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My 91 year-old dad has been in assisted living for two years; he had a stroke five years ago, and was diagnosed with vascular dementia shortly thereafter. He had been living by himself since my mom died 13 years ago. I live 500 miles away in another state. I have his POA, and I arranged for his Veteran’s benefits as his fiduciary. I’m a widowed, childless, only child, so it’s just me and him. We talked about moving him to be closer to me, but he didn’t want to leave his friends and family who visit him often. He thinks he can still live by himself in his house; the reality is that he doesn’t remember to take medicines, he doesn’t make meals, and he hallucinates and sometimes wanders the neighborhood at night. To stay in his house, he would need someone to stay with him full-time. I wouldn’t want to try to manage an agency or private caregivers from 500 miles away. I can’t move in with him because I would have to quit my job as an IT consultant and that would jeopardize my future retirement.


The solution we’ve settled on is that he stays in the AL for three weeks each month, and I work at my job back at my house. One week each month, I pack up my laptop and drive to his old house (which stands empty the other three weeks) and pick him up from AL and bring him back to his house for the week. I work from his kitchen table, while he watches TV or does his house chores like sweeping the porch or tending his plants. I cook and he washes the dishes; this isn’t “show timing”, he does this consistently every week. We have a regular restaurant tour, and I usually plan activities, such as ball games or fishing trips.


This has worked for the past two years. He doesn’t remember what happened 10 minutes ago, so he forgets about being at the AL by the time we’ve driven away from it. I have given up on explaining to him why he can’t stay in the house by himself anymore; I just drive him back to the AL which he doesn’t recognize until he gets to his room. Then he remembers and wants to go back home. Leaving him there breaks my heart; but I know that he’s safe. I always worry that he will be a problem for the staff after I leave, or have to go through an adjustment again. I always ask the staff after I go back how he is doing or if he is any problem; they always say he’s not any problem; he’s usually forgotten about anything that happened that week. I have a caregiver from a local agency who visits him (she's my "eyes and ears" on the facility); she reports the same thing.


During this past two years, Dad’s cognitive decline has been slight, but noticeable. The staff said that he has periods where he hallucinates (thinks his wife or mom is in the hospital) and tries to leave the building. The staff said he tried this a few times last month, and they recommended moving him to the memory unit. I took him to see his behavioral neurologist and family physician; they agreed that it was a good idea since it is a more secure unit and there’s a higher staff/resident ratio. I moved him last month.


The memory unit director doesn’t think taking him home each month is a good idea. She said that Dad needs to think of the memory unit as his home now, and that what he really means by “home” is his childhood home.


I don’t agree. Dad can tell you the address, street by street directions, and show on a map where his house is. It makes him happy to be there. He built or worked on everything in the house. Now, he just talks about what he’s going to do, he’s not able to actually do any work, but at least he can be “on set” for his walks down memory lane. He says that’s where “his memory is” and “where he should be”. I can’t make it happen 100% of the time, but I can make it happen for one week a month.


I don’t want to take that away from him.


I’m preparing for a care conference when I visit next week. Any advice appreciated.

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I personally would do it as long as he is safe while there.

If he doesn't cause any problems when he returns I can't see a problem.
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It sounds like it has worked well in the past. As long as he settles back in I would take him home that week. It’s wonderful you can have that time with him. If he begins to have problems you can always stop.
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What the memory care unit director is telling you is sound advice as far as it goes. It generally holds true for people with advancing dementia that they do better with a structured routine in an unvarying environment. It helps to minimise their disorientation in time and place.

But your concern is not what is generally true, it is what will best support your individual father's quality of life. And you are at a tricky juncture when it comes to knowing what the answer is.

The main drawback is the constant switching. In a perfect world, a genie would pick up your father's house and relocate it to where you live - and staff it with a 24/7 care team, of course. His connections with it are going to be even more deeply embedded than most people's are, given that he built it. He isn't (yet) recalling home as where he grew up.

When you visit him and it's time to set off to the house, is he expecting it? If you didn't prompt him to get up and go, would he remind you?
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Linkabit14 Mar 21, 2019
Hi CM,
You're right about it being a "tricky juncture". That's a good question about if he's expecting to leave when I arrive to pick him up at the AL facility. The last time, I handed him his coat and he asked where we were going...

Then, other times, the first thing he asks me is why he's not at his house, and when am I going to take him home?

Thanks for the reply.
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Really tough call. Try to remember that you do have a long distance relationship with him, not full time. Makes a difference. It is good that you have hired caregiver to be your eyes and ears. You’re a wonderful son. But how often is caregiver there? Still isn’t 24/7. The people in AL are the ones who see him the most and have a clear picture of what is going on the majority of the time. Keep communication open with them.

I can’t speak to ALZ or dimentia like others. My mom has Parkinson’s without dimentia (may happen in future, who knows?). Hard to know how important routines are for your dad specifically. Some say routine in general is important so switching him back and forth is not a good idea. That’s so tough to figure out. Just curious...Did he like routine before ALZ or was he more ‘laid back, easy going’ kind of guy? Still, you and he have to adapt to what is best for him, even if it’s difficult. Not easy to do.

I wish you and your father well. You sound like you research carefully so I would trust your decision.

Has to be hard doing all of this from long distance. Obviously it is important to you to have a relationship with your dad.

I read about placing a camera in AL. Do you see a benefit to that? What does the caregiver do besides report back to you? Is it becoming harder for your dad to manage overall? He sounds fairly independent with little supervision while with you at his house or am I wrong in assuming that?

Is it that he is becoming confused at AL after being home for a week? Is the flip flopping getting to be too much emotionally for him? Is there a quiet area for you to get some work done at the AL? You can still be nearby and he may find comfort in that.
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Linkabit14 Mar 21, 2019
Hi NeedHelp,

The routines don't seem to matter to my dad because he can't remember what happened 10 minutes ago.

The AL facility will not permit cameras in the facility; it's written in the lease. I'm not too worried about his treatment there because my aunt and two of his friends are there. This is a small town, and they all grew up together.

Still, the facility has changed ownership once since he's been there, and there was a lot of resident assistant staff turnover in the AL floor of the place. I've met everyone that works in the memory unit, and they have all been there for at least 3 years. I'm hoping he'll like the memory unit better since he's getting more attention.

Thanks for the reply. Best wishes to you and your Mom.
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Seems to be working for you. Some people with Dementia don't do well with change and its hard to get them "settled back in". Dad doesn't seem to have that problem at this point, but doesn't mean it won't change. You can voice your concerns at the meeting.
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Although I want to say keep taking Dad home as long as it's not causing problems, your comment about his wandering concerns me. When he's home with you and you are sleeping, what monitors do you have to alert you if Dad goes wandering outside the house during the night? Or maybe when you are working? As a fellow IT consultant, I can get so focused on my work that an hour or so can pass where I kinda lose track of time unless something interrupts me. Could Dad walk out the door while you are working and you only miss him 30 minutes later? I used a security system that "announced" anytime an exterior door was opened to keep track of young children and elders during my waking hours and always set the alarm whenever I planned to sleep - even during the children's naps. You may need something similar the next time you take Dad back home.
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Linkabit14 Mar 21, 2019
Hi TNtechie. Yeah, sometimes it helps to be a techie. :-) While he was still living by himself, he refused to wear a "medic-alert" wrist band in case he fell. So, I installed door alarms and motion detectors throughout the house, along with security cameras, and used a service that would text me if they noticed anything (like not moving in the bathroom for four hours). Not ideal, but it worked. I left all the sensors, so I get audible alerts and text messages if he gets out of bed or his chair. Also, I can just listen. The house is pretty small. He has never wandered a single time while I've been with him.
Thanks for your reply
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Oh Hi Linkabit!
I answered last night but didn’t notice it was you and your sweet dad.
Last year you were dealing with his auditory hallucinations. At that time it was a radio he heard. You were contemplating memory care then.
I think you are exceptionally tuned into your dad’s needs and I love that your life is manageable with your spending a week with him every month. I wish everyone could manage elder care as well as you have. Such a great balance of keeping him safe and allowing him to spend time in the home he obviously loves.
So good to see you back on the forum.
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Linkabit14 Mar 22, 2019
Thanks 97yom... I feel bad that I don't contribute much here; the consulting business keeps me busy pretty much full time. The support that reading this forum provides is wonderful.
Thanks again.
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I'm sure their recommendations come from experience with most MC patients and I'm sure for most they are absolutely right. However it sure doesn't sound like the transitions are hard on your dad or you and the 3 weeks in and one week home are working really well for both of you still. I am so impressed and touched by your pattern and can hear how much it means to you as well as Dad to be together in that house so my vote is keep doing what you are doing. He is obviously the exception when it comes to transitions/moves and if you need back up they should talk to the staff in his AL wing since they can confirm it is good for him and not a cause of issues. You are so in tune with your dads needs as well as your own and you will know if and when this isn't a good program anymore. Maybe he doesn't wander at home with you because he is so happy and his mind doesn't have the need to search for anything or anyone else. If this becomes less enjoyable and problematic for you don't feel any guilt about deciding that's the time to stop either, I really believe what works so well here is how happy it seems to make both of you. Keep following your instincts!
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You're doing an amazing job. I'd say that as long as you can give your dad these one-week visits, do it. It may be harder on the nursing team when he returns, but it's all about him at this point, not their convenience.
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Continue doing what you are doing or are Going to Do, My Angel....I have a Dad who is Alone at His House But a Sister who will Do anything to Make sure he is Happy and Contented and to Prolong His Own at Home Quality of Life of no Strife.
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If you can continue to spend the time, and this makes your dad happy, do it. Sounds like this makes you happy too. These will be the last few moments you get to spend with your dad. At 91, tomorrow is promised to no one. After he's left to be with his wife, trust me, you will be happy you did. These last few remaining days or months will be fresh in your mind and YOU will remember how happy you made him.
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It doesn't seem to me that you have to make a permanent decision yet. Is there any reason you can't try taking him home for a couple of months? And then, if he has adjustment problems returning to the memory care unit (which we know he didn't in the AL unit), you can re-evaluate. Unless the memory care director is threatening to expel your dad if you take him for a week, I think it's lovely that you're getting to spend the time with him, and that he gets to continue spending time in the pace where he's happiest.
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Lymie61 Mar 24, 2019
Yes, she can't take him home for a couple of months block because a big part of the success and point here is that he gets to live in his long time home for these excursions. His daughter, the OP, I believe lives and is rooted 500 miles away from his home (and his AL/MC) and while she is able to do her work one week out of every month from a distance it isn't something she can do more permanently or for 2 months at a time. I agree with you that her ability to find this balance allowing her to spend this special time with him and keep him in the place he is happiest as much as possible is a blessing (for both of them) and should continue as long as it works. My guess is this program is and will help him adjust to being in AL/MC full time when the time comes too. It's such a nice gentle way to move him into that, at least it is for him I know it wouldn't be for many patients.
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If your dad had Alzheimer’s dementia, the MC director would likely be correct about your dad wanting to go to his childhood home. But he has vascular dementia, and that’s what makes this different. He knows where his home is, he knows when he’s there. Sadly, many people with Alzheimer’s, if not most, would still want to “go home” even if they were sitting in the living room they grew up in.

Unless the MC director can give specific examples of how the trips home negatively impact your dad (not them) when he transitions back to MC, then there’s no reason to stop taking him home. His wants and needs are what’s important here and as long as you’re able to meet them, it all works. The caveat here is if his transition back causes him distress and this manifests as agitated behaviors. That’s not a good feeling for him.

If you’re really wondering how it would impact your dad to miss his once/month home visits, you could see how he does with not taking him home for a month.
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You’re amazing! What a great job you’ve done looking out for your dad! He’s truly blessed to have you. Unless and until these visits either become too hard for him or you, keep doing what your doing. You’ve found a balance that works, so hard for so many, congrats on it!
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Bless your heart! Follow your heart. My 85yo mother with advanced dementia was in MC, and now in a nursing home. Institutional care is just that--care based on institutional norms, which do not take into consideration individual situations. As long as your dad isn't (or doesn't become) unruly or overly emotionally distraught when you take him back to the facility, and as long as you continue to find peace in doing this for your dad, blessings to you and all your efforts.
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It is so hard when someone has Alzheimer's or dementia my mom had it and I regret to this day not spending more time with her back towards the end she had fell and ended up in the hospital and I brought her home her wish was always to live in her house so I quit my job and moved in with her and my dad took care of her till the end which was only about two months after she had fell. Now my dad who is 94 is having troubles and on oxygen and Home Health and I am doing the same thing with him cuz he can't be alone ...so follow your heart do what you need to do for that what you think that they would want or what they have told you in the past cuz you can't go back and change.
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Most most of the time I think that monthly visit would just create confusion, but it's been working for you and I think you should continue to try to make it work. I understand what a sacrifice it is to go for a week a month I did that for several months last year before my parents both moved to AL together. I KNOW it would be too hard for my dad to adjust going back and forth between their home and the AL each month but you've proven it to work I think you just need to tell the new director that. Follow your heart.
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Linkabit ;Hello! Wow this is a difficult situation do you have any opportunities to transfer to a company thats not 500 miles away ? I cant even imagine any other way unless you take a different job in the area dad is in what will you do when his disease progresses more It only gets worse and worse ? What if your dad moves out of the NH you move in with him and the money he is spending on the NH you and Dad can live on , thats a pretty penny to live in a nursing home?the two can be comfortable on that kind of money ..good luck to you!!
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I have been where you are twice. Except I was in the same town. Unfortunately, there comes a time when it is best for our loved one to establish a new home and adjust to it.
As your dad progresses with his dementia and he will, he will need to feel like his new place is home. It is so hard for you to watch, but it will be the best for him.
My mom went two times back to her home because my dad couldn’t tell her “no.” She did okay the first time, but the second time she got really confused after returning to the facility and then threaten to commit suicide. Now, she wouldn’t have, but she got overly confused and couldn’t process everything.
She ended up in a behavior ward for a week. That was the worse week I went through with my mom, she was this 5’1” little 72 year old woman and surrounded by alcoholics and drug addicts. She was safe, she didn’t know why they were there, but it was very heartbreaking for me.
I know this is hard to hear. Your dad could be different and for now he does ok when you take him back.
My concern for you and him is what could happen.
My suggestion is 3 fold. One is to keep him where he is and let him adjust to it.
Two is to continue to do exactly what you are doing, but understand that at anytime it could change. Three is to find a place near you and move him now before he goes down more with dementia. He will have time to adjust before the processing and confusion gets bad. You will be able to see him more and do things with him. Bottom line is no matter what you decide, what he needs most is your love and your friendship. What you need is to know he is safe, comfortable and getting good care.
Since I’ve been though this once with mom then my dad, both have passed on, my choice would be to have him near me.
He may not like it at first, but just talk to him, tell him your thoughts. Let him know that although you know he wants to be at home, you just cannot make it happen for him. Tell him you want him near you so you can be together more. Bottom line, time together is larger than any house. Good luck, I know it is hard. I’ll be praying for you and your dad. ❤️
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So many helpful answers that I won't repeat. Sometimes, I feel that I am managing my mother's mood. Doing things that help her to feel loved, connected, useful, uplifted. She also can't remember 10 min ago. But not true for everything. Very positive or very negative events - she does recall. I think on a cellular level - even if your Dad doesn't remember the week - he remembers the love, sense of security and familiarity. It's a better quality of life.
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i commend you for doing so much for your father!!! You are fortunate that your job has such flexibility.
If your dad is private care, which I assume he is, then you will be ok with your plan. If he is on Medicaid assistance, it may not be possible to do that. I’ve heard there is a stipulation about leaving the facility for more than a day or so.

I personally, think moving forward, it will be hard to get your dad to go back to the facility. I hope it doesn’t get to that, but if it does, how will you handle that? They can be very stubborn and hard to handle as the disease progresses. (So sorry)

I pray for wisdom for you!!
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As many have stated so far, it sounds like what you are currently doing with your Dad is working well for him and for yourself, at this point. Ultimately you know your Dad the best, and are looking out for the correct signs of reaction to change. Change is handled differently at different stages, and when that reaction to change creates more issues than it solves, then perhaps that is your key indicator for not taking him home. At this point, he is safe for that week. He is active and participatory. And the transition has minimal impact, for him or the staff.
Perhaps it is finding the balance of "when" it is the right time to end the week home visits. Defining what those signs look like, and how to make the transition easier for him. For instance, bringing his favorite chair, some of his plants, and a few things he built himself so that his mind still finds familiarity.
Be sure to mention the differences with your Dad (he can tell you the address, etc), provide context for the Director and try to partner with her expertise and with your insight about your Dad's personal situation to come to the best solution.
I hope that the care conference goes well!
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The first year or so my mother was in a nursing home (where she probably didn't belong, but the only AL in the area was full), when my sister and I were visiting in town, we would bring her back to her house (about 10 miles away) for a few hours where our father was still living. She seemed to enjoy it, and when it was time to go back to the NH (which had sort of a "curfew" at 8 PM), she was the one who was most eager to get back there in time. I guess this is a "mini" version of what you are doing, and it appears your plan is working very well, too.

I believe the bottom line is that each case is different.
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I think what is working for both you and your dad (though it sounds hard for you in all truth) should continue while you are able to accomplish it. My brother is now looking at a move to assisted living. While his space was down to a trailer in a little historic trailer park, he so loved it and had his space and garden so perfect. He doesn't really want to return to it from rehab, because of the severe grief involved. I think what you have to do is what works best for both of YOU. If it were having negative repercussions for staff at facility that would be another thing, but doesn't seem to be having that.
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If he’s trying to leave AL and they are referring him to MC, you really can’t believe his once a week trips aren’t confusing him. To stay a week then return, the entire adjustment begins all over again, and I don’t get how his mind hasn’t been scrambled. The “cost” of the trips home may have added to the elopement need. Let him settle.
Please have an open mind for this meeting.
And to the suggestion you move him in with you, oh Lord. Don’t jeapordize your income and work.
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My apologies my initial response was no doubt too harsh.

May I ask your indulgence once more, I can not feature a MC that even allows this. It’s not just about your fathers return adjustment, they have state regulations and other residents to consider, which would be highly confusing to them. I’d bet his returns are going to be very different going forward. Maybe move him closer to you idk, but AL really didn’t have a chance of real adjustment.
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Lymie61 Mar 24, 2019
I'm sorry I guess I read the OP very differently from the way you do. It sounds to me as though the transitions back and forth from 1 wk home with loving daughter and 3 wks in AL haven't been a problem for anybody in the last 2 years. 2 years seems like plenty of time for adjusting and he has adjusted just fine. I'm sure you are correct that MC is not at all used to this kind of set up but they have a track record within the same facility/organization to prove it's been working and I'm not sure how it affects the other residents. I don't think distance from OP is the issue. Dad accepts having to live in a facility at all and the majority of the time by the way, because he gets to spend a week at home in his own house with his daughter one week at a time, moving him closer to her and keeping him in MC full time may be the most disruptive thing she can do right now. When he can no longer make these stays at home with her that's another story and this poster is way too in tune with her dad and his needs to not know when it's time for a change and make the necessary adjustments. That's the way I read it anyway.
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Wow! I wish I was that good a daughter! My dad is 92 and still lives in his house. He really, really should be in assisted living but refuses to move. I was told recently that he is bordering on memory care. We bring care in 6 hours a day 6 days a week and I take care of Saturday's. His dementia is getting worse but he just hangs on trying to keep things 'normal' at his house. He hires people to help with the yard (he lives on 1/3 acre) and the caregivers clean his house. I have guardianship/conservatorship but he still has enough going 'upstairs' that he helps pay the bills (we've allowed him his own checking account). But he forgets soooo much now. In my own selfishness, I wish he would allow us to move him so I could sell houses, his 2 cars, and just focus on HIM. I spend too much time worrying about house and car maintenance and I really don't want to. Of course, I have a husband, my own house, my own cars, work full time, grown kids and I'm a grandma. Many days I really wish I could get out from under my dad and go back to a 'normal' life. You are to be commended. I wish I had your patience.
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Lymie61 Mar 24, 2019
Babs is your 92 year old dad still driving both of those cars? You do have a lot to cover...but I would say YOU too are to be commended, your realistic wishes don't minimize that or your continued commitment to his care and wishes.
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You are my hero. The love and adoration you have for your Dad comes through every word of your post. Know that whatever you decide, based on all the information you have, is the right decision. I am preparing to place my husband of 39 years in a Memory Care community (the word facility just sounds wrong). I'm not sure what is more stressful--caring for him alone at home, or the idea of leaving him in a strange environment being cared for by strangers, initially. There just are no easy answers, solutions or alternatives.

Blessings to you and your father.
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Invisible Mar 24, 2019
I, too, didn't want to leave Dad to the care of strangers, so I got immersed in his memory care community to know who the other residents were, their families, and the aids. You end up caring about them and they care about you.
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None of this is easy, is it?! I can only tell you my experience. Perhaps it might help.

There is one phrase that you typed, and it is very important: “but I know that he’s safe”. As the POA (and fellow human being), that is job #1. Always keep that in mind, as you plan going forward.

If your dad does not have a problem with the way you are currently doing things, then I would say continue. Keep in mind that as your dad’s condition in the area of dementia continues to decline, you might consider ending this travel to home. I took my mom, who had advanced Alzheimer’s, home for a weekend. In her mind, she thought it was a permanent move. It was all I could do to get her back into the car and take her back to the nursing home. I was scary. I will never forget it. So, monitor your dad’s dementia and overall condition.

If there would be a physical problem at home, do you have a backup plan? For example, if your dad would fall, do you have several people you can call on to help lift him back up? These are simply things you need to plan for.

So, as for taking your dad away from the nursing home, I don’t see a problem, as long as you have planned carefully, since his mental and physical condition will continue to degrade.

I am also single with no children. What I found with my mom was that it was much easier to take her on vacations with me. Even when she had advanced Alzheimer’s, and was in what turned out to be that last six months of her life, I would take her on trips out of state (though only a couple of hours away, should there be a problem). Taking her back home would have been a problem, but going on a vacation or short trip is something she could grasp and somehow continued to know that she would not stay and would return home. Home, then, became the “apartment” at the nursing home.

I hope this somehow helps.
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My mother sounds maybe just a little farther than your dad now but about like your dad when she moved initially to independent living facility. She hated it but eventually it was “home”. Now she has a very hard time settling in after a move or change. I kind of agree with the AL director. You are prolonging the inevitable and now , when he is still somewhat lucid , he could make friends and really settle in since the facility really is and will be his home. While your heart is in the right place, you could be making it more difficult later.
Take his own furniture etc to the AL, make it as home like as possible. But it just upset my mother the few times she went back to her house after moving. Imo a clean break is easier in the long run
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