I think my Father, with severe dementia, is purposely doing things he shouldn't. Is it time for assisted living?

Karen Sue, bless your heart, girl. I know you are going through it.

My mother is Diabetes Type II. She also loves her ice cream. What I do is buy the "no sugar added" kind. They have butter pecan and fudge swirl now. The ice cream does have a good bit of sugar from the lactose, but she is able to eat a scoop of it without affecting her sugar levels too much. My mother is old with moderately severe dementia, so I don't want the rest of her life to be too gestapo. She has become to favor putting the ice cream on a cone. The thin ones at the grocery store don't have many g's of carbs. As long as her sugar stays within bounds, I do not worry. She is toward the end of her life, so I'm not as concerned about what the future impact of things will be. I am most concerned with what keeps her happy now without causing present harm.

I forgot to add that with severe dementia, patients may lose the ability to even know what is safe to eat. The Memory care unit often restricts the residents to things like soap, lotion and toothpaste, since they may ingest it. Use of these things has to be supervised.

There is excellent advice given above.

Reading about dementia will allow you to see why your dad is acting the way he is. It's not intentional. No one can expect someone with dementia to use reason or control. They aren't able to do that anymore.

I have a loved one with severe dementia and Type II diabetes. She is in a Secure Memory Care Unit. I would check out one for your dad. It's very difficult monitoring someone like that in your home. They take care of all her needs, including toileting, bathing, dressing, meals, medication administration, getting in and out of bed, etc. Eventually, all dementia patients will need this kind of assistance and care.

They provide the meals and snacks, keeping in mind their dietary needs. They get treats, but in moderation. My cousin's A1C in excellent now that her meds and diet are controlled.

Your dad can't be expected to make the right choices about anything with severe dementia. I would read a lot about dementia and how it makes the patient behave. I wish you both the best.

He has severe dementia. His brain is damaged. His ability to reason is impaired. He likes ice cream. He likes it, he eats it. I don't think that any hidden purpose is behind this.

You say his blood sugar levels are good. What was his latest a1C test result? Is his doctor concerned at this time? Is Dad on insulin, or what kinds of medications? Have you visited with a Certified Diabetes Educator to learn how to manage his diabetes?

Reasoning with him is not going to fix things. Try for things you can control. What if you only made small bowls available? Two small bowls of ice cream isn't as bad as two large bowls and might satisfy him.

Feed Dad soups, juicy fruits, lots of watermelon, an occasional beer, Popsicles, salads, and lots of foods with high water content. We don't need to get all of our liquids from water.

Dementia is a terminal condition. You say his is severe. Your intentions are perfect, but do you really want to spend the rest of his life arguing with him about how much ice cream he should eat? I would think that at this point his pleasure and comfort would be very high priorities.

I doubt that assisted living would be suitable for someone with severe dementia, but care centers vary considerably and you could discuss Dad's needs with facilities you might be interested in.

Be aware that many (most?) persons with dementia eventually develop so many needs that it is impractical to try to meet them all in a private home. If you WANT to keep him in your home at least for a while, things would probably go smoother if you knew more about dementia and about diabetes. Please don't take this as criticism. None of us is born knowing these things. I cringe at some of the mistakes I made in our first few months!

But if you would rather not have this responsibility now, or think it beyond you, start investigating what facilities are available, how they can be paid for, whether there is a waiting list, etc. And DO NOT feel guilty. Getting your father settled in a safe caring environment is a genuine way of showing love.

What Baba said. He has severe dementia, he cannot reason, and if he could would not remember what he reasoned. Karen, if you want to try to keep him in your home I would suggest some classes through the Alzheimer's Association so that you will understand what occurs in the brain with dementia. If he has severe dementia, assisted living is most likely not appropriate for him. At a minimum he will probably require a memory care facility so that he is monitored nearly constantly. Sometimes, memory care is not sufficient level of care and njrsing home may be required.

Since you have been caring for him for three months I am sure you are becoming stressed and tired. Do you have help with care for him? Start looking at facilities so you know what is available. The better ones frequently have wait lists. Also check into some home care so you can get out yourself.

Karen, you say that your dad has severe dementia. As in, his brain is severely broken. Why do you think he's doing things " purposely", i.e. with intent, rather than that's what he wants to do, as in, I can't reason any more, or make good choices, or keep in my head that certain things are good for my health and other things are bad for it?

Assisted living, if that's enough of a level of care for him, may be able to restrict his access to ice cream and give him more water, but they can't make him drink it, any more than you can.

I think assisted living is a good idea if he will benefit from exposure to others for socialization and if you are getting close to burnout. But it may be hard if he is really at the severe stage because change is hard for folks with dementia