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I live in an apartment building for seniors, and moved my dad across the hall from me when he retired and showed the first signs of dementia. That lasted a year, and due to wandering at night and the need for more social interaction, i moved him to a small retirement home where he has done well for just over a year. He has started exit-seeking and wandering again, and has become more confused and is on Seroquel, and has been assessed for a nursing home. Another issue is that we are Dutch and i am the only one who speaks Dutch with him, and going to a larger nursing home will not be good for him in many ways at this point.
I am thinking that the best thing to do is to move him in with me, and take a leave of absence from work. I live in a big 2-bedroom apartment and he still knows it and loves my cat, and of course feels very comfortable and safe with me. I am a PSW myself, and can arrange homecare and respite care with the Alzheimer's Society in my area, and can work on my BA in psychology that i've been working on part time for a number of years while working.
It would be ideal if i lived in a house with more space, and perhaps i can rent a house and move into it with him, but my question is really, is this realistic, and sane? His need for social interaction is less so that isn't an issue anymore, i'm looking at what is best at his diminished level of functioning. He still goes out with me to a local park, still knows me, has trouble speaking and finding words, can't tell time anymore, needs constant supervision but also naps off and on during the day.
Any thoughts? Anyone else who has a parent in this condition/stage and has them at home? Any advice or input would be most welcome.
Thanks very much,
Helma

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Bless you for considering this. Your father is very lucky to have such a caring daughter.

In some ways, having Dad living with you might be very good for him. And taking this opportunity to work on your degree might be good for you.

But ... how long can you afford a leave of absence from work? Your father is relatively young. You don't mention other chronic conditions. This could go on for 20 years!

Dementia gets worse. Wandering may increase. Total incontinence may be part of the picture. Sleep problems may develop. Dad may no longer recognize you. Perhaps he will have mobility problems. I know that you will continue to love him through the progression, but caring for him 24/7 will take its toll on you.

Dad may reach the point, if he isn't there already, where 24 hour supervision is required. Having trained people available, in shifts, who are well-rested, get breaks, can call in backup help instantly, and who have lives outside of caregiving, may be best for him.

Caregiving one-on-one in a private home, 24/7, is VERY isolating. What about your own need for social interaction? I am glad you are thinking ahead to respite care and homecare. Will that be enough to provide some normalcy in your life? I doubt it. But think it through as best you can. Imagine yourself two years from now. You have your degree. You are back at work. You work a full, demanding day while someone else is in your apartment with Dad. (Will finding someone else who speaks Dutch be feasible?) You run errands on you way home. You come into your apartment and greet Dad (who may or may not know you but who will probably be glad to see you.) The paid caregiver leaves and you start dinner preparations. You have to stop and change Dad's disposable underwear. He tried to do it himself and its a real mess. After dinner you do laundry, taking Dad with you because he can't be left alone. Later you go through all the preparation for bed, helping Dad with his hearing aids, brushing his teeth, changing his underwear, and getting him into pajamas. Now you finally have some time to yourself. It is 9 pm. Tomorrow will be a repeat, except you have to take a half day off work to take Dad to the doctor.

If you are working that relieves some of the isolation for you, but 24/7 caregivers have an extremely hard time maintaining a social life.

Read about caregiver burnout. Understand the pitfalls of what you are contemplating for yourself.

If Dad goes to a nursing home, you are not home free as far as time committment and stress levels go. You will be his advocate. You will see that he is getting the best care available, and work to resolve it when something is interfering with that. You will visit him often and regularly. If he is an early riser perhaps you will have breakfast with him on your way to work. Maybe you'll have dinner with him a few days a week. One caregiver I know tucks her loved into bed each night, reading to him and soothing his anxieties. You will take him on outings to the park. You will bring him to your apartment occasionally. You will still be an integral part of your Dad's care, and that still impacts your social life. But chances are good you could still have a social life.

You need to consider not only what is best for Dad, but also what is best for you. You are each unique individuals, fully worthy of the chance to have a fulfilling life.

I wish the best as you struggle with this difficult decision.
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terrimerrits: Over and over again I've seen adult children, overwhelmed with their parent's care and struggling to maintain their relationship with them, who have re-found the joy in their relationship once the stress and worry of keeping their parent safe and healthy was shared with an AL or SNF.
Please stop characterizing people who have chosen caregiving as their profession as being wardens of a "warehouse for disposable humans." That is as false as the opinion of those who say that adult children keep their parents at home only to preserve their inheritance. You are entitled to your very strong opinions about caring for parents at home, by you are not entitled to disparage others for making the equally loving and equally appropriate decision to care for their parent at a senior facility.
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Thank you both for these wonderful comments. It is strange how even though i have already been through some of the caregiver burnout when he was living across the hall from me (he used to knock several times a night on my door, thinking it was time to go on an outing, and i only worked part time to be able to be with him more) i tend to think of only the benefits to him, and forget about the severe restrictions on my own life. It is just so heartbreaking not to do the absolute best thing for him; and it is Alzheimer's that he has, can't believe that i didn't say that specifically in my first message, it started as suspected vascular dementia but has in the meantime been properly diagnosed. My grandmother had the same thing, and stayed at home (in Holland) with a son until the very end, and i think i have that image in my head, of my dad being allowed to putter away at home in a limited environment as he declines. There is nothing wrong with him physically, and this has gone very quickly.
I really appreciate your thoughts, and do recognize that this is also about my difficulty with placing him in a "final" setting, one that looks different from what i was raised with, even though i work in this field and know that this is probably best for him, to be in a facility with 24/7 care.
Some days this is more difficult than i can bear, and yet i read about others who seem to have it much worse, and i really feel for them and consider us to be lucky in many ways. My dad is very upbeat and positive and has no aggressive behaviours, and is easy to please when i can spend time with him.
@jeannegibbs: Thanks very much for pointing out what i will still be able to do with him, which is largely what i do now already. I think this is part of the grieving process, to want to "fix" it all, but it can't be fixed. We can only do what we can sometimes, but accepting it is a completely different struggle some days. I would rather do more and work harder, than deprive him of what i can give him, but it would become unmanageable at some point, and he is already used to living with others around him now. You are right that we both deserve to have a fullfilling life, i tend to forget that sometimes in my worry for him.
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Helma, While I totally understand you wanting to help your dad, there are definitely problems on the horizon if you take him to live with you. I worry about your ability to work away from your apartment, while all the time wondering if he's going to start a fire or wander off etc. Plus he's going to keep getting worse with the dementia, though no one knows at what rate that will be. My friend lives in a low income apartment for seniors/or disabled and she tells me there are many people in her building that don't speak English. Most of those people are either Asian or Russian but she's able to get the idea as to what they need or want if she keeps at it. So it is possible for your dad to communicate to those that are willing to listen. I guess my point is, sit yourself down and go through all the scenarios in your head about your dad living with you. I think you should take the time to think of the worst case scenario as to how it could possibly go having your dad live with you, and see if you can do it. It's going to be much harder to move him out of your apartment/house and into asst living or whatever, rather then move him while he's already living apart from you don't you think? I tend to be more logical I guess, so that's how I would approach it. Good luck either way.
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@terrimerritts: While i appreciate your acknowledgement of my being a loving and involved daughter, i really don't think it is acceptable to make the judgemental statements that you have made here. All nursing homes are not warehouses, (i won't even repeat what else you said there, too offensive to me) but i do think that smaller group homes are a much better environment for many older people.
In Holland, my grandparents moved into an assisted living house, a small townhouse close to a hospital and nursing home wing, and received PSW support daily. Here in Canada, the Alzheimer's Society is working together with Community Living (for the mentally challenged) to adapt their group home models for those who suffer from dementia and Alzheimer's Disease. These are two examples of assisted living care that are better than a large home with a mix of people, but i can assure you and anyone else that i have worked in and seen nursing homes that are wonderful, supportive, community-supported and compassionate places for the ill and elderly without family.
Thanks for the link to Exelsior College.
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@krnhersh: I'm sorry, you misunderstood. My comment was not in response to your comment.
If your mom is in a nursing home where she is being mistreated or her care is neglected, you certainly should 'make some noise' about it. Meet with the executive director of the facility, hear their view, share with them yours. Itemize the issues, and agree to a plan for improvement. Make an appointment at the meeting to sit down again in a month or so and review progress. If your mom is still not receiving better care at that point, make plans to move her to another facility.
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Thank goodness!!! How unkind she was!!!
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Thank you, EGLord, for a very sensible, compassionate response. I am in the tenth year of caring for my husband at home, with Lewy Body Dementia. (Tomorrow is the 39th anniversary of the day we publically proclaimed "for better and for worse, in sickness and in health.") I have promised him over and over that I will always see that he gets the best care available and that I will never abandon him. And we have also discussed how that promise might be carried out with him in a facility where round-the-clock professional care is available if that need arises. I will not keep him home when that is against his best interests.

The notion that a nursing home is a warehouse is only valid if the family uses it as a warehouse.
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OMgosh! Does that mean she's been banned? How does that happen? Her comment hasn't been deleted though.
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@everyone: thank you so much for your comments and for sharing, it is so incredibly helpful to read about your experiences.

An update: my dad is moving into the Dutch-speaking local nursing home in four days, on Tuesday July 31st. I got the call about a bed available in a Dutch-speaking home the day after i posted here. I keep crying, while driving to work and while telling anyone else about it, but i have to be very honest with myself that it is partly relief that i am feeling as well as grief that it has come to this point. My dad will be all right with my involvement, as he is still able to enjoy other people's company. I had already taken him on a tour there a few weeks ago, and he liked the semi-private rooms, the cozy look of them (it is a really nice place, small but very homy) and that is what we have been offered for him, so he will have company rather than sitting in his room alone. It is a very well supported NH in the community, with very high volunteer involvement, and i am adding myself to that list now as well.
I do already provide him with a "Dutch connection" by taking him to a dutch grocery store in another town, speaking Dutch with him, and having hung up dutch landscape pictures and stocked his bookshelf in his current place with dutch books. He used to go to the library and pick them out, but now he doesn't want to take out new ones when he has so many himself, as he says.
I do think this is the best situation, as i can keep working but spend a lot of time checking on him, and can still take him out and enrich his life while he is supported there 24/7.
I'm glad that someone who was inappropriately critical of nursing homes was confronted in this thread; the last thing we all need is to compound the guilt and grief with someone wagging their finger at us with judgements.
It is true of this, as with so many things, that unless you have experienced someone with Alzheimer's or dementia, it is impossible to know how all-encompassing the demands on our energy and time is. It isn't that i have chosen myself over him, as i used to worry about, but that if he knew what i was thinking about this, he would be the first one to say that i can't take on too much and that i need to have my own life too. He did say that once, last year, and it broke my heart to hear him say it, but it is true.
I'm very grateful that we have a good situation and that his health is good otherwise, and that he isn't suffering. I have to see this as a new adventure for him, and will support him all the way.
Thanks again for your comments and support!
Helma
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