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My dad is declining fast. He has COPD and also can't walk well at all. Literally two weeks ago he was driving (foolishly of course, but still doing it). I took off work to help get him diagnosed and to help get him the care he needs. He can't recall a conversation we had a minute ago, but he's slightly aware that something is going wrong. The five days I've been here, he's not aware of where he is when he wakes up. He believes he's in his home town 20 years ago, so is confused when he doesn't recognize things. He has COPD, is a major fall risk, and has many medications. He needs 24/7 care without a doubt. He really can't be left alone, else he may get an idea in his head and forget he needs his walker, and have a major fall (he's had 3 in the last 7 months.) If memory care near me ends up being the best option, I'll be taking him from his female companion (who loves him very much but can no longer handle this disease) and his cat, the two things he recognizes and loves. What kind and gentle fib has anyone used to get their loved ones set up in an appropriate memory care center?

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You see, from what you have told us it doesn't matter what fib, really. He won't remember. His friend will. I hope that he can be placed near her. I hope the kitty, with a vet certificate, can visit him. There is no way to make this good or perfect. Not everything can be fixed. Some things we just have to do the best we can. I am so sorry. Heart breaks for you all.
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You asked: "What do I say to my dad with dementia now that we need to move him to memory care assisted living, away from all he's ever known?"

Since he can't remember what is said to him a minute ago, then you can say anything you want in the moment in order to get him to agree to do what you need him to do at that same moment. The next moment, you can say something completely different so he will agree to do the next task, and so on and so forth.

So, if you need to clean out his closet, and put all his clothes in boxes, you can make up a story that the clothes need to be laundered because there are bugs.

If you need him to get in the car to go to the new place, then you can say you're taking him out for a drive, or visit some place special, etc.

If he asks why he is where he is, make up something. This new place is a hotel in some exotic place. He's there for vacation.

The point is to tell him whatever you think will work at the moment. If he says NO one moment, he can say YES the next moment when you give him a different reason/story.

Kind and gentle fibs which you want are whatever fibs that will sound good to dad and make him happy and accomplish what you need him to do.

If possible, bring his female friend to visit him often. As for the cat, maybe a realistic looking stuffed cat will give him some comfort. I know it works for some elderly to have stuffed animals to cuddle with.

Good luck and tell us how it goes.
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It sounds like your father is about where my husband was when I had to make the decision. When I made the decision it was time to put my husband in assisted living, I didn't say anything to him. It was my decision, he was a danger to himself by crossing a 6 lane boulevard on a Sunday afternoon and the next night he was going out the door at 1:30 am. It wasn't his decision. Where was he going at that time of night? To see his wife he thought he left in another town 190 miles away. He was going to hitchhike! The next day I contacted the facility I wanted him in, got the paperwork going, got the doctor's signature on paper, his TB tine test, and arranged for a mover to move his clothes, bed and dresser and recliner there. He wasn't able to think if he wanted this move, he was a danger to himself; he couldn't remember much. The hardest part of that whole thing was after his admittance, I had to stay away for 3 weeks until he acclimated to the new home. Couldn't even talk with him on the phone. Was he mad when he saw me, yeah, a little, wanted to go home. I just ignored his comments and let him adjust. Was that hard?? Hell, yeah. After 58 years I had no sleeping partner, no one to sit with watching TV, no one to give a kiss to in the morning. For him, he soon forgot who I was anyway. As for the cat, you can buy a mechanical cat, really looks and acts like a real cat, snuggles up to you, meows, moves arms, legs, turns over. $99.00 Amazon. They had several at the assisted living where my husband was. Be strong, do what's right for him, he doesn't know what is right for himself.
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After much researching and planning, I found a memory care apartment for married couples for my two friends. Wife had frontal temporal dementia, husband short term memory issues. When the wife got so she needed 24 hour care, I was able to convince the husband they needed to go to a place that provided that. He was sure he was just fine, but would do it for the wife.

The day of the move, another friend took them to breakfast about 45 minutes away, then to have their nails done. While that took place, the movers and I were taking the things I had selected and moved their furniture, pictures from the walls etc, and set up their new apartment to look just like their bedroom and tv room. When they came to their new "home", the husband saw his favorite recliner and sat down with a sigh of relief and never said a word about not being home. All the most familiar things were there.

The wife's brain deterioration continued rapidly and she passed away 5 months later. The husband is still in his apartment, going on 5 years now. He never once said anything about their condo and I never told him about all I was doing to get rid of their stuff and sell it. I saw no upside to discussing these things since they had given me complete authority as their power of attorney to make all these decisions. Any money coming in goes right to their checking account. Any money going out is in response to a bill, so there is evidence to show how their money has been spent. Not a penny comes to me, which is how I want it. I am also executor of their estate, but I am pretty sure nothing will be left to distribute. The husband is in good physical health but could not survive on his own. He is now 94 and shooting for 100. He always tells me that the only thing I have to do is live as long as he does. I always tell him I am working on that. We've been friends since about 1972 and there are no children or close relatives to have involved. Just a few friends.

I went to about 9 different assisted living/memory care facilities before I found the one we are using--the only one that offered a choice of two bedroom, one bedroom or efficiency apartments on the memory care level. And they give good care and gave me great advice on what was happening to the wife and what I should be ready for or do next. This was all new to me and I needed that guidance.

Best of luck on your decision and probable move.
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When you say that you "took off work to help get him diagnosed" I am wondering what the diagnosis was. It sounds to me like you are implying dementia.

Also, it sounds like all this is rather sudden (other than the history of falls). Please ask that he be checked for a UTI. The elderly can have a UTI without physical symptoms. There may be no indicators in the appearance, smell, or frequency of the urine. But there may be mental confusion, forgetfulness, disorientation that indicates dementia. Before accepting a dementia diagnosis, ask that a urine culture be run. It will probably take two days before results are in. This is not the same as the quick urine test that is done in the office.

My own story -- I knew (from friends who have been down this road) the above information about UTI but when it came to my own mother, I trusted the nurses and I trusted my father to communicate to the nurses that I thought mom may have a UTI and needed tested. Mom "declined fast" as you wrote. Weeks passed, she got much worse mentally (but still fine physically), until mom literally lost her mind (destroyed things in the house, included her treasured Christmas cacti, smeared feces all over the house -- curtains, walls, furniture etc. -- ran around outside without clothing yelling at the neighbors "Look at me!" and tried to kill my father). The last month of her life was horrible. I will forever regret not being more forceful and less trusting and calling the hospice agency myself and demanding that they get a urine culture done.

Please pursue this possibility.
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I do not understand what you mean by "gentle fib"--what is wrong with being honest. There is no such thing as a "fib" -- Don't lie to your parent. When moving them to a nursing home happens, they will feel even more betrayed because you lied to him. Tell them they need to go to a nursing home because you and his companion are unable to care for him. If you are going to do the nursing home thing, tell him the truth. Do not assume they will not remember.

Lying to people is the worst thing you can do, especially when it comes to their plan of care.

Nursing homes are NOT safe. They often get neglected, prone to bed sores and contractures, they fall, can suffer malnourishment/dehydration, and infections catching whatever is going around. Explore all other options but if none is available tell him the truth.
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MargaretMcKen Aug 2020
Be real, lying is NOT the worst thing you can do to anyone.
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The girlfriend can visit anywhere, but PLEASE look for an Alzheimer's Memory Care facility that allows CATS !! I am sure your Dad probably sleeps with the cat and will take comfort in knowing his furry friend is still with him.
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This transition is so heart breaking. The best thing you can do is make sure your father is safe and cared for, and if Memory Care is the best solution, then go ahead and proceed. It doesn't matter what gets him there, honestly he won't remember it the way you will.
As to his female companion and cat, once Covid regulations are over, they should be able to visit every day. By they, I mean definitely the female companion and also possibly the cat. If that were me and I could have my partner and my cat visit on a regular basis that would be the best possible solution.
His partner will be sad but she will also feel relieved that he is getting the treatment that she can't provide.
I want to assure you that you are doing the right thing, and that this is possibly the hardest part of this journey, and once it is done and your father has settled in, he'll be well cared for, and you and his partner (and cat!) can visit on a regular basis.
Wishing you all the best during this very difficult time.
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Beatty Aug 2020
I agree with all you said. Practical but caring reply.
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Dorry, but there isn't any gentle way.

If at all possible, your Dad would feel live, safe and happy in his own home, not moved to some cold unfamiliar and not so friendly facility where your Dad wouldn't even be able to tell you how he's being treated.

You should let him stay where he is and where he is happy and loved and let him take his chances of falling instead of dumping him at a Facility that will give you peace of mind bur not him.

He will live longer and happier with his ladyfriend and cat and certainly have less of a chance of getting Covid.

You could install Nest Cameras to keep an eye on him in his home.

Ir doesn't matter if he doesn't remember what he said a minute ago.

My 96 yr old Dad is the same way.

He has short term memory loss which means he can't remember something that just happenedor said. But you talk about something he's been doing awhile, he remembers, like my Dad remembers he was a Fireman and he rode motorcycles, ect.

Let him be as happy as he can and live in his own home.

Beleven me, he had just as much chance of falling at a Nursing Facility as home. Maybe even more seeing how they keep you pretty doped up, especially if you're a problem. They'll give him something to sleep, ect.
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DoWright Aug 2020
I know what you mean, I would like for him to stay in place too. The medical appointments his own companion is probably not in charge of can be 100% handled by a facility. Many times, dementia causes real safety concerns at home with just the kitchen & bathtub, elders seem to wait until nobody is around and then they have accidents. Dementia changes how they make their feet move & or forget where they are intending to arrive. So they can get to the point of being aggressive with frustration. I have worked as a caregiver for 11 years & have seen clients who stay at home well past what most consider safe. COPD makes it progressively harder over time to get oxygen fast enough to the brain & organs etc., there will be a need for around the clock care anyway. Sounds better to place him. Just keeping all shifts covered for in home support on a daily schedule so elders could "stay in place" is a chore too. It takes dedication and you are on-call 24/7 honestly if you are a close friend or relative, you will be asked to assign yourself for emergency contact. I do like the idea of keeping loved ones at their home too, really. It's just so much more effort than most realize. Retirement is not all casual living & laughing at small memory loss. * My dementia client now dismantles and messes up just about everything, then he tells me these items don't work anymore. Nothing is sacred, not the mail, any messages & appointments he might have responded. Forgets to take his medication and is extremely grumpy if you repeat for him to get off the bed or shower so we can leave for errands. His wife has her hands full & i only help a few days a week. She reminds me my life is bliss because i can leave. Retirement is a lot of maintenance & often a very busy time of life.
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We have moved my MIL first into Independent Senior Living - which was the most difficult move, but we told her she didn't have a choice because she couldn't care for herself anymore. It took less than a few days for her to settle in. Then it was time to move her to Assisted living, and I worried about the effect. I took her out shopping, and my husband did the move. When I brought her to her new place, and we escorted her to her room - she didn't even notice a change, even though it was a different place, and she went from a one bedroom to an efficiency. Two years later, we moved her into memory - and again, she acclimated. In both cases, it was more difficult for me because I worried about her and what to tell her. If its time, just do it. Don't worry about stretching a story if necessary - like his other place is being painted, or fumigated, if you feel you need to. If he is ready for a higher level of care, you are doing the right thing.
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