How do we begin the process of placing my father, who has Alzheimer's, into a facility?
My father has Alzheimer's and my mother has power of attorney for him. What does my mother need to have or do to place him in a facility? She also has his doctor's support. We have gotten conflicting advice on what needs to be done.
Expert Answer
There comes a time when placing a person with Alzheimer's in a facility is the right solution for everyone. A good care home will give your loved one a circle of peers and stimulation appropriate to his mental state; you can then pursue your life and give your loved one undivided, loving attention when you visit. Important: Avoid talking about the move ahead of time. This may sound counter-intuitive and unkind, but when he has reached the stage at which this move is necessary, he can no longer think in the abstract and imagine himself living anywhere else. You'll only manage to upset him and he's likely to fight you no matter how great your suggestion.
To do: "¢ Find the right home
"¢ Get the paperwork in order
"¢ What to bring
"¢ Transitioning
FIND THE RIGHT HOME
Don't rush into this. It's important that you take the time to educate yourself before making a final decision. This is going to be your father's home and his "family" from now on. You'll want to start by getting a list of homes that offer specialized Alzheimer's care. Good sources are your local agency on aging, your state's Ombudsman's office, geriatric specialists, and the Alzheimer's Association.
The most successful Alzheimer's facilities are "user-friendly" homes with populations of ten to twelve residents. You want the place to be attractive, but ask yourself this question: Is it designed for the residents or to impress visitors like yourself? The furniture, color, and decorations should appear to be chosen for the pleasure and comfort of the residents. The furniture should be selected for the elderly, easy to get in and out of, while still looking attractive.
Individual apartments or rooms should be attractively decorated and personalized as much as space allows. Shared or semiprivate rooms can still offer privacy and personal touches, such as family photographs on the walls.
The residents should have free and safe access to all the common areas, indoors and out. Music and television should be for the pleasure of the residents. All walking paths, inside and out, must always lead back around; no dead-end hallways or hidden corners. The comfort level of room temperature is important; as we age, our body temperature drops an average of one degree and generally we don't move a whole lot. Thus elderly folks are often chilly and need a warmer environment.
You'll want to see evidence of creativity and fun: books, games, flowers (albeit silk flowers), texture, and residents' art works displayed with respect and pride. Progressive facilities often have pets and gardens for residents to tend. There should also be opportunities for residents to participate as much as they wish in normal daily activities: preparing meals, helping with housekeeping and making decisions on everything from menus to activities.
You'll want to witness normal adult interaction between staff and residents. The staff must receive ongoing training in specialized Alzheimer's care.
PAPERWORK
When you have found the home that feels right for your father, the director will give you a list of paperwork that they require.
Typically this includes: POA documents, standard DNR forms (do not resuscitate,) report from your father's primary physician; list of all his medications, prescription, over the counter, and supplements, list of special dietary needs and his likes and dislikes; emergency and family contact information. Person-centered care facilities will also ask you for a biography/life history. This helps them facilitate his adjustment and interaction with other residents.
WHAT TO BRING
Décor: Personal pictures and photographs or color copies; a couple of favorite knick-knacks, and his easy chair, space permitting, and blanket or throw.
Clothes: A clothes hamper. You'll want to bring ample underwear, a couple of sweaters, at least five or six changes of clothes (laundry is usually done twice a week,) comfortable walking shoes, easy to get into and out of (Velcro fasteners are a good idea, since it's easy to trip on a shoelace.)
Toiletries: Favorite soaps, toothpaste, and body lotion. Nail trimmer kit, hairbrushes or combs.
NOT TO BRING: No family jewels, expensive watches, or electronics. Leave at home anything that cannot be replaced.
IMPORTANT: Tag all his belongings with his name. (Most facilities provide linen.)
TRANSITIONING
Ask a friend to help you with this process if you feel overwhelmed.
Once you have found the right facility, ask to be put in touch with other family members to get their impressions. Also request that you, your mom and dad share a couple of meals with other residents. During lunch, help your father connect with his tablemates. When he eventually does move in, it will feel familiar and you can tell him honestly that he's visiting with old friends.
When move-in day arrives, talk about "visiting" or rather than "moving in." It's not important that he accepts the facility as his permanent home.
He'll be extremely sensitive to your state of mind. Leave your guilt at the door and KNOW that this is the right thing to do. Keep reminding yourself that this is for him.
Stay in a positive and cheerful mode. Keep your conversation as natural and relaxed as possible. Be happy, even excited for him. If it's too hard for your mom to feign a cheery demeanor, offer to take care of this by yourself.
The first few weeks while he's adjusting, it doesn't matter whether your visits are long or short, but it's crucial that they are always positive. If you feel overwhelmed, go outside for a breather or come back another time. Keep reiterating with him how "lucky" you all were to find such a nice place for him to stay.
Your mom may have a hard time putting on a cheerful face when visiting. In that case it may be best for her to stay away for a few weeks, until he has adjusted. If he asks for her, you simply tell him that she'll be there later. Stay away from specifics and divert him immediately with an unrelated topic.
P.S. Some of this may sound harsh, but it's important to remember that your father's ultimate well-being is the number one concern of everyone right now.
Good luck.