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Parents with dementia were moved to assisted living and now they want to go home. They were deathly ill at the same time and I took the opportunity when they were in the hospital to make the transition to assisted living. They have been in this wonderful place for 3 months and decided that they are not as old as the others there and are not supposed to be there. They both have multiple medical and cognitive deficits. I want them to be happy but I know that is not going to ever happen considering their condition. They play off each other to get agitated. Could they be home with a full time care giver? Yes. I would probably have to be more involved yet again. It's been very very stressful for me when they were at home. They don't eat properly and often end up sick from one thing or another; dehydration, over eating, over drinking, skin problems, pneumonia, cellulitis. All the stuff that can start off benign and get bad if not attended to. They have been better at assisted living. Not sure if it would be worse or better at home if they go back there.

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Do you think they might be willing to look at other ALs? If they are not happy there maybe they can tell you specifically why and perhaps a different AL of their choice might work. Or, can you talk to the staff and see if they can get your mother involved in some "ladies" activities, and your father with other men, also get them to attend some group events. It could be once they have a little more time there, make friends they will be happier and have a feeling of belonging? Three months is probably not long enough for them to adjust.

It sounds like your parents need to be in AL where they have 24/7 people to help and monitor them. With multiple health issues, if they go home, it would only be a matter of time before one or the other would need more care and maybe even need to go to a NH, which is a drastic transition. The good thing about AL is that spouses can remain together or at least very close. Most AL's have memory care or nursing care attached so the transition is not quite so traumatic.
My mother was in an AL where they had an attached memory care unit for those people who no longer were semi-independent. Yet, they included them in the dining room and entertainment so they were still "home".
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I would consider a few things. One being that they may not really be talking about going home to the place they lived previously, no matter what they say about it. Often dementia patients will be in their own home and still complain of wanting to go home. Sometimes, even walking out and away from the house they live in. So, I'd consider that. Would you have the ability to keep them in the house around the clock.

Also, in their own home, they may not be as happy as you think they might be. The home may hold a number of potential problems, that they may be protected from in a facility. In the home, struggles with them overeating/overdrinking could be more pronounced and thus a challenge to keep a caregiver. You would need to proof the house to keep them safe.

You say one outside person would be required, but for two people who are agitated, resistant and with medical problems, you may need 2 and then multiply it by 3 for 3 shifts. And what if they come in late or don't show? Do you have backup? I'd consider how dependent you would be on that outside help.

And eventually, you would need to modify the house with things for their safety like grab bars in the bathroom, larger doors for wheelchairs, ramps, etc. It's a lot to consider.

If doing all of that would definitely make them happy, then, I think most people would try it, but, depending on their phase of dementia, contentment is often illusive.

I would discuss their agitation with their doctor to see if medication might help. And I'd ask for a team meeting with the director and staff at the AL to discuss their situation. Working together, you might be able to help them settle in more.

I would also explore if the level of care they are getting in the AL is sufficient. My cousin struggled soon after going into regular AL. Her needs increased rapidly and she needed more hands on help and attention. A move to MC made all the difference. It was amazing how much more at home she seemed there. Just something to keep in mind.

I hope you find a solution.
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Hillarious, just curious if your parents still understand the cost of things?

If so, you would need to stress that they would need around the clock caregivers and that could cost them $20k per monthor $240k per year [to make it sound worse] if using a private licensed Agency. Living in Assisted Living or Independent Living would be half the cost. But if your folks are in denial about their age and heath/mobility, you might hit a brick wall. My late Mom was always in denial.

My Dad was happy with being in senior living compared to his home, but he was concerned about the cost. Once he learned he was saving half, that helped settle him down. Of course he enjoyed all the attention he was getting at senior living because he was such a nice gentle soul that the Staff just loved him.

Dad didn't need to worry about shoveling the snow... didn't need to worry about the power going out as the facility had their own generators.... Dad's mailbox was inside the building, so no walking down the driveway in all types of weather... he liked going to the main dining room for supper with friends he made, it was like going out to a restaurant without having to go out :)
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Don't move them back, they will get sick again. They have gotten plenty used to having someone else to cook the meals, clean the room and pass out the medications. Socialization significantly prolongs their lives and that would be gone too. Your peace of mind affects your personal health. So what is best for all of you is to keep them right where they are.
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Ask for the people watching over them at the ALF to help you assess whether they could really manage at home again. Hearing it from someone else that they should not be on their own and what their cognitive level really is may strengthen you to make the best decision, or maybe if they are partly right, how to deal with that better and be happier where they are. Many people with poor judgement due to early dementia will decide they do not need caregivers and fire or refuse them, putting ALL the burden back on you again. I would be very surprised if the answer is sure, they are competent adults and perfectly safe to go back home and do what they think they want... but it is hard to objective when they are YOUR parents and you love them, and harder still to be the one that says "No" to them even if it is the most unreasonable thing in the world.
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Your parents want to be independent. They probably want to be 30 years younger and healthy, too.

To quote my mother, "You don't always get what you want." Did your parents say that to you, too? It is time to apply that to their wants. Of course you want to give them what they want as much as you can. But not if what they want would put them at risk, present health dangers, be prohibitively expensive or otherwise just not be feasible.

You want them to be happy. Of course. Strive to find other ways to increase their opportunities for happiness right where they are. Moving them would not ensure their happiness.

(Parenting your parents sucks, doesn't it?)
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