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My brother who is 84 is caring for my sister-in-law who has Alzheimers. I would say she is pretty far along in the disease. I live over 500 miles away. He is getting where he cannot deal with everything. He has the upkeep of their home, meals, laundry and the care of the home on the outside. Everytime he mentions moving to my sister-in-law's she says she does not want to. She is at the point she does not even remember she has any children. I am afraid for her if something happens to my brother. They could move to an independent care facility now, if it would not set her back. The care-giver is important in the whole scheme of things as well as the patient I would think. Thanks

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Sorry, again just couldn't read all the posts. So if I repeat...
At 84 even having help may not ease his responsibility. If he is willing to move, then help him do it. She no longer can think reasonably or make decisions about her care. I think at this point, an AL maybe better.
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A person with dementia may decline after a move to a different environment.
A person with dementia may decline in the same environment with little new stimulation and social interaction.
A person with dementia may decline if they are separated from a spouse or familiar caregiver.
A person with dementia may decline if their spouse or caregiver is stressed out from the caregiving.

The fact is, people with dementia decline. It is the nature of the cruel disease. Naturally no one wants to do something deliberately to make things worse, but trying to prevent decline may not be the soundest basis for decisions.

Definitely the caregiver's needs must also be considered!
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Those dealing with this horrible disease. Touch base with an Alzheimer's association in your hometown. It is typically only a hour and half ordeal. It helps even people who have family members or friends that have dementia also. They have people who have experience and deal with these types of problems. It is confidential as I have heard and it is free. All it takes is finding one nearby. Not every town has one, but you will find more answers than questions from those counselors who have seen a wide array of stories regarding this issue. It will connect you also to a lot more items and listening to other people talk about that have gone through or going through it still helps you not to have spend all your time thinking about it.
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Oh, gladimhere, I'm so sorry for all your mom's struggles. It must have been terribly hard on you. I'm so happy that she's finally pain free and you are freed from having to watch her go through it all. This is such a terrible disease and nobody knows the path it will take.
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My mom was moved two years ago with her husband. Mom needed memory care he needed assisted. I had cared for them the four years before. Mom never adjusted and needed private 24/7 caregiver a number of times over the past two years. In February, this year mom's behaviors became so extreme she was kicked out of the first facility. She was then admitted to another smaller facility, more like a group home, where the 16 residents had all been kicked out of their previous facilities. Each move with dementia will cause further decline. Mom just last week became unmanageable, again, meds were not helping. She fell three weeks ago and they thought she had broken her hip, had pain causing the behaviors. She passed away with the support of hospice two days ago. Now she is finally free from the prison of Alzheimer's Disease.
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Everyone is different. I had to move my husband and myself because of extensive repairs needed on the house. His doctor said the sooner he was moved, the better. It's been a year but he has adjusted well. I agree that it will be easier if your brother goes with her.
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Staying one step ahead of the aging process is best--of possible. We waited too long to move the folks and they had too few options. I want to downsize to a one story rambler with an attached garage NOW and not "when we get bad" acc to my hubby. Well, I am the one who does ALL the stuff with the house and we have a ton of stairs and every night I am in bed in agony with sore back, hips, legs from trotting up and down 14 stairs---not to mention the outside stairs and the stairs into the attic where all the "junk" is stored. I also do ALL the yard work. My car is parked on the side driveway, hubby gets the garage, so shoveling snow is also my job. He doesn't see the problem! He comes home from work, eats dinner and goes to bed. He hasn't been in the downstairs (which is half of our usable home!) for a year. Our laundry is down there, the big TV, the toys for the grands....if we wait until we HAVE to move, it will be because I fall and break something--then we will be in trouble because our kids will have to be involved and I want to do this independently!!!!
Your SIL will adapt if she is moved WITH her hubby and he eases her into the move by visiting before, asking her advice about furniture placement, etc. Just b/c she has dementia doesn't mean she doesn't have an opinion. (BTW, I am 60, hubby is 65--we are hardly "elderly" but he acts 90. He is not retired yet, thank goodness, so I want to move before he does!!)
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My husband could no longer remember he had married or had children and than the packing every night started. Decided to try assisted living for him - told him the house needed major repairs and he had a place to stay. He did well for 6 months and than started having more issues and than fell and broke his hip. He had the hip replacement and is now in a memory unit and there are other men around and he seems to feel at home with them. It is so difficult for family members but I think we all realize it is best for all. Now of course it's the stress of paying for it.
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When it was time to move my two friends, for whom I am their POA, because the wife was starting to wander out of their condo at night, I found a one bedroom memory care apartment for them since they had to move together. The wife was constantly looking for her husband if he was not in sight. We were able to make their new apartment look just like the bedroom and tv room of their condo--same furniture arranged the same way, same pictures on the wall, etc. Another friend took them out for breakfast in a nearby town, then to have their nails done so it was 2 pm when he brought them to their new "home." The husband saw his favorite recliner facing his tv and sat down with a sight of relief and has been happy ever since. This is a facility that will provide care to the very end and we used hospice care for the wife the last two weeks of her life. The husband is happy to stay where he is, likes the new friends he has made at meal time and spends the rest of he day in his recliner watching tv and reading the paper. The caregivers keep good notes on his condition and remind him when it is meal time, provide his daily medications, etc., and a doctor sees him monthly to check on things. It seems like an ideal solution. He is probably the most physically healthy of all the people on his memory care floor, but his memory is so poor he could not begin to live independently. I visit at least once a week and check with the health care staff periodically to see if there are changes I need to know about. Things seem to be working well and he is happy, so I am happy, too. It seemed like an easy transition once the time was "right." It sounds like the time is right for you, too. Good luck!
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In most cases, when a person with dementia moves into a residential facility, there's an adjustment period that can be difficult but eventually they settle in. If your sister-in-law will still be able to live with -- or spend time with -- your brother, that will help a lot.

Your brother should keep in mind that his stress, exhaustion, and/or frustration as a dementia caregiver affects his wife. So even though she will have trouble with the change, if he puts them in a situation that is much better for him, that's very likely to benefit her.

Personally, I find that it's not usually very useful for spouses to spend a ton of time discussing this with their spouse with dementia. (Assuming the spouse has more than mild dementia and can't be expected to make the decision or properly weigh the pros/cons; sounds like this is his situation.) He already knows how she feels about it. He won't be able to convince her to feel differently. If they can afford a decent residential facility and if he thinks that would serve their needs best, he can focus on supporting her through the change and transition. Good luck to them and you.
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Thanks to all of you for your thoughtful answers. I can only converse with him on Thursday, when he has a little 3 hour break from taking care of his wife. I will discuss all of this when we talk this week. Thanks again for the encouragement.
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My Husband did very well after a move but we moved from one house to another not into a facility.
I think as long as your Brother is with her she will have less of a problem adjusting.
Just have everything set up when she walks in so there is not a lot of commotion around her as well as a lot of strangers.
From what you describe I think Assisted Living would be better suited since he will need help. Memory Care might even be better. And I know some places have allowed a spouse to move in with the person with memory issues. But Memory Care would be safer if she begins to wander. Assisted or Independent Living facilities are not locked where Memory Care areas are.
Your Brother NEEDS a break, he needs someone to help him with your S-I-L. I have attended several seminars and one of the things that I heard in each is that statistics show that often the caregiver dies before the person they are caring for due to stress, ignored illness. He needs to realize that while he may do the best job caring for her he can not do it alone and that others will do a very good job and he needs to get away for a while each day or at best several times a week.
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They may want to look for a facility that has assisted living for him and memory care for her in the same location. She can get the care she needs and he can have socialization with peers. I knew a man at my dad's AL facility who was so relieved to have his wife at the same location in memory care because he was no longer able to take care of her by himself.
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You can read different kinds stories about how the loved one with dementia responded to a move. Sometimes, it's not so bad. I had to move my LO into a regular Assisted Living, even though she was not happy about it, she did agree reluctantly. Shortly, thereafter, I had to move her by doctor's orders to a Secure Memory Care facility. She wasn't aware of what was going on when this happened. She fit right in this facility and it was the best thing for her. She immediately seemed comfortable and at home. It was as if she sensed that they were able to really care for her and there were other residents like her.

It was the best move and there was no downside for us. Each person is different, but, if your brother is ailing himself and is 84 years old, I'd make some plans pronto. If he were to fall or become ill, she'd be in a bad situation, without a backup caregiver. Plus, caregiving is extremely hard work, even for a young able bodied person.

I wish you all the best. I know it can be very stressful. Please post as to how things go.
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Thank you for your thoughtful answer. I don't think my brother would bring in extra help. He is more likely to just move to an assisted living or independent care facility. His concern is for how this might affect my sister-in-laws condition. I think he suffers from the lack of social contact with other people as much as anything. He cannot carry on any conversation with my sister-in-law.
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Debbie, would it be possible for your brother to hire professional outside help to come in to help him for a few hours per day? It won't be easy for his wife, as it will take time for her to bond with the caregiver. He may have to ask the Agency for someone else until there is the right fit.

My boss when though something similar as his wife had Alzheimer's for 15 years and it the last few years that were the most demanding. He was lucky to find a caregiver who was at the house for 12 hours each day so that he could be at work. His wife enjoyed her company and help. He would take over the night shift, but usually he only got 3 to 4 hours of sleep as there were bathroom mishaps that required fresh sheets and showering of his wife to get her clean. He was so devoted to her but it was exhausting him big time.

Independent Living facilities are pretty nice. My Dad lived in one, he had a nice 2 bedroom apartment. He did have his own private outside caregiver who came in in the mornings to help him shower, get him dressed, get him to breakfast, and tidied up the place. The rent for his apartment included weekly linen service, housekeeping, and daily meals. And the cost per month was less expensive then having a caregiver being at the house most of the day.

It all depends if the IL facility would allow your brother's wife to be in that wing. He would need to find a facility that offers of optional care at a cost, which he probably would need for his wife.
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