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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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Mostly Independent
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If your father's dementia is moderate to severe, then as I understand it the best practice recommendation is that you don't tell him in advance, or at least not in the way that you would have done before his cognitive impairment progressed. I assume he no longer has capacity? - and that being so, discussions with your father are no longer anything to do with informed consent, which he can't give, and instead should focus on maximising his day-to-day welfare. Hence, you don't burden him with information that could fruitlessly confuse or distress him; and particularly not if he cannot retain it or process it. I know this sounds cold (I think so too!), but once you chew over the principles of whether there is any purpose or benefit to be gained from involving him in the actual, practical planning of his care it makes more sense.
Is it in fact your mother who has to be persuaded of the need to move him?
It depends on several factors. You need to be very careful about this. 1. is the family member suffering from any stage of dementia or alzheimer's? How cognizant are they? If you do sit down with them and talk to them, how are they able to handle the situation? 2. Do you have any siblings, or are there any other relatives who need to be brought into the decision? 3. Are the financial implications of being moved into a skilled nursing facility worked out? Do you have one in mind? Is care at home an option? 4. I assume your "loved one" still controls their own decisions, and you do not have power of attorney to make decisions for them. I do not think you can actually tell a loved one this, unless you make decisions for them legally You, and others, will need to convince the love one that this is the best thing for them to do. Control issues are always going to be there, especially as our older relations age.
I hear you, sounds like my dad. We decided to move him from assisted living to skilled nursing. We haven't told him because all it will do is cause him anxiety. Don't get me wrong, at times I feel like we are manipulating him behind his back. It is so weird to become your parent's "parent ". We just want him to be at peace as much as possible. Telling him will not do that.
Thank you SoCalEddie. I have poa, but we are having a family meeting with siblings and the non-impaired parent to discuss options. My father has dementia and does not remember much from day to day.
I am thankful for some of this advice as I am in this situation with my mother who has dementia ... she can sometimes be defiant/belligerent and altogether almost unmanageable - but is still canny enough to be manipulative. I feel like a heel triggering the move to long term care ... here in canada though, with her financial situation she has to wait on a waiting list until an opening is available and if we wait until she's completely unable to care for herself it will be too late as we have to factor in the wait list time.
Until then she is in a support environment with personal care workers to help with meds. But she frequently skips out to do her own thing and the nurses bringing meds can't find her. As she's just out of hospital we are amplifying care with bathing and meal preparation/escort to the dining room - but I fully anticipate she will be non compliant. We had her in an transition unit in the home where she could be monitored but have some freedom however she was non compliant and they kicked her out... days later she was back in hospital. I feel like she's deliberately in a power struggle, where she wins each time by simply disappearing ... unfortunately the personal care worker management call me, and when she gets sick its me that does the hospital advocacy runs. This time they released her 2 days earlier without notifying me as she signed herself out and had one of her oldster friends pick her up while I was at work. then she proceeded to rip up her paperwork, including the doctors summary of her stay and recommendations and all the new medications prescriptions. This incident is my cue to trigger the long term care decision and I hope I can last until they find her a place. I won't tell her I'm doing this, as I can see her being very upset as she has friends in the building and has a social life, plays cards, talks to people. She just can't be trusted to act safely in her own interest. she's self destructive it seems like she's turned into a 3 year old or troubled 13 year old and I can't handle it or her anymore. I feel so bad speaking this way about my mother, but she's always had a streak of belligerence and impulse control issues. adding dementia to it is quite something.
111oldest. have you explored the options for where you might place your dad? Are his physical needs such that he needs a nursing home? You say he also has dementia. I would consult with a professional to see what kind of care he actually needs. Is he bed bound?
I don't have much information about nursing homes, but I have visited Assisted Living Memory care facilities for those with significant dementia and they offer assistance in all areas of daily care, except for skilled medical care.
They have residents who are in wheelchairs and some who are not. They can provide care for the patient for the rest of their life there. I would explore it as an option. Touring places and seeing how they operate and what services they provide will help you know if it will be a good fit for your dad.
When my loved one was transferred to a Memory Care unit, she seemed much more relaxed and at home than in a regular facility. There is something about being with other dementia patients that really set well with her.
Once the family selects the placement location, I wouldn't talk much to your dad about it. While you respect him, if he can't process the information, it will only upset and frighten him. I told my loved one in advance and it was not good. If I had to do it again, I would explain we were going to the place where she could get therapy and then leave the house without delay. It sound abrupt, but from my experience it would have worked better that way. Belongings can be brought in later. Even if you explain it on one day, he may not recall the next.
Once a person with dementia loses the ability to reason all bets are off in terms of them understanding or agreeing to anything. There is no easy way to get such a person in a facility at that point. It's going to take cunning, diversion, and trickery with huge amounts of support and compassion. To Mimi, I think you'd better forge ahead, get on the waiting list now. Most places in the US also have waiting lists but maybe not as long as you guys up north.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Is it in fact your mother who has to be persuaded of the need to move him?
1. is the family member suffering from any stage of dementia or alzheimer's? How cognizant are they? If you do sit down with them and talk to them, how are they able to handle the situation?
2. Do you have any siblings, or are there any other relatives who need to be brought into the decision?
3. Are the financial implications of being moved into a skilled nursing facility worked out? Do you have one in mind? Is care at home an option?
4. I assume your "loved one" still controls their own decisions, and you do not have power of attorney to make decisions for them.
I do not think you can actually tell a loved one this, unless you make decisions for them legally You, and others, will need to convince the love one that this is the best thing for them to do. Control issues are always going to be there, especially as our older relations age.
Until then she is in a support environment with personal care workers to help with meds. But she frequently skips out to do her own thing and the nurses bringing meds can't find her. As she's just out of hospital we are amplifying care with bathing and meal preparation/escort to the dining room - but I fully anticipate she will be non compliant. We had her in an transition unit in the home where she could be monitored but have some freedom however she was non compliant and they kicked her out... days later she was back in hospital. I feel like she's deliberately in a power struggle, where she wins each time by simply disappearing ... unfortunately the personal care worker management call me, and when she gets sick its me that does the hospital advocacy runs. This time they released her 2 days earlier without notifying me as she signed herself out and had one of her oldster friends pick her up while I was at work. then she proceeded to rip up her paperwork, including the doctors summary of her stay and recommendations and all the new medications prescriptions. This incident is my cue to trigger the long term care decision and I hope I can last until they find her a place. I won't tell her I'm doing this, as I can see her being very upset as she has friends in the building and has a social life, plays cards, talks to people. She just can't be trusted to act safely in her own interest. she's self destructive it seems like she's turned into a 3 year old or troubled 13 year old and I can't handle it or her anymore. I feel so bad speaking this way about my mother, but she's always had a streak of belligerence and impulse control issues. adding dementia to it is quite something.
I don't have much information about nursing homes, but I have visited Assisted Living Memory care facilities for those with significant dementia and they offer assistance in all areas of daily care, except for skilled medical care.
They have residents who are in wheelchairs and some who are not. They can provide care for the patient for the rest of their life there. I would explore it as an option. Touring places and seeing how they operate and what services they provide will help you know if it will be a good fit for your dad.
When my loved one was transferred to a Memory Care unit, she seemed much more relaxed and at home than in a regular facility. There is something about being with other dementia patients that really set well with her.
Once the family selects the placement location, I wouldn't talk much to your dad about it. While you respect him, if he can't process the information, it will only upset and frighten him. I told my loved one in advance and it was not good. If I had to do it again, I would explain we were going to the place where she could get therapy and then leave the house without delay. It sound abrupt, but from my experience it would have worked better that way. Belongings can be brought in later. Even if you explain it on one day, he may not recall the next.