, but, of course, her dementia progressed very quickly and I had to soon move her to a Memory Care unit by doctor's prescription. By this time, she had no issue with going as she had little orientation to time and space.

The regular AL , that she entered first, did tell me that they would not be able to keep her there against her will. They were not a secure facility and while they may be able to delay her leaving, by begging her to let them call me before she left. They could not prevent her from leaving if she called a cab and just left on her own accord.

So, I might get a consult with an Elder Law attorney about where you stand. Even with a Durable POA, you may see some difficulty. I'd get my options. No one wants the sheriff's department to have to transport, but, I'm sure it's sometimes necessary, if someone is completely resistant. I'd be hesitant to physically engage with her, because, either of you could get hurt.
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rovana Nov 2019
You make excellent points - it is crucial to understand what type of facility elder is going into, the legal aspects of keeping them there, etc.  So no surprises and you know your legal footing.
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I hired a van service that transports wheelchair users back & forth to take my mother from a rehab SNF to her Memory Care Assisted Living community. She's always on her very best behavior with others vs. not so much with me. I paid $100 to transport her about 4 miles, well, SHE paid it actually, but it was well worth the money because there was no drama whatsoever.

Best of luck!
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Beatty Nov 2019
Good tip. We struggled for hours getting Mum into the car for a respite stay. Next one due early 2020. I had been thinking of the wheelchair taxi - like your Mum - best behaviour for others. Decision made.
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Family Vacation is a great movie!
1. If the doctor has told you to do this or he/she will be required due to State Law, you NEED to do this as Mom will be placed in a Medicare nursing home!
2. Get a specialized caseworker to help you. They know these facilities, contact them in advance to make appointments and will be the person who talks with you before the facility manager becomes involved.
3. ASK IN-DEPTH QUESTIONS OF THE CASEWORKER AND FACILITY MGR.
4. The caseworkers will help you with the transition as they understand and it is not their 1st rodeo.
5. Many group homes will help by allowing a pre-move in by having you secretly bring items from Mom's house so there will be a recognition for her to relate.
Many allow you to have Mom's bed moved in so Mom will be more comfortable in her own bed.
I knew the transition would be just as hard for me as it would be for Mom and my Stepfather. Mom was in the hospital due to a constant reoccurring UTI. We moved my Stepfather (dementia with Alzheimer's)first. We told him that due to Mom being in the hospital, their doctor required Mom to be moved to this very special hospital. He was there to help them care for Mom, so until their Dr said it was ok to move back to the house, they would be living there.
I had to then go to the hospital to sign the release papers. I asked that this be done in a private room so Mom did not see me.
The mgr of the group home made arrangements for a specialty service to take Mom to her new residence. It was strongly suggested that I not be present when Mom arrived which I had already decided.
The mgr was so gracious, comforting and let me cry my heart out. I cried our entire trip back to TX.
Our assigned caseworker stayed for Mom's arrival to make sure both were comfortable, any questions and visited every week for 2 months. Of course, they wanted to go home or they would call the police.
Mom/Stepfather have been living there for 1.5 yrs. Mom calls their suite her home. Their dog lives with them too.
You will most likely be asked not to visit for at least a month. The reason is to acclimate Mom to her new surroundings. This takes on average 6 months. Depending on the extent of your Mom's dementia, you can check her out so you're able to take her for lunch. My Stepfather's nephew takes him for breakfast every Tuesday.
The more routine things become, the more Mom will accept the help and her new residence.
I travel back home every month, different times each month so I can check on everything including the staff. Mom's youngest brother visits every week too so I can be assured nothing is wrong. He will call me if he has a concern so I can call the mgr to discuss.
I have not had any issues with this assisted living group home. I have more issues with my siblings.
Buy stock in Kleenex. I have yet not cried when I have to leave Mom behind.
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Do you have any friends, relatives, church, neighbors, community who can sit with her while her things are being moved? Is there a senior center where she can go while things are being moved?
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Original poster here. Thanks for your input and sharing your experiences. I really appreciate it.
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cherokeegrrl54 Nov 2019
I hope everything works out well for you and her during the move💞hugs sent
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Once you get her in a facility things may change rapidly with her attitude. The place I moved my mom to is in the neighborhood of her house and mine.
She and I walked her dog by it all the time. I had been worried that she
would recognize things and try to go home, but once there she did not know where she was and how to get back home. She forgot her home very soon after the move. To actually get your mom into the car and off to the facility I strongly suggest you have help. Hire someone if you have to, someone who seems to be in a position of power - in a nurse uniform maybe.
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CaregiverL Nov 2019
Artist, Didn’t you have to get a PRI Nurse Assessment before taking your mother to facility? So they can see if her needs can be met?
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I told my m she had a doctor's appointment . Once there, the nursing home just took over. I was getting things organized in her room, while they were chatting with her and showing her around. I am not saying it will be easy, but it had to be done. Hope all works out.
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I had to transfer my dad who was fidgety twice. The first time he opened his door in traffic. The second time a social worker suggested transporting in the back of our sedan with child lock engaged (they’re typically located near the latching mechanism of the door, you can only access when the door is open). If your passenger is incontinent, you can ask the destination facility for some incontinence pads to put on the back seat before starting transport. I got very lucky with both trips with regards to incontinence.
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If this is purely a question on how you carry the move out physically, and the room will be set up already with personal possessions etc. clothes labelled and relatives all in agreement, then I would hire a private ambulance to move the person concerned, they will have a second person who can watch and care for the person whilst the first drives. Alternatively I suppose you could do the same with a taxi, but then you have to be looking after the person being moved.
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Humor is the best way to try to deal with all that we are going through!!! We were wondering about putting a shock collar on Mom to keep her from running away from home since I figured the police were getting tired of it too. ( Still kidding....) If she is in a wheelchair, could you call the transport people who bring a van to get her a ride there? We are going through the same struggle with my mom and although I have my brother and his wife closeby, they are just as 'afraid' of her as I am. The verbal abuse she comes up with is amazing - one day she told me " up my bucket" when I tried to help her do something. Best of luck with this and God bless you!!!
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magnumpi29 Nov 2019
You need to be smarter about your situation, think of dementia as a chess game and right now if you are in fear its because you are not making the right moves in the game of chess. For example, if she was physically abusive teh doctors have medication that help with that BUT use the lowest effective dose regardless what the doctor prescribes. For example, if teh doctor prescribes a 100mg a day break it where it wil be 25 mg and start with that, if it doesnt work in a week start with 50mg, etc
Im really agianst mediactions most of the time and i would try other options first and use meds as a last resort i was just useing this as an example of the dementia chess game.
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First of all consider the time of day, hunger, amount of sleep etc you want all those things that you might be able to control to align with the moving time. I have seen some families areange for an ambulance to transport because it is a bit more difficult to say no to authority figures like EMTs and they are trained to handle these things. Some folks have had the doctor administer a mild sedative but as you know this is always tricky because we never know how they may react to it. Others have done exactly what you said earlier they staged a party/lunch etc and after just drove them to the new place but that could also end poorly. Maybe the folks who will be caring for her in the new place can allow you to visit there a few times for activites and lu ch and then leave and take her home after she has been a few times and was returned back home she will be less resistant. But you must feel good about it too or she will feel your fear . I hope some of this is helpful to you and i wish you well.
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the memory care facility you are taking her to should be able to give you a specific plan how to do this transition as they do it all the time. My mom-in/laws looked like this- 1) breakfast out with a good friend who was in on it, 2) my husband and I moved some of her furniture into her new room (so something was familiar), 3) the friend brought her to the facility to see the ‘pretty’ place where the director met them for the tour , 4) the three of them came in a designated dining area where my husband and I and her pastor was there. The director explained why she was there and that this was her new home. My husband reiterated that we love her and are concerned for her safety of living alone (of course she didn’t see that because of her dementia). There was a short conversation where her friend and pastor agreed this was what was best for her even if she didn’t see it. We then were told we should leave and tried to hug her but she wouldn’t have it. It was honestly one of the hardest things I’ve ever done!! We couldn’t visit for a week to try and help her adjust some. The next six month weekly visits were rough - slaps, kicks, hurtful words, screaming. She did eventually adjust and actually liked it and accepted it as home. Take advantage of what direction the director gives you. If it’s a good place he/she will know their stuff. (FYI - even tho it’s hard, visit regularly and get to know the staff so they know ur watching over your loved one. ) best wishes
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Beatty Nov 2019
Thankyou for sharing. A real team effort of support.
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I was always told that it is best to transfer a patient to a facility after a hospital confinement situation. It is more like a continuation of rehab and treatment after the hospital. Otherwise it will be much more difficult.
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Babs75 Nov 2019
That's what we did with my 93 year old dad. I am his guardian but there was no way he was going to go. He had a hospitalization for dehydration because he was not drinking enough fluid on his own at his house and it was after that, the doctors said he could not go home. He has been in assisted living for 2 months now and was extremely combative and angry at first. But now, after my last 2 visits with him, he has quit saying that he wants to move home. He is making some friends and from what I understand from the staff, he is quite the looker with the ladies! He still owns his house and since we kept a caregiver coming to the facility 3 times a week, they take him back to his house for visits until such time we can sell it. It was unfortunate that we had to wait for a hospitalization to make this happen but there was no way it would have otherwise.
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I think this was the hardest thing I had to do so far and, like you, had no idea how I was going to get Mom to the AL facility. The day we went, she was having one of her bad head days so I used that as the reason why she needed to go somewhere that could help her. That didn't work out so well though. She ended up being hospitalized after a fall, then transferred to rehab and from there, went to another facility. That transition was much easier as Ricky6 said. She seemed to accept that she needed to be in a place that could assist her while she recovered. She still tells me daily that she is going home tomorrow but not with the anger she used to have. Now I just say that she has to climb a number of stairs without being winded and when the doctors sign off on that, we can talk about going home. That usually works and we're on to a different topic.

I wish you all the best, know you are not alone in this struggle!
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I had all the same concerns about getting my mom moved to AL. My Dad wanted to go. Mom yelled and made all kinds of threats and wouldn't even visit the ALF. We knew that she wouldn't willingly go out to lunch with someone or fall for any of the other tricks to get her out of the house. She had started refusing to go to doctor's appointments. My Dad had POA, and her doctor signed a letter stating that she was incompetent. We thought we'd need to hire transport, but by some miracle, Mom was having a good day and cooperated. Once there, she flipped and said we'd tricked her and started making threats again. It's been almost a month now, and she has good days and bad days. Make sure you have the legalities to forcibly move her, and set up potential transport. Also, speak with her doctor about starting medication to calm her to see if that will help. I think it did to some extent with my mom. Best wishes to you!
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I have same problem with my husband. Honestly I am in the spot where I wonder if it’s time or not. I wish I had a solution for you and wish you luck!!
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magnumpi29 Nov 2019
I would advise to leave at home as long as possible. Use adult day centers, medicare/medicade/va programs that pay for someone to help you and tehy come to your house. Let me know if you need more details on some of the programs.
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It is probably easiest after some sort of "hospitalization" or an "emergency" where the person is convinced that this is the only option at this time for his/her care.

I am hoping that there can be more conversations about moving to a nice place that can meet his/her needs better than at home. It may take a lot of conversations and maybe some antianxiety medication for the "move" day.
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Why in the world would you want to put her there if you know she would hate going that much? I couldnt even take my dog to the pound let alone a human being. I would advise to leave at home as long as possible, pay a babysitter to sit with at home, mover her in with you, etc etc. Use adult day centers THEY ARE A GOD SENT, medicare/medicaid/(Va if vet or spouse of vet) programs that pay for someone to help you and tehy come to your house. Let me know if you need more details on some of the programs.
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Beatty Nov 2019
Seriously? There are MANY reasons someone needs more care than can be provided at home - by a small number or ONE person.

You would advise to stay home? Do you have ANY medical facts here?

The Pound? Please refrain from being insulting.
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Hi tornadojan, it is one of the most difficult things to do, but it HAS to be done for their own good. I live in South Africa, and I had to do it 20 months ago for both my parents. My 90 yr old very stubborn father with moderate dementia just point blank refused to go ...... and my Mom with mid- stage Alzheimer's just kept on repeating that my father won't go anywhere. Myself & my husband where looking after them, we tried but my father's health deteriorated fast, and he refused physical help from us (so difficult).

So, I softly explained to my father that the situation at home can NOT continue like this anymore, and I got a case worker involved, had a calming medicine prescribed by his doctor AND booked a private Ambulance to do the transport 92 km to the wonderful "Heartfelt Alzheimer's & Frail Care Home", in the Eastern Cape, South Africa, BUT he still refused to go ...... (kept the Ambulance waiting for 2 hours, untill the paramedics abandoned the mission as they were not allowed to take him agsinst his will). That was the most traumatic day of my life ...... I cried the whole day.

Then a month later, we attempted it again, with the same private Ambulance again, but this time with the Head of the Alzheimer's Association in our region, a Doctor, who brought her nurse and assisted us. Same story, he refused again ...... until the nurse softly and tenderly spoke to my father, and advised him that my mother HAS to go to a facility (he díd recognize the logic for thát), and he needs to accompany her to support her ....... and then he said "OK" , and even got onto the Ambulance's stretcher himself ! We couldn't believe our eyes ! Once they were at the Home, where they received so much loving care, they never looked back. My Mom & Dad thought they are at a luxury rehab style hospital (must be, the carers all wear uniform !), and we never corrected them. We were also advised to stay away for at least 2 weeks, and we dreaded the first visit, but they were just so glad that we came to visit (I always brought them nice snacks & stawberries to enjoy with us on the verandah).

They are so much better cared for, by professionals, than what they ever ALLOWED us to do for them ...... It is so worth-it !

You just have to do it, but with professional help. Good luck, you are not alone 🙏🏻🙏🏻
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magnumpi29 Nov 2019
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Contrary to what you intimate, you do not have to do this alone. Involve professionals in the process, particularly the dementia association. There will be no perfect time to achieve your aim, it is a question of going with the flow. My mother has been in a memory care unit for more than 8 months now, and still does not accept the situation. Family should look after family, she insists, no matter how difficult the work (ok for her as a former nurse to say). But dementia, particularly from mid-way onwards, is all but impossible to manage at home without a lot of professional back-up. I suggest you insist on her going into Respite care for a couple of weeks. Invent an illness for yourself, or tell her it is for monitoring some sort of illness she has, or even she is being given a 2 week trial, anything to force her hand. Freebies are very attractive for the elderly it seems. It works for a lot of people when they discover it is not the bogeyman a nursing home is made out to be. And some people just hate the concept and will never, ever adapt. My mother had to go into Respite care for a fortnight otherwise she would have been left alone for 12 hours every day due to an unfortunate set of family circumstances. The first night they identified that not only did she need to be in permanent care, she needed to be in a memory care unit. Rather than bring her home and continue letting her refuse to even contemplate a possible placement, we arranged for her to remain at that same aged care facility. If you are able to achieve Respite care - and it will be monumental, make no mistake - then you are half way to achieving what is best for a 93 year old wheelchair-bound person with dementia. Best wishes for a speedy outcome.
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moecam Nov 2019
I agree to present it as 'temporary' for her benefit due to some issue you have - if you have something coming up then do it or pretend to be on crutches because of a foot operation which necessitated that she be taken care of while you heal or whatever what ever will work - visit her with crutches or other very visual aid [sling or walker] to pad out your story

My mom was in NH 'temporarily' until her hand worked better - she convinced herself that she was in a rehab place [again] - I even had 'props' in her room so I bought a dog toy that could be squeezed for exercise so that when she said something I would ask how her physio was going [she was actually doing some] & hand her an 'exercise' ball to help her but she would stop squeezing after 5 times as her mind drifted
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If you're willing to pay for it, you can get her taken in an ambulance or a bus for disabled persons.

Contact the facility directly as they may even have a means of transporting patients.
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You may want to have a trained medical professional handle her transport because she won't listen to you.
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If the person TRULY has dementia she/he does not know where you are taking them....!!! Be Kind tell the family, ask for help and IF the dr says its time and the place is clean and offers good care. just do it! I do not understand the problem UNLESS the person does not have Dementia? Dr J Grenan
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Beekee Nov 2019
Non-helpful answer. People in early and middle stages of dementia can be aware of where you're taking them. They can talk, drive, take a bus, make phone calls, tell lies, hide pills, and still have dementia. Doctor of what?
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Six months ago, mom went from emergency room to hospital to rehab and then straight to memory care AL--as luck would have it, a really great place. I visited every day for 5 weeks, before I went back to my home state. Even after 6 months, she does not realize how long she's been there and thinks she's going home soon. She's still in her metro area so friends and minister can visit. I just got back from a visit this evening--she has a boyfriend, a sweet man. Mom, her boyfriend, several residents, and I sat at the dining table for another 20 minutes after the food was cleared, talking and laughing. After 6 months, I can finally feel like I made the right decision. In hindsight, I wish she had gone to assisted living 2 years ago so she wouldn't have been so isolated the past 2 years, living alone with early-stage dementia.
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I was made power of attorney (POA) for two friends of mine in 2013. The wife had frontal temporal dementia and the husband short term memory issues where he could not process the changes taking place in his wife. I started visiting assisted living places/memory care apartments immediately and finally found one with memory care apartments large enough for a married couple. It then took another two years to convince the husband it was time. By then his wife was incontinent and wandering at night and needed 24 hour care. In home, that was $13,000 a month. The memory care apartment was $10,000 a month. It took a 90 minute discussion with the husband and wife before he agreed. Then he forgot, so when I came to get a deposit check, we had the same conversation. Then he forgot, so when the Caring Transition director was coming to see how much furniture would be moved, we had the discussion again. Then he forgot, so the day of the move, we had the conversation one last time. Another friend (3rd POA) took them to breakfast in a nearby town, then to a mall to get their nails done. In the meantime we moved the furniture and set up their bedroom to be identical to the one in their condo and the TV area also identical--same furniture arranged the same way, same pictures on the walls. When they arrived about 2:30 in the afternoon, the husband saw his favorite recliner and sat down with a sight of relief and has been happy ever since.
The head nurse gave me the best advice on the wife's care as her mind was just shutting down. She arrived in June, needed a wheel chair by August, to be fed by September and hospice care in October when she could no longer swallow, passing on October 23.
Her husband is still there, misses his wife, but is well cared for and happy otherwise. I just pay the bills, visit once a week, check with the head nurse occasionally. He walks down the hall for his meals 3 times a day and sits with one or two other people there who can still talk. Most of the tables are completely silent at meal time. A medical professional visits him once a month to check on his health and care. Occasionally one of the staff members will alert me to a need--like he no longer wanted to wear white underwear, so I purchased black underwear and came to his apartment when he was eating and stuck it in his dresser. We have been friends for about 47 years, there are no children or nearby relatives involved, just me and a few other friends who stop to see him now and then. He is 93, in good physical health. He doesn't even need glasses. He just tells me to stay healthy. My job is to live as long as he does. I am working on that. His being in good health makes my job easier.
We see his eye doctor twice a year to check his eye pressure and his dentist 4 times a year for teeth cleaning. Afterwards, we stop at Barnes and Noble, since he loves books--though he doesn't read any more--to have a cookie and decaf coffee.
Behind the scenes, I had to clear out their condo and get it ready to sell. That took about 2 1/2 years. I never told him all that I was doing, just did it. Their good furniture went to the area Native American community for free, via another friend who is Native American and could help me with this. The family photos and personal items like that I brought to my house to sort through and send to distant relatives for them to have and decide what to do with. Goodwill took the unneeded clothing and garage items.
When he runs out of money, his Veteran Benefits will have kicked in to help pay for his care, so he never has to leave. One last big thing to do, is to pay for his funeral costs ahead of time while there is still money to do this and before the medicare "look back" kicks in. I am still learning all that is involved with this end of life care, but it has gone very smoothly so far.
My best wishes to you for your journey on this path. I hope it goes well, too!
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mtyra1 Nov 2019
Johnny, you are a wonderful friend! You have thoughtfully and responsibly done so many things to make this couple's lives as good as possible. Working quietly behind the scenes without adding stress to the husband's life makes perfect sense.
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Get the facility involved. Many have transportation and experienced people who can get her there. Let her know she has a doctor evaluation on the move-in date. When they come get her, she will think she has an appointment and the doctor is providing transportation. Don't try to pull this off by yourself. Get the facility involved and make sure personnel meet her at the front door when she is taken out of the facility vehicle. Talk to them for advice on this. JMO and good luck to you.
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Original poster here. Thanks again for all the great, continued feedback. I pretty much have the place picked out. The move will happen sometime after the first of the year. I guess I'm just trying to process it all myself and also figure out how it all comes together. I will keep you posted.
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My mom was at the hospital and needed to go to AL after a broken hip at home where she lived with my dad.  I went to the AL home, put some of her clothes and other  items there so she would know it was her room,  In Ontario Canada she was entitled to a free medical assisted ride home.  I had them drive her to the AL facility. The staff met her at the door and showed her to her room.   I arrived with my dad minutes later.  He hated her there and she didn't understand due to Alzheimer's but I kept telling her she could go home once she didn't need her wheel chair.  (that's not gonna happen)  My dad could no longer look after her but he visits almost every day.  She behaves so much better for others that it was a great choice for us.  No one can tell you what to do,  The choice is not easy but our loved ones safety and our own security is top of the list.
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My Mom is also incredibly and unreasonably stubborn. However, I've had to move her a couple of times... first to be nearer to me, then rehab and just recently to enter a memory care unit. Initially, I couldn't figure out how to make it happen, but some techniques I have used involved:
- Telling Mom that everyone needs to get out because the house is being fumigated.
- Taking her to lunch (or church, shopping, or on a visit) and instead of bringing her home, bring her to the facility.
- Waiting until she gets sick and taking her to the hospital for treatment. Upon discharge, transport her from the hospital to the facility instead of home.
- Just telling her that it is time to move and packing her bags. Note: To make this one work, attitude is all important. YOU MUST BE UNWAVERING! Don't yell or try to reason, just pack her bags while she raves. I was a little shocked when my mom went with me, but she did.
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