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My parents are 81- My Mom has moderately severe (Stage6) Alzheimers. My Dad wants to keep her at home, however, he has refused most outside help and Moms behavior is getting hard to control. He is so burned out and it has become a combat zone. I have been trying to manage the situation from 800 miles away. He has allowed the visiting nurse to come in every few weeks to assess Mom and he gets help twice a week with bathing Mom. I have talked about moving her in with me as he wants to keep her out of a nursing home as long as possible. He has not educated himself on caregiving at this stage and I don't think its safe for either one of them. I am afraid the 13 hour car trip will be tough to pull off with Mom in her current confused state. Any advice would be appreciated.

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The conversation starts with Mom's doctor, because he orders visiting nurses, he would make the recommendation for memory care. The nurses' reports should provide a good picture of the situation. Forget a road trip and don't even think of flying. At stage 6 it is time for Memory Care, but that is a big step to take, a big transition to make.
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Holly, is the issue finances? Resistance to anyone else helping Mom except your Dad? Is the home safe for them now? Is he in good health himself? Is there any family physically near to them?

Can you suggest some housekeeping help to remove that task from his agenda? Perhaps an overnight aide/companion a few times a week to allow him to sleep through the night?

Changing surroundings for Dementia patients is very hard on them. If he would agree to the move to your home, you should accompany them on the trip, he would never be able to safely do this alone. If they were to make the trip to your place, are you able to have them for an extended period of time? It could be several years.

Can you make a trip there to assess? Hire a service to report back to you? Visit some memory care places with your Dad when you go into visit? Most 80 years olds have visions of depressing nursing homes, And (if finances allow) some of the memory care places are much more attractive and appealing. If it is close to his home, he can visit each day.
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I think PStegman's idea about telling your concerns of proper care is a good idea. However I would directly talk to the visiting nurse. She is probably there about an hour and will have a better understanding of the situation vs the doctor. You maybe able to get things moving towards memory care that way. Many elderly lack the understanding of what is needed or what medical problems are. They live in a one track mind so to say. The fact he is "so burned out" tells what the situation is. If you know this from such a long distance away I am sure it is worse than you know.
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Finances are not a problem- his pride is. Dad see's taking help as a personal failure on his part in fulfilling his duties. I have made arrangements for him for respite care, toured and given him information on a fabulous alzheimers day unit- alas he never follows up on anything. He told me that the respite care actually created more work for him.. LOL
Sadly, I am literally waiting for the phone call that something awful has happened. The plan was to bring Mom out to my house for awhile to give him a break. I am afraid once I move her out here- and he has some time to decompress he will either try to drive out here- which is not safe, or want me to take her back there. I also have an 11 year old and am a little apprehensive about Moms behaviors and I don't want to scare the child. I have already started to make arrangements out here for Mom with outside resources available- in the event that we do move her out here. I think the separation will kill him. He is not ready to leave their hometown although he has totally isolated them, and I am the only person he trusts around Mom.
I made appointments to look at several memory care units with him on Thursday. I think he will be surprised at how nice they are. Wish me luck. It seems at this stage of the disease there are no easy answers. The visiting nurse told me today that she doesn't feel it is safe for either of them for Dad to continue to be her caregiver.
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Regarding moving Mom- the plan was for my husband and I to drive out to get Mom and drive her back. I am worried about the 13 hour car ride and then the change of environment triggering behavior issues once she gets here... : ( We will see what happens on my trip I am flying out tomorrow and will be there until Tuesday.
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Holly, that will be some trip. You might want to consider a plane flight instead. Southwest was good to me and my mom when we did it. You are wise to have at least one person free to help Mom while the other drives, but maybe you'd even want to have Dad along for the trip. Or, maybe medication, but that can always backfire. In the long run, or even the short run, they could possibly settle together into one assisted living or memory care situation.
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Holly; my cousins faced exactly this situation several years ago--they lived in Michigan and Wisconsin, their mom and dad were in Florida. My uncle had dementia, unbeknowst to his sons for a long time. My aunt insisted that whatever was going on, she was okay caring for him on her own; they were in their 80s at this point. There was some sort of health crisis with my uncle, one of the boys flew down; he noticed that my aunt's arms were black and blue with bruises. Uncle regularly tried to escape, beat her up to get the key. (if you knew what a sweet kind soul he was, you would understand how terribly tragic and sad this was). My cousins could NOT get their mom to understand that she could no longer do this on her own, so they hit upon the idea of hiring a geriatric care manager, a local woman who had cared for her own mother and other elders in her family. I'm not saying it was easy, but she was able to be my cousins' eyes on the ground, toured my aunt around facilities and was eventually able to shephard my uncle, with aunt's consent, into a wonderful memory care facility. Where my aunt visited every day, fed him, helped him dress, etc. Where he was safe and she was safe from his unintended abuse. Sadly, she had a massive heart attack about a year after he entered care; he lived for another two years. Look into local geriatric care management; your father will most likely listen to a "professional"--after all, what do us kids know? Hugs to you, take care of yourself.
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I think moving your Mom out to you may make many things worse. Maybe its time for a memory care unit near him. At least your father can visit her. After all they are husband and wife. He may listen to the visitng nurse. Remind him she's not the first to ever need specialized care. He's done the best he could. You are right the move might trigger behaviour problems......your 11 yr old will remember her "like that". Also 11 year olds are going through their own hormonal changes at this age.
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Holly you are doing a good job!
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Thanks so much for the responses!!! My brother read Dad a bible verse today that really moved him and I think will help us in getting him to consider a memory care unit for Mom in their town.. Timothy 2- "I have fought the good fight, I have finished the race, I have kept the faith."
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I just did a 4-hour trip with my mom who is not as advanced in her memory issues as what you've described. It was somewhat tough.

* First of all, my mom gets stiff and might get blood clots, so we need to stop every hour to have her get out and walk around.
* However, she has a hard time getting in and out of the car, so getting her to the rest stop is hard for all of us. She doesn't use a wheelchair and so we just have to help her get to the rest stop and back to the car, but I'm not sure if the wheelchair would help. Even with that, her tail bone hurt and she had a hard time of things the next couple days after the trip.
* We did stay in a motel one night because her plumbing went haywire and, poor thing, when she heard me softly breathing in the night, thought she was in the hospital. She was so confused. She kind of understood how to work the locks on the motel room door, though, so if she'd been wanting to leave, she actually could have done so.

With regard to your mom, consider whether you need to stop quite often. Consider whether you could stay in a motel (would she escape? would she be traumatized in a strange place?). Doing the trip alone could be a chore. In my case, I could depend on Mom sitting and waiting for me outside the rest room. I don't know that you could count on your mom doing that. Would the two of you be comfortable sharing the handicapped stall as parents do with children? That's the only way I can think of to watch her 100% of the time, though, but it's no guarantee she'll cooperate (and maybe you're not that comfortable with it, either, I would ask).
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