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My parent and step are both in their 80's. Step has had Alzheimer's for approximately 7 years. They live independently at the moment but I can see that step will be needing assisted living in the near future. Step-siblings are almost insisting that they go someplace together. My parent is very independent and even if they are ready for a new place to live parent does not need Assisted Living. I think it's unreasonable and somewhat pushy for them to not consider the needs of both parents. I also think they're aren't accepting the reality of their parents' future. As it is right now, my parent is overwhelmed with taking care of spouse and contemplating all of the future decisions. All of us children live out-of-town so it's not like we can take turns helping them. How can I talk to my step-siblings without losing it and still be an advocate for my parent?

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Let your parent take the lead.....I would want to stay with my spouse as long as possible. An ALF can provide more or less services for either. There are some properties that have IL, ALF and NH in generally the same property, if they can not be together because of the required level of care they can remain close
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Ernie, I think your parent has every right to stay where they are. Help arrange for care 7 days a week. Take one small step at a time. If steps arrange more care, that's a good thing. You take care of your parent, let them see to theirs. At least you both agree more needs to be done.
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I'm intentionally being vague because I'm not sure if step-sibs are on this sight. I spoke to my parent a year ago because my step-parent was obviously declining. They have a "companion" coming in about 4 days a week for about 4-5 hours. That leaves many hours including all night for my parent to be the care-giver. My step-parent is incontinent and the linens need to be changed daily.Sleeps 12-14 hours a day, very unsteady on their feet and often refuses to take meds, eat or drink fluids. Where they live now is paid for and has access to lots of activities and socializing. Last year my parent stated they wanted to stay where they were, which they obviously did. Step-sibs are looking at getting round-the-clock care which is fine as long as they don't pressure my parent to move when their parent has to.
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What I'm reading between the lines is Erniesmum's concern that her parent will be run ragged by caring for a spouse with Alzheimer's. That is a very legitimate concern for several reasons:

1. Old caregivers die sooner than those for whom they are caring.

2. In their struggle to remain independent, parents take on too many things, feel overwhelmed, but do not ask for help once they are in over their heads.

3. The step parent is getting the better end of this arrangement, which can be a difficult thing for biological children to watch.

After much, much fuss, my inlaws live in independent living. My FIL is the independent one and my MIL needs help with all her ADLs but her mind is intact. Both benefitted immensely by having onsite meal service, transportation, activities etc. but FIL's quality of life has been the most improved because he no longer has to do it all alone. Even though I was caregiving for them before they moved to indy living, FIL felt like he had to plan and/or do everything.

You say it's not a financial problem but an emotional one. Indy living is expensive and assisted living even more so. I understand your financial concerns. Will there be enough money left to care for your parent? I agree it would not be in your parent's best interest to move to a level of care appropriate for someone with Alzheimer's.

They are married and I would try your best to make arrangements that keep them together (for as long as possible) and have progressive services for when the time comes.

Focus on getting your parent the help s/he needs first because it is your parent who is overwhelmed. What are the most important services you want your parent to have?
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I think you have valid concerns. Is your parent competent? If so, I don't know that they can be forced to do anything. What does your parent want to happen? Would there be some benefit to the demented step parent to remain together with your parent? Care perhaps? There are facilities with different levels of care such as assited living for your parent and memory care for the spouse. They may not be roommates but can see each other daily. I'm facing a similar situation down the road with my folks who will need different types of care.

I would argue on the side of diplomacy with your step kin if at all possible in resolving this.

More detail would be helpful and can we talk about mom or dad instead of parent? I understand the need for discretion but some basic info would be most helpful.
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Ernie - you keep mentioning what "we want". What does your parent want?
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But you're happy for your parent to be separated from his/her spouse…

Is your parent happy for that to happen? That's the only question for both sets of siblings, when it comes down to it. Support the independent living until it becomes unsafe or impractical. From there provide options:

move together to a highly supported environment OR
move stepparent to continuing care setting while parent remains living independently.

This is an overwhelming decision, and one that must be heartbreaking for the competent parent. I can't help feeling that what all of the children should do is keep their opinions to themselves and focus on supporting whatever choice that parent eventually settles on. I'd tell your step siblings the same - it's just as important that s/he doesn't feel obliged to continue his/her caring role beyond what s/he can manage - so I hope you don't feel I'm being unfair.

By the way, though, in a good ALF a person is encouraged to maintain their independence; so there is no reason why a comparatively able older person should not enjoy very good quality of life. The Assistance is available, not mandatory. If there is a particular place being proposed, why not go and have a look at it and see how you feel about how they handle married couples with widely differing care needs - you may be pleasantly surprised. The expense is another issue, of course.
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Step is no longer competent. They addressed legal and financial issues prior to getting married. This is more of an emotional issue for us. We don't want our parent being bull-dozed into a living arrangement that is neither medically necessary nor financially prudent. We don't want our parent giving up independence when it is likely they would share accomodations for a very short period of time given the prognosis with the Alzheimer's.
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Some objective input would be helpful. Would mom & dad be willing to sit down with an attorney to plan things? They can put in writing what THEY want, they can designate a POA and Healthcare proxy, they can establish advanced care directives. The fly in the ointment is, if the Alzheimers has advanced to legal incompetency, then a Guardian hearing should be pursued. Please do not delay on this. All interested parties will be given a chance to be heard in court.
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