How to tell my father he will never be able to leave his AL?
About 3 years ago my father was moved near me from out of state due to health and cognitive issues. His driver's license was revoked by his Dr. Long sordid story, I had POA for him which his family forced me to pursue guardianship and conservatorship, which now I have.
Well he has been living at an AL and doing well (stable), and I have always told him that the Dr. would have to release him from AL for him to get out of the AL. I have never told him that this is his permanent residence moving forward. He still dreaming of getting his license back (He knows it was revoked by a Dr.), he's still looking for a truck, and wants to drive back home. The AL is great, he gets all the attention he needs, he likes the food, he has a PT person seeing him 5 X week and reports that now he is trying to hire an attorney to cancel the POA he signed to me so he can leave the AL and get visibility to his money. He does not know that the AL is being paid from his savings.
My siblings tells me I should tell him that the AL is his permanent residence, he will never be able to leave, and he will never drive again and the AL is being paid from his savings. Yes he will remember this, he forgets everything else but focus on impactful events and remembers them.
I am afraid if I tell him he is there permanently he will try to leave on his own. I am trying to prevent that as he is a flight risk (ran away from my house and would not answer phone or return). He was in an ALMC lockdown facility prior to his current AL.
I am trying to avoid lockdown facilities for multiple reasons including cost.
Is anyone else out there in the same situation or was in the same situation? How did you handle?
5 Answers
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Was it a miscarriage of justice that you have guardianship? They don’t just pass those out for jaywalking. Have the siblings look up oxymoron.
I think it should be easier for them to learn how to manage a loving answer than for Dad to be told a “hard truth” over and over again.
Just trying to understand the siblings motivation. What do they think dad will do with this information? Be despondent? curl up and die? Get happy that now he knows? Do they truly believe if told he will never get out that he will drop it and stop asking them? If dads cognition is great on a good day then he already knows he isn’t going home. Let him have his fantasies..
Your concern that he will leave AL if given terrible information, seems more plausible to me based on previous experience. then he is forced back to the MC and more confinement. That may be coming soon anyway. Dementia may be sometimes slow moving but it doesn’t stand still.
We have many only children on this forum and they do have it tough in many regards but I can also see where some siblings just add an extra burden. You have to manage dad and you have to manage the siblings.
I am sorry you have this job Susan. It is never easy. I think I would ask the siblings to suck it up and I would give the siblings a version of the truth that has been suggested that allows him hope and gives them an answer so they are all on the same page for when dad presses the issue.
“Susan said doc will let you go home when you can x,y,z”
Of course, it all rolls back to you and the doc that way but hey, that’s why they pay you the big bucks....
The siblings don’t seem to be able to handle the truth themselves that dad is incompetent yet is stable and better able to handle his current reality when he has hope of someday leaving.
I have never had anyone in this position in a facility but I do have an elder with dementia that I don’t over burden with “the truth”.
To me, all we have is today. Manage today the best you can. Ask the siblings to back off and follow your lead. The job is hard enough.
I remember a woman coming from AL to live at my mom's MC last year. She was a former nurse and understood full well where she was and didn't think she belonged there. She would sit out in the courtyard alone and cry and say she didn't need to be in a locked facility, but within a week she was settled in just fine and pretty much calling the shots on the activities everyone was doing. She made friends quickly and realized that not everyone in MC is a zonked-out dementia patient who can't function any longer. Your dad sounds like he'd be among the higher-functioning people, too.
My mother's place keeps the higher-functioning folks together, and those who can't do anything much any longer do their own activities together with the caregivers. My mother started in the first group and is now in the second one, but she never even noticed that second group when she first arrived.
Look for a memory care that keeps folks separated that way, and I think your dad would fit in well.
Your dad being a persistent flight risk is a much different situation and a bigger challenge. If you go back to the reason why he went into AL in the first place you may be able to get your answer for him: "When you can pass the ADL 'test' 100% then the doctor can approve the end of your rehab"... or some such statement, etc.
Is he currently on any meds for mood/behavior? I'm not very familiar with which may help but others may have suggestions. I don't see many future options except MC lock-down for him if his flight behavior can't be somehow minimized. FYI the cost of MC can be covered by Medicaid -- you will not (and should not) need to cover it. Please find out if his current facility has MC and accepts Medicaid. If not, that's another conversation.
I wonder how common it is for residents of assisted living residents to want to return home.
Same with driving? I was extremely fortunate that neither of my parents wanted to drive again after they were told not to drive.
My dad was like I am. I would much rather walk than drive anywhere. Sadly, some people don’t live in walkable neighborhoods, or they are not in good health and can no longer walk.
Daddy looked forward to his walks. He missed his walks when his health declined further.
Some of my fondest memories with my dad are going on a walk didn’t matter where to, to a store, fly a kite, the playground, a parade, etc.
Your dad’s personal health issues are none of our business. So, I won’t pry.
Did you want the entire responsibility for your dad?
Your dad is in the right place. It sounds like you have accepted this fact and at peace with it. Of course, he can’t drive anymore either.
What do you think he would do if he knew that the AL was his permanent home? Plus, no more driving ever?
You’re concerned by your father’s inquiries about his driver’s license and residence.
Have you spoken with your father’s doctor to see if he feels that medication would calm his anxiety?
In any case, I would mention his anxiety to his doctor. What do you think about that?
Best wishes to you and your family.
Perhaps your siblings are genuinely concerned. I hope so but since you have accepted this responsibility, you have the option to speak to your father’s doctor to determine what is best for him.
You don’t need your siblings criticism, even if well intentioned. You deserve their respect and support.