My mom, who has vascular dementia and Alzheimer's, is living with me.

Your mother requires memory care and father assisted living facility placements.

I certainly wasn't suggesting you were purposefully putting your family in danger, nor did I say there weren't enough routes out. I was just pointing out that it would be difficult for anyone to get anyone else in a wheelchair out of a basement in the event of a fire or a flood while also trying to save a dementia patient at the same time. Not everyone thinks about that kind of thing when they move their elders in with them. I certainly didn't think of it. It was a physical therapist who came to the house who mentioned it to me, and we came up with ways to make it a little safer for my mom if we had to get her out fast.

If your doesn't like to be told what to do, I sympathize, as I dealt with this as well. I could no more keep my mom from the stairs than I could hold back a river. It meant that I walked her up the steps with my sister and husband for 2 years until she physically could not move her legs to do it on her own anymore. We considered the chair lift option but it was not going to be safe because she then developed dementia and would not be able to operate it safely on her own. Operate it on her own, yes, but safely, no.

I would absolutely put some type of barrier to prevent her from going up the stairs alone. That would not be mean in any way whatsoever. It would be the kind thing to do, even if she gets mad at you for it. If you can't change her location and she won't (or can't) listen to you about not using the stairs, then you have to do whatever you can to protect her from going up there on her own. I know you said you were downstairs with her most of the time, but for the times you aren't, when you have to close the door at the bottom of the stairs, maybe you could put in a doorbell that she could ring to you upstairs. I know there's an intercom but if she can't work it, maybe a doorbell would be easier. They have doorbells you can install that don't need wiring and you can put the actual bell close to where you'll be able to hear it.

Also, lol she unplugged the cameras. She sounds like a real spitfire. I firmly believe my mom's stubbornness and pluckiness kept her around and more with it than she would have been otherwise as she started to decline. Your parents are lucky to have you, even if they do get mad about the door or unplug your cameras. It's a fine line we walk when we have to take over things for our parents. It can be very sad but we had a lot of funny and happy moments too. It is hard to do these things that take more and more independence away, and sometimes they can't understand it and get mad. But we have to do it anyway, so I wish you strength and grace in this journey.

A final thought is that even if they don't seem to qualify for Medicaid itself, there is Medicaid LTC which is different, and can help with placement if that time comes. I took care of my mom in her home for over 6 years but I knew there might come a day I couldn't do it safely for her or for me. It gave me peace of mind to know that if I could not safely care for her, Medicaid LTC could kick in. An attorney could advise you on what you need to do in case that needs to happen. She definitely couldn't afford the $6000.00 a month otherwise and we couldn't either.

Mom can't remember that she can't go up the stairs. She won't be able to use the intercom even if there is a note there. It's not just about memory, it's about decision making and executive functioning. A temporary measure is a camera downstairs that connects to your phone. That way you can see what is going on. It will be motion detecting so if she comes near the bottom of the stairs it will send a message to your phone. You can set it so an alarm goes off as well, that might deter her from going up the steps on her own, it might not.

But I agree with everyone else. This is not sustainable for a lot of reasons. One of them is that if there is a fire you will never get them out of the house, and you might die trying. Aside from that, this is too much care for one person to provide for three other people. You need at least 3 for every 1 person who needs care. So you are missing 5 people on your team. Somewhere around 40% of caretakers die before their charges do. Don't join that number. If you do, all three will end up elsewhere anyway, in facilities where they belong. So try to keep that in mind.

You will be worn down and maybe die and they will end up in a facility that can take care of them appropriately. Why not try to make that happen while you are alive and still relatively ok to enjoy some of your life? It's not selfish to think that way. It's also better for the people you are taking care of, as there is no way you can provide the care all three need. Call the Area Agency on Aging in your area and have them evaluate the situation with your parents at least.

If the chair lift for the stairs is broken, how are you getting mom or dad up the stairs? I hope your solution is not to hold on to her as she walks on the stairs.
She could lose her balance, cause you to lose your balance, and you will both go tumbling down.
It is not safe for two elders who are unable to use the stairs to be kept in the basement. They could get trapped there. Especially if your solution is to put a door at the bottom of the stairs! How do they get out of there in an emergency?

Please - Fix the stair lift, or find somewhere else for your parents to be safely cared for.

It's time to move mom and dad into a facility and look into moving somewhere your husband can get about more easily.

Can your parents afford to pay to have the chair lift fixed, as a temporary solution?

This would most likely be a fire code violation. Does the basement have a walk-out exit to the outside? If not, then it's illegal for your parents to be living down there. Enforcement might be lax, but if your parents' apartment includes any kind of cooking equipment, then it's a potentially dangerous situation. Does the broken stair lift mean that your dad is unable to leave the house unless someone were to carry him up the stairs? The door could make it worse, depending on which way it opens -- what if one of your parents fell against it and you couldn't get it open?

I think, as the others have said, you should look into other separate arrangements. You've been amazingly dedicated to deal with all this, but with your mother's health, both physical and cognition, declining, it's just too much to handle it all safely. Plus it must be exhausting for you.

I was able to put a baby gate at the end of Moms stairs because the stairs are enclosed so I had two walls. I placed it so she could not climb over it. The can also be installed as a gate.

I don't recommend a door because it cuts them off. Mom could see us going back and forth upstairs. But maybe a Dutch door? Or the bottom of it at least. You can put a lock on it far enough down that Mom can't reach it.

I am going to say something that I think you already know....
This is more than you can manage.
1. You take care of your husband.
2. You are taking care of your dad.
3. You are taking care of your mom.
This is not sustainable.
As a matter of fact at this point it is dangerous for your parents to be living in the basement. If there was an emergency there is no way you would be able to get dad, mom, your husband and yourself out of the house safely.
Your mom will not use the intercom because she "forgets" either to use it or how to use it. No matter how many times you tell her she will not retain the information.
Placing a door at the bottom of the stairs would be more of a danger because you would be less likely to hear her or your dad if they called out or if they fell.

You are going to have to make a very difficult decision.
You need caregiver that will help them and take a bit of pressure off you.
or
You need to find placement for both mom and dad.
Unfortunately since dad is not walking most MC would not accept him (I say MC because then mom and dad could be together. If dad walks some then MC might be an option. Most facilities other than Skilled Nursing or Rehab can not use equipment to transfer a person.
Mom will need MC. The fact that it does not sound like she has any other "medical" conditions she would not qualify for Skilled Nursing.

For you taking care of 3 other people is going to eventually break you.
If dad or mom is a Veteran the VA may be of help. If your husband is a Veteran the VA may be able to help. At this point even a little help will help a lot.
You can find out if they qualify by contacting the local Veterans Assistance Commission in your area.

This will not get easier..this will get more difficult as mom declines and needs more help and your dad will need more help as well. You can't continue to do it all.
And I would say the same thing even if you get the chair lift repaired

The caregiving situation as it stands is unsustainable. Dementia gets worse. Disability gets worse. And you are only 1 person who I'm going to guess doesn't really have a life outside those 3 other people who are dependent upon your care.

Please look for a good local facility and transition your parents into it. Tell them its temporary, or whatever it takes to get them to move out. They of course will have to pay for it themselves. If they don't have the funds, then your Dad at least should qualify for LTC and then eventually Medicaid. Your Mom may be able to apply for some sort of county program or waiver that may help pay for her residence in an AL.

Contact your local Area Agency on Aging for resources. Or, call your county's social services to discuss options.

You can probably install a door but that won't prevent your Mom from freaking out and banging on it all day long. Loss of empathy for others is a hallmark of dementia. She won't ask you to stop before you grind yourself into a pulp. The dementia prevents her mind from going there. But if she were her prior parent self, she wouldn't ever want to be the one responsible for doing that to you. Nor your Dad. I say this as a parent of 3 adult sons. I've already told them I don't ever want them or their spouses doing hands-on care for me and my husband.

Your husband and yourself are your #1 priority. This doesn't mean you don't love your parents dearly. You have to know what the priorities are or you will eventually not be able to regain your life. I wish you wisdom and peace in your heart as you sort things out.

Your moms brain is now permanently broken and you can tell her to "push the button" until the cows come home and she still won't remember. It's time to stop the denial and realize that perhaps you've bitten off way more than you can chew. I mean your dad's had a stroke and is in a wheelchair, your mom has dementia and your husband is also in a wheelchair. What are you trying to do here...kill yourself?
Your husband needs to be your top priority, and your parents now need to be placed in the appropriate facility where they will receive the 24/7 care they now require, and you can get back to just being their daughter, and not their burned out caregiver. And you can then once again make your husband and marriage your top priority.

The whole situation is a disaster waiting to happen. Your parents shouldn’t be living in a home with stairs. Mom cannot remember not to use them and no sign is going to help. Alzheimer’s means losing the ability to remember and make good decisions, no matter the reminders. Today is the best she will ever be, as the forward motion on Alzheimer’s continues all the time. Do you really expect to keep up with all the needs of two frail elderly people in addition to helping a disabled husband? They all might outlast you. I hope you’ll spend some time further educating yourself about Alzheimer’s (use the Alzheimers.org website and Teepa Snow videos) and reconsidering this plan lasting for much longer. I wish you peace

Marshab.
In my opinion, this isn’t a good idea for your parents or for you. I’m so sorry you are in this position.

Is the idea to just leave them both down there indefinitely? Are these stairs the only way in or out of this space? Do you have any help?

Call the fire department and have them come check it out and tell you what you need to do to make it safe. It’s hard for me to visualize. With three handicapped people you need all the resources you can find.

Don’t worry about if it’s mean. You must keep mom safe whatever it takes! If you can’t, she needs to live where someone else can. I wish you luck in this unfortunate circumstance.