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My father has been declining in recent months. Diagnosed with lung cancer that spread to his brain almost 11 years ago. He has had health problems on and off but in August he wasn't able to walk anymore. He had a bleed on the brain, when they fixed it, he has two small strokes and hasn't been the same since. He is unable to walk without assistance and is in a wheelchair. In recent weeks, he keeps telling me he wants to go home, doesn't like living here and is confused. He is home, in the same home he has been for the past 40 plus years. My mother and I have been caring for him. My sister and her family moved in with us to help and it is becoming hard to bear. We cannot leave him alone now for fear he is going to get hurt trying to get up by himself. He keeps saying he wants to go home. I don't know how to handle this. He was in a rehab facility after the surgery but left the facility worse than when he arrived. We are now 4 months in trying to rehab him but he doesn't seem to be improving. I don't know how much longer we can keep this up. How do you know when it is time to move them to a nursing home? My grandfather had dementia and we are recognizing the same behaviors now in my father and it is heartbreaking. I want him to be home as long as possible but our lives have diminished to nothing. That sounds selfish and I hate myself for it. But he doesn't even know me or the house anymore. I just feel so upset and sad about everything.

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My experience: I have a full time job and I knew I could not handle taking care of my daddy. So I found a nursing home close by and was able to visit him daily. This freed me to work, rest and do the things I needed to do for myself to keep me sane. Just know that caregiving is a full time job and if you are already working one and then add caregiving - that is two full time jobs and that is very hard to do! If you cannot find a nursing home near you try a group home. I had to transfer my daddy to one and it was more personal and the staff treated me like family and I treated them as family it was a great situation for me. Hugs to you and yours
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So sorry about your situation. Most people would not want to be a burden . Your Dad would most likely want you to live your life . It’s time to place him in a care facility or at least get outside help to come into the home, even part time is a step in the right direction . He’s not going to get better no matter what . But taking care of him is taking a huge toll on you and your family .
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When my sister and I got to the place where we both had almost no life of our own, and we would have rather died than go on, we made the move. Mom has been in a private care home for 3 1/2 months now. The transition ended up being a lot easier than we thought it would be. If they don't recognize that they have been there for a long time, it doesn't matter where they are. To our surprise, she doesn't ask to go home like she did in the NH or at her own home. Might as well get your life back when it really doesn't matter to their well-being anyway. Mom does not care where she is. She is so far gone in her dementia that she does not care about anything except eating and staring at the TV. My visits to her mean nothing, and contrary to what Robert1231234 says, you CAN get good care in a facility.
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If he doesn't recognize his home or you (his daughter) any more, it may not make much difference where he is. Does he recognize your mother (his wife)? Caregiving can become too much for the caregivers, and I can imagine that your mother may also be exhausted with the task and the emotional toll. Please don't feel guity about placing him in memory care/assisted living/nursing home. He will have skilled staff caring for him, and you can visit often and help your mother oversee his care. They will know what equipment is available to keep him safe. He will have 24/7 caregivers and probably a registered nurse on staff. When people with dementia talk about "going home" think about it as being symbolic of going back to the time when they were independent and able to care for themselves. Of course this can never happen. That is the sadness of it all. With dementia residents, I think Memory Care facilities are usually the best, until they get to the point where they can do nothing for themselves and can't get out of bed at all. Try to find a facility close to you so that you can visit often. All the best to you and your family.
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Trust your feelings. It is fine for him to go where trained staff knows how to care for his medical issues.
it will be hard emotionally if you do or don’t. But you can’t hurt yourselves emotionally trying to do what is beyond your ability. You tried. You cared
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First of all do some things to help yourselves. Use mom/dad's money to pay for in home help - cleaning, cooking, laundry, etc - anything to lighten the load for all of you. Then, if you don't already have it, ask the dr to order in-home physical and occupational therapy to get others involved in some kind of continued rehabbing for him.

If he no longer recognizes any of you, a move to a NH type facility may not be a big change for him. However, there may be just enough spark left that he still is aware of his current surroundings and moving him could create a faster decline. Then there is your mom and how she might feel about moving him.

It is heartbreaking to hear someone say they want to go home when they're at home, so deflect.....ok we can go home when you get a little stronger. Getting you (the caregivers) some help may recharge everyone's batteries.
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is he on an anti-anxiety pill such as trazadone. My husband was the same and I take care of him with dementia for 3 years and could not do it without it and an anti depressant, lexapro. People with dementia or Alzheimer’s are usually depressed as well as anxious. It made a big difference and he is much calmer and that is the goal which is what they will do when in a nursing home to keep him calm. These are diseases with no cure and we are just keeping him comfortable, safe and give him the best quality of life as possible within our means at home. I would suggest to have a geriatrics doctor specialized in dementia and Alzheimer’s that that help guide you to do this. I have one for my husband and it makes a big difference. Best of luck.
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It sounds like he need(ed) to be placed long before now.
It is up to you / your spouse / family to decide and this is emotionally and psychologically difficult.

However, you have already drained yourself / your family.
It is a matter of how much more you choose to be exhausted, drained, overwhelmed. Only you can make this decision.

Yes, he will feel / be fearful. Do not let this deter you from doing what you know you need to do. This isn't a 'guilt' thing / it is doing what is in his best interest, which is also in your best interest for him.

Yes. You feel sad. This is a very sad situation. Still, you need to feel through it all and do what you need to do - for all concerned.

I send you a hug. I know this is very difficult. Gena
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Food for thought-

Years ago, my mother's elderly sister (90) was sick and in the nursing home. She had been through pneumonia and was very unwell. My mother was visiting her and her sister's mind was still good. She told my mom, "I want to go home. I'm ready to go home."

My mother said "You need to eat and try to get stronger and hopefully we will get you back home." Her sister said "NO! I'm ready to go home to my heavenly father."

She died 2 days later.

There is a book called "Final Gifts." It is very eye-opening about things people say when they are in their final days.

If it were my father, with all you described, I'd have him evaluated for hospice care. And if he qualified for it, I'd put him on that path.

Too often, we keep dragging our loved ones to doctors and rehabs, over and over, because WE are not ready to be sad. I get it. Losing a parent hurts. I just lost my father-in-law.

They get so tired. I've heard many a nurse tell of having an elderly patient who just wants to STOP it all, but keeps having tests and medical procedures because their family wants them to.
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NeedHelpWithMom Jan 2023
Xena,

I absolutely love what you wrote! My mother wanted to join my father in the afterlife. She was so very tired of suffering in this world.

Your post is spot on!
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Home to him could be a place he lived many years ago that he remembers. My Step Father went through this. Long term memory is better than short term memory with Dementia. It sounds like his short term memory is gone. If he can afford it, I would get him placed right away. If he doesn’t bring in much money, you could apply for Medicaid. This all takes about 90 days (or more) once the paper work is submitted. Some people pass before the application process is completed. Hospice would be a good resource now, along with a part time Aid trained with dementia patients. I know how hard this is. You could get burnt out quickly. When he sleeps, take some breaks.
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Robert,

I am truly sorry for the tragedy that you have experienced in your life. Everyone has their own stories to share.

We can learn from each other. Try to hear what others are saying. Everyone has a right to feel as they do. No one is brainwashed. These are our experiences. Please respect them.

Please don’t be bitter. It will only chase others away and you will gain nothing but misery feeling alone in your sorrow.

Go ahead and express your pain if you like. We all need a shoulder to lean on sometimes, but could you please try to be more tolerant of others opinions.

I wish you well in your journey.
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The fact that you are asking indicates that it is time.

I would research facilities first and then decide whether or not you want to place him. Since your mother is still married to him, whatever happens will affect her financially as well as emotionally.

When you research facilities, also ask whether they provide in-home care. In my state, many do, which can help provide a transition from in-home care to managed care at a later time. Because you are familiar with the company, if you decide to place him, the transition for you and your Mom will be easier.

You are not being selfish. You owe it to yourself to have a say in your future. There is not much press about how the family is affected by strokes. Having the stroke is the easy part; life after the stroke is very, very hard for everyone involved.

Also, I would see if you can get a 2nd opinion on his prognosis. It is possible that the stroke has done enough damage to cause dementia like behavior. Also, he could have had more strokes since the original ones, and you just didn't know.

Start planning for the future by knowing your options.
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You are not being selfish! You and your other loved ones have provided as much loving care as is humanly possible. Perhaps arrange a family care conference with his medical team and if pissible, involve your local Aging Dept. See if your State has a Brain Injury Waiver program which may have funds for in home help so you can get some much needed respite. And if he does need to be placed, you will have the energy to stay in his life as his loving daughter and not totally depleted caregiver. Dad loved you enough to do whatever he could to keep you safe and protected when you were vulnerable growing up...you are now at a place where you are doing that that for him when he needs you to reach out for help. Sending prayers to you all.
Ps I agree about Robert.. he seems to enjoy preying upon peoples fears and struggles with his own twisted agenda and a captive audience.
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My Dad is getting to the same point your Dad is and I'm struggling too. I live away from my family with my father and it is so hard. I also feel guilty about wanting my life back. Everyone keeps telling me that it is okay to still do things for myself but I have a very hard time.
My only advice is to not beat yourself up. If it is too hard to bear it is okay to get the help. That is what people keep telling me. I'm sorry you are struggling. It is so very hard to watch our fathers not be the dads they once were. It is crushing me, so I know your pain. Think about what your dad would want for you.
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The moment you decide to put him in a nursing home that is when you will lose him the fastest. I lost my grandmother like that. You cannot trust anyone out there. Do not be fooled by the " smiles on the staff ". They are there for the paychecks they get, not for your father. Get help at home and keep him at home. No senior likes to live the end of his life in a nursing home. They do not like it. Do not try to convince him. ok? Get help from a life insurance policy under long term. That is where they give you someone to help you 24/7. Keep him hydrated at home with his family and stay with him. Make sure he sleeps. Read my posts.
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tothebeach23 Feb 2023
Just because you had a bad experience, it does not mean everyone will. My aunt was in a nursing home/rehab facility for years, and got very good care. She told me herself she liked it there. Please be careful about counseling people to wear themselves out for someone they can no longer care for. Sometimes the needs become too much.
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Shelley727: Perhaps your father requires residence in a managed care facility. His inability to recognize 'home' may give you that opportunity if you will. With a brain hemorrhage and two T.I.A.s/small strokes as well as lung cancer, he requires a team of individuals caring for him.
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I'm in the same boat...
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So sorry this is happening to you, it is truly heartbreaking to watch someone you love fall apart like this. I’m experiencing the same thing with my dad. I’m at my parents helping out for a month and his level of decline is shocking. Depressing and heartbreaking.

I think it is time to look into a nursing facility.
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ROBERT123123 Jan 2023
Wrong !!!!!!! You are going to lose him faster.
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Check into palliative/hospice care. I understand the wanting to keep him home with you. Palliative can assist you to a point and they can asses your dad at the house. They will recommend items and then you can go from there.
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The abuse and neglect in many if not most of these facilities is off the charts! It is often a death sentence for the person you love. They take all of their income and then mistreat them.

Please consider getting in home care to help if you need some time for yourself. You can look into respite options and if you do not have the funds to provide additional care there are programs to help. We have one here called IRIS that will help him pay for his care (that includes family as care givers). They will also help fund whatever he may need in the home or if he wants to do things outside of the home.
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BeckyT Jan 2023
You should never slam an entire industry unless you have had a loved one in every single one of them, which I highly doubt.

You may have had a bad experience in one or two in your area, and I’m sorry for that. But that does not give you the right to take away the hope of an anguished caregiver that may soon have to make the hard decision to put a loved one in one of these facilities.
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That fact that you're asking means you already know but are feeling horrible about it! I cared for my mom (dementia) for six months, alone!, and finally came to the realization that I couldn't do it anymore. I recently placed her in a memory care facility. It was very very difficult and I hung in there for as long as I could trying to avoid having to do it, but I could no longer care for her AND sleep AND work AND take care of myself!. She's been doing great at the facility. Yes, it's a very difficult decision and even harder when you actually take the action to do it. But you can and you will and you will be okay!
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ROBERT123123 Jan 2023
You are giving the answer yourself here. You were doing it alone. That is why you suffered. You think she was well taken care of well at the facility. Lets hope she was because you were not there 24/7 to watch, impossible and they would never let you. These people are sneaky and they do all sorts of shows. When their families come they are all smiles. When the families leaves it is a different story.
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There are Hospice facilities that could care for him, 24/7, which would free you up to live your life and visit him on FaceTime or in person.

Google: "hospice facilities in NY"
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ROBERT123123 Jan 2023
All I see here is wishful thinking in people. Of course these places will free you up not just 24/7, but permanently, forever, of your loved one.
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There is NOTHING selfish about wanting to live your own life. You have a right to it. You are entitled to it. For all we know we only have one and you are now in a position of having to choose to live his life or your life. He has lived his life. That sounds hard, and it’s depressing as hell, but it’s just the way it is. Put him in care so he is safe. You can visit him and be his loving daughter. But please, live your life. I have been visiting MC units in anticipation for needing to place my father most likely a year from now if we can make it that long. Right now he lives alone, has moderate dementia, won’t accept help so I am doing everything behind the scenes with my DPOA without him even knowing, and will never agree to go into care. So it will take some event that triggers placement. I have been researching and visiting the MC centers so when I get the call that someone has called APS, or he falls down and has to go the hospital, or gets lost in his car ( yes he still drives no matter what we do) and the police come, I will tell them he lives alone and it isn’t safe to send him home. Then I will work with a social worker to get him placed in one of the several places I have pre-chosen for him. I made the decision I would not live him him to be his caretaker. It would require more of me than I am capable of giving.
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michelle7728 Jan 2023
I was in the exact same situation as you....couldn't find any professional help local to help my dad (he lived in timbuktoo in a gated community), and he would not stop driving, in spite of losing his license and getting an ID card.

I visited several memory care places, but none could GUARANTEE him a medicaid bed when his funds ran out (some didn't even offer medicaid beds...said they just had to leave at that point....!!!!!).

I finally found an Adult Family Home (a house, not an institution) that specialized in caring for people with dementia, and who would allow anyone who self paid for 2 years to transition to medicaid when their funds ran out.

Finally, when it became too overwhelming for his neighbor/friend (who we had been paying $2K a month to help him out) and they couldn't do it any more, I was able to move him to the Adult Family Home.

It is a horrible disease...hard on them and you:
It was a difficult year last year when this was going on...I gained 30 pounds due to having no time to myself to exercise or plan healthy meals. I'm just now starting to lose the weight and exercise again.
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You have hit the bottom of the caregiver barrel. It’s time to find a good place for him. There’s no reason to judge yourself. Nursing facilities have two shifts of staff to take care of residents, and you’re trying to do it 24/7. Go to the Medicare website and look up facilities in your area. All of them are rated one to five stars—look for the ratings for overall and resident care. That way you can find the best place for him. A study showed that caregivers have a 63% higher mortality rate with all other factors being equal for people. That says a lot about the exhaustion in caregiving.
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The wisest advice I received was from a college roommate who had been through Alzheimer's with her beloved father. Sometimes others need to do the caring so that you can simply love them. It was what I needed to hear as I struggled with what was best for my mom. It is not an easy journey, but we do our best. But I also had to realize that I could not be a prisoner to a disease that had already stolen the mother I knew from me. I honor her by making sure she has good care and by continuing to love her and take care of the needs that I can. That doesn't mean that I must do it all with my own two hands.
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ROBERT123123 Jan 2023
No, you can get help at home. They feel better in familiar surroundings and when their families keep talking to them. Many comments here say to dump them in a facility. If you love your family you will support them all the way, like I did with mine.
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Hospice was a godsend when caring for my mother. The care recipient does not have to be on the edge of death to qualify. In fact, over nearly two years my mother was in and out of care, depending on her health at the time. Ask (or beg) your loved one's doctor for a referral. If it's turned down, keep trying.

Shelley727: As for in-home care: If you don't have a personal referral, use a service that vets and trains caregivers (e.g. Catholic Community Services). Research, get references, try them out while you are in the house. Two hours a day, or ten hours a week (a service probably has a minimum # of hours) will give you a break to carry on. Of course it won't be as good as you! But there are advantages, and it might be a break for you loved one too, without the emotional baggage. (Maybe they will appreciate you more, for a nano-second.) Good luck!
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bundleofjoy Jan 2023
caresurvivor,

i hope to be a care survivor too, one day.
hug!! :)
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You say "I try to tell him he is home and he is being taken care of or say ok tomorrow we will go and I try to distract him. But how long can you keep doing that?" Sorry. This is hard, but continue to tell him that you will go tomorrow or even take him for a ride, then back to the house, or even just getting him ready to go "home" is good and will distract. I found that to take my mom somewhere outside, just to move her around would make her think she'd gone home. And then he'll continue wanting to go home over and over. And you will continue to tell him the same thing. It may stop at some point, but even in a care facility, he will most likely ask. It's very heartbreaking. Just keep loving him, get him in a good nursing home, visit him often, and take care of yourself.
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My husband died of a brain tumor. He had to spend a little time in a rehab facility after an unrelated surgery. At the time we didn’t know his tumor had progressed to the terminal stage. We did hospice at home and every day he’d ask me when he could go home. At first I tried to tell him he was home and that (he was a carpenter) he had installed those windows and that door and all trim and painted the room. It didn’t do any good because in his brain he no longer recognized it. He kept thinking he was still at the rehab facility because he was in a hospital bed at that point. It sounds like your dad would qualify for hospice. They are a great help and support and it’s all free. Perhaps you should ask your dads doctor if it’s time.
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NeedHelpWithMom Jan 2023
So sorry for your loss. Our family found hospice to be wonderful too.
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Only you know how much you can take.

I have been devoted to my mother. 10 years ago, there was no way possible I would have considered putting her in care. I was determined if it came to that, she would live with me. She has a retirement plan/funds that would cover some people to help.

What changed - and these may seem minor, but they all add up to what is now my decision not to fight my estranged siblings if push comes to shove and she needs to go to care.

1). She is a smoker. So am I, but she is still an indoor smoker and the incredible belligerence when she has to go outside when it is too cold, too hot, too windy, too rainy is an hourly battle. Smoke is incredibly hard to mitigate and permeates every surface and facet of a house.

2). She has mobility issues and refuses to “use it” so she “loses it”. She constantly keeps me on the go…coffee has to be hot, water needs ice replaced every 30 minutes. She wants this, she wants that. She needs help getting out of the chair onto the toilet, back in her chair. This also affects going outside to smoke as I do have a step to my patio or three steps to my garage. She has woken me up four times in six hours for bathroom assistance. The fastest way to burn me out is to deny me sleep.

Sidenote - we don’t live together now and her mobility is somewhat better than it was after surgery in 2021.

3). Incontinence. She dribbles a lot and it is pungent. Supposedly, she has a kidney stone that isn’t causing any pain (thank you, God for that blessing), but it does make the urine smell noxious. 2-3 times a year she will have incidents where she doesn’t make it to the toilet in time - and has an upset stomach. That has proven to be a bigger mess than I want to deal with.

4). Pain medications seriously affect her though process. She is non-compliant and won’t listen to anyone. She passes the MOCA test with flying colors, but still won’t listen when she is told XYZ. She loses all ability to empathize or sympathize. She doesn’t care about anyone but getting her wants and needs met. She also doesn’t remember what people do for her or feel the need to adequately compensate or return the favors.

5). As hard as it has been for me, I’ve had to accept and process the fact that my mother will lie to me and about me. It is too much to manage and I respond poorly to gaslighting/rewriting past events. It can be worrisome wondering what she is saying about me. Fortunately good family friends touch base with me, so I can keep the narrative truthful. I’m also concerned she will lose her core group of friends by telling tales. The middle school hijinks can still cause hurt feelings.
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NeedHelpWithMom Jan 2023
You have written many posters stories. It’s truly difficult to care for our parents.

My mom lived to be 95. There were days when I thought that I would drop dead from exhaustion!
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There are many opinions and many different situations on this forum, which is a good thing. My opinion is that home care is head and shoulders above facility care in most cases if it's feasible. A lot has to go into home care - you have to be able to afford either sitters/caregiver when you're working unless you have the means to stop work while caring for your loved one. You have to be willing to accept that your life is going to be very small during the caregiving season - you may have to accept that sleep and peace and quiet and serenity are decreased during the caregiving season. It takes some planning to get everything in order, but it can be done. It's also less expensive than most private facilities and you have the benefit of being at home rather than sitting in a facility when caring for your loved one.

It sounds like there are three-to-four people caring for your dad - you, your mom, your sister/family. It would be a good thing to start working on getting some outside help to come in.

His doctor can write orders for physical therapy, occupational therapy and palliative/hospice care. They will come out and do assessments to see what he is eligible for through insurance/medicare, etc. My mother receives weekly physical therapy and is also under palliative care.

You can also find sitters/caregivers to come in when you most need it and stay with your dad while you get a break.

I can assure you that your father will not receive that much one-on-one care in a facility - they just can't do it, so your dad will most likely suffer from a decreased level of care.

If you place him, in my opinion, he would need a sitter to be with him in addition to the facility staff. You said that he left the rehab worse than when he went into it. That's would be a red flag for me. If you look at a facility, ask questions. Will they sedate him in order to keep him still? Will they catheterize him? Will they even try to rehab him? Or will they just let him sit/lie there?

I know it's sad - so sad to see our loved one become confused and upset about their surroundings. Wanting to go "home" is normal for someone with dementia/alzheimers. My mother also wants to go home - and to her that means her childhood home with her parents and siblings.

I wish you all the best.
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Grandma1954 Jan 2023
Home care is wonderful if...IF it is SAFE to care for the person at home.
And safety is not just safety of the person that is recipient of the care but the caregiver.
Safety is not just physical safety but mental, emotional safety as well.
Placing someone is care is NEVER an easy decision.
It is not a "failure" to provide care is is acknowledging that the care for this person is beyond the scope of what can be done at home given the circumstances.
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