How can I leave my father at a memory care facility with out conflict?

Gamar asked...

My dad is 92 years old with diagnosed dementia, copd, afib, and a few other conditions. His only medication is the Exelon 4.6 patch. While he doesn't know where he is or who I am, he is still ambulatory and can walk at least two blocks (but he doesn't enjoy it). Dad can still feed himself, but not prepare meals, doesn't bathe without supervision, and needs some assistance with dressing. He doesn't remember that his parents, wife and most siblings are deceased. He has been assessed by the state, as well as by his doctor, and it is agreed that we will move him from my home in to memory care. How do I leave him at the memory care facility? We are planning on having his private room set up with his bed, recliner, lamps etc when we arrive. Telling him he is moving to memory care has only caused him to say "no". Of course, 10 minutes after he settles down he doesn't remember the conversation so preparing him for the move doesn't seem possible. I can no longer keep him in my home with my family. Do I just tell him we are stopping for lunch and leave him when he falls asleep? Is there a better way? How have others handled this situation. I can't believe my dad is the only dementia patient who can't be reasoned with regarding change in living accommodations.

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

Many of us consider a move into an long term living facility as failure in our ability to care for our loved ones; it can make us feel terribly guilty. When we have these feelings, few of us realize how we affect the mood and behavior of our loved ones. I hope you feel very positive and optimistic on your dad's behalf. You are doing the right thing and the success of your dad's move depends greatly on your attitude. If you need to, work on your own mind-set first.

There's no doubt that you'd feel a lot better if your dad would agree to this move. The chances are slim that he will accept the idea, however. Anyone of us would be very distressed to be told that we were to be moved into a "secure" ("locked") facility. Since this conversation will surely upset your dad and he forgets it within minutes, why have it at all?

There's a common belief that staying at home is far preferable to living into an "institution." The truth is that many people with dementia flourish when they move into a care facility. They have much richer lives and find their spirits improving. They'll have activities and companionship with people with whom they share the experience of living with dementia. On the other hand when they live at home with family, they are often the only ones with cognitive problems "“ that can be very lonely, even in the midst of a big loving family.

I recommend that you look at a variety of facilities in your area, before you make your final choice. Take your time to observe the activities, ambiance, and interactions that he would experience if he lived there - and as you do, see everything through his eyes. Daily life in a care facility has little to do with the cosmetics: the perfectly manicured grounds or the flawless lobby. It's about good food, companionship, and interesting and stimulating stuff to do. When you've found one that you like, you'll want to avoid packing or doing any preparations in front of him. He may not notice that things have been removed from his room, but he is likely to be very upset if he sees you taking his things away.

On the morning of the big day, invite him to join you for lunch at "this really nice resort" "“ Over lunch you can help him connect to his table-mates. It's important that you are upbeat and positive. While you're lunching, his belongings can be moved into his room. Arrange with one of the staff-members to step in when you're ready to leave; at that point you can introduce him to a "really good friend" (the staff-member) who will then walk him off to an activity, allowing you to slip out, unnoticed.

Your dad will reflect your attitude and mood, so it's important that you accept these "loving lie" of the "resort" and "your good friend". The first few days can be critical. Ask the staff for a report on his demeanor before your show up for a visit. He may have made a quick adjustment and accepted his "vacation-stay at the resort," in which case you're best off simply listening to him telling you about the other "guests" and the activities at "the resort." Crucial to the success of this move is to maintain a positive tone. If you find yourself getting emotional, excuse yourself and step outside for a few minutes.

One easy way to make your exit is to tell your dad that you need to use the bathroom, excuse yourself and discreetly slip away.