Should I bring Dad back to his house for visits after his move from AL to memory care?

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Should I bring Dad back to his house for visits after his move from AL to memory care?

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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.

Alzheimer's & Dementia Assisted Living Care Decisions

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I really do not think of a right or wrong answer but it does sound to me as if you have made up your mind to do it your way and that's OKAY!! If I am right this was a post from some time ago ..I do remember this post ...so Good Luck to you and hang in there hugs to you

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In-home services can help a person living with Alzheimer's and their caregiver

In-home care for a person living with Alzheimer's includes a wide range of services provided in the home rather than in a hospital or care facility. It can allow an individual living with Alzheimer's or another dementia to stay in their own home and can also be of great assistance to caregivers.

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My mom (97) has been in memory care for the last three months and has adjusted to her surroundings. I occasionally think it would be "nice" to take her out and bring her over to our house the way we did for the last six years. But, would I be doing it for her or myself? Would the few hours spent in front of the TV playing cards in our house be worth it? If I attempt to make her happy, will I only cause her sadness and agitation when she returns to her room in memory care?

I can only strive to keep her in a safe and clean environment, I can not make her happy nor can I restore her emotional well being.

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How did you know it was time to move her? My dad is 92 and I've had a couple people say he should be in memory care. He still lives in his own home with the help of part time caregivers. I go there every Saturday afternoon. Today when I was there, it was the frailest I've seen him. But he still hangs on, still manages the incoming money (I'm the conservator!) and pays some of the monthly bills from his own checking account. But asks the same questions over and OVER! He will not allow us to move him and all I can think about is the space between now and when he's in memory care --- how much 'stuff' will happen between now and then (when I took his car keys last year, it created such an outburst that we had the police there -- handcuffs, a ride in an ambulance, 3 day medical hold in the hospital). The whole thing makes me exhausted just thinking about it. And sell his house? I don't think I would be able to do that until he dies. He would insist on going through everything and he is totally incapable of making any kind of decision anymore.

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If your Dad can't remember that he was at his house 10 minutes after you head back to the AL then I say don't continue to take him back to his house. The stress on you is too much. BTW you seem to be doing an excellent job of taking care of him.

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I do think you are doing a wonderful job. I think you will know when it is no longer a good idea to take him to his house. Or, you will determine that he is running out of funds, as memory care is expensive -- and you may find that other arrangements need to be made for the house.

Please be sure to think about yourself and your needs. You need to build and enjoy your own life as well.

Other than that -- follow your heart and your good judgment.

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My opinion is that you enjoy doing it for your Dad and you manage to get your consulting work done while you are with him. Even if he cannot remember that he was at home for a week, you will be at peace because you did your best for him. Keep doing what you are doing. God see your heart. Enjoy the last years with him

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You know your father better than anyone, and memory care is a term not an experience. Your dad seem to enjoy the time he has in his home and that should be , in my opinion, the way it works for you. In the end, and our elderly love ones want are family, friends , and some sense of Peace and for one week a month, what's the harm of having and spending that time together in an environment that works for you. Memory care is important, but he has dementia which effects his memory not his overall health. Forgetting what happened 10 minutes ago is a memory issue not an illness like diabetes or congestive heart failure. That is the catch 22. Doctors see the medical terms and not the individual that may handle their dementia without medication or one size does not fit all. My mother was the same way. She could hold and intelligent conversation, eat, laugh, etc.. but she still could not remember if she watched a program on TV or took a bath that day. If your father knows his home than what is the harm of keeping up this routine that works for you all. Sometimes it is the costs of care that concerns these facilities, so please do your research and continue to manage his funds and care, and make decisions from experts but also your intuition.
Again, one size does not fit all, and as the decline becomes more evident, than you will make the arrangements of providing more care on a full time basis. Please research also of signs of the end of life to know the non-medical signs of knowing what to look for as your father comes to the end of his life. God bless you for being a caring and engaged daughter.

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Do as you have been doing lately and spend a week with him … don't pay attention to the Memory Unity Director. Think that your father will be looking forward to being with you and that if he doesn't see you he'll be sad, anxious, depressed, irritated -- don't give up, try finding a good and trustworthy housekeeper who could help during the week that he is home with you.
God bless you, you are an excellent daughter! Good luck!

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You have made the best of a bad situation and if you are prepared to keep up what you are doing, do that. My sister and I take turns in taking dad back to his home for a half day visit once a week as that is the only place he ever asks to go when we suggest an outing. At home he waters his plants and sprays for bugs and even does a few minutes on his rowing machine. Many people told me this would confuse him and was not a good idea but he tells us how much he enjoys those days and never complains about going back to the nursing home (he still remembers that is where he actually lives). If this becomes too much work for you stretch out the time between the visits as he will not know how much time has passed. Best of luck, you are doing a wonderful job.

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Wow! I feel blessed to have so many comprehensive, thoughtful, and caring responses! I'm sorry that I can't answer everyone individually, but I really appreciate all the advice and kind words. So many of you are doing so much while still dealing with kids and spouse that I don't have to worry about.

I appreciate the advice about moving him closer to me, and that's probably in the future. Where he is now is his hometown; we have local family and life-long friends that come to visit him, and in his long-term memory, which still works pretty well. If I bring him to live with me, his social circle shrinks to only me. I hope he's still able to continue living where he's familiar for a while. However, I've been shopping for skilled nursing facilities near me, since I think that will be the next step, and I want to have a plan ready.

Dad's cognition hasn't declined that much in the past year; it's strange how this happens--he can still beat me at checkers, but he can't begin to play scrabble (used to be good at both). He knows every melody and lyric of obscure country songs from the 50's, but can't remember where he slept last night. He cleans the kitchen counters better than I do. This hasn't changed much in the past year.

I'm starting to worry more about him getting physically weaker. Over the last two years, he has fallen several times; he's always been able to get up by himself. That's why he said he didn't need Medic-alert. I tried to tell him he's been lucky that he hasn't broken a leg or hip. No sale. So, I went with a tech solution with sensors and text notifications (I still use the door alarms when we're at home).

Thanks again for your helpful responses.

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I really admire what you are doing and say that if you enjoy it and it makes him happy then don’t stop. My experience taught me that my Dad went downhill fast in the memory unit and I will always regret not bringing him home and instead listening to what staff and family thought was best. He always asked to go home, even his last words to me were: “Come on, let’s go”.
I will support your beautiful efforts. You are giving him so much happiness that he deserves. God bless you dear. He probably loves being with you too. These days of his are prescious and to be cherished.
Maybe you can get help from the VA or Medicaid and get him a live in aide. Not so hard to manage from a distance. My friend had one for her mom and she was wonderful! If you can find one he could probably go home and he could wear a device that locates him if he should wander. Alzheimer’s association gives 24 hour counseling to care givers regardless of the type of dementia. Good luck!

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Is he confused about the moving to and fro once a month? I would think this may confuse him even more, BUT NOT TO A PERSON WITH DEMENTIA. I am concerned about the wandering. I am also concerned about your own wellbeing. So as he ages, this may not work. There may be no magic answer,

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I think y'all have a great arrangement! Sure wish we had kept our mother's home.

My experience with memory care is that no matter what your concern is, they tell you it's the dementia. Like your dad, my mom remembers things and I Know she does.

Best of luck to both of you!!

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NO. DO NOT TAKE THAT AWAY FROM HIM. LISTEN TO THE SOUL OF A GOOD CONSCIENCE AND IN YOUR TIME OF NEED, AN ANGEL WILL BE THERE TO LEAD THE WAY! AND STAY THE COURSE!
COPPERTINO

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I'm going to answer this first and then review the other answers. Just buried my father and if I could have given him what you are giving your father, I would have. Moved my father (also at 91) directly into Memory Care from his independent living apartment of 14 years. He did not want to move but he was having falls and with the last one he could not call for help on the medical alert button, so laid there until I found him the next morning. We moved all his stuff into Memory Care while he was in rehab and went directly there. 2 weeks later, I drove him past his old apartment building and he didn't know it. Never completely bought off on the idea that memory care was his new home. Thought it was another transitional place and "home" was probably where he grew up. But he did miss family life and wanted someone to stay with him. This is the part you are able to give to your dad that I didn't. There was no way he could live with me; I couldn't lift him if he fell and could not be there 24/7, nor is my house easy for someone in a wheelchair to navigate. But being caged all day in memory care with nothing to do isn't a great quality of life. Your dad is stimulated by return to family surroundings if only just to putz about with the reassurance you are there. If you can do and want to, it is a real gift to him. But it is also a lot of work for you and his house sits empty 3/4 of the time. I wanted my Dad to have a sense of community after living alone so many years and I think he did eventually adapt to it. They should have activities, be flexible to his needs, be trained in dementia behavior (including hallucinations) and you can help foster that community for him. You might start calling that special week "vacation" and transitioning him over to full-time memory care.

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so sorry for your loss of your dad. I too, went thru it with dad and mom three weeks later. I will keep you in my prayers.
lizzy

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Ok.... I'll try not to be too negative here...you're doing a great job it sounds like managing a difficult situation...I'm a nurse of 30 years have worked in long-term care. Am a mental health therapist and lost my mom two years ago and she was in a dementia unit. if I were in your situation I would encourage the staff to be part of the solution rather than part of the problem. By this I mean what if they start talking to your dad the day before and help him anticipate making the change. What if you leave a photo album in his room that shows his house. He and you in it doing activities... and they talk to him about it and show him pictures from time to time? I made a box for my mom and had memories from her earlier life on small pieces of paper and they would read these and talked to her at times. She enjoyed it... And they got some ideas about who she was when she was younger... Maybe the activities department would have more ideas... Hope this is helpful...

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Having been through this as well, I would say follow your instinct and also do what gives you the most time with your dad. It is difficult (or it was for me) to spend a ton of quality time with my mom at her AL. It sounds like for a week out of every month that you and your dad are happily enjoying eachother. That is such a treasure. Believe me, in the end you will not beat yourself up for the little things, but you might beat yourself up for the time you did not spend. I think what you are doing sounds beautiful. it doesnt matter if he forgets it 10 minutes later. The only regrets I have from my time as my moms caregiver are the times I could have stayed longer and didnt, and the times I felt resentful because I was stuck with such a burden. When they are gone the love you shared truly is all that matters.

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Somtimes you have RIP THAT BANDAID OFF. Once it's off, it's over. He will be fine whereever you move him.

If its easier for you, and I know you want to see him, he is your only family from what I read, so move him closer to you. Who is going to argue?

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Why rip it off? Things have been fine as they are. He has friends who visit him where he is. Linkabit is happy to provide him a pleasant week once a month. Braggdeb has good advice. Unless and until he suffers somehow from their time together, why give that up, why take it away from them?

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Its confusing him, he doesn't know why he is being moved constantly. He doesn't understand... To him, moving to AL every other week is unnecessary, he has a home, why does he have to go back to AL? mom's saying, GO HOME GO HOME GO HOME....That is heart breaking. I couldn't do it anymore, keeping her at her home. She lived 2 minutes away from me. I moved her into a board n care about 2 miles from me. then I moved her to another board n care 2 minutes away from me, another street other than her original home. I also moved my aunt into the same facility - 2 minutes away from me. See... 2 minutes away from me.. When I left the morning to clear my head, the morning she was passing, I got there in 1 minute. The nurse heard the door open, looked at her watch and pronounced her death time. For me, location,location, location - 2 minute drive for me. I bet you, if you did your homeowrk,, and found a memeory care unit near your home, the both of you will be okay. Your dad is losing mental compacity. So, move him. Then you can visit him possible every other night, if you want, and he will make new connections with new faces and make new friends. You don't need to rush into it. Call around find a place near you that is feasibly close enough to see him every day if you have to. Or every weekend. Talk to people or family who has people in these places that you are going to see. He doesn't have to move right away, so take your time and find a place close to home. It will be okay. He knows he is losing control over what happens, and sometimes that is the hardest hurdle to get over.

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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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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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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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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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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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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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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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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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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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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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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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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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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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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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Should I bring Dad back to his house for visits after his move from AL to memory care?

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