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I am writing about my in-laws. My fil, at 87, has been as spry as you an imagine - university professor, writing his 25th book, and caring for my mil with dementia. (They moved 9 hours away from family 18 years ago to live in a fun retirement community.) Last week my husband didn't like the way fil sounded, and jumped in the car and drove down to check in. It had been four weeks since anyone had been there. My fil could barely walk, the house was a disaster, mil not clean...he took fil to the hospital, diagnosed with an abdominal tear of all things. Fil headed to rehab after hospital stay and we are caring for mil. They have agreed that once crisis is over, we are moving them back up to our area where there are three adult kids ready to help (but also still working, so we do need them near us.) Here is my question - what options do they have for assisted living when one spouse is totally independent and the other needs ft care? FIL is nowhere near needing care, but she is diabetic, incontinent, etc. His independence kept us at bay, and we think he avoided calling us because he knew it would trigger changes (that he is on board with now.) Thank you for any advice you can give as we begin the process of finding their next and final place.

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Call facilities. If there are options where they are, check into those. After all, what if the kids decide they are too busy with work and families to help as is needed?

Avoid the knee jerk reaction. Maybe they can remain where they are with outside support coming in.

So many times the good intentions blow up on families and become the beginning of irreparable family dysfunction and breakdown.

Dad probably would not want to.live in the memory care area. BREATHE catch your breath, take your time, evaluate, reevaluate. And again.
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There are many AL facilities that will allow a spouse with dementia to remain with the cognizant spouse. And the extra help is there when needed.
I also know of MC facilities that will allow a spouse that has not been diagnosed with dementia to move in with their spouse. The spouse without dementia can come and go as they wish.
Other facilities that have IL, AL, and MC will have the spouse with dementia in MC and the other can come and visit when they wish.
When you call to set up appointments to tour ask what their policy is and eliminate any that will not allow that arrangement that you want.
Talk to FIL and ask what he wants. I am sure that he wants to be with his wife but the stress of caregiving most likely lead to his health problem. the real question is if he moves into AL with his wife will he allow the staff to help as much as needed or will he still try to do it all? (because we all know .. "no one can care for my loved one as good as I can, I know what they want")
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Please make sure FIL has all his legal ducks in a row: assigned DPoA, Living Will (aka Advance Healthcare Directive), Last Will, etc. He may be spry and "able" now but cognitive impairment creeps up until it's too late to create any of those documents. Once these docs are created he should have a cognitive/ memory exam so there is a baseline measurement in his medical records.

If he doesn't have any of this, and is resisting to create them... be warned that this will be a future headache unlike any you've had before.

If the house was a disaster and FIL didn't call for help... I don't think his cognition is as good as you think it is. He may not be "totally independent". If your family had to "rescue" him, or orbit around him to keep things normal, then he is not independent. Moving them near you is a wise start!
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What Geaton said.

FIL is not "sharp as ever" if he didn't respond appropriately to this disaster.

DO NOT any of you give up jobs/careers to caregive.
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JennyCville Mar 2023
Trust me - we can't. But we need short term and long-term solutions.
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I've know several couples who have lived in independent living apartments and have great differences in their abilities. As one needed more care, it was addressed and dealt with. Having a 'healthy' spouse is a great blessing, b/c with help, they can often function really well--still be with their LO and not be separated at the EOL.

As needs grew greater, a couple of them did opt for more care, less space type living--and more dependence on the community part of the facility. Mostly for meals, I believe. And laundry.

It's great that 'right now' you appear to have a lot of family help, but you haven't actually put that in place, so you don't know how it's really going to work out.

I will add that in each of the 3 cases I'm talking about, money was not an issue. As their care needs increased, so did the costs. All of them were very well off financially, so no problems there--which is huge.

I hope you can find a way to make this work for you & your LO's.
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Time to as quickly as you can check the facilities in the area. While some folks like businesses like A Place for Mom and some do not (my experience with them was good) you NEED something now like this because your timing is short to address this. You need to know a good facility and with them you tell THEM your needs and your assets and set them on it.
Some places like the wonderful one my brother found in Palm Springs have cottages that have varying levels of care from level 1 basically self caring to levels in which a locked facility and some care with bathing, dressing needed to memory care. They are rare as hens teeth, these places, but are more and more available as the population is aging.
I sure wish you good luck. This is a really difficult situation, and whichever child is best able to take off some time is going to need now to do this as your Mom and Dad cannot. Speak with their village, their place to get a head start and hope you will update us as you go.
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Wait a minute - FIL is a long way from needing care?

Not so, m'dear. Husband didn't like the way he sounded. FIL could barely walk. House disaster, MIL not clean. Abdominal tear.

Please accept reality. He needs care. Lots of it. Rehab may not solve all his problems. He may end up with more.

Spry university professor writing his 25th book at age 87 does not mean that he'll resume that life tomorrow. Things change rapidly at age 87. You admit he needs AL, so you do accept that he is NOT totally independent. Yet you choose to think of him that way. That's nice, and he may be good at convincing you of that, but make sure your eyes are wide open as you proceed.

I wish you luck with finding a place that meets all their needs for now and the future. They are lucky to have you helping them.
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JennyCville Mar 2023
You are so right - I think what I was trying to articulate was that he doesn't need memory care.
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Well, I cannot agree with your statement that FIL is no where needing care at this point, he does.

My step parents were in AL, he in a wheelchair with a host of medical issues, she with mild dementia. He died, she is now in MC.

There are facilities that will be able to take them both in. I would go for one that has a step up program, from AL to MC and so on.

This will take some legwork, but it will be worth the effort.
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They can both go into an assisted living facility. I agree to find one that also has memory care in case it is needed down the road.

It is wonderful that your FIL has been active but he’s getting older and his health is changing now.

I bet he will be relieved not to be the primary caregiver for his wife once they are settled into a facility.

I agree that it will be more convenient to have them move closer to you.

I am happy to see that you are continuing to work and live in your homes. So many people who move into their parent’s home to care for them end up regretting their decision.

Best wishes to you and your family.
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Thank you to everyone - we have a short term problem (how to handle things once he gets out and we have to go back to work) and then how to move them up near us (which he does want to do.)
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