Moving Dad from assisted living to Home (long thread)

[Lakewood90712]

Our dad is 84 , wheelchair bound , has been in assisted living for 2 years, and last 10 mo in the dementia unit. It's Belmont Village, not a nursing home. The care is safe and adequate, ( no bedsores, only one trip to the hospital , and only 2 falls). I really feel bad , like I'm leaving him in a Human warehouse in his last years . This makes me feel like a rat , not having him in a comfortible place , I sure wouldn't want to be there if I was in his position . There is no "do over " at this stage of life.

I'm the youngest of 3 children at 50. Brother carred for him by himself for 2 years and is burned out on caregiving / manageing his care. Sister is 200 miles away with her own issues. Dad's dementia is vascular , not alshimers, so he is often aware of his suroundings . Current care cost is about 85K per year. His retirement , ss , and a small cashflow from the rental of his house almost covers it.

I'm thinking of doing some accessibility modifications to my own home and bringing him here, hiring a service for 24 hr. care. I don't want to be a direct employer of caregivers/nurses . I have no ability to do the care myself.

His rental house has about 650K of equity in current market (2 blocks to the beach).

?1 What does 24 hr care cost ( Los Angeles)and ?2 Selling the house and investing with 100% safety , I only see 10 year treasurerys yeilding about 3.4 %. Carrying a first mortgage back would yeild more, but could be problematic.

Any ideas welcome.

 

[bizlady]

Talk to your county social services. They can make some referrals for homecare. Your local hospital may also be able to make referrals. Your dad may need to pay taxes on any capital gains for the house.

Are your siblings on board? Does someoene have power of attorney to handle his house sale etc?

These are challenging and emotional times. We too are dealing with similar issues, but expenses are much different in the midwest. Best wishes.

 

[Martha]

How has your father adjusted? Will the move just be a disruption for him?

 

[Moemg]

Think long & hard before you make this move . 24 hour care giving is ultra expensive and sometimes unreliable . Plus since your Dad is wheelchair bound you will probably need to assist the caregiver when she or he moves him into a chair , the toilet or back into bed .You will also have to fill in when the caregiver does not show up .Sometimes even though it is hard on us a Assisted Living or Nursing home are the best solution just visit him often .

 

[REWahoo]

Think long & hard before you make this move . 24 hour care giving is ultra expensive and sometimes unreliable . Plus since your Dad is wheelchair bound you will probably need to assist the caregiver when she or he moves him into a chair , the toilet or back into bed .You will also have to fill in when the caregiver does not show up .Sometimes even though it is hard on us a Assisted Living or Nursing home are the best solution just visit him often .

+1

We cared for my MIL at home for five very long months. Finding competent, reliable caregivers was challenging, expensive and often frustrating. Be careful your heart doesn't overrule your head and you end up having your good intentions backfire.

 

[Lakewood90712]

How has your father adjusted? Will the move just be a disruption for him?

He is very withdrawn , hard to get him to even talk. I don't know how much of this is dimentia and how much is from being away from home.

 

[Lakewood90712]

+1

................ Be careful your heart doesn't overrule your head and you end up having your good intentions backfire.

That is exactly what I am dealing with. I am his court appointed conservator. Everyone else , including the probate court investigator thinks I have dad in the best place under the circunstances.

I guess it's just time for me to grow-up , accept what I can't change and do whatever I can to lift his spirits where he is.

 

[Sarah in SC]

That is exactly what I am dealing with. I am his court appointed conservator. Everyone else , including the probate court investigator thinks I have dad in the best place under the circunstances.

I guess it's just time for me to grow-up , accept what I can't change and do whatever I can to lift his spirits where he is.

Yes, this is what my gut is telling me about your situation--keep him where he is. I know you feel guilty but you can only do so much to change his situation. Even at home, his world has drawn so small that you can't really improve it by changing the surroundings.

Since he can't tell you this, we will: you are doing a fine and honorable job of taking care of his physical, emotional, and financial well-being. He is a very fortunate man to have you looking out for his interests.

 

[RonBoyd]

He is a very fortunate man to have you looking out for his interests.

+1

 

[MichaelB]

Belmont Village is a good facility – definitely in the upper tier of assisted living. It costs far less than equivalent in-home care. They are careful with and respectful of their residents, and work to enable a strong social network among them. I have a very close family member in one and DW has done volunteer work in another – both in the Chicago area.

Bringing your father home might not improve his care, because he really needs multiple types of support that would be very expensive and difficult to provide at home.

One option to improve your father’s care would be to hire a companion for him. They compliment the caregivers and help with many personal aspects of daily life, such as personal hygiene, dressing and meals, and are very helpful for people needing assistance with mobility. I don’t know what they charge but they are common in the Belmont Village facilities I have visited. They have the same skill level as the Belmont “pals” – mostly aides.

It is hard to see a loved one with declining awareness. Just visiting your father regularly and showing him your affection while others care for him is meaningful and important.

 

[omni550]

I agree with the other posters that you have him in the best place for him at this time.

I have an elderly (93-year old) relative with mild dementia in a long-term care facility. He's a 5-hour drive away, and in a different country.

My sister and I are his POAs and closest relatives.

We've spoken to the doctor who assures us that he's "doing great for his age and stage".

She did mention that as much as we try to find things of interest for us to do with him (taking him out to eat or to a park or for a drive) --- those activities are probably more tiring for him than they are rewarding.

She said that people at that stage know you are there to see them, but don't really have a sense of how long you are there. So short visits of 15 -30 minutes are more beneficial that longer ones. She suggested that we take him for a short trip around the block in his wheelchair in lieu of any travels by car.

She also suggested for conversation that we don't ask any questions that he might not know the answer to (things he doesn't remember, like what the weather was like yesterday or what he had for lunch) -- so as not to make him feel uncomfortable -- but to keep the topics either neutral or possibly reminiscing (if he remembers) about people and times long ago, etc.

I understand the difficult situation you are dealing with and wish you the best.

omni

 

[DeborahB]

You're doing the right thing. Also, getting used to new surroundings is tough, as is finding a reliable person to help at home. Staying where he is keeps the surroundings the same (now) so he can acclimate.

I've noticed a huge difference in my father's mental and physical health between age 85 and 90. He's very high-functioning - drives (scary) and plays tennis - but there is a definite difference. He's still in his own home but my brother moved in with him, so he's not always alone, especially at night.

I guess we all have to be prepared to deal with this in our parents' and our own lives, as we age.

 

[Sarah in SC]

Omni, I want you to know that I copied your entire comments to share with DH, who has a hard time understanding what he should do when we visit his Dad in assisted living (just put him in there this summer). Excellent points! Thank you very much!

 

[Lakewood90712]

Thank you everyone for your kind words and input .

 

[omni550]

NYT article today on caregiver intervention techniques at some nursing homes that seem to be helping dementia patients ...

“There’s actually better evidence and more significant results in caregiver interventions than there is in anything to treat this disease so far”

http://www.nytimes.com/2011/01/01/health/01care.html?pagewanted=1&ref=general&src=me

omni

 

[Lakewood90712]

Homecare v. assisted living

I haven't posted on this for some time. Homecare was a pipe dream. Dad's general condition has not declined much , but yesterday was the first time he really did not know who I was. Maybe it was just a bad day for him. I was hoping this would never happen during his lifetime , but I guess it's just a part of the disease if someone lives with it long enough.

Makes many work issues look small in the whole scope of things.

 

[obgyn65]

Your assumption is correct. Sorry to read this, Lakewood, and take care.

I guess it's just a part of the disease if someone lives with it long enough.

 

[JOHNNIE36]

Lakewood, I'd say you are a very good son. You've done your best. Went through this with my father, my brother doing all the caring while dad lived at home. Brother lived 20 miles away but was up there almost every other day.It got to the point where dad was becoming a danger to himself, wasn't eating what was prepared for him, didn't take his medications or would take two or three days worth at a time. You feel guilty doing it but it's in their interest to have around the clock care, or at least have someone readily available for his needs. It's a full time job, even when he's sleeping. Also, his condition will only get worse, never improves so think that decision over carefully. Best wishes to you and your father.

 

[Ally]

I've been down this road with both my parents and it's not easy. It sounds like you have done the best you can to insure he has good care. I'm sorry you have to go through this with your dad.

 

[Nords]

I haven't posted on this for some time. Homecare was a pipe dream. Dad's general condition has not declined much , but yesterday was the first time he really did not know who I was. Maybe it was just a bad day for him. I was hoping this would never happen during his lifetime , but I guess it's just a part of the disease if someone lives with it long enough.
Makes many work issues look small in the whole scope of things.

You're already doing more for your dad than anyone would expect.

It's time to do something for yourself... even if it's just reading a dementia discussion board. Joining a local support group could be a big mutual-therapy help, even if you're crying while you're laughing.

My Dad thinks I'm his ol' college roommate. I'm glad they got along well, and that I wasn't mistaken for someone he couldn't stand!

What affects me is hearing my Dad brag about me in the third person. I appreciate it now, even if I've never heard it before.

 

[bbbamI]

It's been a year since my momma recognized me. I would have bet my bottom dollar if anyone in the world would always know their daughter...it would have been her.

I know it's hard Lakewood..... I'll be thinking about you.

 

[JPatrick]

I'm currently reading a book titled, "Protecting Your Parents' Money" by Jeff Opdyke. Although I haven't reached the chapters relating to the care issues referenced in this thread, I did a quick scan and it looks like there is some pretty good info to be had.
Some folks here will be familiar with the author from previous (pretty good) works.
The info presented should be quite current as this is a 2011 release.

 

[FreeAtLast]

I think that you need to figure out how much quality time that you will be able to spend with your dad should you become the full time care giver. We chose the assisted living route for my mother (age 90) 3 years ago and I have never regretted it. She was happy there and they had social activities on a daily basis.
My mother would often comment on what a nice place she was living in.

I question if you can provide the same level of care given by a good ALF as there are so many different skill sets that come into the picture 24/7. Sometime it requires 2 or 3 sets of hands to cover a small crisis.

We were all able to spend much time with my Mother in her final years just visiting and taking care of the things the things that the ALF did not provide.

I know it is a hard choice. Best of luck.

 

[Queenie]

Lakewood, my heart goes out to you. Just lost my mom in March and she didn't know us all the time. She lived in an assisted living home in Bonita Springs and it was really nice. She was also assisted by Hope Hospice in the end, they were great, for her and for us children. It is hard to see a strong parent go like this. Mom was 88, I get a lot of support from my brother, we talk and laugh about her all the time.

One thing I always try to remember, she had a good life, we had her a long time and we were lucky. She knew she was loosing her mind to dementia and that was the hardest part for her, she would have wanted to go earlier if that could have been made possible. Unfortunately it is not an option in most countries.

You can't care for them at home, it is impossible unless you have unlimited amounts of money.

Queenie

 

[braumeister]

Omni550's post above contains absolutely outstanding advice.
I can verify that everything in it is correct.

Mom has been in an Alzheimer's assisted living facility for a little over a year, and I visit her nearly once a week. One thing I might add is that the earlier in the day I can get there, the easier it is, since she becomes increasingly "foggy" toward evening.