We're headed for assisted living. Do you have any guidance?

He will probably fight assisted care more when you commit him. Keep him at home under professional care.

My sympathies to everyone and their families and loved ones going thru difficulties in older age. I know it, I've seen it.

A quality retirement-home experience can require advance planning years in advance. Simply put, every one of us will be not as healthy as we are now, or crippled, or developing various mental problems, or just being feeble or whatever.

But I've found that many of the bad situations can avoided or minimized by simply being aware of the future. Of course, nobody can guarantee a successful later life for anyone.

Our living circumstances will necessarily change in unexpected ways. To make the best of being older later, we and our loved ones must take that simple fact into account and just deal with it. (I realize there are bad individual situations that don't work out.)

I'm 67, my wife is 73 - in average to declining health. We put our names on the list at a very nice local nice retirement center 5 years ago, knowing their wait-list for new admissions is very long. My wife and I knew that arrangements for a retirement home were in the future sometime or another. Well and good.

We're very familiar with the retirement center. My sister's in-laws went there, an uncle, my great-aunt who entered when they first opened in the early 70's,and my wife's late mother. And God knows who else. Also my 94 year old stepmother Margaret who is still there now, as alive and as tough and loving as ever - everyone's much-loved elder matriarch.

A few months ago, we re-visited their office, talked a while, and learned our admission date for us is now down to around a year or two, maybe 2019 or so. We reviewed the current pricing and monthly rates, and all that. Everything was higher than before of course, which we expected. My wife and I thought "that's expensive" and it is, but everyone already knows that. It is what it is.

What we all have in common is that we all wanted and planned to live reasonably as best we can. Many of had middle-class incomes in their earning years, a few had much more. Most of the people we know who had/have difficulties in later life are those who were not prepared.

People who prepare mentally have fewer problems and more options. Those who do not prepare tend to have more problems and fewer options.

FEU

Thank you TG

I work as a caregiver for seniors in their homes to allow them to stay in their home as long as they can. I had cared for my Mom over a year in my home before that, then moving her home. The time your Dad spends alone in a chair sounds depressing. I have a client like that who has shared thoughts of being better off dead. He lives with his daughter but family doesn't have time for extra care he needs. I'm sure that if you found the proper facility for your Dad that his quality of life would be better. A lot of seniors just need companionship to boost their life. I would never feel guilty moving your Dad. I had a man I took care of who is being forced against his will. He's not as bad off as your Dad. I don't agree with that family decision. I agree with what you are thinking. Unless a caregiver was with your Dad daily, an assistant living facility would be better for him.

When I did my search for AL-memory care places for my two friends, I visited 8 or 9 to see what they were like and to find out how much they cost. All were far more expensive than I had ever realized. Most memory care apartments were one small room, hardly large enough for 1 person, let alone a married couple. Only one older place had a choice of two bedroom, one bedroom, or efficiency apartments in the memory care floor and that's where I placed them. The wellness director-nurse visited them at their condo before admitting them to assess their needs and warned me right away that the wife needed to go to the ER to get a calming drug as she could not remain still for a moment. I did that and it helped for the time. This facility assured me my friends would not have to leave as they provided care to the very end, and they did for the wife. They had a hospice nurse visit with me when the time came and explain that next step for her and were diligent in seeing to her needs and care. I was also told that after 18 months of regular payment, they would accept whatever public financing would pay. They had enough income and savings to cover that easily and I can see being able to pay the $7400-$7800 monthly fee for two or three more years yet before starting his veteran's benefits if he is still alive. The staff is used to seeing me show up and ask how he is doing and are observant to any changes. Fortunately he is stable health-wise with no physical ailments other than BP issues and low iron--which is easily addressed. With your situation, I would try to get something in the works quickly. If he is sleeping that much, he could just as well sleep in a memory care apartment as at home. Use his same bed and pillows and familiar furniture to keep it similar to "home." With all that is happening, it is too much for one person to do. And the right place has others to interact with and activities that might help waken his mind a little. Then you will have a chance to recover and get your own life and health in order. Wish you well!!

Wow, after reading some of these posts, I am so grateful that I found a wonderful AL facility for my mother, she has a real apartment, with a kitchenette (refrigerator, sink and microwave), and excellent care. She can stay there with increasing levels of care until she is either on a feeding tube, permanent IV or ventilator. None of which she wants, it's in writing.

The facility was built by two men who could not find adequate care for their own parents. The owner's parents live there, so the care is excellent, the facility is clean and has great amenities.

Like you, I tried to care for mom at home for almost 4 years. Until her short term memory and cognitive function declined to the point that she could not be left alone for any amount of time, she would panic if I left to go to pick up a pizza. I had home care for working hours, and then she left and the agency could not find an adequate replacement.

To make a long story short, mom is adjusting to AL, I went for a surprise visit this afternoon, and she told me she went to the resident's meeting, and for the first time didn't try to guilt me into bringing her back to my house.

My point with that is, don't feel guilty, your dad will be in good care, and if you continue like you are now, the stress may very will kill you. My health was not great, and now I am so much better, and I can actually just visit and be a daughter again instead of the constant worry and stress.

Good luck!

thanks Dianna61 ,, I cannot quit my job so this all has to fall on in home care and the visits I can manage weekly. its taking a toll ,,, xanex is my constant companion. sorry ,,but think im reaching my breaking point.

Its a hard road and never an easy one I regretted placing my mom in nursing care ,as the nursing care was sub standarded and they brushed me off ,try and get as much home care in as you can then you know you have tried everything before you decide to go into nursing care its not their fault and love your dad I no longer have both my parents.

Update so tomorrow a Nurse Practitioner will come to the house. Honestly I Hope they take him to the hospital to drain the Hydrocele for him which makes it impossible to diaper him and they do a complete neurological eval and blood work as well as possible UTI as his decline has been rapid. So the AL or Nursing home is on hold for now. On another note the lovely new Caregiver they sent me yesterday was amazing !! so there's hope .. I'm just going to take this all one day at a time.. that's all I can do.

Depending on the type of Assisted Living your dad goes to, see if they have an Activities Director. Speak with that person and let them know about your dad's history (work, hobbies) and hopefully they can engage him to be outside of his room.

We understand the resistance and it is a difficult decision to make but the transition will be smoother if he connects with his peers and the staff.

It took me two years of gentle prodding to get mom to move into assisted living. We'd visited several, ate at a few, discussed it endlessly. She moved in two weeks ago, and she's done a real 180 turn in her mood, health, energy level, the way she dresses, her eating habits, even her doting on the cats!

She'd come to the point where she really wasn't leaving the house except when necessary - sometimes not even going down for the mail, which used to be a highlight. Her eating habits were awful, there was nothing she liked and ate more cookies that anyone should. She doted on those cats, her entire day revolved around them and what they would eat. She spent 8-10 hours a day - no exaggeration - sitting in front of the computer playing solitaire or online jigsaw puzzles. She'd stopped visiting or having visitors. Her self-esteem was at an all-time low, a lot of it because of the word loss that has come with early Alzheimers.

What helped move things along was having her visit with the resident "ambassadors" there, uber-friendly folks who had a meal with her and talked to her about what life there as like.

Two weeks later: Her new apartment (bedroom, living room, kitchen - with no stove) is sunny and decorated with her own stuff. She has welcomed visitors - family and friends. She looks forward to her meals because of the company at the table and the quality of the food. Normally very shy, she is branching out and facing her fears - taking trips into town with the group, checking out things she used to look down on like beading classes or knitting groups, and had the most delightful time when a group of kids came to visit and hang with the "olds."

This was the best decision we could have made. What I didn't expect is that I am having a harder time with the transition than she is. I'm the one having difficulty letting go of control of her meds, control of everything.

I used to call daily, just to make sure she'd eaten, had gotten dressed, etc. Now, if she doesn't come for a meal, someone comes to find her, and they come find her in the evening to give her her meds. So, at least 4 times a day, someone competent is laying eyes on her. This has been a more difficult change for me than for her on the one hand, on the other, I know she's safe, well-fed, has good company, and is happy.

Hope that is helpful.

Dear Didgens,
I am sorry for your heart breaking situation.Are you able to get your father to a Dr.? It sounds like he may be helped by an antidepressant.He sounds depressed.
If you place him in an assisted living...here has been my experience.My sister placed my mom in one.It was a brand new,beautiful facility.The care was horrible there.The staff were far too young with no experience.No schooling is required to work in one.Every week people were quitting and new workers hired.The care was poor and inconsistent with three different shifts of personal care workers who did very little.They sat on their phones a lot.Some really horrible things happened in the two years she was there.The food was not good.She was not given fresh water daily if there was any in her room.She forgot to drink water so it had to be offered to her.It was not.Her floor was not cleaned.Her room was not straightened.She fell and fell breaking bones in her wrist,hip and a finger was severed completely off.
My advice to you is do some serious shopping around before placing him and be sure to NOT pick a place that is brand new with no history or track record.You will want a facility that has been well established with a history.Brand new,fancy and beautiful buildings are no indicator of the care your loved one will get.Some privately owned facilities are there for nothing more than making money.Not all are that way but do your research before placing him.Will he talk with you to tell you what is troubling him?It really sounds like depression.There is this one assisted living,memory care facility in my town.It was smaller,not so fancy and very homey.I wanted to move my mom there out of the fancy,horrible one she was in because this small one did not like to drug their clients with sedating medication.Their approach was to use an antidepressant to help the clients to get better.Many facilities will give drugs to sedate and make clients sleep or be more manageable thus less care is required but that is not quality of life for the loved one.If I could have done it without harming myself,I would have kept my mom in my home and cared for her but I did not and she suffered greatly at the facility my sister placed her.If you must place him...take much time to select a really safe and good place.I will keep you in my prayers.
Cares.

Didgens,

Thank you for asking a question that many do not bother to ask. This is a mountain of change in both of your lives.

All that said my words of advice are simple 'follow your nose'. Show up as a surprise to visit. Ask to walk through and have a look for a family member. This will tell you a mountain of answers. First can you smell any unpleasant orders like urine, spit on the floor, unkept areas.  Don't stop there, are people dwelling here smelling or as you walk by an open door is there an order. Another aspect of the visit is while walking around does the food smell inviting. Are there snacks out for the residents to get for themselves at times in-between meals.

One of the best ideas to keep in mind - this is a business. They are here to not only provide assistance, also to make money. And they need your loved one to make money.

Please do not let all of this make you change your mind. There are many ALs out there, it is just that sometimes it is necessary to look a little more closely.

A move is stressful on anyone and when it is due to inability to live at home any longer, the stress level is very high. That said let us make the best decision possible for our loved one.

You sound so overwhelmed; hang in there. Why don't you consider hiring a geriatric care manager. They can help you with everything and take the burden off. They will also be a strong support system for you.

The very first thing that does need to happen is that my dad needs to see a doctor ASAP ,, I have calls in and they are trying to get him on the "Home Doctor Program" but they did not return my calls yesterday. Yesterday I met a New in home caregiver ,, I didn't pull an punches ,, when we walked in I thought ,, gee the toilet isn't that bad so he must be doing a little better ,, but It really looks like things are going downhill fast as I found pajamas that he had pooped in on the floor .. its like the house is his toilet now. I don't know what's going on ,,, I think I may have to call 911 just to get him into a hospital and seen by someone ,,, this waiting is crazy making and I have to work and my son graduates on Saturday and im getting a colonscopy on Monday ,,, I want to scream ,,,, other then the house being his toilet he seems in good spirits,, liked the new caregiver and when I left yesterday was warm and clean ,, I have to keep reminding myself ,, I can only do what I can only do ... ok .. so another call to his doctors office today ,, and the social worker ,, the new caregiver yesterday gave me hope

The best guidance I can give; tour several facilities they are all different. Regarding price, some are all inclusive and others have several additional charges - so you have to be wary of that. Money was an issue for us, so I moved mom farther out into the county. The cost difference was significant. Memory care where I live is around $7,000 a month; an hour away, $4,600.

What to consider - do they have different levels of care; end of life care? Are their recreational activities that your dad would enjoy; is the facility and staff appealing at first glance and clean. There are also other options like group homes - which tend to be more affordable. I have heard very good reviews from people who have chosen this route. My mom is at risk for wandering - so she needs to be in a locked memory care unit.

Think about what your dad likes when visiting these facilities. Also get on the waiting list, not all places have vacancies you can always decline if you decide to do so.

Good luck.

I moved into assisted living with my husband. He has LBD with Parkinson's. Due to his many falls, I realized that I needed more help to care for him. Like your Dad, he sleeps 20 hrs a day, but there are a couple of activities that he will get up for. The only thing you have to watch will be his meals and meds. The med techs tend to bring meds at their convenience, not necessarily at the prescribed time. Meals here leave much to be desired -- too high in carbs and low in fruit/veggies. If he has any special diet requirements, it will be very hard. Everyone picks what they want from a menu, not exactly the things they are supposed to have. Make sure you have durable POA in place because you will need it.

AL gave my Mom (89 yrs) a place to recover from nursing home. Broke leg in 1 month & 30 days later broke same leg again. AL is like having an apartment but CNA's check on you. Breakfast, Lunch & dinner. They required you come to lunch & dinner, if possible. They will bring your meals but if that turns into a habit they charge. There are a lot of good reasons to be in AL. There is alot of paperwork to handle & you will need to know everything about your person to get these done. Someone with slight dementia (they do not like change) may get by. You will still need to check to see how your person is doing. I finally hired outside help to stay with my Mom 24/7. She would just do stuff to jeopardize her safety. There are extra services usually cheaper to get whole package as more care is needed. Be aware that a law was passed supposedly for ALs & I had to pay a separate company to come in twice a day & dispense my Mom's medicine on top of the already high cost of living there. Someone will want to do an evaluation of your person, determine level of care needed. They are salespeople they sell their facility, services so it will sound great so shop around. Nursing homes are different than ALs. This site is a really good place to get information. Every place, every city, every state is different. It's in your hands to do the best you can to get the best place & services for your person. My Mom is at home but she still has 24/7 caregivers (companions). Drugs from 3 surgeries really did a number on her brain cells. She is doing well. But she is slowly getting shorter on the memory..the old memories are still clear.she thinks she is running her life & to some extent she is, but I handle all her affairs. I am her personal assistant & everything POA. POA disappears after death. So be ready for that also. Sometimes stuff happens so quick.

Has his doctor had any input? That is where I would start. AL is not for everyone. If he is sleeping 20 hours a day, a NH might be a better fit.

Digens, I moved my Mom from her home in FL to a Nursing Home in VA last August. She is only 76. She did not have much money and nothing more than Social Security & Medicare so assisted living was out. I found a nursing home that was a non profit with a max of 90 beds and 1/2 of them are for rehab. so the long term unit is small wing. Let me just say facility care is always hard and the key is families continued presence. Everyone knows my mothers family comes in daily and I follow what she eats, I shower her and take care of all of her personal hygiene needs. I also understand that you might have more difficultly doing all care for your Dad which means you will have to rely on CNA's to bathe and handle the intimate care. It is a tough road and it is exhausting but for my sister and I it was better than traveling 1300 miles round trip every month for a week. The 2 factors that would be critical in my choice would be 1. nurse ratio and the facility rating and inspections and how much they have paid in fines/law suites. 2. location to you so you can be there routinely. I was amazed to find the Medicare website had an incredible user friendly database of all nursing homes and assisted living facilities. It identifies profit and non-profit along with there inspections, the ratio of patients even identifies the percentage of certain medications being used, percentage of UTI's. I was impressed and it guided me in my decision. Good luck.

When the day came to move my two friends, a married couple, to their memory care apartment from their condo, another friend took them out for breakfast in a nearby town, then to have their nails done. While they were away, we moved their bedroom and den furniture to their new apartment and set it up just like in their condo. At 2 in the afternoon when they came to their new apartment and saw it looked just like home, the husband sat in his recliner with a sigh of relief and has been happy ever since. He was the one resisting the move, thinking everything was the same as usual and not seeing the changes in his wife with her frontal temporal dementia due to his memory issues. He is still happy two years later. He enjoys his new friends at meal time, then goes back and watches TV and reads the paper. He never was a game player, so doesn't enjoy things like Bingo, or art, though he will listen when someone comes to play the piano. But he's happy. I am grateful for the watchfulness of the care givers and ask them occasionally about any changes they might see. Every encounter is recorded in writing and a doctor visits him once a month to check. He is physically healthy and still smart, but without short term memory, cannot function in the outside world without help any longer. Good luck on your move. We used Adult Protective Services to get the ball rolling and when they did the wellness check after my call, I was able to get their car keys and move their car out of their possession since both had lost their licenses but did not remember about that. They were able to live independently another 6 months or so before the wife needed 24 hour care due to her incontinence and wandering. She passed away about 5 months later.  Best of luck with taking care of Dad. Perhaps you could do the same and take him out to eat once everything is in place for the move and not take him back home but to his new apartment.

My mother also has dementia & neuropathy in her hand and was placed in AL. She was not allowed to bring her bed due to health concerns (bed bugs), but was able to bring whatever else she wanted that could fit in her living area. I found the AL was not the answer when she began acting out and I was finding her medication on the floor, noticed other residents in poor hygiene, being placed in the dining area to eat, but unable to feed themselves and staff did not assist. I moved her out to an adult foster care for the aged. That worked out great. You may consider this as an option.

Didgens, my heart goes out to you and I will be praying for you and Dad! We had to put my Mom in AL on March, 2016 and she still has not accepted it! Everyone told us not to worry and just give her a couple months and she would come around. Well, I'm still waiting on her to accept it! Between my 2 brothers and myself, we make sure one of us sees her every day. I'm really not sure that's the best thing for her because she constantly badgers is that she wants to go home. I just hope and pray that your Dad will accept it from the beginning!

Make sure the place you choose, has several levels of care. From early dementia to late stage.

My Mom has been in AL for two months now. It was not without tears on her part at first. We felt so horrible and I kept second guessing myself. She is doing much better now and is making friends. Though she makes it quite clear to those around her that she really does not belong there. But those comments are getting fewer and fewer. She often comments how kind the staff are and that the food is good. She has involved herself in the activities and that helps. Be aware of the extra charges that are not included in the base cost.

It's definitely the right move. Placement in the right level of care is essential, but you can always move up if necessary. My mother has been in AL for five years and she's been comfortable and content. All too often I've observed new residents who definitely require a higher level of care than AL. They aren't able to find their own room or even the dining room and they are placed in SN or MC area. The positive aspect of this AL is that they have a Separate SN next door that also has a MC unit so residents can transition easily. If a resident goes into the hospital they'll return to the SN and if they improve they return to AL. You may want to find a facility that has multi-level care.

Sometimes finding a place having an A+ rating is easier said than done. My mother's NH has less than a stellar rating but although some of the residents there are seeking better places, the others in the area have (sometimes long) waiting lists. Because my mother is bedridden, she isn't in a position to take advantage of what many of the others offer anyway, and her NH seems to cover the bases. They always have empty rooms and others have only one bed occupied, so short-term people are often placed there, and long-term can essentially "walk in" and get a place.

One thing you'll definitely want to do is take down the name and location of the place you're considering. Do a check with the BBB to see if there's been any complaints and to see what kind of rating they have. I personally would not want a place with less than an A+ rating, and if they have less than an a plus, I would keep shopping until I found what I was looking for. Another thing you want to check is the price and even talk to others who have or currently are using assisted-living to see what they say. If they have anything negative to say, use your gut instinct and believe them

Hi!
The day my father arrived from Canada to spend some time in his Portuguese residence after the passing of our youngest sister (47), the love of his life, he had a severe stroke which left him bedridden, totally dependent and unable to express himself.
During the first year we kept him at home and hired professional caregivers who would come twice a day to do his higiene. Things went more or less smoothly despite the inevitable difficulties.
Things started to get complicated when he started choking with food. He got a respiratory infection and was always going to the hospital for urgent assistance.
My biggest wish was for him to be home with us but by the 15th month it became impossible; his life was constantly at risk.
Finally, we had to put him in a home. It broke my heart to give in to my eldest sister's wish. I felt like we were dumping him and I'm sure that's the way he sees it too. But there is no other way given his fragile health. He has to be looked after during the 24 hours of the day and at home it was impossible.
At this moment, I feel relieved because I know that he is being properly taken care of (I hope) although these meisers don't heat up the place and the houses here in Portugal are like refrigerators.
He's five minutes away from our house which allows us to visit him more often.
Life isn't easy.
Some people reach old age and this is what happens to most of those who are that lucky.
Others, like my poor sister, die young :(
With time things will get easier for you.
Good luck!

I agree with all of the above.

Let me just add: trust the staff. They have tons of experience with every aspect of this transition.

I didn't believe that my mom would adjust. They told me she would--and she did. She loves her AL now. She also sleeps all day and doesn't do much, won't leave the building. But she loves her creature comforts and that is paramount to her.