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My dad is 93 yrs old and still lives in the house I was born in. He fell in May and now needs 24/7 care. WOW is it expensive!! Almost 11,000 a month of his hard earned money which is quickly dwindling down. While the caregivers feed him and mop the floor, that's it! They don't play games or interact with him at all as far as giving his brain some stimulation. We (his children) want to move him and he could live with our brother. It's an ideal situation and we could see him all the time! But he is adamant about living in his house. He has dementia and wouldn't remember our conversation about money. We thought about telling him we are going on a vacation and then have him just stay at my brothers house. We would LOVE to have him close by instead of 1000 miles away.

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He made his wishes clear. He is spending his own money on his care. So far you have no business intervening. But does anyone have durable power of attorney for him?

Who hired the caregivers?
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swicklund75 Aug 2020
We hire a company
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I have a social worker friend who often says that events will happen that will make the decisions for you. Sounds like the event that’s coming soon for your dad is his money running out. The question I have is, do you want to make a change before he has no money to help with the changes? Moving anywhere is expensive. Most everyone has that huge desire to stay in their home, often it’s finances and safety that make that no longer a possibility, you’ll have to decide if and when that time comes. And don’t underestimate how difficult moving him into a siblings home will be on that sibling, even a compliant, happy senior is a lot to have around the clock in one’s home
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Your profile says Dad has Dementia. Does someone have POA? If Dad is declared incompetent to make his own decisions, then the POA takes over. Its now what he needs not what he wants. Just be aware by moving him at this age with Dementia, he may decline more.
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mslynne Sep 2020
You made a good point. I want to stay in my home no matter what! It's my life. If I get dementia I hope I live and die in my own place. That's just me.
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All three of us are POA. I too am afraid of him declining if we move him but the cost is ridiculous! And maybe I’m being selfish wanting to be closer to him since I can’t move closer to him.
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If you're paying 11K a month and literally all the caregivers are doing is feed him and mop the floor, I think you'd better find a different agency.
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Did anyone create a Care Plan for Dad that would tell the Aide what they are supposed to be doing while in the home?  Is the Care Plan being followed? Who did the assessment?  Did family members have any input or were goals put in place?  Have you as family members looked into caregiver support?  You say moving to brothers is the ideal situation, why? how far is the move?  will he be able to keep his current medical team? will brother be home with him or will you still need to hire aides?
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Are you and your siblings all in the same area? Is there any family near Dad? If all of his family, kids, grandkids are all in the same area 1000 miles away maybe a “visit” for say 3 months or through the holidays could help you all decide if a move is in order. Dad doesn’t “loose” his house or his sense of security and autonomy, your brother can see how having him live there actually works and you all can see what the difference is having him closer, Dad too. A longer term visit rather than move might be easier for Dad to look forward too.
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If your father's dementia is advanced to the point he is unable to make decisions for himself, then the POA can take care of placement. You can get a lovely Assisted Living place for one half of what you are paying; however, if you need memory care then it is a toss up, and he would be sharing a room. This is a difficult decision. He may not qualify for Assisted Living, so his funds may dwindle as quickly wherever he is at this point.
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disgustedtoo Aug 2020
We had POAs in place long before mom developed dementia. Her plans before the dementia included moving to AL, if she decided it was necessary. With dementia, those plans went out the window. She refused to consider moving anywhere, ESP not to AL. The EC atty who had set up all our paperwork said we CANNOT force her to move (actually he said we can't just drag her out of the house!) He suggested guardianship, but the facility we choose wouldn't accept committals. They said just get her there, they would handle it going forward. We had to wing it...

So, POA is NOT enough to "take care of placement." It does allow you to sign for the person and make [some] financial or medical decisions, depends on how it is set up as to what one can do, but in general it does NOT give you the authority to move someone.

To drive this home further, AFTER mom was already in MC, a staff member told me they can't force ANY resident, even those with dementia, to do what they are refusing to do - medication, shower, EMS trip to hospital, transport to necessary medical treatment, etc. Their hands are tied just as much as ours are! I have watched them work with the person, coaxing them, doing what they could to get the person to agree, allowing THEM to make the decision. Granted they don't have POA, but the point is that the LAW prevents us from forcing others, even those with compromised cognitive abilities, to do what they refuse to do. POAs just make you a proxy for signing docs, making financial decisions FOR them as if you WERE them.

Also, not sure why you say MC would be a shared room. Our mother has her own room, she doesn't share with anyone. One place YB found did show us a shared space - 2 bedroom with a shared bath. I didn't ask, but presumably for more money she could have a private room. It was too far away for me and I knew I would be the one doing all the work and visits, so there's that. But, the cost of that shared room/space was hundreds more than the place I felt was best. She's been in the one I thought best for over 4.5 years now and only this year has the monthly cost gone over the price quoted almost 5 years ago for that lovely shared space with a view of the parking lot and a 4 lane highway! Mom's room looks out into an enclosed garden area. Can't imagine the cost of that lovely space now! Think of all the money I saved for her not going there and all the money, time, stress and strain I saved for me as well!

Not all AL or MC places are the same. Hers IS a private pay endowed facility and I only just recently found out that if someone's funds run low, there are ways to tap into the endowment so they don't have to move! I doubt we will need that, but it is nice to know!
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I think that it is what you would have to do. Tell him it is a vacation. U may have to regularly tell him something happened to the house and he won't be able to go back until it is fixed. Something internal like asbestos.
He would be better off. With dementia I often have to give alternative facts to get him to comply. It is hard but for his good.
It is the sad reality of helping a loved one who cannot reason. Prayers 4 u all💜🙏🏾💜💜
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Dementia changes everything u cannot solely allow him to make decisions.
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I take it that your brother lives far from him and or the house that your father lives in is not adequate for him and his family?

I would tell Dad that we are going on vacation and then move some of his personal stuff that looks like home to a room where he would be staying I believe that is your best option and I applaud you and your family for wanting to care for your elderly father!

God bless all of you and best wishes!
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Life doesn't always go as we'd like. You need to do what's best for Dad, and his wishes aren't what will be best for him. I firmly believe that even in the best living situations with the best care, it's vital for family to be nearby to keep an eye on their loved one. If Dad is 1,000 miles away from the rest of you, that's not a good situation.
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Does your brother want to give up his life to be a 24/7 caregiver? Who decided this for him?
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My MIL lives in Hawaii with 2 paid caregivers. We live in Florida. My BIL lives in California. He manages her care. Ideally, she would be better off with either family but she is adamant to live in her beloved home state... and my BIL is managing it to fulfill her wishes. So, she has limited phone conversations with us. I send her monthly letters with pictures. She doesn't see her grandchildren or their families since nobody can stay with her in Hawaii. Travel, accommodations, and food is expensive in Hawaii... zo family can't visit often. So she lives where she wants and is alone. Also, every asset is being liquidated to keep her in her condo. When she dies, there will be nothing left - which we are OK with.
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Before making a decision like this, "WE" need to fully understand what 24/7 care-giving means and know that your brother can cope with it. Your profile indicates dementia. Are you all, esp brother, well versed in what to expect and how to deal with whatever dementia throws at you? Early stages might be fairly mild. As it progresses, it could go so many ways - some people remain pleasant but get more forgetful, some people become very difficult to work with, some forms of dementia progress quickly, others are slower. There is no one-size-fits-all when it comes to dementia or what you might have to deal with! Understanding what *might* happen and when is important. Knowing how his behavior is now and with one of you living with him is also important. Sometimes the care-giver becomes the "evil" one and the person becomes relentless in treating them badly.

I understand it is hard having him so far away with no family nearby AND the expense (add to the expense the cost of the house itself - taxes, utilities, insurance, repairs, etc. - many people think it is cheaper to keep someone at home, because facilities are so expensive, but in reality it is WAY more expensive if you have to hire 24/7 care!)

Someone suggested a trial period, say 3 months. Could this be done in your dad's home? Trial before making the actual move makes more sense, because if brother realizes he can't manage the care, it will mean moving dad more than once. A single move is enough to cause a set back in memory. Multiple moves make that worse.

IF they try this out and it seems to work well, fib your way into getting him to brother's house (hopefully it can be coordinated such that enough of his bedroom and fav things can be moved and set up before he gets there. You can always tell him it's temporary, perhaps something in his house needs repair and he's going to be here while that's done. Whatever works. With dementia, sometimes the same excuse can be used over and over, as they forget. If he asks when he can go back, keep the responses vague. Soon, Still working on the issue. Not today, maybe tomorrow. Later. Etc. Some will forget, some don't. It took my mother about 9 months to forget her condo, and then fixate on the house they had prior to that.

IF they try it out and find it is too much for them to handle, hopefully someone has checked out facilities nearby where you all live. While they are expensive, it will likely be less than the 11k being spent now, and if the house can be sold, it will eliminate those expenses AND put some money aside for his care.

While I don't know the cost of AL or MC in your area, I do know it varies a lot from one state or region to another. Down south where OB lives it tends to be less expensive as the cost of living is lower. However, where we are, mom's MC is just over 8k/m. Clearly a lot less than 11k being spent for your dad, and as you ask, what does he get for that? In AL/MC they should be getting more socialization, activities and care than what he gets now.

Not every place is the same, so while planning and perhaps trying out staying with him, someone should be checking local places. Compare prices, amenities included, cost of any extras, visit/tour if you can, use all your senses to assess each place. Bad time to move, otherwise I would suggest interaction with staff and/or residents too, when possible, but with the virus you may only get virtual tours.

If you can't fib your way into getting him to move anywhere, you will have to consider guardianship. POAs don't really give you the authority to move him, but guardianship can. We had to manage with a fib - injuring her leg just prior to the panned move facilitated that.
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This post sounds like it’s mostly about money and not about your dad’s needs or well being. Who is paying the ticket for his care? If it’s his money, it sounds like your concern is actually about the rapid depletion of his estate. After all, the expense is the first thing you mentioned. If he wanted to live with your brother, who must live far away from your hometown, he would. He wants to live and die in his own home town, perhaps using money he earned himself. I’m also puzzled by how you think you know about the type of care he’s getting from 1000 miles away. Who is your key informant about his care? Your dad? He seems satisfied with it. Or is it an objective observer who is qualified to evaluate the care he’s getting?

It sounds like your dad has always been very independent and wants to live and die on his own terms and he probably will, very soon. He doesn’t sound like he has much dementia to me; he sounds determined.

Men who have the misfortune to live this long and have been successful
and self sufficient most of their lives tend to want to keep it this way. If he can afford to, accept the fact that his estate will be depleted because it’s more important to him to die in his own home than it is to leave his kids a sizeable inheritance. My father would have done the same thing if he had lived this long. His life was mostly about him.

If he can afford the care, the cost of which is roughly equivalent to the cost of skilled nursing care, simply get someone locally to check on him who truly understands who your father is and what he wants. My father’s entire estate was depleted because of my mothers private care for a further 23 years after his death. We didn’t want to make her eligible for Medicaid using one of the many tricks that elder care lawyers now use to preserve wealth to benefit entitled children. If these suppositions sound anything like your family, unless you wish to try to declare your father incompetent and force him to live with your brother, you have no choice but to go along with his wishes.
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