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My father has vascular dementia and has recently declined. He spends a lot of time sleeping, is starting to have trouble with swallowing and is not really able to engage in conversation. He has lived in assisted living for 2 1/2 years. My family was just notified that they can no longer safely transfer him. He requires a hoyer lift that the facility does not allow. Has anyone been faced with this and contemplated moving their loved one to another state? I live in Boston and my father lives in Philadelphia, where he has limited support. I am fearful such a big move would cause him to decline even further. Thanks in advance.

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I'd sort out any financial, insurance, etc. issues in advance. This is especially true if he has benefits through the state where he is currently residing.
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Diane11, every person with dementia is different, but my experience in moving my dad from his home in another state to my home (when his MOCA score was in the high teens) went well. He adjusted easily and within a couple of weeks he didn't remember ever living anywhere else, except for his childhood and college day homes. Three and one-half years later I moved him to memory care assisted living (when his MOCA score had dropped by more than 10 points) and he again adjusted easily. That said, during all of the 5 years he lived under my care he wanted to go "home" almost every day (or several times every day), but " home" to him was his childhood home where he thought his mom and dad were waiting for him. Often he thought I was his dad and he seemed more content during those times.

Your father may not adjust as easily, but he will benefit from having a better support system by living closer to you.  Kudos to you for watching out for your father and best wishes during this hard time.
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You are between two not so great choices.

Keep him in Philadelphia in NH where you need to travel a long distance to visit or move him to a NH in Boston where you will better be able to visit and oversee his care.

Since you are going to need to move him anyway, it seems like getting him closer to you is the overriding imperative.

Can he pay for Medical transport? Is he on Medicaid? Getting that started in a different state can be a daunting process.
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Any move at this point is going to be difficult. So I would move him where he has the most support.

I would also put him in a continuing care community so that he never has to move again. Make sure that the facility accepts Medicaid if that is somewhere in the future.

Hugs, this is such a difficult journey.
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