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The thought of putting dad into assisted living has been weighing heavy on my mind the past few months. He's able to live on his own, drive to get groceries... but, for how much longer? His memory issues are becoming worse. The stress is wearing on me. How do I even bring up the topic to him? I know he's going to be extremely angry about it. And one of his first responses will be about the cost...I'm sure. But, it sure would be a big relief for me to get him into a nice facility. There's one just 3 miles from my house and it's close to my brother also.

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Yuor Dad is able to live on his own.
So let him.
When he begins NOT to be able to do this be certain not to ENABLE him to continue when he is not safe and able. Gently let him know he will have to hire others to do for him, or enter ALF and tell him you will be willing to visit facilities with him.
Stop overworrying now. Today is not the day. So enjoy today.
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NUGGET3268, there are communities that have Independent Living, then the next step Assisted Living or Memory Care.

My Dad could still do a lot of things, but he didn't know how to cook or do laundry. Plus he was a fall risk. I was lucky, my Dad was ready to sell his house as it had become too much for him to keep maintaining. Independent Living offered him a really nice 2 bedroom apartment, large living room, full size eat-in kitchen, plus weekly housekeeping and linen services [washing sheets/towels]. Also he had the option of having some or all of his meals in the restaurant style community dining room. There was always a RN on duty around the clock.

Back then the cost was around $5k per month, he signed up in winter when the facility had vacancies so he got a discount [prices vary from city to city]. Those who lived in Independent Living and who could still drive, were allowed to have their car.

Eventually the facility said it was time for my Dad to move over to Memory Care, at that time $7k per month, as he was "sundowning" and trying to leave the building at night. Dad was happy with his "college dorm sized room", and I felt he was safe and unable to leave the building.

You don't say how old is your Dad. If he is between 80-100 the thought of moving to an old folks home would make him think of the County Asylums that his older relatives had moved into. Today's places are built more like a hotel with a lobby, with restaurant style dining room. More fancier places have onsite barber/beauty shops, gift shops, bank branches, doctor's office, swimming pools, etc.
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Unless you have POA (and that POA is active as opposed to some time in the future when dad becomes incompetent), you don’t “put dad” anywhere.

You say his memory is worse. Than what? How much worse? Over what period of time? Is he forgetting he already had a jar of Mayo or forgetting to turn off the stove? A leap to dementia is unreasonable without a medical diagnosis.

You want to dictate to dad because it would be a big relief … for you. Meanwhile, he gives up his home, his independence, his car, his routine. And does it happily, so you aren’t stressed he doesn’t like the assisted living you put him in.

Expect anger. Expect pushback. Expect to fail. A neighbor moved to senior living/assisted step up care. She said those who moved by their choice were happy, while those who were forced to move adjusted poorly.

Why not “Dad, I’m concerned you seem forgetful. Can we have this checked out?” “Humor me. I can’t sleep at night.” “Dad, can we talk about what if?” “Dad, can we set up electronic bill payment?”

You want to hit the easy (for you, not him) button and force a solution when you don’t have consensus on the problem and scope of the problem.

Seek a way to deal with your stress and expect transition to be the result of an accident/medical problem or negotiation over time.

I wish you good conversation and patience.
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Debstarr53 Apr 2022
Wow! That was quite a leap. When I read the post, it does not sound as self-serving as you make it out to be. It just sounds to me like she is having a hard time trying to get the courage to bring up the subject. Your answer was OK until you said, "You want to hit the easy (for you, not him) button and force a solution when you don’t have consensus on the problem and scope of the problem."
Then: " expect transition to be the result of an accident/medical problem or negotiation over time?" Several years ago, when my 2 oldest kids were coming home from school, an elderly man pulled out in front of my son. In order to avoid t-boning the elderly couple, he swerved, but ended up hitting a tree on the edge of a golf course. Fortunately, my kids only sustained minor physical injuries, my son's Camaro was totaled, but my daughter, who is almost 43 years old now, to this day has problems riding in a car if someone else is driving. If my son had hit the other car, the elderly woman would have probably been killed. The elderly man took the right of way from my son, not my son's fault.
So, according to you, just wait until some accident happens?

It sounds to me like she is only wanting advice on how to approach the subject because it's a stressful thing to bring up.
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One suggestion. This one will only work if you do have your own money and home and family.

Something has happened so that you can’t go over. You need to travel overnight or two nights to consult with some health or financial specialist for you or your family. In your absence, you have booked a couple nights in a senior hotel. Really, pick the nicest of als. they are gonna treat him white glove for future business.

Once they actually do go, resistance may be diminished.
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Start the conversation with him at his doctor's appointment. Ask the doctor when it is "time" for him to make that move. Then, abide by what the doctor outlines. He won't need that nice facility until then.
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I've had to have this conversation with my mom. The cost is huge. In my case, I consulted an eldercare attorney, to get a list of things I need to get ready. My mother will need to be on Medicaid to pay for an assisted living and they all have a set private pay period. If he is going to need Medicaid, only look at those facilities. Then tour them yourself until you find a couple that you think he would like. Then start talking about the benefits and arrange tours for him to go eat lunch or dinner there. There are usually brokers out there that can give you information about elder care facilities. You don't have to pay them, they get paid by the facilities, when you choose one. Like a referral fee.
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Hi Nugget,
I went through this worrying about Dad, wishing he would choose to move to assisted living and dealing with the eventual move only when it became a crisis and he had a fall and ended up in rehab. If you can begin to broach the topic with your dad now - try. Does he have any friends in AL? Any elderly acquaintances who can be a positive influence about the move? He's probably secretly struggling and might find the extra help and care a relief. Would he be responsive to your telling him that this is causing stress and worry for his family? Can you convince him to take a tour of the facility near you and meet some of the residents, have lunch and check out the amenities? I'd start now and have your plan for the future as he may decline very quickly (and he may not at all). Start the conversation, stay calm and make your case. Money is a completely different issue - I see others have responded to that concern - I have a mother who is now on medicaid in a really nice AL in Massachusetts, options and assistance really vary from state to state and facility to facility,
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Debstarr53 Apr 2022
Great advice without the unnecessary judgment like someone else posted above.
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I think you are wise to plan ahead, but Erikka is right. Remember it is HIS life and you are asking him to make many changes. Start to look at facilities near where he lives. Visit them without him and try to view them through HIS eyes.
If you find one or two that seem suitable, describe to him the advantages he would have living there...an apartment of his own (probably with a kitchen), meals furnished, no home maintenance, simple housekeeping service. He could take his car (as long as he is still driving). Don't push the idea too hard, just open the conversation. Food for thought. Don't emphasize his failing abilities (that discussion may come later) only how much more convenient it would be. Feel him out...what does he think? You may bring the topic up again later or if you see him struggling with something.
If you're lucky, he may entertain the possibility without total resistance... especially so, if he knows you will be near to enjoy his company and help if you are needed.
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Please due your due diligence with any facility. Make sure they are staffed well enough, specfics on what they provide. and at what cost....i had my mom in an AL with Brookdale, its a nationwide company, understaffed, and money hungry. Did not provide adequate services forcwhatvwe paid for. Staff point blank lied to me. Be present and follow up for thecsake of your dad
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Some people with dementia don't realize that they have dementia. These people will deny that they need assistance. My mother was like this, and she resisted the move to assisted living/memory care. What exactly are his memory issues? If they are little things, perhaps the need for memory care is not urgent yet. The things that usually raise red flags are if he is not caring for himself well any more, not eating properly, not taking his medications on schedule, getting lost when he leaves the house, etc. Will he accept having aides come in to help if he's having these problems? That might be a first step. Seek counseling for yourself as his caregiver to learn techniques of how to be a caregiver with less stress to yourself (easier said than done, I know). Try to work in some breaks for yourself. Make sure all of his paperwork is in order while he can still sign legal documents. Will you be his POA for medical and financial matters? He needs to set up Powers of Attorney for medical and financial matters, a living will with his advance medical directives, a will if he has assets. Many banks have their own POA forms. You can ask his credit card company to issue you a card with your name on it so that you can purchase things for him if he becomes incapacitated. His POA needs to be on file with Social Security/Medicare to be able to speak on his behalf. You can do this with a phone call with him sitting next to you. You may need an attorney for these legal documents. All the best to you and your Dad. This is going to be a difficult time for him, too, as nobody wants to be less independent and capable.
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JoAnn29 Apr 2022
Medicare and Social Security do not recognize POAs.
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