The doctors and family members feel that the Alzheimer's patient can no longer stay in his house because he makes poor choices when problem solving. He does not want anyone coming into his house to stay with him and refuses to go into assisted living because he feels it is one step closer to death. No matter how many times we have tried to explain that assisted living will make life easier for him because he doesn't have to worry about the upkeep of his house, laundry, and meals each day, the person doesn't want to leave his house.
We would like him to decide which assisted living facility he would like to go but don't know if we should check-out the places without him or take him to look at them. A year ago, I took him to just see what assisted living facilities are like reassuring him that he didn't need to go to one at that time. He broke down, got sick, and cried. A year later, it's time for him to move into a facility, and I am not sure if he should accompany me. He has mild to moderate Alzheimer's.
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Its nor "forcing" them. Its doing what has to be done for their safety. Its no longer what they want but what they need.
I think taking them on "tours" is a waste of time. Find a place convenient to family that meets his needs. Then move him in. Tell whatever fib you need to get him there. We told my Mom it was a new apartment.
Don't expect a good response. Expect an honest one. Which will be grief. There are times when grief is a fact that cannot be avoided for you all.
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Go into this knowing this is the right decision but expect some resistance on his part and know it’s normal. Be ready with "therapeutic fibs" to placate him. Hope all goes well.
The above was the only way my Mom would leave her house where no strangers could set foot in "her house". Sadly she didn't even know where she was after going into long-term-care due to serious dementia brought on head trauma. She needed a village to help her :(
My Dad, on the other hand, couldn't wait to move from the house her shared with my Mom. At 94 he was tired of cleaning gutters, doing yard work, shoveling snow, and the "honey do" lists that he just couldn't do anymore but Mom would insist. After Mom passed, he was ready to sell and move. When I pulled up to the first senior living facility, which looked like a Victorian hotel, he asked "where do I sign up?". The place was so nice, even I wanted to rent an apartment :)
Now, if a parent is dealing with very limited eye-sight, I can see where moving would be difficult trying to find their way around a new place. Later on I believed that is why my Mom refused to move.
Some very elderly parents will refuse a nursing home as they remember back when they were kids or teenagers, a relative leaving home and moving into a facility. Usually the facility was the County Asylum, not a user-friendly place as all types of disengaged with reality patients were placed together. My great-great grandfather was in such a place due to brain injury caused by a farming accident. He was only in his 30's.
Oddly, mom used to visit all the places local to where she lived (free lunches/tours.) She would also often say something about cleaning out stuff, in case she had 'to get outta here.' When I asked what she meant, she said assisted living. So, this was in her "plan." Fast forward - early signs on dementia, we proceeded in steps... Take car away when it became obvious it was an accident waiting to happen. Help when we could (groceries, doctor appts, etc.) Even one neighbor was somewhat helpful, at least for checking on her (55+ condo area.)
The next step was to explore bringing in help. She was still able to "self-care", but needed a little oversight. Locked/timed med dispenser needed to be checked as sometimes she wouldn't see/hear the alarm. We hired aides 1 hour 3x/week, bumping that up shortly after to 5x/week (didn't care what they did for the hour other than checking meds were taken) since it seemed to be going well. After a few more weeks, she refused to let them in. Great. Time to start checking out places... We settled on one that isn't far from me (her condo was 1.5 hour each way!) We had to wait for their rebuild of the old facility, then they opened in stages (IL, then AL - MC was last.) MC was delayed a bit until they had enough residents.
Meanwhile, mom was adamant that she was fine, independent and could cook (NOT!) She refused to move in with any of us (I wouldn't be able to care for her anyway.) When AL was mentioned, the response was "Paugh! I wouldn't live in one of those places!" So the old mindset of what NHs were in the past didn't apply. She KNEW what the places in her area were like. We did bring her for a visit/free meal/tour. She liked the place, but her big question was who will pay for this? Bring on the fibs... VA. Medicare. Whoever. She wasn't 100% convinced, but seemed to like it. However, on returning home she told me that it was a nice trip, but she wouldn't go the next time - she thought we were looking at houses for my brother who was with us! Elder Atty says we can't drag her there, suggested guardianship. Facility said no committals! Rock|us|hardplace. Facility said just get her here, we'll do the rest.
Just before the planned move, she injured her leg, didn't tell anyone and ended up with cellulitis. This delayed the move a few days. It also gave YB the idea to make a fake letter from 'elder services' at the hospital that treated the wound, saying she moves where we choose, or they will choose. Madder than a wet hen, but she went reluctantly. To her it was a temporary thing. Still wants out from time to time, but is now in year 3.
So, it isn't always a preconceived notion about NHs (though it can be.) If at all possible, come up with a ruse to get him there... vacation, house needs big repair, etc - something that is plausible but seems temporary. Don't call it what it is (AL/MC), pretend it is just a temporary move for whatever plan works. With dementia, date/time becomes muddled and he can be told tomorrow, next week, whatever, and have no clue when. Fibs can be a great friend/tool! Blaming the doctor for making the decision is another option - takes the onus off friends/family members. Whatever works - while sometimes nothing can be done but wait for that inevitable fall/injury/illness, sometimes that is too late!
Once that is out of the way....
What is your loved one like? Do they like activities? Lots of people? If so look for a place that has those things. Again keep in mind that what a person likes now may be way off in 6 months.
And when you go visit have a lunch or dinner during your tour.
And when you have it narrowed down to 2 or 3 stop in unannounced sometime and just see what it is like as the residents go to breakfast or lunch. You would not be able to get into a locked unit but the rest of the facility you should be able to get into . Try parking in a back lot and try a side door, they are often unlocked.
One other thing to think about IF there is a possibility that this person may have to go on Medicaid look for a facility that will accept Medicaid. Usually once a person has been private pay for 1 to 2 years a facility will "let them" stay if they go on Medicaid. So do not start looking at Private Facilities that do not accept Medicaid
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