Dad has been living in an independent living apartment in a retirement community a half hour away from me and my sister, the past 4 years since Mom died. He doesn’t love the place where he is, but he’s used to it. Three weeks ago he was hospitalized...I think he stopped eating and drinking for a few days even though we had hired home support to look in on him every day, so he lost a lot of weight and fell. He went into rehab, and is being discharged on Thursday with a recommendation for assisted living. The place where he is doesn’t have any assisted living units available, so we’re going to put him back in his apartment with a full time aide while we figure out the next step. Another place very close to me and my sister does have an apartment that is kind of assisted living; he’d be checked on a few times a day and prompted for meals and medications. This seems like it would be barely enough, at least for has vascular dementia and my main worry is that he needs assistance washing himself. But I guess we could hire an aide to help with anything the place doesn't provide. The place he is now provides good care and peace of mind that he will be cared for medically. But I’m pretty sure my dad will hate moving to a new apartment there, having less autonomy, and, as before, not seeing us more than a couple times a week and being stuck having meals with strangers. He doesn’t do activities except with us and will not make a lot of friends in either new place. We’d love to have him closer so we could visit him nearly every day, which he enjoys, but what if the staff attentiveness and medical care at the new place turns out to be less reliable? I think he’d be happier there because he could see us at least a few times a week and it is a more diverse place in a more urban area, which Dad likes—but is it worth the upheaval of changing his insurance and his doctors, and the risk that he won’t be as well cared for? I guess we are choosing between Dad’s overall well-being and our convenience of visiting him on the one hand, and the peace of mind of knowing that at least his physical, if not his mental, health is being cared for even if we are not able to see him as often, on the other. I just don’t know how to answer that question. I'm afraid of being filled with guilt if things go wrong with either decision. Any suggestions?

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Ditto what Barb said.

On the fear of making the wrong decision point, go easy on yourself. The good news is that you and your sister are weighing this up very carefully and thinking it through, which is the best anyone can do. The bad news is that even if the world's most perfect facility magically appeared equidistant between your and your sister's house, like an oasis shimmering on the horizon, your poor darling Dad would still have vascular dementia and there would still be gremlins and hitches to sort out further down the line. You can't win.

So looking ahead, try never to beat yourself up about the 'if onlys'. You are doing your best in a situation that must, for all of us, inevitably end in failure.
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I think you are wise to move dad back where he was with aides whole you look further.

Making these decisions in haste is never a good idea. Have you asked the discharge planners at the rehab for suggestions about facilities? Do they have an affiliated AL or continuous care community on their Campus?

What we learned with mom that as dementia advances, having close proximity and the ability to pop in and to be able to get there quickly in an emergency were very important.

I'd spend some time at any proposed facility, perhaps ask some exiting visitors how their loved one is cared for. Look at online reviews.

Change is hard, on us and on dementia patients. Good luck!
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