As many of you know, my dad spent some time in the hospital last week and was released to go to assisted living, not home. He cannot be by himself anymore. We had care coming to his house for 6 hours per day, 7 days a week before the hospitalization. It was about $6000 per month. He insists he is walking out of assisted living on Friday. And I know he will although I don't know how he is getting home. The facility he is in is wonderful and he actually seems to like it but is treating it more like a vacation. Full time in-home care would be over $20,000 per month. That's just not in the plans. And even at that, there are many other things wrong with the in-home scenario and having full time care would not fix them (i.e. he refuses to allow med management, he won't eat properly, refuses bathing, no socialization, lives on a busy street with no sidewalks--going for walks is dangerous, etc - he has way too much control for making unsafe decisions in his house). I am his guardian and we have sent the paperwork to the court for the move so I guess the final decision will be with the judge (dad will contest and we will have a hearing) but I'm not sure how to keep him there between now and then. I need to give the facility 30 days notice if he is going home or he's out over $6000-$7000. I could refuse to allow any in-home care since he's already paying for assisted living but then I'll be in trouble.
It is time to do the tough love thing.
Often the facility suggests you curtail visits during this adjustment period because the elder sees you as "a way out" as someone he or she can manipulate, knows, and knows HOW to manipulate.
Only suggestions I have, because if he insists on this then he likely IS looking at memory care. You can tell him that along with being much less nice, it is also much more expensive, and if his money runs out during his lifetime he could end himself in a quite not-nice circumstance that you would be helpless to fix for him. Remind him you know how tough it is to go through this one loss after another thing, but that you will continue to do the best for him that you can, and that you love him, and that you don't EXPECT him to be happy about it, because not everything in life is about happy.
This will not be easy. Think of a toddler that is given too much control and ends up in meltdowns constantly with the fact they can win, then don't know what to do about it. It needs to be more certain for him. More set in stone. No argument. Just the simple loving facts told as kindly as you are able, with sympathy, over and over and over when he goes "there".
Talk to the faculty about this issue. As an AL, they may not be able to keep a person who wants to leave, against his will. You may need to move him to a secure memory care unit.
Have you consulted his doc about meds?
I like the idea someone suggested about getting 'an expedited hearing or a temporary restraint'. I do know that EC attys can request expedite.
One thing I will add - dad NEEDS to be in MC. AL will not babysit him or be there to stop him from walking out the door. The ramifications could be dire if he does walk out. This was my argument with YB, who insisted mom would prefer AL. Sure dude, maybe 5 years before that, but not with dementia! Staff said no to him.
If the AL he is presently at happens to have something like that, the transition may be easier than having to remove and transfer him.
Your first reaction, if you are anything like me, is that he is functioning at a higher level than the other residents of the locked unit, and in some ways that may be true, but if he has been diagnosed with dementia, you have been granted guardianship, and he has no perception of his inability to manage his ongoing needs, you can begin to assume that his need for a secured, structured environment is somewhere on the horizon, and in some situations, it is easier to head in this direction earlier than later.
Under the terms of the guardianship, is there any language that requires you to provide a safe, secure environment for him?
If you place him now, in a locked unit, you will at the very least have a certain amount of time to figure out what to do next.
If his prior living arrangement was NOT possible as a consideration, it is not fair for to him OR YOU, to spend time figuring out ANY REASON OR PLAN for keeping him there, so start thinking forward to other scenarios that MAY work for him and don’t look back.
My LO has been in a well run MCU since last June. I visit often, and whether I leave in tears or marveling over how much she is still her old self, I am content that she’s monitored, safe, and lovingly provided for.
If he walks out they will come looking for him and then require that he be placed in the memory care wing on lock down. Or they will tell you that he needs to be placed somewhere else.
You are in charge, not him.
As my father's dementia worsened, I became the "only person who can deal with him", primarily because he knew I was as stubborn as he was and would do what I said.
When Dad didn't want to go to MC and told me he wasn't going, I told him yes he was. "You can go the easy way in the car and walk into MC with your dignity or you can go the hard way drugged and strapped down to a gurney by removal attendants. Either way you are going. You need the level of care the MC can provide and I think you will like it there once you get used to it. I would rather see you walk in but one way or the other you are going to MC." I showed up at an appointed time and followed the car while my estranged brother drove Dad to the MC. Dad walked in to his room where he was surprised to find it contained his favorite rocking chair and was decorated with photo collages of family and collectibles. He did adapt and even like being there.
I don't know your Dad's personality or whether his dementia allows him to remember things enough that talking to him would do any good. If you think it would work, I suggest you talk to Dad about what's going to happen if he walks out of the AL. That he has no money and no keys to his house; his picture will be on the news as an elderly dementia person the police are looking for and when the police find him he will be taken to a hospital to be evaluated and held until a locked MC facility can be found, or maybe a NH if an MC isn't available because he won't be able to return to the AL after "escaping". Emphasize that you will have little to no control over what's happening once the police are involved. Ask him to please not do this to himself. You want him safe and someone available to see to his needs and right now the AL is the best place for him. Good Luck.
What will you do when he refuses to leave his home with the caregivers? Have you been in touch with the local police who might need to assist?
That's what happened to my mom over 5 years ago--she just *suddenly* started wandering and I came home from work, and she was missing. I almost had a heart attack not knowing where she is, and lucky the Emergency Room had her and left a message on my phone. She wandered out on the street and fell face down. The CT of the head was negative, and no urinary tract infection. In fact, physically she was healthy. THAT CHANGED MY LIFE requiring 24-hour supervision around the clock. She had her moments of confusion but was able to talk to me fine, but she NEVER wandered. Strange after that fall she forever changed and had that glassy-eyed Alzheimer's look which is like a flat affect. This worsened as time went by. Oh they did the CT of the head and found no bleeds or clots, just age-related atrophy. I've been dealing with her Alzheimer's since age 78. She is still alive. Living with me. 90 years old, and kept alive with a feeding tube. Bedridden, and practically brain dead ravaged from years and years of Alzheimer's disease. Been to the Emergency Room multiple times...long story. It is although she already died..but her body is kept alive with that feeding tube.
Mom has been on hospice for over a year. It took over an hour to feed her and I gave her fluids one teaspoon at a time thickened and feeding/drinking was an all-day affair. Eventually she stopped taking in food/water and she went into dehydration with kidney issues so I did have to revoke her hospice to get the feeding tube put in (they tried to talk me out of it, but I did NOT want her to die a slow and horrible death due to dehydration which can take 2 to 3 weeks). Sign a piece of paper hospice is revoked. Feeding tube insertion only took about 10 minutes. She was discharged put back on hospice and they provide me with supplies such as diapers, feeding pump, tubing, tube feeds. She's doing good--but her brain is gone.
After having the "authority" explain why he can't return, make arrangements to sell his home. Go through his home with him to cull keepsakes from things to let go. Have him decide what to give to others and what to sell - and do it. Have a realtor come by to give advice on staging and get the place sold. Help him make the ALF as "homelike" as possible. Then, remind him that the ALF is "home".
What do you think the best outcome would be for your Dad? Whatever it is, put that plan into place. Because it is up to you. The court decided that your Dad is incapable of making decisions, so they put you in charge. Don’t make the Court give the Guardianship to someone else.
Another website I found lists "Guardianship, by nature, requires the elderly person to lose some of his or her rights. For example, the elderly person may lose the right to manage his or her finances, to choose his or her own caretaker, and to decide where he or she lives." Note it says lose SOME of their rights. I believe Babs75 is in the DonutHole of guardianship!
Hope is that the courts will revise enough to allow her more control as it is needed in this case (dad is worse than a mule!!!)
My concern is that if he starts to wander, the AL will insist he move to a higher level of care. If there is no brain damage/disease just repeat it is doctors orders and you are waiting for permission to move him home.
If you're sure he will try to leave, prepare & schedule the trip for him...Supervised by someone you & he trusts.
Change the locks, if possible move furniture out of view from the windows. Maybe even put a sold sign in the front yard.
This will make him angry, but he will see moving home is not what he thought. If he is functioning like a child, wanting the security of his home, he may need to see someone else is living there..or will be soon.
I know it seems like his finances are bleeding money. Once a guardianship has been placed, your role as his caregiver is to keep access to that much money away from him. Once you have the support you need, and temporary guidance from the care manager, you won't need the support of a care manager.
You do need support, maybe a full support team. Keep trying, you are not the bad guy.
From a previous thread you posted, I was curious about guardianship and the issues you were having with it. I discovered that it might not always be 100% control! Others seem to believe this, but I know now and they should READ this and understand it is what the court decides and it might not be 100%. For others education: The courts try to ensure the person retains as much independence as possible. Sometimes they can still function at some level, so not all control is granted. Later this might need revision, which is where you are.
Similarly, many misunderstand the whole POA business - too many think this is the answer to everything and that is NOT what POAs are for, nor can they allow you to do everything you want! They allow financial oversight, signing for the person, contribution to medical care/decisions, and not much more. Too many on the site tell others to get POA to assist in moving someone. NO. We had DPOA and MPOA and EC atty said we cannot force mom to move. In the end we had to use some "trickery" to facilitate the move.
I am hoping the courts will revise your guardianship. I also hope your dad will stick to the 'arrangement' you have - if not, see to getting an emergency hearing to ensure he doesn't skip out of the AL.
Many of us would love to have the chance to look at a previous life, previous home, previous friends. Perhaps it would make him happier. Just leaving your home on a stretcher without notice can’t be easy. Perhaps a chance to say goodbye to it might help. You saying that you will take him there on Friday should take the immediate pressure off.
What he needs to see is that it isn’t really the way he is thinking about it, that he can’t be ‘independent’ unless he has you to depend on, and that ‘for now’ he is better off at AL. Perhaps tell him it’s much cheaper anyway - he can’t depend on you, he can’t cope by himself, and $6000 as against $20,000 if he wants to depend on other carers. Lots of older people are very responsive to wasted money!