I have both my parents in AL. Mom has progressed to mild - moderate dementia & my dad is beside himself. He feels the need to "take care of her" even though there are staff around to help (though not always prompt). The main problem is that she has outbursts of anger toward him; other times she says things that make no sense.
Today she told him that she heard him talking to my aunt (who has been dead about 8 years) about buying shoes. This befuddles him as he doesn't know how to respond. I've been trying to help him with "therapeutic fibbing" but it's taking a while. She really needs memory care, but he does not. So we're planning on separating them, with her moving to the Memory Care side of the AL & he would stay on the regular side in a different apartment. He can see her anytime, but knows she will be monitored more closely when he's not with her.
The problem is that mom has moments of clarity when she seems to relate fairly well. What would be the best way to present the separation to her, with the idea of avoiding a blow-up or meltdown? At the AL there is another couple who has this same arrangement & seem to be doing fine, but I think the wife has more advanced dementia than my mom. Obviously we will try to discuss with this gentlemen, but I'd like to get some other ideas. Please advise if anyone has experienced this & has some recommendations. (By the way, this forum has been a great resource for me as I've been part-time caregiving for them for about 4 years & finally got them to AL. I have recommended AgingCare to others & even some health care professionals. Thanks to all who contribute!)
I hope some other ideas will come out, too! It’s a difficult time for you all.
My Mom and stepdad had to live separately because of mom's dementia. He was able to visit when he wanted. In the beginning he would take her to the main facility dining room for lunch and dinner. First the dinner visits had to stop because of mom's sundowning behaviors. Later lunches had to be moved to the memory care dining room because mom was extremely disruptive to others in the main dining room. Once she ended up in the kitchen yelling that the couple eating with them was trying to get stepdad to pay for their meals.
Rules for him visiting will change. The facility may even ask him not to visit at all for a period of time, one week, two? Depends on how mom's adjustment progresses.
Good luck this is really hard for all of you.
Or the licensing website.
I was Shocked to find out that Assisted Living in Michigan cannot be licensed unless hold by a doctor.
They can't be licensed third party either. That means they can't supply any Medical Care and there is no one watching or mondering the facility.
If he does not need the security of Memory Care he could be given the code so he can come and go as he wishes, just as if he were visiting.
He can continue to "help care" for her but obviously would have more help in doing so.
I know of more than one facility that allowed a spouse to move in and the spouse had NO medical problems at all.
Always ask, never assume. The answer could be yes.
After her last hospital visit, i was concerned she might need memory care. I was advised by AL that they could provide more support and she did not need to go to MC until she needed to be fed or she wandered. Does your mom have either of these needs? Also, what is the highest level of care the AL facility provides? They are not all the same.
When I checked it out, the cost for MC for one person was about the same as the cost for AL for 2 people! So if money is a factor, please do your research carefully. My guess is that moving both to MC would require that MC cost for both. If your dad does not need it, it could seriously impact his social life and it may have implications regarding medical care as we'll. Investigate this carefully.
You might also consider if your mom would qualify for palliative care for dementia and if a part time private pay aide would be sufficient and less disruptive than separating them.
We had a conference with the AL staff and are having a paliative care evaluation, covered by Medicare, next week.
Also see if there are meds that can help with your mom's anger. My mom has melt downs that require meds as needed.
As an aside, when I can no longer take my mom to her multiple medical appointments, it may be time to reconsider MC regardless of other needs. She is a largest woman and is becoming weaker due to inactivity. If she cannot assist with standing and getting in and out of wheel chair, then I will not be able to take her.
At least your parents are already in a duel program facility! I dread having to move mine for the 4th time as it is so disruptive, but it may be necessary. Time will tell.
Good luck to you and stay in touch.
I was relieved that I had found a place that provided excellent care for them. The head nurse guided me every step of the way as the wife's condition deteriorated. I needed that help since I had never done this type of care before and had to know what decisions to make.
After his wife's passing, the husband continues to live in that same apartment. He misses her everyday, but understands she is in a better place now and it's just a matter of time before he joins her. I visit him at least once a week, unless I am out of town, bringing him his weekly magazine as my excuse, but also always checking on things and his care. I am very impressed still and always thank the care-givers for their observations and insights.
I would echo the others in saying they should go together. Their time together may be short now, so make it work as long as you can.
After she she began hitting my dad there was no other decision but to separate them. We sat them both down and discussed that the state wanted them separated for safety and that the memory unit had more experience with helping mom. The doctor said to tell her she had Alzheimer’s and needed more support, the psychiatrist told us not to tell her since she would forget. We asked the AL to talk to them instead and mom seemed to listen. Dad was angry and did not agree but we reiterated what AL said and told him that this way they will be in the same place vs being separated .
my suggestion is to talk to them both about what’s going on and concerns being careful not to put the blame on mom, have the AL talk to them about providing more care in memory and let them be the ones to tell them they have to separate. You just be the supportive adult child. Eventually your dad will understand and there will be brighter days. It’s a long road of good and bad days.
By the way, the move for them has been about 2 months now. Mom is in memory and dad is in AL. Mom’s quality of life has improved, no falls , no hospitalizations and less outbursts now that they are separated. I bring dad to see mom at least 2 days week for 3 hours and they are both happier. It takes about 5 weeks for someone to adjust to being in memory but it will get better. Just get your dad to socialize a lot in AL as they get lonely not being together.
While dad was in rehab, we jumped at the chance to get Mom in MC. When he was released, he did not want to be home alone or away from Mom, so he joined her in the MC room, at a very good rate. Mom's AD has progressed to the point of angry outbursts. Plus, they know each other's buttons, push them regularly, and dad "fell" a lot.
After a third bout between them in a short period of time, the MC facility told us our parents would have to be separated. Because Dad had been restless and bored on the MC side of the facility, even though he had been given the code to have more freedom, we were happy to see him go to the AL side of the facility where he might have more activity.
We set up his room with his favorite bed, one that is positionable and vibrates, that Mom never liked. We brought him the coffee maker, stocked his fridge with beer and watermelon, brought jigsaw puzzles that Mom didn't want him to do on her and did anything we could think of to show him the advantages of having his own place.
That was two months ago. Unfortunately, in the beginning, Dad was at Mom's place every waking moment, wondering why he had to pay for a much more expensive separate room when he was never there. He was a mess!
Growing up, Dad was always very outgoing, even to the point of ignoring Mom when they went out to eat because there were so many strangers to meet. Dad has also been very self-centered, to the point of not understanding why Mom would even eat something that he himself didn't like. She has been his body, picking things up off the floor, walking across the room to get something, etc. At the same time, he has been her mind, paying the bills, tracking the schedules, etc.
When they were separated, he didn't know how to function. Even before they separated, when he was in rehab, he locked himself in his room and would not go meet anyone or participate in any activity without coercion. Dad is doing the same thing in his new AL room. He won't go meet anyone because he "doesn't like them. He doesn't need to get to know them, because he already knows he doesn't like them."
The MC facility finally started enforcing visitation hours for Dad to be able to see Mom. He hates it, but has now started playing games with the staff, to see how long he can get away with staying on the MC side of the facility.
Unfortunately, when Dad visits Mom, he is back to his usual behavior of turning up the thermostat to 90+ degrees which is too hot for Mom, blasting the TV on his station so he can hear it, and locking the door, keeping the two of them in the room totally by themselves.
On the other hand, Mom has been doing much better when Dad adheres to the visitation schedule! She allows the aides to help dress her, is less argumentative with Dad, is more manageable for bathing, and she has even ventured out of the room to be with other residents.
Each day is still a different story, but we are certain that separating them it has been the best thing. Granted, it has been a whole lot easier with them being in walking distance of each other, with us not being able to visit them as much as we like! This arrangement allows them to see each other and eat meals together much more often than they would otherwise.
I hope this helps!
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We found an AL with MC units in one of the buildings. I have been clear with Dad (and brother and SIL) that when mom must go to MC that (unless his condition changes) that I DO NOT want Dad in that environment full time. It is a very difficult thing to try and convince them of, but we have been paving this road for a few months. I dread the day we must move her due to her inability to 'follow the rules' and disrupt the AL living side of things. So far there have been none of the anger fits, but last time I stayed with them in their apartment she got up in the middle of the night and was sure her casserole was burning and when she couldn't find it in the apartment was about to go into the hallway, and from there who knows?? So the behaviors may result in needing the controlled access unit more than anything else.
They have been married for 63 years and neither sleeps well without the other. THAT is the hard part I worry about... but I keep encouraging Dad to make friends, sign up for the activities, go to the dining room for meals and once in a while if she doens't want to go, don't stay with her. TRY to continue to live and hope that knowing he's going to go without her gets her to leave. He's been almost codependent in the concessions he's made for the last couple years. She doesn't have to muster any effort at all... he caves on everything. She has a spell of falls in June/early July (thankfully no breaks) that landed her in the hospital and then rehab. I INSISTED on the rehab even though insurance only covered the OT/PT costs, to keep him from waiting on her hand and foot! She can't get up, has no balance, cuz she only has to go from bed, to chair, to toilet. He brings her EVERYTHING she asks for... and I've tried to explain how "helping that way is not really helping" and after the falls I think he sort of understood that if she had to get up and get her own drink of water, or snack, or sweater, that maybe she would not be so weak and lacking of balance.
This is a slippery slope and I appreciate all of you and your replies. This site has been the 2nd best resource I've found in the year I've been primary care for my parents. My Mom was diagnosed last December, but I think that was year 2 of the dementia. It has progressed quickly this year, and the transition to AL has barely 'settled' in - I hope we have a few months of this 'new normal' before we have to figure out the next one!