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My family is in quite a dilemma as to whether or not my father should return to the country where both him and his wife were born. He is 95 years old, suffers from dementia and lives with his 85 year old wife of 48 years also suffering with dementia. The relationship between his wife, my sister and I has never been good and has caused a terrible strain with all of us.....that's actually putting it mildly.


We totally want her to go back and be cared for by her daughter as she won't be looked after by us but they also want my Dad to go back as well. They have promised him everything and making it look like the grass will be so much greener if he goes back. They will live with her family and they've promised should anything happen to her they will take care of him for the rest of his life. They have arranged everything including health coverage, easy access in their house, etc.


They should never have made these promises to him because no one knows what's going to happen in the future. Second he will more than likely never see most of his family again and knowing this is just tearing us apart.


We are very angry that they discussed this with them before consulting the rest of the family here and the fact that they have waited until this late stage of his life to do this. They should have done it years ago when they were still of sound mind.


If he goes he's going to be unhappy leaving his family and if he stays he's going to be unhappy leaving his wife. My mind is in turmoil as to what to do, one day I’m saying for him to go and then next I’m saying he should stay.


Right now they live in AL but we do have their names on for long term care at which time they will most probably be separated anyway.


Do I want to deal with the fall out should we split them up or do I let him go knowing it will more than likely be the last time we see him?


I'm so angry that they have put us in this position and will never forgive them for doing so.


I might add that I think they're crazy attempting to take care of 2 elderly people both with dementia and they don't realize what they're taking on. Unfortunately he will not be able to return once he goes as his name will be taken off of any waiting list for care and he wouldn't be able to return to AL because he could no longer afford it without their combined income. I couldn't take care of him as I am looking after my husband who also is starting this horrible journey with dementia and I know how difficult it's going to be with just caring for him.


Even though I have POA for him I know that I cannot legally force him to do something he doesn't want to do unless I have him deemed incapable of making decisions. I don't want to go that route as forcing him to do something that he doesn't want to do will only make things worse after.

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Yikes. How terribly difficult for you.

I understand you might not want to go into too much detail, but it would help to know what sort of country the home country is and what the logistics both of moving the couple and of ?visiting later on would be.
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Sorry - I only just noticed "they will live with her family."

Come again? They're thinking of moving an elderly couple with dementia into a family home following international relocation?

Good luck with that...

When did they last come to see their mother?
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givingup1 Nov 2018
Exactly Countrymouse…..good luck with that is exactly what we say, they have no idea how difficult this is all going to be for them. Taking care of one person with dementia is bad enough let alone 2. They have their home all equipped and ready with stair chair, reclining chairs, personal space ie: sitting area. They have all appointments set up for Drs. optician, social workers, etc. They did a quick visit of 3 days in July to "assess" the situation themselves without even telling us they were coming, prior to that their last visit was about 2 years ago. I would say in the past 38 years since they left the UK they have seen her mother perhaps about 10 times between them coming here to Canada and her Mom and my Dad going there to visit. I should say that mother and daughter talk on the phone on a regular basis and have done for many years.
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What country are they going to? For us, the Philippine is really cheap for long-term professional care. Most of our people go to the P.I. for their annual check-ups, cancer treatments and surgeries. I know that several people have also sent their parent or husband with dementia to the P.I. for professional care. Because the cost is soooo much cheaper than here in the USA. I see nothing wrong with this because airfare can be as low as $375.00 to fly roundtrip to check-up on your loved one - like monthly, etc...

With regards to your father, is it possible for one of you to fly there first and check out 'home' situation? You go to the facility, the clinic, etc... Then you go back home, and have a heart-to-heart talk to your father and his wife. Ask leading questions to see what it is that they 'comprehend'. Then go from there.
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Many or most of us here have been faced with the horrifying decision of “forcing him to do something that he doesn't want to do”,
If you have not had a thorough comprehensive assessment of his cognitive status, done by a professional psychologist or psychiatrist trained in the evaluation of geriatric clients, the time is now.
You may find this very helpful as a tool for considering making the best of all terrible choices concerning your father’s future, At the very least, it will serve as a baseline for considering his potential for decision making as you move forward.
As hard as it is, you and your sister also must consider his situation as objectively as you possibly can. Unfortunately I am dealing at present with something quite similar, and the stress on me, as a POA, is unbelievable unless one is personally enmeshed in such a situation.
As difficult as it would be, I think you must at least consider assuming legal guardianship, especially since you don’t seem to have a full and accurate picture of what his life in his home country would be.
Whatever you ultimately decide as to how you will continue, arm yourself with as much specific diagnostic material about his mental condition as you can possibly acquire.
If a PROFESSIONAL has previously described your father as having dementia, that designation inherently IMPLIES difficulty with decision making, and since you indicate that he acknowledges being aware at some level that his present situation is in some respects a “lose-lose” for him, you and your sister MUST make
the best of all terrible and unfair decisions regarding his lifestyle. That’s what confronts all of us who care for and dearly love someone who has dementia. We can only HOPE that they made many joyful, self-affirming choices for THEMSELVES during the lives that they lived independently, and that their choices of us as POA allow us to serve them as the decision makers they can no longer be.
I think that thought many times a day. The LO for whom I care saw me lovingly address the needs of my wonderful, stubborn, dependent/independent mother for 10+ years, and participated herself in my mom’s care. She then chose me as a POA who I think I can fairly assume would faithfully carry out her care needs.
I STILL lose sleep about doing what needs to be done for her, and she vacillates between being relatively comfortable/relatively anxious in her very good AL, but
backed by a good quality psychiatric exam combined with the love and respect I feel for her, I do feel empowered to make the impossible, “no good solution” solutions for her.
I hope for you and your sister that you will be able to find a similar place for yourselves. I see a therapist, pray, and visit my LO often. This also helps.
Sending positive thoughts to you.
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PrairieLake Nov 2018
This is an excellent answer. To remember-our loved one trusted us enough to give us POA when they were competent. This reminds us that they trusted us to make the tough decisions when they were no longer able to do so.
It is a great honor and responsibility.

The first ability my father father lost was executive reasoning and problem solving. Not memory, not daily living skills.

He needed someone else else to make those decisions for him even though he did not see that. I am glad he trusted me enough to work our way through the year long process in getting him somewhere where he was safe, and cared for.
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My sister is married to a man from another country. His family is scandalized that my 89 year old mother- who has no physical or mental deficits- does not live with one of her children. It's just not the way things are done in their country.
They may not have any hidden agenda other than caring for their mother and the man she loves. Givingup1 states that separation is in the couple's future if they stay here. He or she also points out that when in complete control of his decisions, her father chose Givingup1 to make these decisions for him. So I'm sure Givingup will make the best decision for him. But I wouldn't completely discount letting the mother's family care for them. In my sister's husband's family everyone has help. Maids, gardeners, nannies. It's not as expensive as it is here to get full time care in the home.
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They have tickets to fly them back to the UK with their belongings which won't be much other than their clothes. They do not have much in the way of furnishings as they downsized and got rid of a lot of their possessions when they moved into AL. Because of everything that has gone on there is now a lot of animosity between the two families so when it comes to visiting I'm not sure how that is going to work. I know I will not stay in the same house as I'm so angry with them at putting us in such a terrible position, something I will never forgive them for. Also with dementia how long will it take before my Dad forgets my sister and myself?
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anonymous594015 Nov 2018
The forgetting happens. You can't stop it. My step-MIL's local children visit frequently now that she is in a nursing home. She thinks they are people who work there.

Best of luck to you. I think you made the decision your father would have wanted.
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I am so, so sorry.

You really are between a rock and a hard place, and I cannot see any cranny for you to wriggle out of it.

But you know what? Your Dad made his bed 38 years ago, has lain on it happily and at this point - it's not a question, for once, of whether it's better for him to stay with you or go with them, not because it isn't important but because it's literally impossible to know.

So the question, then, is: do you really need this utterly thankless task?

I doubt they will let any harm come to him beyond what is going to be inevitable in any case through the one trauma - moving - or the other trauma - separating from his wife.

I should let him go. With your blessing. And the best of British luck to them.
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givingup1 Nov 2018
Thank you for your input Countrymouse. I have decided to let him go with our blessings because either way there is going to be fall out from it. As much as we don't like his wife and would love to have been able to take care of him without interference from her, something my sister and I have not had since they got married, I realize that they've been together for such a long time and she is going to be the one that he is going to miss as they're together 24/7 and there would be repercussions should they be split up. I am just starting this dementia journey with my husband as well so adding all of this to my life would be a recipe for disaster for me. You're right, he made his bed many years ago, even though he regretted it.....another story altogether, but there's nothing much I can do now.
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Not 38. 48. All the more so, then.

Um. When he did last set foot in England?
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givingup1 Nov 2018
I'm taking a guess and say he was last there about 9 - 10 years ago.
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I am assuming here that Dad never became a citizen of the US? So he has a British passport? Since he hasn't lived in England for years, how does it work for Medical over there? Who is going to fly with them?

I agree, get them both evaluated before you make any decisions. All Dementia patients want to go home but it may be a place they lived at one time not where they are going. Dementia people no longer reason or can process. Once Dad is diagnoised and found incompetent, your POA kicks in. To be honest, I doubt if this is going to work out since Dementia people do not do well with change. At 95 there will be a decline.
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Countrymouse Nov 2018
It slightly depends where in the UK they are, but in general, if he was born in the UK and still has family here...

I'm not sure how to put this without making everyone concerned sound inept, but I can imagine it just wouldn't come up. Not unless they need local authority funding for his care. He'll have got an NHS number with his birth certificate. They might be a bit sticky about updating it, but they're not going to refuse to treat him and I can't see them being very efficient about chasing up bills afterwards even if he is technically a Canadian citizen - and in fact, there may well be some kind of reciprocal arrangement with the Canadian health authorities.

Whatever happens, it definitely isn't going to rebound on GivingUp1. So at least that's one thing not to worry about.
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It might be difficult at this point to be constructive with the people who want him, but could you ask that one of them comes for a longer visit first? ‘Three days to assess’ doesn’t sound like more than a physical assessment, ie bed, chair and stair lift. Did they live with the two of them around the clock on the visit? Even if they still decide that they can handle it, it would be good for everyone if they have a better idea of what your father and his wife need, and what they are taking on. At a minimum, they should be accompanying them on the trip, and spending a few days with them before hand. If either your father or his wife become very disturbed by the changes, they may not even understand who these strangers are!
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givingup1 Nov 2018
It's like talking to a brick wall telling them they've no idea what they're taking on here. Her daughter has said that she's worked with elderly in nursing homes before and knows how to take care of them. How many times can you tell them that doing an 8 hour shift in a nursing home vs taking care of elderly parents 24/7 in your own home is completely different? My Dad and his wife do know who they are as they have kept in touch with them constantly by phone so I'm not worried that they might think they're going with strangers. They are coming on Friday and spending time with them before accompanying them on the flight back.
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Givingup1, perhaps this might be one of those social occasions when it's better TO talk about politics and religion.

How long before the flight back? Do you have any time scheduled with your Dad?
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givingup1 Nov 2018
Yes I'm done with getting upset and seeing him flustered. I have been making small talk and this works for him.
I will be saying my goodbyes a couple of days beforehand because I think leaving it to the last day would be too upsetting for us and for him. Sad to say that I usually don't have long to visit with him on his own because she get suspicious if he's away from her for too long......domineering control freak. I have no intention of trying to coerce him into staying, like I said I'm no longer prepared for the fall out that I'm pretty sure would happen if he were to stay.
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GivingUp, if you'll forgive me, especially following your last reply about health and support set-ups, I have to say that as projects go Stepsis has managed this one pretty well, no. She does seem to know what she's about. That has to be a good thing from your Dad's and her mother's point of view.

If she'd identified a better, earlier time to discuss it with you, would that have made it easier on you?

But what it does leave is the fact that she's pinched your Dad. Again. Well, dam'!
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givingup1 Nov 2018
Like I said Countrymouse this should have been done 5 - 10 years ago when they were still of sound mind and their bodies more mobile than they are now. It certainly would have made it easier then because he would have made it more clear to us what he really wanted to do. As it's been this past couple of weeks, he's been yes I'm going, no I'm not, yes I'm going, no I'm not so has put us in this very difficult position as to what to do.
I'm not too concerned about the care he will get from them as I know they won't let him come to any harm but I tend to look at the "what ifs" and worry about what will happen should they not be able to manage him or if something were to happen to them, where would that leave him? I know we can't predict the future and I shouldn't surround myself with the unknown. There has been much hurt from my father over the years and my sister and I have always both stuck it out but this just seems like the final "kick in the gut" so to speak, where he's putting others first, as he's always done, even though he's not really of sound mind. I know she's his wife, unfortunately, but I can honestly say they have never had a blissful marriage right from the beginning (his words plus many more to me over the years)
Yes she's done it again and there's not a whole lot I can do.
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Givingup1, what a painful situation to be in. You really are dealing with a great loss here. I hope that in this situation you build in support for your own (and your sister’s) emotional needs. There are family therapists who specialize in helping people who are dealing with the the aging or illness of a loved one. And some who work with families, not just individuals. I went with my brother to a therapist to help me deal with the overwhelming decisions and work related to our mother. It has been very useful for getting perspective, practical ideas on how to handle specific situations but also to deal with issues that are rooted in the history of our family. In a way this move will feel like you’re experiencing your father’s death. And there is so much history that you have alluded to. I hope that you will find a therapist to help you through this transition.
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givingup1 Nov 2018
Thank you for your advice Ljanoe, it is, like you said, like experiencing my fathers death. One thing this has all taught me though is the importance of planning. My Dad and his wife never make any plans whatsoever about anything.....finances, care, their final wishes, absolutely nothing and I am angry at them for leaving us to have to deal with all of this.
There is no way I will leave a mess for my son to sort out when my time comes. All the i's will be dotted and all the t's crossed so everything is in order.
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Haven't seen anything regarding their physical health and ability to make the trip. I recently traveled to Europe, as a 69-year old in relatively good health. The 8-9 hour trip in economy just about did me in. Can they handle the trip?

Also, unless they have a direct flight, is their mental capacity such that they could find connecting flights in a strange airport? Will they be able to get through customs on their own?

Is either incontinent? That could present serious problems on a long flight.
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JoAnn29 Nov 2018
They will have wife's daughter with them. I live near Philly so a flight to England is nonstop and at night. Hope no one sundowns.
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Givingup, one thing that I read in your responses is that you and your sister were hoping at some point to actually have a dad that gave you his love unconditionally and actually thought about how his actions and choices affected you.

No matter where he lives, you will never have that. He made choices for himself and that can not be changed, he no longer has the ability to think of anyone other then himself and his wife. That he would complain about her to you, yet always choose her is a form of manipulation. He was trying to not be responsible for how his choices hurt his children and it seems to have worked.

Any time he could have divorced his regretful choice, yet he never did. Hm? However, he did gain your sympathy and your willingness to put up with him by these tactics.

Im sorry you did not have a dad that gave you the care and reassurance that a loving caring dad instills in his children. It is what it is, be thankful that her family is willing to deal with him. You dodged a bullet in my opinion. I would send the stepsister flowers and fruit of the month membership.
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givingup1 Nov 2018
As much as I would like to say that's not true, I can't help but agree with you.
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So many elders wait till the "virtual eleventh hour" to make decisions about their living conditions. Who am I to say where they should reside, but WOW, what a major change if it were to go forward?
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I think you should let them go together. That being said I really hope your stepsister realizes that a trip like this is going to send the both of them into a decline. I speak from an experience of taking a road trip with dad and spending a week with my sister. We did this twice, the first trip when we returned the decline was very obvious and seemed to last about two months before it leveled out. The second trip it wasn’t so obvious but it was still there. The adjustment they will be making is going to have an effect on them, so I hope she is prepared for it.
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givingup1 Nov 2018
I'm sure you're right Glendaj2 and I don't think she really realizes this.
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Will you check in with us over the weekend, GivingUp? Hugs, thinking of you.
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givingup1 Nov 2018
I will do.....although something else has happened which is totally going to change things now. My Dad had to go to the hospital last night as he wasn't feeling good. He's hemoglobin count was pretty low and he had to have a blood transfusion. Because of this, flying on Monday is out of the question and will be until things are stabilized. Right now I have no idea what to expect as, come Monday, her family is preparing to take them back to the UK. They are well aware that my father cannot go at this time so I don't know what they are planning now. I guess I'll deal with it when the time comes.
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As long as they are together that is the primary relationship to be protected.
Does anyone have POA for his wife?

I have heard the "You can stay here forever" "I love you" "Will take care of you" from the step-family.
That lasted a year. One is bereft of finances and assets were taken.
Those plans did not happen, each parent is alone now, one in AL.

Keep them where they are as long as possible. Hiring private caregivers to come to them in AL has worked well for some.

The wife should stay with him where they are, imo.
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Surely, this is an ever changing situation, and now that your Dad was hospitalized, the doctor may not reccomend he leaves the country.

Take a deep breath Givingup.

You are in no way responsible for his wife or her family.

And since you cannot physically care for Dad, you can get him help, not be the help.
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givingup1 Nov 2018
Trip for him is off as per drs recommendations. She's going (thank goodness) and he's staying. If in a months time, should his health be ok and he really wants to go then we'll talk about it then but for now he stays put.
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Oh crikey. Well, as they say: "if you want to make God laugh, make a plan."

I hope he's feeling a lot better after the transfusion, and I expect he will do, at least for the immediate present. From there, goodness, it's anybody's guess isn't it?

Here we are in your corner, anyway. Thanks for the update, hugs.
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Your Dad and step mom are planning to move permanently to the UK on Monday.
There are no options available here. Dad will refuse to stay in Canada alone and you have already stated you already have a husband to care for. Stepmom will not want to leave without him (after all she too has chosen to stay in the marriage) so if they stay you face the future with three demented elders in your care. Things will not stay the same. Shortly they will not be able to live independently so one or both will need more care. They will not necessarily be separated at that point. Many couples share a room if they want.
Healthcare in the UK is much complained about but I doubt the complaints are very different in Canada or the US so that would not be at the top of my worry list.
Stepmom's family has already demonstrated they are willing to make adaptions to their home and have actually done. No empty promises there.
Presumably they also have the funds to afford a property large enough to comfortably make these changes and will the able to support Dad and SM.
I do not know how pension and healthcare rights transfer from Canada but they do from the US as far as pensions are concerned.
Do you think the family can afford sufficient help to provide decent care when the parents need more skilled nursing care or institutionalization?
Dad may in fact be very happy returning to his country of birth as probably will SM but only time will tell.
I agree things could have been handled differently and it would have been nice if your family had been part of the decision making but you weren't so try and make it a pleasant transfer for the pair.
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Givingup: Thank you for the update, Big Hugs coming your way ((( ))). Those are difficult days.
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givingup1 Nov 2018
Thank you Llamalover47. Yes these past few days have been agonizing for us . The Dr. has said that flying is definitely out of the question right now so thank goodness that decision has now been taken care of. In just the short space of time she visited this afternoon I could tell the effect it had on my Dad. He was pretty good this morning when I was there but when I went back this evening I could tell he was stressed and I firmly believe it was because of her visit this afternoon.
Daughter and son in law have arrived and preparing for her return on Monday. In 36 hours she will be gone.....the end of an era.
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If his hemoglobin was low enough for a transfusion I think you need to really talk to the doctor. Hemoglobin carries oxygen thru the blood. Low levels are not good. He may need oxygen on a regular basis.
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So did they go, and leave him behind?

How's he doing today? Hope he's feeling better.
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