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Background: up until he was 93, he lived alone in another state with no support system. He drove to a drug store for food (Oreos and Coke). He drove to a restaurant daily to eat. He should not have been driving. My last visit the electrical was bad in the house, bathrooms leaked, etc etc. clothes were not washed. He refused help. My brother sold my dad’s car. I sold his house and we moved him to be near me. He’s now 94, getting worse. He’s in Assisted Living. Very little attention is being paid to him. His memory comes and goes. He has congestive heart failure. Do I move him to a different kind of care?

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My experience with my friend Jim, for whom I am POA and have placed in a memory care apartment, has been quite good. He eats with all the others in the dining room, but doesn't want to participate in the daily activities. He prefers to go back to his apartment, sit in his recliner, and watch the old reruns of Gunsmoke, Mash, the Andy Griffith Show and CNN news. Compared to many there, he is coherent and verbal. He tells me each time I visit how happy he is there and how grateful that his hearing and vision are good and how grateful he is that I am taking care of things behind the scenes. His door is always closed when I come and one time I left it open. A few minutes later one of the staff came in to check on him because the open door was a change. When I ask the nurse how he is doing, they have detailed records to refer to. The nurse has given me good advice about this care--something I have never done before--so I appreciate the guidance and wisdom they share with me. I need to try putting up a sign by his bathroom sink that says "Brush your teeth!" as he has been forgetting this and has 4 cavities now. He gets testy when staff asks him about showering and they have decided it is better not to ask. Maybe coming from me, it won't seem so nagging. I am grateful to have found a place that seems to be doing this caring job right, and I let the staff know how much I appreciate this.

 Good luck on your efforts. I hope you find a place as good as the one I have found. I went to 8 or 9 different assisted living/memory care facilities and luckily picked this one. Back then, it was a the only one that had memory care apartments large enough for a married couple, with a choice of a two bedroom, one bedroom, or efficiency. Jim's wife has since passed on and he remains in that same apartment. He remembers his wife and misses her, but nothing could stop her brain from shutting down. And he is thankful he had such a wonderful person in his life for the 47 years they had together. She is in a better place now, so wishing her back would not be an improvement for her. This attitude helps him be happy for what he has each day.
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Dear c47090,

I'm sorry to hear about your dad's health. What an amazing man to have lived independently for as long as he has. I would definitely talk to the doctor and nurses. Congestive heart failure is very hard to manage. I wonder if maybe he could be depressed as well after living independently for so long. It must be hard to adjust to a new environment.

Talk to your dad and see if you can get to the bottom of how he is feeling and what he wants. I wish so much I had talked, really talked to my dad instead of assuming.

I hope you can find the right care for your dad.

Thinking of you.
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Als are not for people who need a lot of care. They r not set up for that. There comes a time when its time for a nursing facility where there are more staff.
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OMG....STOP RIGHT THERE!!!

YOU have EVERY RIGHT TO MAKE SURE YOUR FATHER IS BEING CARED FOR AND PROPERLY ATTENDED!!!

When a parent is in ANY living facility, their physical, medical mental care DOES NOT END WHEN THEY PASS OVER THE THRESHOLD...NEVER.

All facilities must be under the scrutiny of the State. The State or County MUST conduct unannounced inspections for various areas of care, treatment of residents, health violations etc.
1. GET A SOCIAL WORKER THERE NOW!! Call his doctor, voice the concerns, request a healthcare provider to make that unannounced visit under the guise of a family friend. GO WITH THEM SO THE HOME DOESNT ADD 2+2= WE'RE IN TROUBLE
2. Get his doctor to make a house call, yes you can request this due to your concerns
3. TAKE PICS USING YOUR CELL PHONE!!! PICS OF EVERYTHING, EVERYBODY. Are there residents just sitting all day and in the same place you saw them the last visit. LOOK for physical harm that you CANNOT see by just walking into his room...TAKE PICS.
4. Taste his meals, check the kitchen yourself no matter the upset you'll be creating
5. DEMAND to see their records regarding your dad's routine
6. DEMAND that they give you daily, weekly reports as well as text pics to substantiate their claims
7. REPORT YOUR CONCERNS TO THE ELDER ABUSE LINE!
8. Ask the State health department for the records regarding the home's report card. They MUST meet a required % or the State MUST shut them down. Find out what that % is and go for it. MANY inspectors turn their backs or do not do their job at all, they're typical government employees.. NOT all of them
9. THE MORE YOU COMPLAIN, DEMAND FROM THEM AND THE STATE/COUNTY, YOU'RE NOT ONLY ENSURING YOUR DAD'S WELL BEING BUT ALSO EVERYBODY ELSE UNDER THEIR CARE!!! WHAT IS MOST IMPORTANT TO YOU AND DON'T BE AFRAID OF MAKING NOISE
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I moved both parents into Memory Care within months of them going into a home. My Mom was upset because she couldn't come and go as easily, but in the home she's in, they check up on her every 10 minutes... and she needs it. In the beginning she was complaining about being locked up, but after Dad passed, she went and looked at some of the non-Memory Care rooms and decided she liked her ocean view rooms better. I'm definitely have a good laugh over that.
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This is something I struggle with too in relation to my parents. When I start to wonder whether it is time for the next level of care, I have conversations with the folks at their graduated care facility (they started in Independent Living and are now in personal care AKA assisted living). In their facility it turns out there are four different levels of care within personal care. So I am keeping in touch with the personal care clinical director as I see my parents’ needs increase. It is so hard for us to know what to do because we have the emotional component to our decisions. That’s why I rely on the folks at the facility to help me through that part. I hope this is helpful to you. It’s a difficult journey. I wish for you strength and clarity.
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My dad lived in assisted living. At first he was able to attend activities, enjoy meals with other residents, etc. but the last 4 months of his life he was having memory issues and did not know what time a day it was. Rather than move him, I had sitters with him 12 hours a day and they helped him go to activities and meals. You dad may just need more support to remain where he is or a dedicated memory care unit. Staff at his current facility should be able to provide input on his situation.
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My stepdad was moved to assisted living at the age of 87. He had a full, busy life. The previous eight years he had been caring for mom with Alzheimer's, four of those with me as their 24/7 caregiver. He needed help too, and would not have been able to care for mom alone.

The first few weeks at AL the staff would come to escort him to meals. He would usually just go to lunch and would take mom from MC with him. He had a very full and busy life and had reached the point that he preferred alone time. That is ok. Some people are just not social and like their time alone. He was one of those, as am I. And staff have many people to care for and just do not have time to spend trying to get an elder interested in being social.

Does he need a higher level of care? Get an assessment done by his doctor to determine that. Ask staff where he is now their thoughts. Then decide. Also consider how difficult moves are on the elderly. A move nearly always causes decline, sometimes temporary. My thought is always if it is not broke do not attempt to fix it. There are too many unknowns.
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Sounds like he may have some dementia...he first needs a full medical exam, then a determination for better placement.
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He sometimes eats with the group, sometimes not. Recently he’s been refusing to change clothes, bathe, etc. He doesn’t do any activities except fidget and write notes on paper. Sometimes he watches TV (mainly a news show that is local and repeats the same news all day long).
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Has your dad had a complete medical evaluation to know what other issues he may be dealing with other than CHF? What info do you get from the staff at his assisted living about his health and activity level, such as if he’s eating well, participating in activities, etc?
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