Dad has dementia -- will he settle into the care home eventually?

You certainly have your hands full but are not alone in making decisions regarding your dad settling in an assisted living facility. My biggest concern is his recent behaviors. I address this in #6; however, I think you will benefit from the rest of the information. Sometimes knowledge can be very powerful and empowering. That being said, I'd like to break down the issues you are experiencing, especially since there are a lot.

1. You are lucky that your dad was able to live so independently for so long. You should be proud and happy that you were able to help him with little assistance. You helped preserve his dignity.

2. Falling is a very difficult experience for older adults, especially for someone like your father who already has his own healthcare issues. Even though your father-in-law's fall was unexpected and disturbing, it facilitate a dianosis of Congestive Heart Failure, a chronic illness. Hopefully his doctors will be able to manage him better knowing this is an issue. Making a full recovery from a fall at his age is very difficult. He might surprise us, but realistically he may now be at a new "baseline" of independence and cognition.

3. Your experience with maxing out insurance and having to make the difficult decision to place him in an assisted living is frequently experienced by other caregivers. Sometimes, it actually is easier to make this transition from care facilities and not from home.

4. You definitely have to take into consideration his dementia. A difficult issue in these care transitions is that your father-in-law moves from place to place and he likely does not remember being in the hospital. Dementia individuals need stability and structure. Given his dementia, this can make him even more confused and even scared. I know I would be, regardless of my mental status.

5. Your father-in-law's behavior is not uncommon in those with dementia. Paranoia, unrecognition, and fear often come into play. Sometimes they may become unruly like he did. To start, I recommend looking at things from his perspective. What could be unsettling to him? Did someone look at him weird and make him scared? Could another resident have approached him the wrong way? Or, was he simply revolting for his loss of indepence. These are all things to consider. The important thing is not to rationalize with him. You can try distraction and redirect his behavior, but he lives in his own world. Rationalizing or convincing him otherwise only leads to further frustration and agitation for everyone.

6. Your father-in-law's nurse was absolutely correct in calling a doctor. However, the purpose of calling him/her to sedate him (although well-intended) may not help the real cause (whatever that may be). Given that this seemed to happen suddenly and he has underlying chronic health issues (including his very low oxygen), it sounds like something more may be happening regarding his health. I am not a physician; however, I do know that patients can become very confused and unruly when a number of health factors come into play (low oxygen, swelling of the feet, dementia, his recent fall and his diagnosis of Congestive Heart Failure). Because of his limitations, he may not be able to say "Help me! Something isn't right." As a result, this thought pattern often results in inappropriate behaviors, especially if the "strange" behaviors happen suddently and are not him norm. I strongly encourage you to seek further medical assistance from his doctor. This experience may or may not be his dementia, but it's always better to err on the safe side.

I know this is a lot of information, but I truly believe your father would benefit from a doctor's follow up, especially all that he has been through. And...find some support for yourself. This isn't an easy road and you shouldn't have to do it alone.