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My dad is declining fast. He has COPD and also can't walk well at all. Literally two weeks ago he was driving (foolishly of course, but still doing it). I took off work to help get him diagnosed and to help get him the care he needs. He can't recall a conversation we had a minute ago, but he's slightly aware that something is going wrong. The five days I've been here, he's not aware of where he is when he wakes up. He believes he's in his home town 20 years ago, so is confused when he doesn't recognize things. He has COPD, is a major fall risk, and has many medications. He needs 24/7 care without a doubt. He really can't be left alone, else he may get an idea in his head and forget he needs his walker, and have a major fall (he's had 3 in the last 7 months.) If memory care near me ends up being the best option, I'll be taking him from his female companion (who loves him very much but can no longer handle this disease) and his cat, the two things he recognizes and loves. What kind and gentle fib has anyone used to get their loved ones set up in an appropriate memory care center?

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My cousins had to move mom... she didnt
t even realize she moved.

he may be aware of something different... and that can be an issue, especially if his LOVED ONE is not there, but what is holding her up from moving into a memory or senior facility with him?
The more he falls, them more brain damage possibly... broken bones..
the more he gets an ambulance ride to hospital, and the stuff that goes on there, the more brain cells he will lose too.... an ER doctor told me that.... sadly
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Reply to MAYDAY
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Dad needs a detailed evaluation from a qualified Geriatrician.
It may give you better insight!
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Reply to xrayjodib
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Perhaps his cat could move with him. Many facilities will allow their residents to have pets.
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Beatty Aug 14, 2020
I would expect Independant living & some Assisted Living's accept pets. But not Memory Care as the residents needing this level of care could not adequately care for the pet.
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After much researching and planning, I found a memory care apartment for married couples for my two friends. Wife had frontal temporal dementia, husband short term memory issues. When the wife got so she needed 24 hour care, I was able to convince the husband they needed to go to a place that provided that. He was sure he was just fine, but would do it for the wife.

The day of the move, another friend took them to breakfast about 45 minutes away, then to have their nails done. While that took place, the movers and I were taking the things I had selected and moved their furniture, pictures from the walls etc, and set up their new apartment to look just like their bedroom and tv room. When they came to their new "home", the husband saw his favorite recliner and sat down with a sigh of relief and never said a word about not being home. All the most familiar things were there.

The wife's brain deterioration continued rapidly and she passed away 5 months later. The husband is still in his apartment, going on 5 years now. He never once said anything about their condo and I never told him about all I was doing to get rid of their stuff and sell it. I saw no upside to discussing these things since they had given me complete authority as their power of attorney to make all these decisions. Any money coming in goes right to their checking account. Any money going out is in response to a bill, so there is evidence to show how their money has been spent. Not a penny comes to me, which is how I want it. I am also executor of their estate, but I am pretty sure nothing will be left to distribute. The husband is in good physical health but could not survive on his own. He is now 94 and shooting for 100. He always tells me that the only thing I have to do is live as long as he does. I always tell him I am working on that. We've been friends since about 1972 and there are no children or close relatives to have involved. Just a few friends.

I went to about 9 different assisted living/memory care facilities before I found the one we are using--the only one that offered a choice of two bedroom, one bedroom or efficiency apartments on the memory care level. And they give good care and gave me great advice on what was happening to the wife and what I should be ready for or do next. This was all new to me and I needed that guidance.

Best of luck on your decision and probable move.
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Reply to JohnnyJ
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As graygrammie suggested, I highly recommend a test for UTI (preferably a culture, not the dip stick test), IF that wasn't part of his checkup before diagnosis.

Generally dementia is NOT that fast acting. UTIs, on the other hand, are. He may still need to move or have home help aides, but if he has a UTI and it is treated, the need may be delayed.

When I first joined this forum, I was skeptical of the various suggestions to test for UTI. When mom had her first one after moving to MC (long after the move), I became a convert! The only symptom she had was serious sun-downing. She was out of control, demanding to get out, insisting she had guests coming and had to go home. Later afternoon and evening for her (it can be any time of day.) We needed anti-anxiety along with the antibiotics, to keep her calm every afternoon/evening. Once treated, she was ok and didn't need the other med. Subsequent UTIs have shown up as bed wetting.

ANY change that is SO sudden should be explored - full exam, urine and blood tests. There are other conditions that can mimic dementia, so if all the doc did was a cognitive test, get him fully checked! Not enough fluids, too many fluids, and other medical conditions that can be treated can show up like this.

IF they did check everything and all was good, then try what the others have suggested for enabling the move or bringing in help. Hopefully you can and have applied for FMLA - you don't get paid, but you also don't lose your job! It might take some time to find an open space with no virus restrictions.

Hoping you are dealing with UTI...
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xrayjodib Aug 14, 2020
disgustedtoo,
You are correct that dementia doesn't escalate as quickly as UTI symptoms. However, it kinda depends on how the original diagnosis was given.
In my Aunts case, her PCP after a joke of a mental status evaluation diagnosed her with mild cognitive impairment.
The recent video exam by a qualified Geriatrician revealed the diagnosis of moderate Alzheimer's.
Could be that OP needs to seek in depth evaluation.
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I’m so sorry. I can hear the heart break and I understand. My husband and I are in the same boat. MIL is still in her home with rapid decline of short term memory, then a minor stroke. She still wants to drive her mustang convertible and hates it that a care giver is at her home 24-7 now. She’s “tired of everybody telling her there’s something wrong with her brain.” She doesn’t remember to take her meds, but can still shower, dress herself, take a morning walk, etc. It’s so difficult because sometimes she seems perfectly fine..then that ends within 5 min.
We’re grieving the MIL we used to know. She’s greiving because she knows nothing will ever be the same. This just happened so quick. She’s on a waiting list for AL as soon as it opens to visitors again.
Wish I could just give you a hug.
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Reply to DILhagen2
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This transition is so heart breaking. The best thing you can do is make sure your father is safe and cared for, and if Memory Care is the best solution, then go ahead and proceed. It doesn't matter what gets him there, honestly he won't remember it the way you will.
As to his female companion and cat, once Covid regulations are over, they should be able to visit every day. By they, I mean definitely the female companion and also possibly the cat. If that were me and I could have my partner and my cat visit on a regular basis that would be the best possible solution.
His partner will be sad but she will also feel relieved that he is getting the treatment that she can't provide.
I want to assure you that you are doing the right thing, and that this is possibly the hardest part of this journey, and once it is done and your father has settled in, he'll be well cared for, and you and his partner (and cat!) can visit on a regular basis.
Wishing you all the best during this very difficult time.
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Beatty Aug 14, 2020
I agree with all you said. Practical but caring reply.
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Imho, "the kind and gentle fib" may well have to be employed, e.g. "Dad, let's try this place out for lunch." Even so, that seems very trite for me to say when your father is so ill, but since short term memory has diminshed, perhaps it may work. Prayers sent.
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Reply to Llamalover47
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I had a blue bedspread on my moms bed in her condo and for the week before she went into memory care home, I kept telling her that where the blue bedspread was, it was her bed. I wasn’t sure if she would remember that but it was worth a try. I told her we were going out to lunch when we went to the home. We enjoyed lunch together there, had the bedspread put on her new bed while we were eating. After lunch we escorted her to her room and showed her the bedspread we hoped she would recognize. Sat with her in her room for awhile then said I needed to go to get something and I left til the next day. The home caregivers were helpful. Was there a period of adjustment? Yes, but it was the care that was needed.
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Reply to Marylepete
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Dear "wlesnefsky,"

I have a feeling this will end up being harder on you than on him.

My mom lived in the home I grew up in since we moved here in 1968. She wanted to stay in her 3 bedroom/2 bath home with a pool until she died. When my dad died in 2004, I tried to keep my mom in her home for as long as I could which turned out to be ten years. Even though I tried all other avenues the problem for us was money. She was diagnosed with Alzheimer's in 2014, I took her car keys away and started looking for an AL facility. After finding one, we moved her in early February 2015, cleared out the house, put it on the market and once sold, I used the money for her monthly rent.

She lived there up until April of this year at the age of 95. She nearly died of severe dehydration and COVID and went to ER along with a very short hospital stay, transferred to a physical therapy/rehab center for three weeks and I did not want her going back to that facility. She lost all mobility, the ability to dress herself, was very weak due to losing 20 pounds so it was time to find a new facility with a memory care wing. With the pandemic, it was extremely difficult to find one that would take any resident in much less my mom who was still recovering from the virus.

She moved to the new facility back in May. I have never told her she is in a memory care wing nor does she know I brought hospice on. I told her she just has a lot of extra care now compared to her previous facility. Before being released from the rehab facility, I simply told her we found a nice, new place and apartment for her. I told her I picked an apartment that was private and had a window so my husband and I could do "window visits." At her previous facility, I was not able to do that because her windows faced an inner courtyard. I'm the only child and her five remaining siblings all live in other states and aren't involved in her life or care so it was very important for her to have us visit from the outside looking in so to speak. She is doing pretty well under the circumstances and for everything she's been through. So my main tactic was talking enthusiastically about the whole move as I hadn't seen her since February 28th and wasn't able to be with her when she went to the hospital where I honestly thought she would die.

The Activity Director has two dogs and brings one of them for pet visits. Maybe you can ask if anyone on staff has a cat or dog who can do that. Is his female companion in good health? If not and she needs help too, they could share a companion apartment.

Because my mom is no longer able to walk under her own power, she has fallen at least 8-9 times now since the end of May so the staff has pushed one side of her hospital bed up against a wall near a window which cuts her fall risk in half and then at night they put a fall mat down. Another thing I would look into is his medications since he has so many. You never know what being on so many can do not just physically but, mentally. Also, has he been checked for a UTI recently as that can also play a role in what he's experiencing.

Hopefully, with everyone's comments, you will find a way to communicate to your dad any change you decide to make in regards to his living arrangements. I wish you luck!
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Reply to NobodyGetsIt
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We just moved my dad to memory care 5 weeks ago. To do so, meant separating him from my mother who has been caring for him but simply couldn't do it any longer. They have been married for 69 years. His short term memory has seriously deteriorated over the last year. He has no concept of time and thinks Roosevelt is still president.
Once we'd made the decision to move him, my sister and I were going through all of the stuff from their apartment (he and Mom constantly complained about all the "stuff" they didn't need) and he asked what we were doing While we had discussed fibbing to him, I decided it was better for us to just be 100% honest with him (as I knew he wouldn't remember anyway). We told him that he needed care from people who specialized with Alzheimer's and that Mom has her own health issues to deal with so we were moving him to memory care and Mom was moving into a studio apartment. He was a little upset that they wouldn't be together but within an hour, he had forgotten. When the move actually happened, he was confused and kept asking when he could come home but now he is doing fine.
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Reply to britehopes
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I understand how difficult and heartbreaking this is for you!

After my Uncle passed last
October, I had to make the same decision. My Aunt had obvious Dementia. She since has been diagnosed with Alzheimer's.
She lived in the same house for 43 years.

I used the "therapeutic fib" that her house need repairs/pest control and she needed to go stay somewhere else in the meantime.

She went mostly willingly! She is in memory care. They keep her very busy!! She loves the activities even though she can't remember what she just did.

Your Dad may ask to go home often. That's the hardest part!
Fortunately, he won't remember how long he's been there. You'll have peace of mind that he is safe and well cared for. As his Alzheimer's advances, he will most likely stop asking.

God bless you in this journey!!
Sounds like you're on the right track!!
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Reply to xrayjodib
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Many memory cared allow pets in their rooms. My mothers memory care has a some residents cat that wanders in and about with the residents and is part of the family there.
His girlfriend can visit as much as she wants.
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Reply to Difficult
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You know your dad and you know that his care is beyond your abilities. It seems you have already decided that memory care unity is the best option. Maybe a good suggestion is to let him know that his health is a problem right now and these kind people will care for him and his health issues. it is the truth and not a lie. It doesn't imply when the care in the new facility will end.
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Reply to Taarna
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2 weeks ago we moved my mom into Memory Care. My dad could no longer look after her. Because of Covid, we cannot visit in her suite and she says she’s been just left there. We are lucky that my dad lives in the same building so he can visit daily. We told mom a lie. Told her Dad had to go in the hospital for tests but he could be let out to visit her. We left a note on her table so she keeps reading the same thing. She is worried about my dad. The problem is my dad is having a hard time living with this lie. He wants to tell her the truth. When he visits she’s all smiles because she thinks he’s there to take her home. We have no idea where home is for her. I’ve spoken to other people who are in similar situations. Bottom line is a white lie hurts no one. You can change it from one to another as situations change. She won’t remember. Now we have to convince my dad that this is not about him. We need to do what’s best for mom. Hard decisions have to be made and the guilt is endless.
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Reply to DIaneAL
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It is most convenient to have people in a senior facility near you, if you will be responsible for them. Then under normal circumstances you can visit them often. Things are different with coronavirus. You may not be able to visit him, or in my mother's case, I can visit her once every 2 weeks with mask and social distancing. Another alternative might be to have aides go in and help him where he is (and give his companion a break). I arranged this for my aunt who had a live-in aide. Towards the end we had 2 aides. With aides, it's best to have all of his bills and financial statements sent to you, and you can take over paying his bills. Hopefully you have all the paperwork in order to take over his financial and medical decisions (POA, living will, will, etc.).
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It sounds like your father is about where my husband was when I had to make the decision. When I made the decision it was time to put my husband in assisted living, I didn't say anything to him. It was my decision, he was a danger to himself by crossing a 6 lane boulevard on a Sunday afternoon and the next night he was going out the door at 1:30 am. It wasn't his decision. Where was he going at that time of night? To see his wife he thought he left in another town 190 miles away. He was going to hitchhike! The next day I contacted the facility I wanted him in, got the paperwork going, got the doctor's signature on paper, his TB tine test, and arranged for a mover to move his clothes, bed and dresser and recliner there. He wasn't able to think if he wanted this move, he was a danger to himself; he couldn't remember much. The hardest part of that whole thing was after his admittance, I had to stay away for 3 weeks until he acclimated to the new home. Couldn't even talk with him on the phone. Was he mad when he saw me, yeah, a little, wanted to go home. I just ignored his comments and let him adjust. Was that hard?? Hell, yeah. After 58 years I had no sleeping partner, no one to sit with watching TV, no one to give a kiss to in the morning. For him, he soon forgot who I was anyway. As for the cat, you can buy a mechanical cat, really looks and acts like a real cat, snuggles up to you, meows, moves arms, legs, turns over. $99.00 Amazon. They had several at the assisted living where my husband was. Be strong, do what's right for him, he doesn't know what is right for himself.
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Reply to JoAnne80
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Is there anyway he can stay at his home with hired home care even part time? This way he could still see his girlfriend and enjoy his cat. Home care agencies ( I used Concierage) have staff that do a huge variety of tasks including medication help. Well worth it even if its just part time.
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Reply to InFamilyService
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We have moved my MIL first into Independent Senior Living - which was the most difficult move, but we told her she didn't have a choice because she couldn't care for herself anymore. It took less than a few days for her to settle in. Then it was time to move her to Assisted living, and I worried about the effect. I took her out shopping, and my husband did the move. When I brought her to her new place, and we escorted her to her room - she didn't even notice a change, even though it was a different place, and she went from a one bedroom to an efficiency. Two years later, we moved her into memory - and again, she acclimated. In both cases, it was more difficult for me because I worried about her and what to tell her. If its time, just do it. Don't worry about stretching a story if necessary - like his other place is being painted, or fumigated, if you feel you need to. If he is ready for a higher level of care, you are doing the right thing.
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Reply to karenonthames
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Dorry, but there isn't any gentle way.

If at all possible, your Dad would feel live, safe and happy in his own home, not moved to some cold unfamiliar and not so friendly facility where your Dad wouldn't even be able to tell you how he's being treated.

You should let him stay where he is and where he is happy and loved and let him take his chances of falling instead of dumping him at a Facility that will give you peace of mind bur not him.

He will live longer and happier with his ladyfriend and cat and certainly have less of a chance of getting Covid.

You could install Nest Cameras to keep an eye on him in his home.

Ir doesn't matter if he doesn't remember what he said a minute ago.

My 96 yr old Dad is the same way.

He has short term memory loss which means he can't remember something that just happenedor said. But you talk about something he's been doing awhile, he remembers, like my Dad remembers he was a Fireman and he rode motorcycles, ect.

Let him be as happy as he can and live in his own home.

Beleven me, he had just as much chance of falling at a Nursing Facility as home. Maybe even more seeing how they keep you pretty doped up, especially if you're a problem. They'll give him something to sleep, ect.
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DoWright Aug 13, 2020
I know what you mean, I would like for him to stay in place too. The medical appointments his own companion is probably not in charge of can be 100% handled by a facility. Many times, dementia causes real safety concerns at home with just the kitchen & bathtub, elders seem to wait until nobody is around and then they have accidents. Dementia changes how they make their feet move & or forget where they are intending to arrive. So they can get to the point of being aggressive with frustration. I have worked as a caregiver for 11 years & have seen clients who stay at home well past what most consider safe. COPD makes it progressively harder over time to get oxygen fast enough to the brain & organs etc., there will be a need for around the clock care anyway. Sounds better to place him. Just keeping all shifts covered for in home support on a daily schedule so elders could "stay in place" is a chore too. It takes dedication and you are on-call 24/7 honestly if you are a close friend or relative, you will be asked to assign yourself for emergency contact. I do like the idea of keeping loved ones at their home too, really. It's just so much more effort than most realize. Retirement is not all casual living & laughing at small memory loss. * My dementia client now dismantles and messes up just about everything, then he tells me these items don't work anymore. Nothing is sacred, not the mail, any messages & appointments he might have responded. Forgets to take his medication and is extremely grumpy if you repeat for him to get off the bed or shower so we can leave for errands. His wife has her hands full & i only help a few days a week. She reminds me my life is bliss because i can leave. Retirement is a lot of maintenance & often a very busy time of life.
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The girlfriend can visit anywhere, but PLEASE look for an Alzheimer's Memory Care facility that allows CATS !! I am sure your Dad probably sleeps with the cat and will take comfort in knowing his furry friend is still with him.
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Reply to LonelyOnlyChild
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Therapeutic white lies are a great tool when someone reached the stage of dementia thAt your dad is in. They are not able to reason what you are telling them but help to comfort them, which is the purpose and primary objective.

You need to do something about his driving. Take his keys or disable/sell the car. He is a danger to himself and everyone else driving the road and children out on bikes or playing in yards.

You won't be moving him from all he has known. You will furnish his room with many of his fAmiliar things, that will help.

Be careful about telling him he is on a vacation, this could be disorienting to him and increase his agitation. This was tried with my mom, including a sign on the door to her room, that was eventually taken down as it caused more agitation. Mom just wanted to be home.
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Reply to gladimhere
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I do not understand what you mean by "gentle fib"--what is wrong with being honest. There is no such thing as a "fib" -- Don't lie to your parent. When moving them to a nursing home happens, they will feel even more betrayed because you lied to him. Tell them they need to go to a nursing home because you and his companion are unable to care for him. If you are going to do the nursing home thing, tell him the truth. Do not assume they will not remember.

Lying to people is the worst thing you can do, especially when it comes to their plan of care.

Nursing homes are NOT safe. They often get neglected, prone to bed sores and contractures, they fall, can suffer malnourishment/dehydration, and infections catching whatever is going around. Explore all other options but if none is available tell him the truth.
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MargaretMcKen Aug 14, 2020
Be real, lying is NOT the worst thing you can do to anyone.
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When you say that you "took off work to help get him diagnosed" I am wondering what the diagnosis was. It sounds to me like you are implying dementia.

Also, it sounds like all this is rather sudden (other than the history of falls). Please ask that he be checked for a UTI. The elderly can have a UTI without physical symptoms. There may be no indicators in the appearance, smell, or frequency of the urine. But there may be mental confusion, forgetfulness, disorientation that indicates dementia. Before accepting a dementia diagnosis, ask that a urine culture be run. It will probably take two days before results are in. This is not the same as the quick urine test that is done in the office.

My own story -- I knew (from friends who have been down this road) the above information about UTI but when it came to my own mother, I trusted the nurses and I trusted my father to communicate to the nurses that I thought mom may have a UTI and needed tested. Mom "declined fast" as you wrote. Weeks passed, she got much worse mentally (but still fine physically), until mom literally lost her mind (destroyed things in the house, included her treasured Christmas cacti, smeared feces all over the house -- curtains, walls, furniture etc. -- ran around outside without clothing yelling at the neighbors "Look at me!" and tried to kill my father). The last month of her life was horrible. I will forever regret not being more forceful and less trusting and calling the hospice agency myself and demanding that they get a urine culture done.

Please pursue this possibility.
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Reply to graygrammie
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clearly you love and care for him a lot, and you seem to have a ( valid) concern his being taken away from his companion will affect him, what about the possibility his female companion and one or two others could cover the 24/7 so he can remain at hone which is a familiar place of comfort to him? How do you feel about that option
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Reply to Sarah3
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You asked: "What do I say to my dad with dementia now that we need to move him to memory care assisted living, away from all he's ever known?"

Since he can't remember what is said to him a minute ago, then you can say anything you want in the moment in order to get him to agree to do what you need him to do at that same moment. The next moment, you can say something completely different so he will agree to do the next task, and so on and so forth.

So, if you need to clean out his closet, and put all his clothes in boxes, you can make up a story that the clothes need to be laundered because there are bugs.

If you need him to get in the car to go to the new place, then you can say you're taking him out for a drive, or visit some place special, etc.

If he asks why he is where he is, make up something. This new place is a hotel in some exotic place. He's there for vacation.

The point is to tell him whatever you think will work at the moment. If he says NO one moment, he can say YES the next moment when you give him a different reason/story.

Kind and gentle fibs which you want are whatever fibs that will sound good to dad and make him happy and accomplish what you need him to do.

If possible, bring his female friend to visit him often. As for the cat, maybe a realistic looking stuffed cat will give him some comfort. I know it works for some elderly to have stuffed animals to cuddle with.

Good luck and tell us how it goes.
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Reply to polarbear
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You see, from what you have told us it doesn't matter what fib, really. He won't remember. His friend will. I hope that he can be placed near her. I hope the kitty, with a vet certificate, can visit him. There is no way to make this good or perfect. Not everything can be fixed. Some things we just have to do the best we can. I am so sorry. Heart breaks for you all.
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Reply to AlvaDeer
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I can't wait to see the responses to your question at the end of your post. I recently asked the same question in this forum and haven't gotten responses.
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