How to care for LO when they refuse to move and live with you?

Im glad Im on the right track...I have POA and an his health care proxy. I do understand what you mean about him living with us. We are looking at ‘next-gen’ homes..houses that have an attached apartment which would give us some separation but I could still check in or have home health care come in for assistance. Assisted living is also something I want to look into where we move to...I think the social aspect would help him a lot, but would be so much more affordable having him with us.

I am afraid of faster decline if he moves as I’ve heard this can happen. Finding a nice assisted living here is a challenge...the best one is a half hour from the town he wants to be in and at $8,000 a month it’s a Hefty bill. Having someone overlook meds is additional cost. He doesn’t have a steady line of visitors ... once every few months a friend may call or stop by. I speak to him 1-3 times a day by phone and we are with him every weekend and 2-5 times weekdays during the month. I fear him declining without us here. I know if he moved with me it might get to a point where assisted living is a better fit and having him close to where I live I could check in on him.

I do have POA and Dr feels memory loss is ‘regular’ aging. Right now he’s fairly independent but I feel like he’s not looking ahead and preparing for what his future may hold. Assisted living in NY is a lot more expensive than down south. If he goes to assisted living in NY, I’d be afraid of his level of care without me here to check on the services he’s getting.

He’s not old, but is starting to have more aging issues between his back and memory. We have had discussions over these last couple of months as he’s realizing his memory is starting to slip. He still thinks he’s capable of handling everything, meanwhile we are assisting him more and more. I let him deal with the last snow storm we had but he didn’t call anyone to shovel and instead canceled his Dr. appointment. Knowing it was an important apt. we wound up going to his place to clear the snow so he could get to his car. If we weren’t here I think he would’ve cancelled his Dr appointments and just waited till it melted.

I think Keeping the discussion open is important but without pressure and as you said giving us time to really think things through as time progresses. Traveling back to NY is a must...I would want to return to this area as well as I have friends here and I do still love this area.

I do want him to be independent and in control of his decisions as long as possible. He’s been relying on us to do more and more. I will continue to keep an open and honest communication with him. Being 6 hrs away via plane won’t be as easy as having him with or near me.

"In NY in home help is less expensive than a good assisted living place. The AL we liked is over $8,000/mo not including an aid or medicine management. In home aides are about $25/hr."

Many people think in home care is less expensive... that depends a lot on various factors, including the hourly charge:
*how many hours of care are hired?
*how much does the home/apartment cost?
*how much are all the other expenses (utils, food, insurance, etc)?

Yes, AL is expensive - more so in NY than some other areas. Then there are the no-show and/or quality issues. In AL, there'd always be several working, so a no-show isn't as bad, and often the less qualified aides will be let go.

My mother's MC just eeked over 8k/mo last year. If you break it down by hour (of course people/services/supplies etc don't get paid by the hour, but bear with this), 8k is just over $11/hr. Granted, the residents don't get 24/7 one-to-one care, but most don't really need that much - some more than others, but it all works out. The fee/rent has to cover taxes, possibly mtg, food, utilities, cleaning, maintenance, repairs, admin and the care staff.

Meanwhile, if you have to hire someone just 8hr/day 7 days/week, you're talking $6k PLUS the cost of the home, utils, food, ins, etc. Consider also that the "going rate" increases for nights, overnights, weekends and holidays. BUT, just that 8hr/day at $25/hr plus the cost of the home, etc is MORE than the AL. Just some food for thought.

I understand the concerns. The local AL you found isn't exactly local. You can't really watch over his care if he is alone or in AL in NY. He wants to stay where he's been a long time. I would, like you, be concerned not only with what help he needs, but his isolation. Sure, he has friends, but you say their visits are not very often.

You say the plan to move is a year or two down the road. Would he take a trip with you, when you go house hunting, so he can see what it's like? Arrange tours for some of the AL places there, so he can see for himself. Some will offer a free meal, and you could ask them ahead of time to introduce some of their more gregarious residents to chat with you and your dad. Make him feel welcome. Show him around, etc. Meanwhile, make concessions with him, saying you plan to visit a few times/year yourself to see your friends, so he can check out his old friends and haunts during those trips. He can invite them down to visit him too! They might like that, esp in winter.

Make a list of the tasks he has difficulty with now (not talking about what you do, just the tasks HE can't manage) and show how at AL those are managed for him. Cleaning, laundry, perhaps some meals. Medication management can be part of that, but if he's just forgetting to take meds, I would suggest getting a timed locked dispenser - it will alert him and present the meds for that day/time he should take them. Of course the most you can get from these before refill is a month (if there are meds 2 or more diff times in the day, it will need more frequent refills.) If he stays, someone will need to be hired to fill it - aides are not allowed to handle medications, so it would be a more expensive nurse. If he moves, you can manage that.

If he's still refusing to go, after your move, ask him to come visit for a week or 2. He'd still have his place to go back to, but show him a good time while he's there! Do go overboard and wear him out, but if you can find places to go that he would really like or activities that he enjoys, he might start to like it!

Many older people become snow-birds, heading south for the winter! Some choose not to go back. I suggested a compromise of sorts, assuring the dad that they would visit several times/year - OP indicated she would likely be doing this, as she has friends in the area too.

My parents had a condo up here and one in FL. I was surprised that the decision was made to sell the FL place when it became too difficult to travel between them. My mother raved about the FL place all the time. I suspect it was more because most family was up here and many friends as well. I'm glad they did - the 1.5 hours each way to clear, clean and get repairs done on the condo here took almost 2 years for me to finish before we could sell it. I can't imagine how we (make that I - most everything has been done by me, very little help from brothers) could have dealt with one in FL!! Between my mother and my cats, I wouldn't be able to go stay there, and on top of that, I'm not a big fan of FL. Always look on the bright side!

I love my Dad dearly and I know how hard taking him away will be as it’s also been my hometown for over 50 years. I have intentions to regularly visit a few times during the year after we move. For the last 55 years he has lived in a second floor apt of a old historic building that the landlords are neglecting (Ie: Many nights he’s gone without heat) which is another reason I’d like him to move.

I do know what it is like to care for the elderly...I helped my Dad take care of my Mom for the last 5 years until she passed at 87 last year from Parkinson’s. I’m still working full time with a family of my own to also take care of and am hoping to retire next year. It was difficult but I wouldn’t trade the time I spent helping take care of my mom for the world. We had hospice in the last few months along with home health aides as my Dad at 79yrs couldn’t lift any longer and we needed someone with mom 24/7.

This experience with mom taught me that the best care he will get is from me until his needs exceed what I can do. And that when aides or AL is needed I need to be close by to monitor and advocate on my Dads behalf.

My Dad is declining...I see the signs...I don’t want to wait for a disaster that will force him to move, although this may be what will happen. If possible I really want to avoid this stress on me and on him so I would like to find a way for him to be comfortable with coming with us. While I love my hometown, In my heart my home is where my family is.

Thank you for your kind response.

My Dad is the same way...hiding memory issues although it’s becoming more apparent to him. Lately if he can’t remember something he just says it’s due to some holes in his brain due to his strokes.

I looked at an Atria Sr living here in NY...it was my favorite. I can’t get over the difference in cost...between $3-5,000 more here than in FL. I will check out their other locations and talk with my Dad about checking them out with me.

Prayer is definitely something I need to remind my self about. Such simple advice that will help my Dad and I a great deal. Thank you.