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I am so struggling with this. I have had a week off and got it off my mind, but the time has come to make a decision. I need to start by saying that 10 years ago, dad, hubby and I bought a house together so that he would never have to go into a nursing home. his is a separate apartment although connected to the house. So little did I know about what happens when you grew old .... now he is pretty sharp in some ways but gets confused and very very forgetful. He is now in an ALF where he signed a 1 month contract and I had promised him when I got back (I went away for a break) id bring him home. Two social workers not connected with the ALF tell me that it would be crazy to bring him home because it just means he has access to alcohol and he is really jonesing for it. IF he does what I suspect, he could fall in the middle of the night and I wouldn't even know it. We can afford some day care, but not 24 hour care and I dread finding him passed out again. But I promised. And I ask myself if I were very sure when its my time to go wouldn't I want someone to support me? And what if he is good on his word and stays dry, which he did when my stepmother watched over him like a hawk for a decade. I so don't want to break his heart, so much that im thinking about ignoring all the advise and binging him home. am I being delusional? oh, he tried to go awol 2 times in a week. and he is not participating or connecting. and he hates it although it is a nice place. he wants home, where nothing happens except he has control. VA called and said they could send about 3 - 1 hr days of help a week and I could get more from private sources, but nobody can control that bourbon bottle at night. I think I know to do but then I change my mind because I made a promise and because he's scared and because he is still going through psychological withdrawal and because I have to go back to work or my company could go down the tubes. Still, if I could get the right care and let God take care of I the rest, we could have an agreement that if something happened and he didn't die from it (I am okay being that blunt) then he doesn't fight me anymore about ALF or something called Medical Foster Home that is VA's equivalent of ALF. 4-5 vets live in a house .... under medical supervision. Eat as a family; I can see him playing gin with the old timers... this is hard. I know there is no perfect answer but in times like this ive always followed my heart instead of my head and honestly it usually works out better in the long run; my company is a medical, mission-based nonprofit driven by my passion for animals. if he had 4 legs this probably wouldn't be a problem! (wow, a little levity?)
if this all sounds familiar,i apologize. I haven't resolved it yet....thanks for input....

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Check with the VA social workers and the social workers at the ALF about whether he is medically safe to bring home.

It sounds like you know the possible problems of bringing him home. This is pretty blunt but you have to be really sure that you're OK with him dying next door from something you could have prevented by leaving him in ALF.

Is he able to get out and buy his own alcohol? If not, you can just refuse to buy it or keep it at your house if you're OK with the occasional drink. It sounds like he has a long history of drinking too much. You can't really fix that unless you're willing to police him like your stepmother did, which isn't any way for you to live. Has he ever tried a 12 step program to stop drinking? You never know, it might help.
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How is he getting bourbon? If this is the primary worry, it would seem that simply not having alcohol in his apartment would be the answer. But you mention his confusion and forgetfulness. Is he safe alone in his apartment? The fact that it is part of your house is a great help, but is it enough? You work. Is he alone in the house during that time? It is awesome that you bought a house together to enable him to avoid a care center. As you are finding out, sometimes that is not enough. If the memory problems and the confusion indicate dementia then you can indeed expect him to get worse.

Personally, I think IF you can keep him home safely and IF it is not having an adverse effect on your marriage, then taking steps to make that possible would be best. It doesn't sound to me like one hour three times a week would be sufficient in-home care. How much help can you get for the same amount he is paying now for ALF? Does he have additional money or assets to pay for more help if/when it becomes needed?

But please understand this: even if you can arrange for enough help and things go smoothly for a while, it may very well reach a point where he will require too much help to remain in a private home. If that happens, this does NOT mean you've failed. You've already given him 10 more years of independence than he could have had without you. If you can give him another year or more, fabulous! If you can't, or if you can now but can't continue in the future, celebrate what you achieved and take the next difficult but necessary step with no guilt.

Let us know how things work out for you.
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Apoloosa--
did I say he was 91? he will never join a 12 step group. or so I assume.... he would find it "a waste of time" and I really don't want him driving..no problem with keeping no alcohol here. hubby has a drink once in a while, but he could do without or put somewhere. dad currently has a car but I could make that part of his coming home.

to answer you question about how I would feel if he died here when he could be living in an ALF, I think I can honestly say I would be okay, cause its where he wanted to be. I have read "The Good Death" and I have also reread my POA agreement and it indicates that my mission is to do for him what he would want and cant do for himself. that would be to come home.

Jeanne -- I have already applied for the aid and attendance and can spend it on home care as well which is another 1700 with no problem. I definitely would review (after these damned holidays!) with a out service agency on what I could get for that or even more since he has more needs than just those. Yes, I can make that part of the talk. I spendt till 3am this am on the mayo site checking his diagnosis and the meds. they've got him on Ativan which strongly affects the memory and nothing (even though the evaluation recommended it) for memory loss and depression. the ALF couldn't get anyone to take his PT order over the holidays so he's slipped backwards in the mobility range, but I could either have him stay another month for that or bring him home. Problem is if I brought him home now the PT would be covered by my own funds. So maybe we are looking at a compromise...

Breathe in, breathe out. Thanks guys.
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Also, my niece is an RN. Unfortunately she is 1,000 miles away, but she advises me. She leans toward bringing him home but I think that's because she knows how to care for him. I have the name of an agency that puts you together a package plan that was recommended for home health. no way I could afford 24 hr coverage, so I would have to somehow be on call for night time.

Also, my RN niece told me that they had a patient that they kept on 4oz bourbon 3 times a week. Maybe something like that (and I keep the bottle) would give him enough to "look forward to". Of course, he might save it until he has a cup and a half, but like you say, I cant make myself crazy over that kind of control.

breathe in, breathe out.
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The last person that I know to go through alcohol withdrawal began to have convulsions, was in ICU for two weeks, on haldol, and administered last rights. But he made it through. It seems that one week in ALF would bring about severe withdrawal and he would need to be hospitalized. It sounds like that didn't happen. Maybe all you need to do is make sure there is not alcohol in the house. Are you sure he didn't somehow manage to sneak some in when he went to ALF?
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If you proceed to bring him home, make it conditional on you controlling his funds. Elders can be very clever, there is always a neighbor or acquaintance willing to bring them the liquor. That way you can implemement limits, whether 0 or a few oz. little chance a drinker has enough self control to hoard as you fear.
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Glad and Ismiami --dad detoxed in the hospital (2 days) and the rehab (6 days). He's been in ALF since then (9 days). He's physical through the withdrawal but the psychological will take about a month for every year he drank. that's what they told me when I sobered up, which was 30 years ago. But now I can be around it now and not be afraid of it -- it is totally neutral in my mind, even when I am stressed. like smoking. I never crave a cigarette anymore. but I asked for help from a power greater than myself and I breathed in and out. I let it ride over me. I learned somethings that my father (who I am biologically a core duplicate of) never found the opportunity or chose to learn and embrace. Although I am totally powerless over whether he could find the freedom I did, if he did, only for a year, that would give such meaning to my life. If he dies because he didn't, I will know that I did the best I could. that's why I resist leaving him in a home. it just feels like the easiest way out wrapped in a nice wrapper. His social worker said to me "choose: ethical or moral right thing to do". She was talking about leaving him in. In his universe, he has seen so many deaths, starting with his own wife when he was only 30. well, really with his buddies in the invasion of Normandy and then the germans and the Italians. and then his wife. his parents. his 2nd wife. his brother. his friends. control means survival. I just wrote him a letter and saved it, telling him all the risks of being home and asking him how he feels about them. I will need to find a clear day to present them to him, but he doesn't expect me back till the weekend so I still have some time. thank you so much for helping me....
I
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Linda-
It sounds like you would like to leave him in the ALF but feel guilty about doing it. It also sounds that if he came home he will find a way to drink. Have you cleaned out his apartment and found all of his hiding places? What about your portion of the house? My only thought would be that if he comes home then you would have to go through this entire process again. What if something happened to you? I think it is time for you to let someone else take care of him so you can take care of yourself.
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You made a promise at a time when you did not know what that meant. Now years later dad is not the same person .Probably nor are you.
Are you prepared for a complete personality change in your Dad. Can you deal with the rages, the incontinence and hurtful things he may say. refusal to take medications and eat properly, not be prepared to bathe. you have read of all these problems on this forum and they are very real. he will eventually get very weak and not be able to get out of bed. Are you prepared to check on him multiple times in the night. can you continue to work with little sleep
Does your niece have experience dealing with demented patients? she can advice you from a technical point of view and understands medications and physical care, but she works a shift and goes home and has regular days off.
Think about it. Of course everyone wants to stay home and many are able to. but with dementia you have to make your house a prison, that is why memory units have locked doors. Why not compromise for now and leave him therefor another month to get his PT on track. The fact that he has slipped back so much in a few days should also be a big warning sign. Don't make any more promises it just is not fair to either of you. I would urge anyone never to make such promises to an elder when they can not know what the future may bring or how their own health may hold up.. I personally worked till 68 and could have cared for anyone but at 75 could not in anyway manage that. You just never know. Blessings
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thank you veronica and all. I have a thought: what if I appeal to his intelligence? Does it make any sense or would it backfire? He just had a psychiatric evaluation and was determined mildly cognitively impaired, but when he has sharp moments he understands and makes a lot of sense. what about if I told him what his options were: and that home was the worse because would cost him a lot of money, probably more than he has and the state would put him in a nursing home ....and the other info I got from the social workers? I believe he is entitled to understand why its not a good decision and given a chance to change his mind so he retains control by being the one doing it; not being the one having it forced on him. If he still says no, then I go for okay, lets talk about it again after you stay another month for more PT, which even he agrees he needs. (the PT, not another month). Yea, what about that? That will have given the Aid and Attendance some time to kick in, and make him as healthy as he will probably get. Even that seems dishonest so maybe there really is no perfect answer. No I don't want the weight back on my shoulders. I would love to see it come off his as well, though. Has anyones parents that you know of ended up being HAPPY in an ALF?
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Honesty is not ALWAYS the best policy! I don't know if you have kids, but sometimes you have to force a kid to do something they REALLY don't want to do.

Your dad is an intelligent and wise man, but nowadays, his brain cells are interfering with that. It's up to you to decide what's best for him. That also includes doing what's most likely to keep you well and able to oversee his care.

You can decide to leave him in the ALF for three months to give him a chance to adjust. You can change your mind in the future, but it would be good to take advantage of the present situation to give the ALF a real trial. Many people actually bloom in the ALF from the social stimulation.

God bless you and Dad.
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urg. this ALF has a sister (Emeritus Carrollwood) which is just as close as the one he's in (Emertis Dale Mabry) They appear to have PT and OT right in premises. Im going to scoot my fanny over the and find out why we didn't choose that one. I don't think it should be a big conflict to move within the same organization, like one St Joes hospital to another,, do you? How do I find out if they are corporate owned or francised? They seems to use the same paperwork...
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My father is 91, I moved him into an ALF in June 2013 and he is loving every minute of it!! I searched until I found one that I was comfortable with. I made a number of visits to the facility at various days of the week, as well as different times of the day and found "no surprises". He is extremely HAPPY and so am I. The ALF is his home and there are folks available 24 hrs a day to assist him when help is needed. He's made many new friends (his age), they have activities, planned outings, etc. It took me 1 year to research but I found one that gave me that "homely" feel. Good Luck and much blessings.
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Okay, now im curious. Was he compliant with the idea to start with and just picky, or did he start off with "nothing will make me happy" attitude?
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No he was not at all in agreement with my decision to place him in an ALF, by no means; however, the placement was the best decision for myself, my mother, and my marriage. I spent 4 years trying to please a man who was never satisfied nor never happy. I came to the realization that it was time for me to think about ME no matter how much he complained. I am his caregiver so I decided what was best for him with no input from him! When he saw I wasn't backing down he settled in to his new home. Even though he says he loves living where he is HE STILL finds something to complain about whenever I talk to him. That's just his nature! I visit him and when I have had enough of his complaining and trying to pull my strings I leave and come home to relax, pray, meditate, and enjoy my life knowing that he is being well cared for!
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very good to know. thanks Sydney.
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I know many people that are/were happy in ALFs. Though generally they are people that lived alone and knew they didn't want to handle the day to day stuff anymore. If he has you to do it for him, I think he'll be more resistant. I think the key is joining in on the activities and socializing. Could you speak with the staff and see if they can try to get him more involved? My FIL did not want to go. He swore he would die in his own house, even though he had friends in ALFs that were begging him to try it. When he was finally forced to go, he ended up liking it. He will complain sometimes and say that it's not home. But when I go there, he is always involved in some activity or another, and really seems to be enjoying himself. He was a very heavy drinker (vodka for breakfast). And when he started out at a more independent facility, he would get others that could drive to bring him booze. But as his aging and dementia progressed, he was moved to a memory care unit. So he no longer has access to alcohol. He can barely steady himself now, so that is good. He likes to complain about the food there too. And yet all he ate when he lived alone were 89 cent TV dinners. Every time I've walked in during mealtimes, he is obviously enjoying his food. So remember what they say and the reality may be quite different. I know my FIL is much happier there than he was at home. He will not admit it, but I don't think it's because he isn't happy, it is because he remembers what he was capable of, and wishes he could live independently. Definitely try the extra month for the PT before any decision is made. I would tell him that he needs the PT, and we'll see how that goes before talking about moving out.
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