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My question is whether this is something I should discuss with him while I'm researching locations, or do it quietly without his knowledge. He has always said he does not want to be placed in a facility, but it is becoming more difficult for me to care for him although I have caregivers come in twice a week for three hours each time. -Red

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Fergie, what stage of dementia do you think your husband is in? What aspects are making it more difficult for you care for him? I ask this NOT because I am opposed to facilities (I placed my Mom in Memory Care - MC- as well as my MIL and Aunt into assisted living (AL).
One alternative to consider, is to arrange for Adult Day care for your husband several times a week. This could be 5-6 hours a day! And, to bring in more help at home. MC near me is about $240/day. There is adult day care near me at $70/day. And Aides through a services costs about $26/hour. My personal philosophy was to delay placement (and the resulting run on funds) for as long as possible.
But to answer your stated question. I don't think you need to discuss choosing a facility with someone with dementia. When you are ready, check out the offerings in your region. Placing my Mom followed a hospitalization and rehab. Rather than coming home from rehab, she was brought to MC where we told her the doctor wanted her to continue to practice walking to get stronger. I was fortunate, she was very easy going and never complained or pursued the topic.
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I agree with Geewiz. Even if he’s in on the planning and touring, he will still have days when he blames you for putting him in a facility. Like Geewiz, I “lucked out” so to speak with my mom. She was hospitalized for a urinary tract infection and tested while there. It was decided she could no longer live on her own. I found a great facility for her.

Do you have family who could help you with this? It’s always good to have someone to bounce ideas off of.
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I promised my husband that I would never abandon him; that I would always be there for him, and advocate for him, and see that he had the best care. When the subject of care centers came up I'd say something like, "If it ever gets to the point where I can't give you the best care at home I'll see that you get an excellent care center, I will advocate for you, and I will spend time with you everyday." I said this many times in the ten years I cared for him at home. When he didn't want to go to Day Care, I reminded him that we both had to do what we could to make it possible for me to continue caring for him at home.

"I will never place you in a care center" is often not a promise we can keep. "I will never abandon you" is one we can.

As it happened, I was able to keep him home (with 32 hours a week help from an aide) until the end.

My mother reached a point where to get her the best care required placement in a care center. We did not share the research period with her. I don't think she would have been able to make reasonable decisions at that point. We didn't want to place her where she liked the blue walls instead of in the place that could meet her care needs best.
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Thanks to all of you who. Responded to my question. My husband is in late stage six. I've decided (with your information) to quietly check out some facilities and see about respite care for two or three weeks while I have some medical issues of my own taken care of and evaluate, at that time, where we are with his care.
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jeannegibbs May 2018
Respite first is a very good idea! I know a woman who placed her husband in a nursing home on a respite basis while she took care of her back problems. When she saw that the NH considered him a 2-person lift with mechanical assistance she knew why she was having back problems! At the end of the respite period she decided to place him there. She spent a lot of time with him every day, and when she left at night he assumed that her bedroom was down the hall. I hope you can find a place you'd prefer for long-term care that has a respite opening now.
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Fergie, great idea on the respite care. I hope everything works out for both of you. Perhaps the most challenging part of caregiving for those with dementia IS to 'get' that the person is there in body but their mind isn't what we experienced in the past. Things have to change for everyone to have the best quality available. Please keep us posted.
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