It's time to separate our parents and move Mom to a higher level of care. Any suggestions?

So are they both living in a facility or are they at home? If they're in a facility, will they still be able to see each other frequently? Can someone get dad over to have lunch or dinner with mom on a regular basis?

When my dad had to move to skilled nursing from independent living, I'd get my mom over to visit and have a meal with him (and I'd go eat with him too). That minimized their separation. If your mom has dementia, there's probably not going to be much reasoning that you can do that will "help" her, other than to frame it in terms of her needing more medical care and where she's going will be able to give her that care. Make it "doctor's orders", so that it's the "doctor" who is requiring the change. Good luck and let us know how it goes.

So, your parents are in an Independent Living facility, and you need to move mom to what level? AL? Nh? Could she stay at IL if you brought in caregivers? Would dad also be well served in AL? Is there any way that they can be kept in the same facility, or at least on the same campus?

If not, the facility needs to be the bad guy! It's because "they' say she needs a higher level of care. Or her doctor.

Would any of the above work? Let us know!

This may surprise you, it may be harder on Dad. We did this. Mom and he had been living at home with me as their caregiver. Everything was going well but the dysfunction in my family made it impossible for me to continue because of sibling denial of just how sick mom was.

Last June they were moved to a facility, mom to memory care, he to assisted living. Initially, they had all meals together in the AL dining room. They had to wake him for breakfast and were using him, yes I said using him, as her caregiver in an effort to make the transition easier for mom. This did not work for him as he is a late sleeper. He was exhausted so I put a stop to breakfast within a week.

Then it became him taking mom out of memory care to have lunch and dinner together in the AL dining room. Upon returning to memory care after meals mom would become quite agitated, especially after dinner during her sundowning. The facility ended the dinners after about another couple of weeks and they asked him to have lunch with her in memory care area. He was not willing to comply with that request and kept taking her to AL for lunch. When he took mom back to MC after lunch her agitation would increase because she did not want him to leave.

Eventually, the staff told him he must remain in MC for lunch with mom because they thought the change in environment was causing the agitation. He would comply for a few days, and would then revert, once the director of MC had a day off. This on and off to AL for lunch continues. You see, he seems to still think he can reason with mom and explain why they are there and cannot go home.

In mid-December he had taken Mom to lunch in the AL area and another couple sat with them. Mom thought these people were trying to get a free lunch on them. This pushed mom over the edge and she ended up screaming and yelling at the staff in the kitchen to get those people away from their table and they most certainly would not pay for the other couple's lunch. She had to be escorted back to MC by security she had become so angry.

Did he finally learn from that experience? Sadly, no, and he still continues to try rto take mom to the AL dining room for lunch. Sometimes the outcome is not as bad as this. But, he still thinks or hopes that he can reason with mom, which is impossible to make him understand. His dementia? Maybe.

Just before the move his geriatric care manager told him he would see mom more often with the move as I took her to a day program Monday through Friday. It was very obvious early on that this was not to be the case. You see, there was nobody involved in the care of them as I was. They all had their fairy tale ideas that they would live happily ever after, which is not as any of them have imagined.

I wish you the best with the pending separation. I believe it will be harder on you Dad as he is the one that understands what is going on. Naturally, it will be hard on mom too, but she will be redirected by staff which will be hard for them. Eventually, if dad cooperates with staff and their requests, mom will have an easier time. You will have to remind him frequently that his cooperation with staff requests will make the transition easier for mom and easier for staff to care for her.

This is still difficult for them both and the separation was nine months ago. Your support to Dad is going to be the most important. The staff in memory care are specialized in helping with the transition of those with dementia. Support the staff and whatever recommendations they make. They have done this many times and your support of them will make everything much easier for both of them.

SHS, I just read your profile. It says mom's primary ailment is lung disease, since you are now having to separate your folks because of mom's dementia and behaviors, it sounds as if her primary ailment should now be changed to dementia. This will help responders to your posts to adequately respond to your questions.

Gladimhere, wow, thank you. I had never considered all of
the potential social challenges involved with placing
both parents. Your post was most enlightening.

My parents were split up, more because of my mom, but dad never stopped caring about her. I would say talk to the facility staff and see what arrangements they might be able to make to keep,them together in any way that is possible. There are even some AL and memory care facilities that will give you a price break if they share a room, probaly not for skilled nursing though. Sad, and not easy, but I hope there is a way to make the best of it.

It is very hard to split them up. We considered keeping them together, sharing an apartment. To do so would have required an overnight caregiver because of Mom's aggressive behaviors. At that point any cost savings of having them in the same unit was gone. Mom's behaviors at times were nearly impossible to manage so same unit was not at all realistic, it would have been too difficult on him.

Thank you, all, for your extremely helpful responses. I took lots of notes. They are currently in "Independent Living." The suggestions about making the doctor or facility the "bad guys" and them sharing lunch rather than dinner are going to help us navigate this difficult journey. (Her Sundowners is difficult.) When my mother had a brief stay in nursing care (following a brief hospital visit) the staff called my father for everything. It was too much for him. We will definitely need to have a meeting with the staff, listen to their advice, and set up some boundaries when we move forward. Unfortunately, my father seems to think it will be better to wait for another crisis before moving her. My siblings and I do not feel the same, so there will certainly be further discussion.
Once again, I am extremely grateful for everyone's input. Thank you!

key thing here is the dementia. even if you explain til you're blue in the face or put the blame on others, won't matter as she won't remember the explanation anyway and you'll have to explain all over again ---and again---and again. No answers but maybe your Dad might find some respite in not having to care for her 24/7 and doesn't want to admit it out loud for seeming uncaring. Why isn't your dad making this decision by the way? Does he have all his facilities? My father would never let ME make the decision after 60+ yrs of marriage. He's very much in charge of the decisions of my mother's care. I just try to facilitate the conversation.

Seems like if the plan involves splitting them up, a new plan is needed.

While your parents love each other, I would keep in mind how challenging it is to be around a person with pronounced dementia on a continuous basis. And if the staff are relying on dad to help with mom....I wouldn't like it for dad's sake.

Mom will not recall what is going on, but dad will deal with the frustration, pain and helplessness day after day. Keep in mind that depending on the progression, the woman he is helping to calm, soothe and control in the facility is someone very different from his wife and she may not recognize him either. I'm not sure what the answer is, but I would be careful to not overburden dad.

If Dad is still competent and doesn't want his wife moved, you have a problem. Has there been any progress over the last week or so?

We are reaching the same point as you are, shs0707, and are struggling with what to do with my MIL who is very close to being bedridden. My FIL still insists on controlling everything for her but then complains about how hard his life is. They live in independent living. There is nothing you can do or say that will make your dad not hurt at being separated from his wife. This is a sad time for him especially. Get him pastoral care - emotional and spiritual support - and he will need it a lot especially as you get closer to separating them and in the initial 30 days afterward.