When is it time for a parent with dementia to be put into a home?

Before putting a lien on your family home, check with an Elder Care Attorney. They may help. It is true that the other spouse may stay in the home until they leave, but I've been told there may be other alternative ways to pay for your mother's care. Please check first.

My boyfriend & I take of my parents. We are full-time caregivers for them; we all live under one roof. You are fortunate to have siblings who are willing to help! Before my parents came to live with us, I was going to their house at least four times a week to assist them with meals, grocery shopping, paying bills, doctor appointments., etc. At this time, I was working full-time and I was a part-time college student.

My mother has Lewy Body Dementia. Neither my brother nor my two sisters care about us or are willing to help out. Plus, we had to clear out my parents' house by ourselves to get it ready to sell. It took a year an a half because my parents were hoarders.

I've been through a similar situation with my parents. Of course as they got older, their ability to manage became more difficult. Mom had a stroke, did well for about a year, then other acute health problems developed & she became more frail & confused. Dad could manage for a while but it became too much - he didn't know ANYTHING about running a house. Didn't know how to wash clothes, run the dishwasher, cook a meal, etc. And mom was unable. So...I managed to move them to my town to an AL facility which was a relief for me. Dad recently admitted that they should have moved here 20 years ago, but didn't, primarily because they thought my brother & sister-in-law would be forever nearby. Well, that changed - my brother moved away & parents were stuck 7 hours away by themselves. They had great neighbors, but that only goes so far.
AL was the best answer, but Dad really didn't like it. As mom's dementia progressed, I could see Dad was perplexed - at times mom seemed OK then she would behave & talk bizarrely. I think Dad thought there was a chance she would get better & we just hadn't figured out what to do. But...she was only going to get worse. I think an honest discussion with a trusted physician would have helped him with information & decisions. Do your parents have a physician who could talk to him about realistic options & what he is facing? Do you think that would make any difference? I think it would have been helpful to my dad. Now he realizes he had no choice but to move & that there was no way they could stay where they were.

If your dad is still of sound mind, his POAs over mom would still be "active." I understand bro and sis are #2 after dad, so they can't really use those yet. HOWEVER, POAs are not what some people think they are. They give you authority/oversight in some circumstances (medical and financial decisions while honoring their wishes, signing for someone who can't, etc.) They do NOT have power over where a person lives or what care they get. That would be guardianship.

IF you can start with getting the dog vetted and moved to your place, you might be able to convince dad to make the move to the VA. You indicated his concern was the dog. If you can reassure him that you will care for the dog and bring him/her for visits, perhaps you can crack the ice on that.

I would also highly recommend a good checkup for mom. IF she can't be taken to the doctor's office, could they send someone qualified to the home to check her?

Also, if possible can you "kids" perhaps set up a room on the first floor to be their bedroom, to avoid the stairs? This won't work well if there is no first floor bathroom. Hopefully there is at least a 1/2 bath. Eliminating as much of the stair use as possible is one goal to achieve! (Curiosity: how does she get help up/down the stairs? Is she mobile with help? If so, she needs to be someplace where she will get encouragement to MOVE - it could make life better for her!!!)

If he refuses the VA move, there are options for getting in-home help, depending on their income. VA, Medicaid both offer some in-home (mutually exclusive) assistance. You could bring some help in and pay for it yourselves (hoping siblings will kick in - may sis, who is getting burnt out!), just tell him Medicare is paying (have any bill sent to you AND you need to check into this as well, as Medicare DOES sometimes provide minimal in-home care for the home-bound.) When we were hiring aides, they sent a nurse to evaluate (covered by Medicare!) and she told us mom could have gotten some free care IF she would accept some personal care, such as help bathing. She refused. I had taken over finances, so we let her think doc ordered the aides and Medicare was paying! Worked okay until she refused to let them in. :-(

IF mom needs to move, Medicaid is still a possibility if they qualify by income (they will split income/assets, allow one car, the home for the spouse, etc.) Their goal is to get as much as they can without impoverishing the spouse. Maybe VA would take her in? It would be best to get appt with someone at the Va and discuss the issues. They might be able to guide you.

To BEST explore these and other options, find an EC atty who will give you a limited free consult. National Academy of Elder Law Attorneys (NAELA) www.naela.org - plug in zip code for local list. Make a list of your questions and concerns, take notes, see any attys who will offer the free consult. Explore all options (hopefully someone has some idea of what their income/assets are, that would help!) Ask for fee rate and ball-park estimate. Ask about guardianship - even if just for your mother. This will override ANY POA.

I would get these balls all rolling at once. It's a matter of time before something drastic happens! It is GREAT that you are voicing concerns, even if the others in the family are not listening! WE hear you, WE understand and many of us have been there, done that!

Your profile says mom is 58, but the question states 87 - perhaps that was 85 when you created the profile?

Clearly YOU have concerns and rightly so. As others pointed out the parents' ages, medical conditions, 3 story home and inability to provide proper care for mom (and likely dad too) are BIG issues! Add to that you "kids" are probably getting up there in age as well. If dad needs physical support, who will he take out first if he falls? Mom, being bedridden, is more likely to develop some serious medical issues (UTIs, pneumonia, sores, etc.)

If dad has trouble getting around without walker or cane, how does he do the stairs? He can't be doing that often, so how is he really caring for your mother during the day? If you all have to provide the evening meal, what are they eating during the rest of the day?

Having one of you come every night to put food on the table and put mom to bed isn't enough. What do they eat other times of the day? Where is mom during the day? You mention you "bring her back up to bed..." How does she get "down" and "out of bed"? You also say "...she will remain in bed sometimes until we get there and get her up to come downstairs." So, which is it? Or both?  Eating little could be a swallowing or eating issue she has and should be checked out. She may need a specialized diet.

"...he states that we are selfish and just thinking of ourselves." Learn to let THAT roll off your back or go in one ear and out the other! As someone said, guilt trip, aided by the "travel agent" parent!! You are NOT being selfish to say enough is enough and to understand they need much more help than you 3 can provide. You might not be able to convince him as you wish, but that doesn't negate being proactive.

"I wish I could convince them that it's time for the dog but they refuse and my brother POH and my sister POA after my father are refusing to do anything but pick up after the dog. My hands are tied so I will continue to help them the best I can."

The dog is the lowest concern, BUT, I would suggest YOU take the dog to the vet for a checkup and then keep it in your home, even if you have to crate it, to see if the incontinence is real or just not being taken out to do the biz. I would suspect the latter, esp if dad has trouble getting around! Being deaf isn't a reason to put a dog down. If there are other major issues, the dog is sickly and/or very old, perhaps it is time dad lets go, but get him/her checked first. For now, get the dog checked and care for/treat at home if possible. You can just tell your dad the dog needs medication or something and it's easier for you to do this at home. Once the dog is out of the picture, start on the rest!

I'll cover suggestions for moving forward in the next post. This was mainly to assure you that you are NOT selfish, NOT guilty and are hamstrung by dad and inactive siblings (it is nice that they "help" mom and dad, but they are not doing them any favors in enabling this stalemate!)

This is an addendum to my post about the value of in home care, and my stating insurance covers some of the cost. The only information I have is from 2 clients who had private long term care insurance. These clients did say it was less expensive to live in a facility than to have in home care. I appreciate the replies to my post on this matter of insurance coverage since I don't have experience with that issue.

Regarding POA... getting a POA for your father is a good idea if he will agree. The mother has dementia and cannot sign a POA to designate anyone.

If you have a POA, you cannot override the person's wishes, unless the doctor has signed a Certification or Declaration of Incompetence. It sounds like your mother should or maybe already has one. But unless the doctor thinks your father cannot make decisions and agrees and signs one for your father, then you legally have to abide by his wishes. Which makes it very difficult.

Petitioning the court for guardianship may be an option but from others as I understand it, is very tedious and probably would be difficult with your father as long as he is aware.

There is another possible way to do things, not that it is the best and not an immediate answer. But if your mom becomes ill ( a UTI, maybe says she has chest pain, something, call EMS to get her admitted to a hospital ) and get a social worker involved that way and / or call APS. Make it known that going home is NOT an option, that it is unsafe, her care is being neglected. As others have said, if Dad cannot bring himself to make the decision, then hopefully all 3 of you children cannot present a united front and enforce your concerns that the home environment is NOT safe. ( I know none of this is easy... I brought my own mom to live with me almost three years ago and she requires very little physical care, but was not safe in her own home. Finally selling her home in another town, but she still makes little remarks here and there about not getting to live in her home. It's like a little stab in my heart each time she says it, but I know it is for the best. )

He is already unable to care for her with or without children helping at night. If she is in the same diaper all day long, it is not healthy. UTI's cause confusion, and when you add that to dementia, makes it worse. Dad has a lot going on and trying his best to maintain what is familiar to him - his wife and his dog are deteriorating before his eyes. Of course he is trying to maintain his current residence situation so that doesn't change, too.

If the dog is the only thing holding him to a 3 story home, is it possible for one of you to take the dog and contain it to an area in your home? It's very possible the dog can actually be trained to use the bathroom outside and the real problem is dad just doesn't get up to let it out. A deaf dog does not mean dumb dog. If the dog is an old dog, then it's not like this arrangement will last for a lengthy time.

Or, see if dad is willing to put mom in a nursing home if it was affordable. You can apply for the NH medicaid and they will tell you how much two people would have to spend down before being eligible and how much of her SS or retirement they will take if she goes to NH. They allow money for the spouse still living at home when they are dealing with a couple.

Could he afford a few hours a day for mom's care? Perhaps someone to come in midday to work w/mom, clean her up, bathe, etc. I would also move their bedroom downstairs to avoid falls. Make use of a living room, den or other area not used all the time downstairs.

No no. Not acceptable. Please call your equivalent of Aging Care or Dementia government bodies. Your mother should have been in care a long time ago. This is elder abuse on your fathers part. Perhaps that’s who you should call first. He no longer gets to call the shots. Unite and get this sorted. I would start by getting your mother assessed then remove her from your home to respite

A 3 story home is too much for them now. Prepare now.

Your first sentence struck me "My father refuses to put my mother in a home...and the reason you say is "because he expects his children (myself & 2 siblings) to come every night and put my Mother to bed"
Your father is from the old school...like my Grandfather. Men from that era don't 'talk about feelings' and 'gush emotion'...pretty much ever. "boys don't cry etc etc"
However, his actions say that he loves your Mother very much, and is afraid of
what the future holds once his (and your mothers ) lives are out of their control. And in the hands of overworked, often underpaid, staff at a nursing home, being under the influence of multiple medications
He is intelligent and understands that he will never get his life as he has known it for decades back again. I don't know the financial situation, however you might make enquiries as to the eligibility of your parents for Medicaid
They have an affordable health plan for the elderly. And home care providers are part of that plan. Paying care takers anywhere from $9.00 to $19.25 per hour
There are other similar programs..Another worth investigating is IHSS. A Federal govt in home elderly support program. I suggest you ask the MD at the hospital system your parents belong to, to organize an appointment for you, and your parents to speak with a social worker. This way you will be able to get an outside clear minded professional viewpoint (which is always helpful) and become informed about all the support services etc that are available for your parents and yourself.
In the final phases of a persons life the body slowly but surely closes down..And the signs or patterns you are seeing in your Mother are what we see in patients who are close to passing over...ie.little desire for food, and or water...and sleeping the majority of the time.
Which means its highly probable that she may pass over before too much longer
It IS demanding taking care of people who are old and often disgruntled, and not taking care of the most basic of their needs for hygiene.
However, what your Father is telling you when he "demands dinner and putting Mother to bed each night is:
a. I take care of her all day everyday & have no complaints about it. Why would I? I love her!
b.Your Mother made Your (you & siblings) dinner and tucked you into bed for years on end. Now it is your turn

Im sure its a strain on your Father taking care of your Mother every day...without any break. And the fact that he has no-one to communicate with, as her lucid times are less and less
However, he doesn't complain at all
And (again he won't tell you, and would probably deny it) however, I am sure he really looks forward to your sister, or yourself or other sibling coming in the door with a smiling face
For that short hour or two each evening, he has his family back
He's quite a guy.

In a calm (after a good meal) discussion your father might be willing to concede to a part time caretaker ...provided by one of the systems available....to come in part time to take care of things like washing, cleaning floors, making some meals in advance etc
Be patient with them. You only get one set of parents per lifetime. And if we are honest, I think that the greatest majority of women wish hope and dream for a man who truly loves her.
The way your father loves your Mother!

Dr Bach's Rescue Remedy is very helpful in these demanding emotional situations. You can buy at pharmacies or markets or amazon.. in a cream...or a liquid....rub onto perfume zones....add the liquid to any and all liquids.. Invented by a doctor over 90 years ago. And made only from the dew of flowers. Remarkable at helping us recover emotional balance.
I just say you have 51 replies. I would just suggest you
a. follow whatever is your highest thinking in the situation
b. LOVE is Always the answer

I see you have a lot of input here so I am probably just repeating but first let me say I can only imagine how difficult this must be on all of you. Your parents, father in particular are clinging onto what they know and see as their independence so you all are bending over backwards to give them that. However the way I’m reading this what really needs to change is your perspective (yours and your siblings), you are not likely to change your dads perspective through reason and I think you know there is even less point in discussing it with mom but it sounds to me like you have all reached the point where you are being more selfish by enabling them. One could say dad is being selfish and you are enabling him but I’m not sure he’s really capable of being “selfish” now, self involved, self protecting, scared and an ostridge, maybe but he probably believes he is protecting his wife too not resisting what’s best for her to get what he wants.

You and your siblings however know they both need to be somewhere else, particularly your mom but your dad too and keeping them together as long as possible is probably best for both of them irregardless of the VA money and benefits. It’s not going to be easy, it wouldn’t be easy even if he was agreeable, loss never is and your parents needing to give up their home is a loss for you as well as them. They may however have more to gain from it actually, you gain piece of mind knowing they are safe and cared for but they gain back more independence and hopefully can shed some fear of the unknown.

Perhaps approaching the need for a move from the perspective of taking care of mom, providing what’s best for her which is being in a safer location where she can get around in her own and has knowledgeable, professional help when needed but can still be with him. She needs help her kids and husband aren’t qualified to give now but she also needs her rock (Dad) to stay with her as long as possible. Maybe the benefit advantage helps here too but an even bigger help will be if it isn’t just coming from you and your siblings. Maybe Mom’s doctor can help by being the one to say she needs 24 access to professional care and to be living on one floor (no more stairs), then the family can team up to explore the options for providing what Mom needs. The key here is the doctor is clear that part time family help doesn’t cut it anymore and neither does the house set up, it’s not your or your siblings opinion it’s the doctors orders so you can then work together to accomplish meeting those orders. If the insinuation can be clear that the doctor can and will call authorities if the family doesn’t make appropriate changes and he or she has the authority to do so it might help Get more cooperation from Dad too. All I can say is while this isn’t going to be easy on you and your siblings if you stick together and don’t engage Dad in fighting but hold firm (while maybe commiserating with him too) you are really doing the best thing for your parents and eventually you will get through this and to the other side where that becomes even clearer.

So many emotions as well as practical barriers wrapped up in this, my heart is with you. You and your siblings stick together, support each other and take strength from each other because that will not only make this easier but it may create some surprise positives when you look back at this tough time.

Speaking as someone who has four years of experience working as a Certified Personal Care Aide with the leading Senior Caregiving company I can tell you that your first consideration should be to speak to a very high quality care giving company about having a caregiver coming into your father's home for as few as 12hrs/week or as much as 24/7 care in the home. Insurance pays for most of this expense. The caregivers have training and experience working with dementia patients. Services provided address needs from entirely bed-bound to entirely independent, including all levels of dementia and hospice support, meal preparation, feeding, medication reminders, toileting, bathing, dressing, driving to appointments, shopping, walking with client, engaging client in stimulating activities, companionship, and light housekeeping of areas used by client in the home. Pets and plants are cared for also. The only time to consider placing your father in a live-in facility memory unit is if he becomes dangerously aggressive to those around him. The longer an elderly person can remain in their own home the better because people can deteriorate rapidly when moved into an impersonal facility and away from all that is familiar to them. It's very sad.

Sorry that you all are going through this difficult period. Good that you have a relationship with your siblings and that they are close by and hopefully onboard with a plan to move forward. I had the same dilemma with my mom’s cat, had me more flummoxed than placing my mom in memory care. Once I decided to take the cat, I could get my head around what needed to be done with my moms care.

As someone else pointed out, there are Medicaid services available in the community to include personal care (bathing, etc.) and homemaking service for the person needing it, but these are just usually for limited hours a few days a week, never live-in care. If someone needs more care than a limited amount, there is assisted living and / or nursing home.

There is also VA Aid and Attendance for help at home.

But I agree with most everyone else, their care really sounds like nursing home level of care is needed.

For the dog, have a vet check him out, as to his age, whether as someone pointed out, maybe he isn't incontinent and just needs to be taken outside. Then he could have a new home. For a dog who has never been caged and has the run of the house, a cage would be cruel.

BUT I say all this because if the dog is very old and truly incontinent and does not have a good quality of life, euthanizing is the more compassionate route.

Are there affairs in order? DPOA, advanced directives, last will and testament,etc? Another reason to involve an elder attorney. Good luck.

In addition to my previous post, I would not depend on Area on Aging as some people suggest. After coming to my house, filling out numerous paperwork...they sent non English speakers who were inexperienced in caregiving...especially for a dementia patient...not to mention not knowing how to transfer with lift machine. Stick with plan of getting them into VA facility or any facility near you that you like.
Hugs 🤗

Have you considered contacting the area agency on aging to determine if they are eligible for any services? Are they eligible for any assistance through the VA aid and attendence program? Have you thought about contacting an elder attorney for input regarding the finances and Medicaid? It seems to me that they both should be placed. Her needs are barely being met and I'm concerned he is at risk for falls. Perhaps someone could take the dog after a vet determines what is causing the incontinence. Is it organic or is it because your Dad isn't able to get the dog outside? I think the time has come to face the facts with him regarding your inability and his inability to provide the care she needs. Her hygeine and medical needs are suffering. Giving medications once per day is problematic especially if the prescriptions indicate otherwise. She us at risk for urinary tract infections due to her briefs not being changed. I worry that both of them are fall risks. No one wants to face the decision of placing a loved one but what is worse someone getting seriously hurt or I'll or guilt over placing one or both of them for their safety? The only other thing that comes to mind is that if you and your siblings can afford it and are willing to hire private help.

I would be inclined to explain the way it is to a Senor Nurse and ask Her to come and access your Mom's need for specialised care in a proper care home facility so the Nurse Who is an expert in this area can explain to your Dad how important it is for Mom to receive the care She kneed's now.

First see Elder Atty...get poa & Health proxy for both parents. Start touring facilities near you. Or get both parents into VA facility closest to you...Try your best to keep them together...one may need more care than the other...Get in the meantime home care helpers...but that would only be temporary solution...you can pay for it with their funds once you get poa ...take dog to vet.
Hugs 🤗

You can get for both parents thru Veteran Affairs -- the Aid and Attendance Program where they have at least 3 ADLs-- things they need help with-- dressing, eating, cleaning themselves, you name it... you will receive $1130 per month-- it increases each year because of cost of living. They will have to give up the dog if they go somewhere where their safety will be paramount. You may have to help them make the decisions and sell the home before it is destroyed and worth very little. This way they will never have to cook again or clean. There will be activities and your mother will have lady friends. It really is in their best interests. If you do nothing, you will reap the whirlwind. Luckily we were pushed into it by my Mother's stroke which did not kill her but gave her rather bad dementia. Be smart, do the right thing. Have them appoint you as Power of Attorney. Get them the help they need.

One thing you can point out to him that people who are in diapers are very susceptible to frequent UTIs. They can be dangerous if untreated and lead to life-threatening infections. Also, a UTI causes more confusion in dementia patients. (I can tell within five minutes of visiting my mother if she has another UTI, because she's wild-eyed and distraught and doesn't know where she is. Give her an antibiotic, and she's back to her version of normal in 24 hours.) Your dad is risking your mother's life by not handling her diaper issues promptly.

My dad was like yours -- determined to care for my mother because he was honoring his marriage vows. However, honoring those vows means making sure your loved one is cared for PROPERLY. You and your siblings -- and certainly not your dad -- are not trained caregivers, and none of you are doing your mother any favors.

Change is hard for everyone and especially for the elderly who aren't used to being dependent on others. It's humiliating, and your dad is a proud man. Appeal to his pride by pointing out that you understand he wants to do what's best for Mom, and what's best for BOTH of them is to move where she can get the best care. One of you will have to take the dog, but assure them he'll also be cared for.

My family has been there twice making that decision. My father wasn't aware he was at a home for a day and a half. A big problem is when they start wandering at night - my father put a screwdriver into an electrical outlet as that's what he thought he should do! The wall was all singed around the outlet - thankfully he was ok. Then he mowed the curb with his riding lawnmower & got lost in his town of 5,000 people he'd lived in for 45 years. We tried all we could do, but no one can last long at 24X7 and you have to think of their health & safety as well. I still have regrets about placing my Mom in a home two years ago, but I just couldn't work and take care of all she needed - she lived with us for 7 years prior. I hope to come to peace with that one day...it was the right thing to do, but one of the hardest things I've ever done. She was getting up at night on her own, was very unsteady - we'd already had many ER trips for stitches & staples - some requiring extended hospitalization. It was time...

But what I did do was visit the home every single day! The patient care in many of these homes leave a LOT to be desired, but found out that if you go every day and make a commotion about lack of care, those are the patients that get taken care of first. I did find her in soaked clothes and diaper one day - so I put the diaper in a bag and dropped it in the middle of the Director's desk telling him this won't happen again! It made an impression to say the least! You need to be an advocate for them and if you see problems, raise a stink, go to the nursing & home's directors - you can also contact your state's ombudsman - that's what they are paid to do. There were days I didn't want to go as these are depressing places, but she needed round the clock care. Mom & I made many friends and I still visit them often. My Mom was the Pokeno & Bingo Queen!

In the end, there are no easy answers. One thing is for certain, if she continues to sit in dirty diapers all day, she is going to get bed sores and they take a long, long time to heal as well as cause other complications. Your situation seems to be an accident waiting to happen. You need to think how you'd feel if something does happen where an injury occurs - stairs & the elderly are a bad combination. The advice about the POAs is golden - you will need those (medical, general & financial in our state).

God Bless You & Yours! My heart goes out to you - be gentle with yourself!

You and siblings need to all get together with your Dad and have a serious discussion!! Tell him none of you are able to continue caring for your mother. Because she needs more help than any of you including him can give her I would tell him he has to hire more help or place her in a home. Sounds like he needs it too. If he refused call APS he doesn't have to know you called. APS was very helpful to us with information and suggestions.

It is LONG past time for both your mom and dad to be in supportive living or receiving extensive home care. Mom is beyond decision making and dad is making terrible decisions. You three have to take over (I realize that's easier said than done). Your parents' situation is what's known as "one foot on the banana peel." And, given their ages, I'm assuming you and your siblings are no spring chickens. You are putting your own health in danger by continuing like this. What if one or more of you couldn't contribute to their care because you're recovering from tumbling downstairs or wrecking your back helping mom up the steps or lifting her.

Let dad's comments about your 'selfishness' go in one ear and out the other. If he didn't have some dementia himself, he would be able to see that what his is expecting of his adult children is wholly unreasonable.

Go visit a reasonably priced assisted living/memory care community. If the sales person there doesn't seem knowledgable, visit a different one.

Tell the whole story, don't hold back in your descriptions of their healthcare status. If dad is making it to the second floor on his own and mom with just a bit of support, they're actually in pretty good shape for AL (except cognitively).

Be sure to let them know that dad has Aid & Attendance and paint an accurate picture of their finances.

It doesn't sound like they need skilled nursing care, but if they'd qualify for Medicaid, that may be an option. You also might want to get a hospice evaluation for mom.

It's easy for us all to give you "advice", however, being in your shoes is being in YOUR shoes. The situations we go through with our parents are unique to us.

My father passed several years ago, but they were divorced anyway. Mom is 89 and living with me as she fell three years ago, fractured her neck and had about eight months of recovery in ICU, "mini-hospital" with rehab, and then a nursing home type facility that had rehab and finally home health to get her back on her feet. She has severe arthritis in both knees and can only walk short distances with a walker. If I take her anywhere, which she hates, I have to use a wheelchair. She lost all short-term memory (like the last 30-40 years) from her head injury. Thank the Lord she created a living will/trust years ago and made me POA for medical and financial. I am the only living child as both younger brothers have passed away (medical conditions).

Are you or one of your siblings the POA for one or either of your parents? If not, I would suggest you find out who is, if anyone, and if it is your father for your mother, you may need to go to court to get guardianship of your parents or at least your mom. If you can afford it, you should try to speak with an elder attorney to get all your legal options. Some places have free or pay as you can.

I am currently in the position of trying to "let go" and place my mom in a memory care facility, as she has Dementia that is only getting worse by the day. It is one of the hardest things I have had to do in my life. She is a dear, sweet woman who is so grateful for all that I do for her. However, it is becoming very difficult for me, and I feel I may be being selfish in not placing her where she could get the memory care she needs.

I wish you the best in all that you are doing.

Dad is dangerously irrational and abusive in this situation. Was dad always the type to isolate and neglect his wife to the point of medical risk? If not, then dad's thinking, judgement, and personality have been affected by dementia or some other condition. If dad was ALWAYS abusive, controlling, neglectful, and threatening, then he was probably mentally ill all along and his mental illness has gotten much worse with his dementia and other medical conditions. Either way, you must rescue your mother immediately. Someone take dad to the sports bar or the casino or bird watching, whatever. While dad's out of the house, someone take mom to the emergency room to have her evaluated--ideally the hospital will keep her for a few days. The third sibling can take the dog somewhere.

You can't fix this for them; you will have to live with accusations, apologize for being, in their eyes, inadequate, admit to human frailties and inadeqacies. You will not be able to "convince" your Dad. Does someone have POA? I would get together a family conference and lay down the law, because this is an unsafe circumstance. What will happen when Dad trips on the puppy pads and falls, and is unable to take care of Mom?
I do not know, all said, after you and the rest of the family comes to a conclusion and a plan to speak with Dad if it will make a difference. He may continue to insist that he is able to do the care ALONE. If he isn't suffering from dementia it is his decision to make. With or without help. You know where this is heading and I think Dad should be told that in his heart he knows where it is heading as well, and it would be better that it gets there without your mother or he himself breaking a hip. As to the dog, it would be better that one of you assure him that you will care for the dog. Hopefully that is one with a warm comfy porch with linoleum on the floor until this poor animal can itself pass. The animal would now be better PTS by a kind vet who does this in the home, so it doesn't feel abandoned. They always say animals help people in hospital heal and get home, but I can assure you they also cause this sort of situation. So sorry for all of this and sure do wish you all luck. I think this is going to take an effort of coming together with force and laying down the law, leaving Dad with numbers for some agency and withdrawing until he understands that this isn't working. You know your options. The other option is to keep on keeping on until disaster comes.

My suggestion would be to first call an Elder Care lawyer for guidance.

I am in a similar situation, not as dire as yours seems to be, but similar. I agree with those that said it's time for decisions to be made for them. You have to do whatever needs to be done to keep them safe and it sounds as if their situation is far from that.

From experience, elderly parents are travel agents for guilt trips! But I've learned not to get on that boat. I know that I do what I can but there is going to come a time when that is just not going to be enough. You seem to be at that point. It is time for the next step and I believe the ECL will be able to walk you through those steps. POA may need to be done for both of them at this point.

I hope it all works out for you.

It sounds like your father loves his wife dearly and is under stress. It isn’t easy watching someone you love deteriorate from the ravages of dementia. Perhaps in desperation and fatigue, he is trying everything possible to keep her home—including resorting to guilt tactics. I would venture to say he enjoys having his children come by every night—not just for her benefit, but also for his own. He needs support and who better to provide that support than his children?
 
Yet, there is only so much help you can provide while maintaining your own household at the same time. If your father insists on keeping your mother home and will not pay for outside help—perhaps the short answer to your question may be…
 
When it is no longer safe for your mother to be at home.
 
Alas, the long answer is much more complicated. Try reaching out to your local Area Agency on Aging. These agencies have many resources and ideas to help you navigate the challenges of elder caregiving.
 
Best wishes,
Junko2020