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Became father's caregiver when my mother was hospitalized. My mother has been the primary caregiver for my father, who has advanced dementia. She was hospitalized and is in rehabilitation. In the meantime I have been caring for my father. I had an aide come to the house but that became too expensive. My father has his good days but his bad days are scary. I know he has a disease but he can become angry and won't let me change his clothes. He won't let me touch or bathe him and he really needs to get clean. He has refused a bath from the home health aide. It is really becoming a problem. I feel like I am way over my head in caring for him. Is the next step a memory care facility?

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Yes, the next step is a memory care facilty. His care will keep getting much more difficult.
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Yes, it's time for memory care.
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Caregiver burden is real and can be significantly detrimental to your own physical and mental health. While taking on the task of caring for your loved one is admirable, it should only be considered after a considerable amount of thought and hopefully consultation with a doctor, Elderlaw attorney and Senior Care Advisor. Knowing what to expect and the needed reactions to events is critical to success for all involved.
There is great physical, emotional and monetary stresses that occur when being a caregiver, even overseeing a caretaker(Aide)is burdensome, taking tremendous amounts of time and focused energies.
Know how these burdens will affect your life and that of your family as well. Many caregivers find relationships with friends and loved ones have deteriorated due the burden brought on by becoming a caregiver and or overseer.
All options can be or are expensive, especially when related to memory care. In home care is expensive, yes however so is Memory care in a facility/community. Research your state; go to you state website on Ageing. Find facilities and communities that work for you demographic, then reasearch their care/violation history. No missed steps in safety. Reach out to a Certified Senior Advisor (Certified and insured), one in which zero costs are associated with their consultation; discuss all options that meet your medical, financial and personal needs/requirements.
Once you have your information on all costs associated with a community, then compare with costs of home care, utilities cost of home, taxes etc,. Usually it will be a break even or close.
Then it's either you are steadfast in your resolve to take on this burden or you let trained, skilled professional take over. At that point, only visiting and love is required by you. Good Memories continue to be made and expanded socialization for your loved one begins. Giving them the best possible route in their travel through this unfortunate turn of events.
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I suggest you watch some videos on bathing from Teepa Snow. You might get some ideas. I am sure it is difficult for your father to have someone other than his wife undress him or attempt to wash him. I know it was tough for my mom at a certain point. For her, I think it was like being molested.... Think how scary... Someone touching in an area you have guarded your entire life. Not knowing how far advanced your father's demensia is, I am not sure what would work for him. Some of the strategies we used earlier on were to get a shower chair, be sure the room was warm, start the shower, and cox my mom to come take a shower. I had a Terry cloth robe ready when she got out. We had a hand held shower sprayer. Later, when she really didn't like the shower, the sound and spraying water became scary, we would have her sit on the bedside commode with the bucket off and sitting on the floor. I could use peri-bottle with warm water and no rinse wash to spray her off down under. There are adult wipes that can help to clean under arms, etc. You will just have to use lots of patience and trial and error to discover what will work for your dad. Good luck.
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I can speak from experience when I say that caregiver burnout is no fun. When a caregiver starts feeling overwhelmed, the quality of care and patience with the one being cared for starts lacking. Sometimes there just isn't the "mood" when trying to clean or bathe a person who is resisting to cajole them into cooperating and turn the experience into one akin to visiting a spa. When my mom, who had dementia, didn't want to do something, no amount of convincing would change her mind, and she would eventually become combative. Luckily, the staff at the NH knew how to hand,e her bahvior.  I did not.  Granted, a person who is home bound and fairly inactive doesn't need a complete scrubdown 7 days a week, but I've had days when I am definitely not "in THE mood" to change, clean, bathe and change linens for my husband. That can coincide with the days he is "in A mood". Even though your mom will be released from rehab and return home, will she then be able to resume caring for Dad? Does she sincerely WANT to? Should she? One of my (many) fears is that something will happen to me. I have 2 children but having them care for their Dad, who is bedridden and basically can only feed himself, would be an impossibility. I have been advised by the wonderful people on this site to consult an Elder Attorney and find if there is a way for us to qualify for Medicaid so my husband can go to a facility. He does not have dementia, but he will still make life miserable for everyone if he is in a facility but at this point, it's him or me. You say his behavior on his bad days is "scary" and that's a red flag and an indicator that it's time. In my mom's case, her mental state just continued to decline and the bad days became more frequent. Start looking now and compare facilities. Apply for aid if you need to. Basically get all your "ducks in a row" so there will be no doubt or hesitation in your mind or manner when the time comes.
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There is a big difference between cranky and scary, is he violent?
You need to look after yourself first so you can continue look after him, and it isn't acceptable to excuse violent behaviour just because he doesn't know what he is doing. If you can't control his outbursts with the help of his doctor then he may need a facility, or a short stay in a geriatric psych unit to find the optimal medications to help him.
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Yes, it sounds like it is time for a care facility for Dad. It will probably be best for your mother, too, for him to be cared for elsewhere, but she might not see it that way.

Not everyone with dementia needs memory care. Some do well in assisted living and others need a nursing home. Memory care (a secure environment) is needed for people who wander, and also people with behavioral problems that would be disruptive to other residents in a regular environment.
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demstress, I am concerned about your Mother. Was her hospitalization due to being your Dad's caregiver? Was she doing this all her shelf with some minor help? There comes a point where the primary caregiver becomes ill just because of physical and emotional needs of your fathers, thus the caregiver will crash and burn from exhaustion.

Of course, some elders will say they can manage without any help, many of us have been that position, when reality they can't manage at all.

What does your Mom think about Dad moving into Assisted Living/Memory Care? Can they budget that amount? Cost are in the ballpark of $6k per month, depending on where you live. Now Medicaid [different from Medicare] can step in an help to pay for Dad's care at a Nursing Home.
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I am assuming ur female. If so, your father in times he fights you is lots stronger. You could get hurt. I give you lots of credit but once he needed to be bathed or toileted, I no longer would care for a man unless he was my husband. I have brothers that could take over that job. Talkvto Moms doctor. Tell him the situation and that you find u will not be able to care for Dad indefinitely and you r pretty sure Mom can't. He may be able to help you with options.
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Demstress, I totally agree with Hugemom. Your dad sounds a lot like my husband. I understand "the Mood" is not there when you get so stressed out and your loved one is not cooperative in their care. I started looking into memory care in March and just placed my husband this week. It takes time to go find a place, meet with them, figure out finances and prepare your heart for the move. I found the place I wanted immediately but there were lots of ups and downs in the process. I was on a waiting list and when I was ready, I was at the top of the list. I also suggest talking to the doctor about meds to help you dad's mood and aggression. I would not have made it the past year without it. The facility will also assess him and some may not take someone who exhibits aggressive behavior. So getting him on something to calm him will help. My husband is doing well so far and I am getting some rest. I visit every day. Your mom may have a hard time with making this decision but you can do a lot of the info gathering and and be her moral support. I have been so thankful for my two daughters and their help and support.
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