Dear Family Advisor

Assisted Living Parents Together

Last updated: Mar 09, 2009

My siblings and I have come to the conclusion that our dad, who has Alzheimer's, needs to be placed in a memory-assisted care home. But my mother (who had a heart attack two months ago and has been in a rehabilitation center ever since for pneumonia) insists that she can go back to being his caregiver. Dad's been pining for Mom while she's in rehab -- he asks when she's coming home a hundred times a day.

She cries every time we even start to talk about it. All of us have been helping Mom out with nights and weekends for years, but none of us are in the position to take on Dad's full-care needs, and he's showing some angry behavior.

We all agree that moving Dad to a care home is the best thing for both of them. But how do we help them adjust?

Moving a parent out of the family home is a hard part of caregiving, and you'll question yourself at every turn. I won't kid you: It's going to be tough for both your mom and your dad. But you're right, I don't see how your parents could manage at home. Even if you hired a full-time care person around the clock, spouses tend to be relied upon for everything from decisions to some physical care. In your mom's condition, she's not up to that.

I'd focus on persuading your mom since she's more aware of what's going on. Start by reassuring her that this is best for both of them, that she's been a loving spouse -- and that she still will be. Remind her that she can still see your dad often and that their time together could be even more fulfilling without being his caregiver.

Expect her to grieve this change and to feel guilty. Let her talk, vent, cry, and worry. She may get depressed, and her doctor may recommend medications for that -- but over time, and with lots of support and encouragement, she may begin to let go of the feeling that she's abandoning her husband. Know that if your dad takes to the home right away, your mom might even have "issues" with him doing well there -- it's hard to see your spouse thriving while you're still adjusting.

Once you move your dad, create a regular visiting schedule. Stick to it as best you can so that your mom can trust you, but also realize that your dad may have days where he can't handle company. Check that he's in a good mood and is stable before you visit to avoid upsetting your mom. It may take a while for him to become comfortable in the care home -- or he may do quite well there from the start.

You may not be able to make your mom or dad happy, so let that one go for a while. Right now, your focus is on providing them with a safe and healthy environment. I hope that you and your siblings can remain united and support each other. Moving your dad out, worrying about how your parents will adjust, and other changing family dynamics -- all this is a lot to take in. You and your sibs should give yourselves permission to fall apart, cry, or talk to each other or friends about all that's going on.