My dad is 94 with Parkinson's and a bunch of serious health problems, who has been in assisted living for just a few months. He has mild Parkinson's dementia. I'm seeing these past few weeks he's starting to fall more, with bruises to prove it, but he won't admit it because he's a) in denial and b) medium-high on the narcissist spectrum. And c) because his brain is broken by Parkinson's. He also admits that he's got more urinary incontinence, peeing his pants and sometimes his bed (thank goodness for the mattress protector). So far he's refused to wear Depends becase of a, b and c above. (I told him if he didn't want to make an embarassment of himself in front of the residents and staff, he'd better get with the program. This after two years of trying to reason with him.)
He still dresses and showers himself, and gets himself to the dining room. But I'm pretty sure the staff at this ALF is onto him with the falling, and may ask us to move him soon. He's gotten so weak and skinny. He just settled into this place on August 1 and none of us has the stamina or bandwidth to move him again, but we may be forced to. Our dilemma is, memory care will be needed soon, but I can't see him among the more advanced folks in MC who are sitting in the common areas looking like zombies (this would horrify him). Adult family homes seem too small for him to be comfortable at (I'd be uncomfortable too among a handful of strangers in a strange house.) Do his physical frailties point more to a SNF or something else? He's in this inbetween place. How do you find the right facility for a parent that fits them well? I toured two with memory care recently, and they're just ok. Dad likes his finer things in life and would want a facility that felt "upper middle class" to him. If you know what I mean. I know there are continuing care places in our city (Seattle area) but I can't find them online unless they are the ones you pay $300K up front. He's too old for that kind of plan.... am I missing an obvious choice for type of housing/care?
(He asked me recently if we would ever "lock him up" and I hedged and said we would do whatever the safest and most caring option was, and we would be very discerning and thoughtful about choosing.)
Otherwise, your dad can move into a Skilled Nursing Facility but they also house a lot of dementia patients. You'd have to find one that doesn't accept Medicaid residents and only private pay. The upscale one in my area of Denver was $14k a month in 2014 when my dad was in need of managed care.
There's no ideal or perfect set up for a dementia patient who requires managed care. Tour a few Memory Care ALFs to find one that you feel will meet dads needs to socialize with elders at the same level of dementia he's at. Keeping in mind he WILL progress and get worse, maybe slowly, maybe quickly. What the situation is today may not be the situation tomorrow or 3 months from now. You need to set dad up for the long term, perhaps sacrificing some of his immediate happiness for his long term safety and care requirements. And lets face it, at this stage of disease, there is not going to be a LOT of happiness under ANY circumstances. My mother fell 45x while living in MC. Sometimes 3x in one day when she forgot she couldnt walk. And the male nurse would come and pick her up every time, gently, and make sure she was okay and not hurt, take her vital signs, give her a pep talk, and get her back in her wheelchair. But when she first got into MC, she was the "sharp one"....who didn't belong there and yada yada. Not a day went by when I didn't thank God she lived there, where she was properly cared for, with no threat of being asked to leave, etc.
She passed in Feb at 95, peacefully, with hospice in attendance, and a parade of caregivers going in and out of her room paying their respects, the likes of which I've never seen.
Wishing you the best of luck with a difficult situation.
I might hire one of her previous caregivers to help her out here and there if it comes to that. Speaking of which - can you do that? Instead of moving him, hire someone to come help him a couple hours on a couple of days a week?
Does the facility have PT/OT services? Maybe he's falling due to weakness and PT could help him out and keep him in AL longer?
Good luck!
Thanks for reminder about asking A Place for Mom to help with resources; it's like the service in my City that I'm already using, though.
Wishing you peace as you navigate your way through this challenging caregiving journey.
It seems like your dad would need more than just assisted living, especially with the Parkinsons. Message me if you would like a little more info about what I found...I live in King County, WA.
The two I toured recently were the type I didn't feel great about. They were small and homey ALFs with a memory care wing. They took me behid the locked door and it was definitely obvious that there weren't many places to go beyond a hallway and a big common room, and that the farther advanced folks were mixed in with everyone else and not much was going on in the big room. My dad would want to just stay in his bedroom, like he does now but even moreso (except to eat). He's not a big socializer these last handful of years.
I think he's less "upper class" and more "upper middle class" - perhaps we need to get him installed at one of the Aegis residences, but I hadn't looked yet because it is a $13-16K community fee (after already paying an $8K fee to his current place) and is around $6K a month for a studio in AL, so prob similar or a bit more in MC.
I guess I will just have to step it up and look at as many as possible, yet don't know where to start! We have a nonprofit group here that acts as a liaison (kind of like a real estate agent) to find facilities that meet certain criteria and that have openings, but they keep steering me toward adult family homes.
perhaps the trade off of him using a chair ( or walker) so that he doesn’t need to move to other care would motivate him to actually use the wheelchair.
His conditions do speak to needing more care, very hard when the person fights that.
Finding a good place where he has things around to keep him mentally busy.and doesn’t feel like a sterile place.Hope you can find support to navigate that next step
My Mom's brain told her she could stand and walk, but in reality she could no longer do that. It was even difficult to keep her in a wheelchair as she would constantly try to stand up. Eventually a geri-recliner helped slow her down. Staff would place a pillow under her knees and Mom would be busy working on trying to get that pillow out.
As for Memory Care lock-up.... it is no different than any of us here locking our front and back doors during the day/night. My Dad was in Memory Care and he had free range of the whole building until 8pm when the elevator on his floor was closed off to the residents [Staff had a code to use the elevator], and of course, the front door to the building was locked. Dad was in Sunrise, a national chain, and he loved it there.
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