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This is his third ALF. No matter how hard I try, he thinks its a hospital and that are supposed to be doing for him what they did in skilled nursing. This am he called and said "get me out of here. they aren't doing a thing for me". I have tried to explain, but now I think I should just change the subject?

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I hear the same chant from Mom. They never help her. As luck would have it she called me at 7:30AM to miserate. Then I heard the aide's sweet voice in the background, there to get her ready for 8AM breakfast. Mom told her "Not now I'm on the phone." Take it with a grain of salt.
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Depends how rational he is capable of being. If he wants to go home, he has to relearn to do what he can for himself; if he wants and expects to be pampered and taken care of totally even though he does not need that, it may just not be the reality of what's going to happen. If he is not very cognitive, you may just want to tell him "later" "maybe" we can find a different place but for now just do it yourself.

I was not clear whether he is delusional about where he is, versus just unrealistic in his expectations. Actually, even in the hospital, you'll find they don't do it all for you any more either!
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What does he want them to be doing for him? Sometimes my mom has the same issue in her NH; she no longer differentiates who the various staff are--doctors, NPs, RN's, therapists, CNAs, Aides, laundry people, they are all the same to her. She asked me about a medical issue and I asked her, did you ask the nurse practioner (who sees her every day). Who would I ask? she asked me! Ask Dad what he'd like to be done for him. Is it PT he's looking for? If there is an exercise room, tell him he's been cleared to exercise on his own now, that it's HIS responsibility to get the job done. DO point out the assistance that he's getting (medication management, laundry, cleaning, etc.) but yes, give it a month at least. Our elders adjust slowly to these changes.
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How long has he been at this AL facility? It might take a few weeks for him to stop mentioning leaving so much. I would just keep saying, this place has people who assist you with things and it makes you better. Then ask a question that's unrelated such, how he is feeling, does he need new pj's., etc. Tell me him you have sent him something in the mail and really do it. Send him cards, notes, photos, that will give you something to talk about next time.

Good luck. I've been there. Sometimes, it does get better.
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"Dad, you're not in the hospital. You're in an assisted living facility. They're two different things. You can't live alone anymore." THEN change the subject.

Repeated over and over again ad nauseum.
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