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After my dad was hospitalized and I realized my 88yo parents could no longer live independently, they both came to live with me 13 months ago. Mom has some age-related decline but is mostly self-sufficient. Dad has dementia and needs a great deal of care. I am their only child. Mom and Dad have been married 69 years. Even with his dementia, Dad still knows Mom and doesn't ever want to be apart from her. I am married and work full-time, and we're managing right now with hired caregivers during my work day. It's getting more and more difficult, not to mention more and more stressful, to care for Dad, and I anticipate some point in the future when we will have to put him in a memory care unit. Mom does not want to go to a facility with him, nor does she need that level of care. It breaks my heart to think of him in a place without my mom, knowing how emotionally dependent he is on her and knowing how confused and sad he will be without her. How do I handle the emotions that will come from separating him from his beloved wife?

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You have my sincere sympathy, and this is just to give you another story of how you never know how things will work out. My parents in law needed more care because of my MIL’s health and mobility issues, and we finally got them into a fantastic facility which was AL with NH level care provided to each unit via a common back corridor that served all the units. It also provided a shared unit, and allowed them to keep their little dog. Three weeks later our dear FIL went out to walk the dog using his walker, fell, went to hospital and died three days later. We suspected that the changeover in medication wasn’t done right, but it was too late to help him or anyone else by making a big fuss.

See if you can move them in together. But don’t assume that your mother will outlive him, just because she seems self-sufficient now. Just keep them together as long as you can. Lots of love to all the family, Margaret
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Just do it. I know, I know, there is a lot of anguish there but it might not be as bad as you think. If your mother does not want to go with him, then find a memory care facility as near to your home as possible, just to cut down on travel. He will be confused and sad but those things happen at that age. The staff will really keep him occupied, he will be cared for and he will adjust. It will be sad and painful for you too, because this is the end of their lives together but there are hard choices and you are suffering too. And your mother is limited in what time you have to enjoy her because of the care he needs. So in the land of "trade-off's, having him in MC and having her still able to be out and about with less stress for you and your family is a reasonable one. Try to not feel guilty; this is really hard. My inlaws were married 70 years. We initially placed them together because they both needed some care, her more than him. She fell after 6 weeks in MC and broke her hip so they had to be separated. And really the two of them together, with the different stages they were in, was not going well anyway. He was sad and he worried about her and it was sad for us too, but it was making the best of a bad situation. Sometimes that is all you can do.
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Although mom doesn't need the care and doesn't want to move to a facility, could you talk her into moving there at least temporarily? Guarantee her that she will come back to your home and ensure that she has capability to get out of the unit during the day (if she doesn't drive, some places offer transport to shopping, etc or you can hire drivers), even if it is to take a walk or hang with other residents (assuming the facility has other levels of care, such as AL.)

At some point he will begin to forget your mom, and that is likely when you can bring her home again. If she would agree, going out during the day will require some fibbing on her part, to assure him she'll be back. She could say she's going to work or out to shop, etc. Another option is to have her spend part of her day there, taking meals with him, maybe lunch or dinner and then come home when it's his bedtime. That way she gets to be with him without having to provide care but doesn't have to live there or incur the cost of living there. It would make his adjustment a little easier. It's only temporary, until he adjusts.
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There are ALs with memory cares attached. She could live on the AL side and him MC. Then she can visit him when she wants. She needs to realize that this is a strain on you. Its now what he needs, not what he wants.
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Get more caregivers. You can do it.

I know you feel at the end of your rope, but these times are short-lived and you can never get them back.

Separating them may hurt you more than them.
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They can both go to same place in different units of care maybe. Call around get info will they be able to visit each other with assistance there?!
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Mom needs to Sit Dad Down and no Frown.....She can always Visit with you.....
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You have a lot of advice here to do quite different things; and this is sensible, because the path ahead is not yet clear. Having been married 57 years myself, with my wife 10 years into dementia and confined to bed and incontinent for the last 22 months, I feel for you. Here are my thoughts:
1. If you have a good hospital bed (in the United Kingdom there is the Dyna-Form Air-Pro Plus bed that is an air mattress that adjusts sections of the bed every 20 minutes by electricity), this makes it possible for someone to remain in their home and still have a surprisingly contented life. I pull up a separate bed frame and mattress and sleep beside her each night, which we both appreciate.
2. You do need carers (or the Americans say, caregivers) to come especially in the morning and evening to change incontinence pads and help with meals. We have Home Instead, a US firm, that has local franchises especially in the USA. Each franchise will be different but our experience is that they are very competent and caring. If you try to keep care for yourself or within the family, you will burn out.
3. Both persons going into a care facility at the same time is a possibility, but you have to make the choice cautiously. It could be difficult for someone without dementia to spend the entire day surrounded by dementia. However, it might be a possibility with a shared room and different activities. I considered this, but rejected it. A lot of the problem in the United Kingdom is that care facilities are quite regimented with people being required to eat, sleep and do specific activities at set time. Each of us are unique human beings with different needs. For example, my wife is sleeping some 16 to 18 hours out of 24 (with 12 to 13 each evening and morning and afternoon naps). This is essential for her to be able to relate to others; and there is research evidence that sleep helps a person to cope with the Tau tangles and amyloid plaques in the brain--not to remove the underlying problems, but to temporarily diminish their impact. In a care facility this is hard to handle, unless the person just stays in bed and is somewhat ignored.

Be encouraged and move ahead slowly. There will be a solution that is right for everyone.

Love and Prayers
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Check other home agencies in your area if more are available. Before covid I used two different ones. Also check into Hospice at home for the dementia diagnosis. My mom has been in Hospice at home for 6 months now and was just renewed for another 9 weeks. Hospice supplied everything we needed (We already had a Hospital bed through the Lions club) and a nurse to bath mom twice a week. One home care agency had a 2 hr limit great for putting mom to bed or coming in mid day for meals. The other had a 4 hour minimum requirement. This was good for mornings, get mom up dressed and through breakfast & teeth brushing. My dad is like your mom self sufficient but not able to do moms (94/dad 96) care. I fix dinner for everyone. If I have to go away I bring in someone to cover lunch through dinner. I pray you find a solution that works for everyone.
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There are tons of places with memory care and AL mixed. My aunt is in AL one. We had planned to put my mother in memory care there, but she became very sick and went from the ER to skilled nursing, back to the ER, to hospice care.
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A further thought:

As the years progress, what you eat has a cumulative health impact for better or for worse. Those with dementia do not have the ability to know what is best to eat, especially as the dementia progresses. Therefore, the family and carers need to be alert to what works best. My experience is:

1. LIquid intake is very important, preferable 1,000 ml a day in small doses. Coconut water (not coconut milk) works well with a lot of nutrients, as well as mixed with Kefir (kefar). However, this needs to be in doses of not more than 250 ml throughout the day, with pauses after each 100 or so ml for a possible burp. Coating the lips with vaseline helps to reduce air being sucked up.

2. People with dementia tend to like sweet foods, so putting some honey on some foods works well. For example, for breakfast porridge (Ready Brek) with a banana is a good start, with a teaspoon of honey.

3. Don't encourage overeating. Often the person with dementia will know when to stop.

4. What comes in comes out. Incontinence is an inconvenience but manageable. Failure to urinate or constipation is a much more serious problem, often requiring nursing or medical advice.

5. Keeping track of how much a person with dementia is sleeping and eating, as well as their activities throughout the day is often helpful in deciding how best to provide care.

6. If vomiting occurs, you may need to give a medicine (Zoton/ Lansoprazole) that coats the inside of the tummy and should be taken half an hour before eating, although you can drink immediately after taking it. Ideally, the tablet is placed on the tongue, but it can also be dissolved in a small amount of water and sucked up in a straw. Also, sometimes a powder that is placed in liquid such as Nutilis thickens the liquid and helps drinking.

7. Note these comments are not from a medical doctor, just from personal experience with one person. Check with a medically qualified person before acting on this advice.

Love and Prayer as you make many little and big decisions.
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sister46 Jun 2020
Eating wasn't the issue.
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My uncle went every day to be with his wife (in a SNF) all day. He had all three meals with her, said good night and went home. She was content, not lonely, loved, and he felt that he had taken good care of her. Occasionally he could not be with her all day and she was fine. She missed him, but she knew he was always coming back. She passed peacefully after several years, and he was able to recover from the loss knowing he did the best anyone could. Find a good facility nearby and bring Mom over everyday unless she needs or wants a break. They will adapt. He will miss her when she isn't there but it will be healthier and safer for both of them.
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My father has advanced Alzheimer's. My parents have been married for 64 years and have rarely been apart. When the writing was on the wall that they would soon no longer be able to take care of their home, we brought up the subject of assisted living.
It took over a year to convince my mom that they needed to leave their home of 62 years. (I realize that your parents live with you, not independently, but the issues are similar).
Knowing that Senior Housing would only be a short-term fix, since my dad was getting progressively worse, we started looking for assisted living with memory care.
We found a few options that allowed them to live together, but also offered services for dementia.
Now they live in a beautiful apartment building. Still living independently, but assisted living services are available ongoing, without moving. Eventually my dad will need to be moved to memory care, but it's in the same building, just in a different wing. By then they will have adapted to their new normal, and hopefully my mother will have made some new friends to help occupy her time.
Maybe it's time to let Mom know that living with you is not the best answer for any of you. You also need to live your life, and know that they are safe and cared for.
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I could have written this question! I am going through the same thing right now with my 89 year old parents who have been married 69 years.
Mom has some heart issues but is more than capable of taking care of herself. Dad has Alzheimers and Mom has been caring for him. They live in an independent senior living facility. Caring for Dad has taken a toll on Mom mentally and physically and she simply can no longer care for him. They adamantly refuse to live with either myself or my sister. So for both their sakes, we are moving Dad to memory care and Mom will move into a studio apartment in the independent living facility for now (we expect that at some point, she may need home health care or a move to assisted living).
The memory care unit is just across the parking lot from independent living. Due to COVID, they won't be able to physically visit at this time but can do Facetime (with the help of employees at the facility) and if the weather is nice Mom can go over and visit at his window.
This was not an easy decision and we know it is going to be a big adjustment for all of us but we had to do what was best for both Dad and Mom. Dad has been "existing" for the last year. There is no joy in him (and he was always upbeat and joyful). We hope that the professionals at the memory care unit will be able to get him to be more engaged than he has been and we might see some of the real Dad again. It is especially hard because he is physically healthy.
I wish you luck in your decision. No matter what you decide, you will have moments where you second guess your decision. Keep what is best for each of them care wise in your mind and it will help minimize the guilt that naturally comes along with these decisions.
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Do you have the authority to separate your father from your mother? Unless your father gave you his power of attorney/health care proxy I think you might find this is her decision to make and not yours. What does your mother want to do about his care?

She may be longing for a break, you know. Be prepared to keep your face neutral.
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I agree with Countrymouse. Not knowing their history, it is possible your mom may not share/vocalize her deepest thoughts but may internally be looking forward to “freedom” from having to deal with her husband. Many women (and possibly men) from that era stay in marriages and put on a happy face even if they aren’t happy. Just a thought...I could be totally off base.
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Does the memory care facility you are looking at have a campus that includes Independent Living? I recently moved a family into a senior campus that offers an Independent apartment and the spouse can walk through the facility and go in to the memory care unit and visit every day

Kimberly G., BSN RN SRES
Geriatric Nurse Consultant/Senior Real Estate Expert
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I'm thinking that an intermediate solution would be to find adult day care for your dad. This would develop a tolerance for each of them to be apart from one another as his condition declines. After all those years together (my parents were married for 70 years, but apart for the last two) your parents are co-dependent so obviously it will be an adjustment. But it is an adjustment that they will have to make. If the day care is a location where your dad could become a permanent resident eventually, that would be ideal. But day care, then memory care will likely need to be provided for your dad, not just for your sake, but for your mother's and father's. You have three aims. Provide care for your parents without sacrificing too much of your own life, find and facilitate appropriate care for your dad, and very importantly, protecting the quality of life of your mother. I made sure to bring mom to visit dad as often as possible, took them both out for lunch once a week and made sure that she could get to the facility by way of the council on aging van or a kind neighbor in between my visits so they could have time together without me. I realize that you now have Covid to contend with, but hopefully, there will be an improvement in that aspect soon for your sake as well as all who are in this stage of caregiving.
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I agree that you need to ask your mother what she wants to do. What kind of financial resources do they have? What kind of space do they currently have in your home? Is your property large enough to put a pre-fab "granny pod" on it where they can live together with help? At least it would be not inside your home but you can keep on eye on them. That option would require a lot more management on your part and finding reliable help.
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Figure out what the cost of memory care is going to be and see if the money would be enough to get more hours for your dad - even overnight. Maybe you won't have to separate them.
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Why separate them? Look at ALL the memory care communities in your area and pick one that's the most appropriate for a couple to live together, even if one is more cognitively healthy than the other. Or, if finances allow, move mom into IL or AL and dad into MC. They'd still be living together all day (and as often at night as they choose) and your mom would be able to have a social life that doesn't included worrying over dad.

The key is to find a FLEXIBLE senior community that's really lifestyle and resident focused. They all say they are, but some are run more like nursing homes with more rigid (and sometimes arbitrary) rules.
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Would it take some of your burden away and would your mother agree, if your Dad had 24 hr a day caregivers? (If you can afford it). You might need 3 8-hour shifts. Perhaps then he can age in place.
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Imho you should determine what their financials will afford them.
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Move them both.
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my father, with starting of dementia, had fallen, was put in hospital but my mother could no longer care for him. they would have been married 76 years this year. he just recently passed.  however when we had him put into the nursing facility my mom would visit every day, then switched it to every other day.  eventually over the years we would visit 1 time a week and it worked out fine.  you just have to explain that you all visit and I am sure he will do fine there.  make it a point to go on special occasions.  and most places do things for veterans day, holidays, etc where everyone is involved.  good luck
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