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My dad is almost 93. His dementia is advancing and he forgets more and more (although he still catches me on some stuff!). I am his guardian and conservator. I have yet to attempt to move him to assisted living and I really, really think he would thrive. Even with the dementia, he is a pretty social person. His house is not safe. To bring it up to safety standards would be a bit of work. He still lives on his own but care comes in every day for a few hours. They take him out in the car, to the store, church etc. nearly for the entire shift. He is having a good summer with the longer days but once it starts getting darker earlier, he will dip back into a bit of depression. His care service is pushing for longer hours. Yes we could do it although dad doesn't want that. Says there's not enough work to do although I have explained to him that part of the reason they are there is to make sure he is safe. I know the care service would like 12-24 hour shifts but I really don't think that is necessary. He is still continent, still manages his own meds, heats up food they prepare for him in the microwave. 24 hour home care would be cost prohibitive. He will definitely run out of money. So we are at the break even point financially between home vs. assisted living. He doesn't want to move and I have to go to the court to move him because of the guardianship. Our state is very generous to the protected person. I doubt I will win and will be forced to do these long shifts or be in trouble with the care service and then we will run out of money. At a loss....... don't know what to do..................

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You are the guardian. That means a court determined that Dad is not competent to make his own decisions. You have more power than being a POA. Its no longer what Dad wants but what he needs. By the time you pay for 24/7 care you might as well pay for AL. He will be able to socialize, have activities and outings.
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The attorney keeps talking about his civil rights. That he still has rights. But yes, he no longer is able to make correct decisions for himself which is why I was assigned as guardian in the first place. The bad thing about this is that he will be served papers when I decide to place him elsewhere. That will start a FIRESTORM. OMG. Not gonna be pretty. I plan to have his doctor write a letter for the court. She will know what to say.
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anonymous912123 Jul 2019
Attorneys are not qualified to make the business decisions of ones life. Their job is to interpret the law and advise you of the consequences...that is it. You are giving the attorney too much credence, make the right decision for you and your dad.
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Whoa. Dad doesn't want to go and he seems, at this time, able to manage with the level of support he's getting and your overseeing things. Do not be bullied by the care company that just wants more of your $$$. I'm sure you don't want to go through a switch of agencies but if you tell them there are no $$ maybe they will back off.
I would stretch out what is working as long as you can, but if you haven't connected with an elder law attorney (certified, preferably who works for a flat consultation rate) I would...they will want a financial accounting to help you plan into the future but will give you guidance on that. You should probably be doing research on locations, so you can be ready when the time comes...if it comes...
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It sounds like you know what he wants. Let him have life on his terms as long as you can.

Additionally, you are setting the precedent that your own caregivers (your kids?) will follow someday when you are the elder.
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AnnReid Jul 2019
I dearly love my children and have explicitly told them that if I am deemed by professional evaluation to have dementia, they are to place me in a comfortable local AL if I am well enough to benefit from such a placement, and in a SNF if I am not.

My children have seen and experienced loss by dementia, and never, EVER would I inflict upon them the lifestyle that was mine as a caregiver.

If you love your father and can make objective decisions about what would serve him best, do so.
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One of the biggest things I am struggling with here is just the cost of all of this. We are at a break-even point as far as home care vs. assisted living. If I am forced to go 12-24 hours a day in-home care, we will be looking at 10,000-20,000 per month. Then, yes, he would probably run out of money and for what? Because he's too stubborn to move? His house is dark and dreary. Reminders of his wife (his second wife - not my mom) are everywhere including her hospital bed still in the living room and her clothes in the closet (she's been gone 3-1/2 years). He spends the entire care shift (6 hours) out and about with the caregivers because he hates being at home yet he won't let me move him. I know he would thrive in an assisted living environment. He loves going to the senior center and talking to other seniors. At the one I'm looking at, the bus from his church picks up a group of them every Sunday and takes them to church. They have on-site bible study. We've decided that if he ever needs hospitalization and/or rehab, we will push for some respite care after that at a facility so he can see what they are like.
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Vlange Jul 2019
You will find what works best for you but
I am thinking that not everyone thrives.
In fact some decline. The professionals I have consulted all fall on the side of the fence where your loved on will decline.
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I was going to suggest placing him the AL for a week or two of respite while you take a vacation. That way he can see what it’s like. You don’t ask, you tell him that this is going to happen. His vacation while you’re on vacation.
24 hour caregiver from the service is as much cost as a nursing home and to me it doesn’t sound like he needs that level of care. Why pay someone to sit and be on their phone while he is sleeping?
After he has been in the respite have a sit down with him about the things he enjoyed and an honest discussion about costs vs more in home care. Let him realize he will run out of money and go on Medicaid and have to move to LTC. You’re trying to avoid that and he will still have good meals, friends and people he knows, activities etc. and if he still wants to go to the senior center these places normally provide transportation at a small fee. At least they do where my dad lives.
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Those if us who have moved a loved one know that the thought of doing so, and the anticipated reaction of the loved one, is a swamp of angst for everyone.

Where will he be safest...where will he be more engaged and have the opportunity to make new friends...and with which situation will you have more peace of mind? Move him with a gentle heart and lots of active listening. Visit him and join in with some of the activities. Have conversations with some of his "neighbors" by visiting during lunch a couple days a week and engage your dad. You will never regret doing so.
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Talk to Adult Protective Services Firstly, Get them on your side. They will Come UP and assess the Situation and be on your Side during this Tough Ride.
No worries, If athis is goin gon, What court int heir Right Mind would Not Feel it Unsafe for an Elderly person such s this One, Hun, To Move him to a safer Environment?
We call this Endangering the Welfare of an Elderly person in the Industry call them tomorrow, Protective Services for the Elderly.
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i would take him to Adult Day care at the facility you are thinking that is Assisted Living and he will get used to it and want to move right away. This happened with my mom. She lived with me for 6 years . She wasn’t having any parts of going anywhere. After 2 weeks of Adult DC she loved it and moved in. She was sad for a day or two but is happy now. So much to do there and made friends right away . My mom was never very social but Now is the social butterfly of the place. Try it you never know what will happen. She fought me at first but I told her I’m taking her somewhere for an hour and I’d be back. Loved it! Do I kept doing it and she asked me everyday if I was taking her to that “ place” because she wanted to get her seat by her friends!!!!!
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Babs, who is this attorney?

You are guardian for person and money. YOU are in charge of his best interests, which clearly point to his being in AL.

I agree with getting APS on board if you think dad or attorney is going to court to claim "abuse". Perhaps the attorney is looking to take over guardianship and be paid?

I smell a rat.
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cwillie Jul 2019
Babs has posted before about having to bow to all of her father's demands despite being his court appointed guardian and conservator, IMO something is definitely screwy.
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Tell him the same thing we did with my MIL. I know we promised we would never make you leave your jome as long as you could take care of it and/or it could take care of you. The time has come that it cannot take care of you any longer. Make a large list of everything the home needs for his safety including large ticket items, upgrade electric, new hvac,roof,bathroom remodeling,ugrade plumbing, how are the windows do they need replacing? Show him that it is cost prohibitive for you to repair/replace. They tend to have a skewed sense of how expensive things are,living in the past. MIL wanted husband and I to repair/upgrade house so she could stay. I told her no way was I spending that kind of money from my retirement account. The idea of a respite vacation is a great one.personally I would place him for a month. Take a well deserved vacation but also a couple of werks to box up stuff, remove hospital bed, ask a cleaning service about a 1 time scrubbing, a coat of light colored paint on the walls will ho a long way to brightening up the dark interior. Also take this time to pitch all expired foods and bring expired meds to local pharmacy (they can dispose of safely for free),DO NOT FLUSH OR THROW OUT IN TRASH,it gets into ground water system. Make sure to check all pockets,purses,books,shoes,etc. before packing up, many family treasures, important documents, and money have been lost this way. A friend of mine works at Goodwill, she found $5000 in a shoe in the box. They were able to track down the owner and return funds to family.As his guardian you have every right to help make his environment safer and more hospitable. Assemble all financial information, tax records and take to your home for safe keeping. Is home health pushing for more care because someone snooped into his bottom line and figures he can afford it? This month of time will pass quickly so have plan of attack ready. He may surprise you and not want to leave AL. May be enough time to appreciate fact he can get out, make friends,meals and snacks, transportation to and from church. Biggest is interaction with other people. Phone him during this time but don't go visit until month is almost over. If you do, he will want to leave sooner.Tell him you need to go to store to make sure he has everything he needs before he goes home, unless he enjoys it where he's at, then he's more than welcome to live there and you can visit take him for outings ect. Accentuate the positives of AL, friends he's made,etc. Well, if you really want to go back to doing nothing and not having your friends around that's up to you dad, I thought you enjoyed getting away from us and being able to be more active....Just a suggestion.
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Sounds like Dad may need to go to a center where he could be social 2-3 days/half days a week. That's what we did for my Dad and helped tremendously. He was in a better mood and slept better.

Shop around and visit some. They kept him busy and he created some great friendships. It was also very affordable. The center I chose was run by "meals on wheels" and had a great staff with a nurse on staff.

It also allowed us to save money for later when we needed it (spend the money when the time comes to move him) and able to have companion help also when he was home. Companion help runs cheaper than someone who comes in to do cleaning and meals. Get companion help if they are going to drive him around.

Hopes this helps.
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DizzyBritches Jul 2019
That sounds really good.
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Here in NY, I asked about respite care at the SNF my mother was at before I took her home...& their rates went up to $456 a day. (It was $375/day private pay when she was there after Medicare stopped paying...due to mother not progressing) Also they said she needs PRI Nursing Assessment & that’s about $100. She is not on Medicaid & insurance won’t pay for it. So it would not be much of a relaxing respite for me knowing how much $$& a “respite” will cost!!! Hopefully you can have respite care paid for by insurance. Hugs 🤗
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Socialization helps people with dementia to do better. It keeps them involved longer. If you need to go to a court can you take a geriatric lawyer to help explain that?
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Babs75 Jul 2019
He has an outstanding geriatric psych that would back me up 300%. But she knows like we all do that he will not leave his house willingly. The manager of the care service has offered to take him. He would not suspect anything. I would probably actually stay away for the whole thing. He will hate me as it is. They have told me a the assisted living place that if he was confrontational when he got there that they would call the police.
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Babs, it's tough when our parents' mental health challenges make doing the right thing difficult.

So, the AL will call the police? Is this the right place for him if they dont have a better answer?

What meds have been tried to soothe his anger? What activities does he enjoy?

I think I'd go with a therapeutic fib about YOU needing to have surgery. Tell him he needs to stay there for a month so that you have no need to worry about him while you are recuperating. Tell him that the doctor is to blame, or that the law requires you to do this.
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It sounds to me as if you can use an advocate.

I would talk to a lawyer, someone well-versed in elder law, to let you know what your options are. They know a lot about Medicaid, Medicare, etc. and may help smooth your path.

It might make you feel a lot better to have an expert who is unequivocally on your side. I don’t know what the protocol is for nursing homes, maybe they make a habit of covering their butts. But I get the impression you’re being pressured, and my antennae are quivering . You know your dad as a person, and if you think AL is best for him, check it out. Thank God he’s social by nature. That’s probably the best thing for his mood.

I wish I could help more. I wish you and your father the best.
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You will find that he does well after about a week. Find one that is sunny and happy.
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