What do you do when your father refuses to move to an assisted living facility?

Well, for us, it happened when my mom fell and broke her leg, up in her hip. With that, came rehab and and more memory loss. The doctor from the rehab called me and told me that there was no way she was going to sign off on my mom being able to live alone. Besides her hip, her memory is just too bad. Thankfully, I had already started searching ALs when she had broken her back and ribs over a year earlier. Once I got that call, I had to get the ball rolling. I contacted an eldercare attorney, the AL that she liked the best when we had visited earlier in the year (just in case). When her insurance quit paying for rehab (I got 2 days notice), I let her know that they will not sign off on her living alone and we had to put her in a facility. I will say that breaking my mother's heart, was one of the hardest things I had to do. It took her a couple of months, but she's thriving in her facility. She's eating better than she had for years. She's more active and social than she had been in the 6 years since my dad died. I, absolutely, believe we did the right thing. We were lucky to be able to research places, eat lunches and participate in some of the social activities of these ALs, so we were able to find the right fit. It's not the most expensive. It's not the newest place, but she's in a lovely community. Her relationship with her kids is better, because now we can visit for pleasure and not just a "honey-do" list or the constant worry of finding her on the floor. She is safe, she is clean and she is fed. I regret nothing.

MP, welcome!

This is a tough situation and one not easy to navigate.

The usual answer in that if you have an uncooperative elder, you very often need to wait for something bad to happen--a fall or severe illness that puts them in the hospital. Once admitted to the hospital, you can work with the discharge planners to get him safely placed.

If friends nearby call YOU to say he needs more supervision, encourage them to call Adult Protective Services to report him as a vulnerable adult. You should do this as well. They will tell you that as long as he can do his ADLs, they can't force him into care, but it gets him on their radar

Another good resource is the local Area Agency on Aging. They can offer a needs assessment and case management services.

Since your Dad is only 66, a fall at this age most likely won't send him into a medical crisis like if he were 86. As a PoA whose authority is legally active, you don't need to wait for cooperation, you use a therapeutic fib to get him in. If you talk to the AL/MC's facility admissions head in advance, they will certainly help you with this since they've seen it all. (Also, he may need MC and not AL but the facility will be able to tell you which is more appropriate for him).

You'll tell your Dad that his residence has a 1) gas leak, 2) bug infestation, 3) water main break so no water or heat or a/c or whatever... and tell him you've arranged for him to temporarily stay in an apartment. Don't tell him too far in advance since he won't remember. Once he's in, he's in.

Respectfully, based on what you've written in your post, you don't have a full understanding of how to deal with people with ALZ. I found Teepa Snow videos on YouTube to be immensely helpful. People with dementia lose their abilities of reason and logic, and therefore, judgment. They also lose their ability to empathize with others. This is why you simply cannot try to "reason" him into moving -- that ship has sailed and you need to use another technique. That's where the therapeuctic fibs come in. It is perfectly moral and ethical to do this since you are operating in your Dad's best interests and they are not harmful or destructive fibs.

Also, with memory loss, even if you could persuade him one day, he'd forget it the next. I wish you much wisdom and peace in your heart in this process.

He has now been declared incompetent to make his own decisions. The ball is now in your court. You find an AL or MC. He no longer decides where he lives. Its no longer safe for him to live alone. You find a man to help you take him to the facility. We told my Mom when she got to the AL that this was where she was going to live. She was getting a nice apartment and meeting new friends. If you think he will become aggressive, ask his PCP for something to keep him calm.

You need to get yourself into the mindset that you now make all of Dads decisions. When I took Mom to a diner with us the first time, I handed her a menu. Next time it was 3 choices I knew she liked. Later, 2 choices then it was just Liver and Onions one of her favorite things. I never asked her if she wanted a bath, because the answer would have been NO. I just said "time for a bath". They can no longer make decisions. And its really not right to ask them to try and make one. The brain is broken, actually dying.

I went through this with my mother. I called the County Area of Aging . They sent a social worker to the house . She spoke with Mom , gave her hypothetical scenarios and asked Mom what she would do. Mom could not “ come up with a plan “ . The social worker said Mom was not safe living alone and needed 24/7 supervision . The social worker then said she would return in two weeks with strong men to physically remove Mom from her home and place her in an assisted living facility that I had chosen . ( I already had one chosen on my own because Mom would never tour ) . I let the facility know the date she would be coming The social worker had suggested all my siblings and I meet with Mom in person and tell her she can not live alone and that she was going to be moved from her home to assisted living with the help of the Area of Aging . Before we could all meet with Mom together , One of my sisters told my aunt ( Moms sister ) what was going to happen . That aunt called my mother to tell her to refuse to go. Mom then faked a heart attack ( and had somewhat of a panic attack ) to avoid being removed from her home . My Mom called my faraway sister because Mom was so angry with me and my sister called me and I called an ambulance and Mom went to the ER. When I got there I told them what was going on . The hospital social worker called the social worker from the Agency of Aging that had been to Moms house.
Anyway , after a heart attack was ruled out , they did cognitive testing , finally diagnosing dementia ( Mom had been refusing to go to a neurologist and her primary ( family physician ) was useless , he just said go to a neurologist or a geriatrician ) . When Mom left the hospital she went straight to assisted living facility that I had chosen via ambulette with 2 men . If I had taken her in my car Mom would have refused to get out of the car . I was lucky the AL could take her sooner than expected .

Try calling your County Area of Aging .
Good Luck

First thing is to stop thinking you'll convince him to make the move willingly. Even if he agreed this afternoon that he wants to move to AL, by tomorrow morning he won't remember agreeing to it. Second thing is to just accept he's going to be upset and angry with you. These are the basic facts of the situation. Once you stop worrying about those two things it all gets easier. Also, get used to theraputic fibs. At first you'll feel like it's wrong to tell these little lies all the time but eventually you'll find that it's totally necessary. Tell some little tale to get him to the AL for an interview so they can determine placement and level of care. Then get everything ready for him at his new accommodation and finally, enlist the help of friends and neighbors to get him actually moved. Some people take them out to lunch and then return to the AL and drop them off. He won't know why he's there and you'll make up some story about his house needing work and then you leave. He will call you and be angry and he'll blame you and then you can come here and we'll remind you that you had to do it and you did the right thing. Don't accept his ranting about going back home, just don't respond. My dad, 5 years later and 102+ years old, has finally accepted that the AL is "an OK place" but he really doesn't understand why he needed to move from his 3 story single family home where he lived alone because he was "doing fine."

My parents refused to move into a care facility of any kind for two main reasons… First, they had a very distorted view of what the place would be like. In the larger area around the town where my parents lived, the care facilities are actually very nice, clean, and inviting. Not all of them, but many of them— especially the newer ones with the newer designs. The second is that my dad especially thought there was absolutely NO way they would be able to afford a place like this, and he was very set on making sure that his money did not run out before the end of his and my mother’s lives. In my dad’s mind, the nice IL & AL facilities were only for the rich.

Those are both very difficult hurdles to get over, especially when someone’s cognitive abilities are beginning to slip. But, after my dad passed away, I sat down and did the numbers. And my mother was much better set financially for a transition into a care home than I would have thought.

It helped a lot to take my mother over to a couple selected assisted living facilities to visit. Not just one visit, several. There was a welcoming committee of women that made it a point to come over and talk to my mom each time we went to visit. We did not have an opportunity to have meals there, but she was able to see the kinds of things that were being served. Actually getting her eyes on the place, and meeting some of the people there, made a huge difference in her buy-in.

I would like to comment also on how much of a difference good food and low stress can make in a person’s health and cognitive ability. There have been several couples that moved into my MIL’s IL facility that were on a pretty steep path of decline. Once they got settled in, and began eating regular, nutritious meals, their mental health stabilized dramatically, and they were able to stay in IL for many years. It was impossible over the last years to get my parents to eat good nutritious food. They lived— literally— on cocoa and English muffins. The reality is that they were not very hungry, and they ate junk all the time, with truly no real food. I live many hours away. I cooked for them and filled the freezer. The food went untouched, still there when I came for my next visit. There was a wonderful meals on wheels program in our city that I tried, and the food really was very good, and they kept turning off the service because they didn’t have anywhere to put the food. (!) Because they were not eating it. One visit, I found bags of the food sitting out on their back porch, rotting and spoiling. And they continued to eat English muffins and drink cocoa with extra whipped cream and marshmallows.

Anyway, all of the good care, and all of the good programs in the world don’t make any difference if your loved one refuses to participate in them. By the way, my parents also refused home care. The couple of times that we tried to dip our toes into home support were disasters. One aide stole their medications, and another was just a very bad personality fit. All of the home care people that came to our house treated my parents like they were idiots. I hear great stories about home care people from time to time, so I know good people are out there, we just didn’t find them in time for it to make a difference. And again, being many hours away, I wasn’t able to manage that as well as I would’ve liked.

Good luck with your search!

So sad that he has early onset dementia of this degree already.

My mom lived with me for 7 years. Cognitive impairment came, soon followed be dementia and then the doc said no driving and then declared her incompetent which activated my DPOA. When her living here, even with caregivers, was too much, I decided it was time for AL. I found a place and applied as her POA. When the time came, I told her 2 days before that she was moving. She was pissed! But I stayed firm though I was very upset at her outburst. I just said something about it being too much work and helpers were always calling out sick and she would be better off with more help and socialization. And that it was for me since I was too busy with babysitting for my grandkids. The next day, my husband I set up her apartment and the next morning I brought her over. While it was a big of a challenge, she quickly accepted it and adjusted to it. She doesn't love it there and never will but that's ok. At 80 with dementia, there aren't many good options. And no matter where she lives, she won't be happy since dementia makes their lives so difficult.

I agree with using therapeutic lies. Your situation if perfect for them. Do what you need to do for him to be taken care of and safe. He doesn't have to like it.

Best of luck!

Follow the advice by Geaton about a crisis with the house. Plumbing, termite tenting -- something that will require him to be out of the house for several days.

He needs a Memory Care facility, not assisted living. Don't make a mistake and put him in the incorrect level of care, because you don't want to do this a second time if you can help it. He appears to have early onset Alzheimer's or another dementia, so that's what you need to focus on when selecting a facility. Memory care is a locked facility with lots of supervision and activities designed to stimulate their minds. It's the best place for his particular needs.

My friend told her mom she had termites to move her out of the house.