How long can you fool someone with dementia?

Ok. Now that I've got over the coughing fit brought on by choking on my coffee, I'd like to concentrate on your primary good intention: to see that your father is taken good care of.

You live five states away from your father - to an English person, that equates to "another planet" basically - and it is clearly not possible for you to provide hands-on caregiving for him in his own home. Fair enough. And it is also completely understandable that you would like to move him into your area so that you can supervise him closely, and also just see more of the old guy. Not only fair, but nice - good for you.

The means of achieving this, though, are a problem. You know categorically that moving near to you, or in with you, are not what he wants. You can't say you respect his wishes and then just ignore them. Your plan, practical or not, is totally unethical.

So what are the alternatives? Does he have the means to buy support services at home? Would he consider moving to supported or assisted living in the area that he knows and loves? If you have exhausted all possible options for keeping him at home and there really is no alternative but to move him, in his own interests, then so be it; that will have to be faced up to by him, with your support; but fooling him into it a) is an ethicist's nightmare and b) will get this new phase of his life off to an extremely shaky start.

Set out from the point of view that he wants to stay at home. Call for help and advice from service providers in his area to find out what is possible. If it turns out, or becomes the case, that living at home is no longer an option, you then move on to working on his acceptance of that - again, with help and support from professionals in his area, such as his doctor, social workers and so on.

It won't be easy; but unless he has given you power of attorney to make these decisions for him, and unless he has been evaluated as no longer being legally competent, you have no right to uproot him against his consistent and clear wishes - and especially not through deceit.

Welcome to caregiving! Now you either manage your dads care 5 states away (not going to work for him or you) or move to him (unlikely) or move him to you. You could try having him live with you and if it starts to destroy your family, place him in assisted living or a nursing home. Just know that you may not have a clear view of how damaging caregiving can be on your family. Trust them and listen to them if they complain about what dad is doing to the family unit (already started with a 'vacation' to clean). Be good to yourself, eat right, exercise. You're going to need every bit of healthfulness to take care of dad. Reality is many caregivers die before their charge does because of the stress. Do not tread lightly here - this is more difficult than anything you have ever done.

My mom has had dementia for a few years, and at the stage she is at now, your plan would work. A couple of years ago when she had her first serious fall, my sister suggested moving her bedroom from the far end of the house to the small one across from the bathroom. My dad said she would never agree to that. By the time she was out of rehab, she didn't remember where her original bedroom was, and I did her new room in her favorite colors, with the walls hung with tons of photos of her family and friends. She loved it.

Could you not perhaps get live-in help for him or someone to pop in twice a day? Definitely get rid of the car tho' - the danger is not only for himself but others.

Suggestions: a really good evaluation of his capacity (or not) to take care of himself. He might be better in an appropriate facility near where he is now; familiar weather, scenery, environment. Remember that he almost undoubtedly cannot make new memories. which means he cannot learn anything new. Also, placement would probably be easier from a local hospital, and he would have access to doctors, etc., who know him and that he knows. Moving into an unfamiliar home with more people than he's used to is a stress in itself.

I had a similar situation with my cousin, who was not able to care for herself of live alone anymore. Her doctor suggested she go to get assistance in a facility. I explained to my cousin that it was temporary so she could get her physical therapy, medications, meals, etc. and so she could regain her strength. It worked and she agreed to go, but she would question me repeatedly as to how long she would be there. I kept saying it depended on her progress and that it would be soon, since she was doing so well. In fact, she was not doing well at all.

Eventually, I had to place her in Memory Care and she forgot about it. She no longer even knows she has a house. So, I would recommend it if you have no other choice. It's not common that a dementia patient can understand the situation and agree on a sensible plan. You have to do what you have to do to keep them safe, IMO. Good luck.

I do want to say in the OP's defense, renewing his driver's license probably isnt that big a deal. First, if Dad is as forgetful as it sounds, he isn't gonna give a crap whether he's got a current license or not...he's just gonna drive if he wants to, expired license or not. Secondly, I was told by a nursing facility I was checking out for my Mom that when her license expired we should get a new one because it's important ID for admission, proof of ID for Medicaid & Medicare, etc. so, yeah, that was probably a smart move.

The bigger thing is to take the keys like I did with my Mom! He might have a current license but it's not gonna do him much good without the keys to the car! He can still drive the car with an expired license!

Ozark makes a very good point. If you were to take dad back without a plan for care in place you could be prosecuted for abandonment. You may want to start with contacting Adult Protective Services and ask them to check on him and complete an assessment.

He's obviously unsafe if he's living in a home without running water, etc & can't remember a week-long visit beyond 2 days. Legally, I don't think it's as easy as "we'll just move him back" if he's unhappy in your home. If you move him back knowing that he's incapable of caring for himself, living without basic needs & with poor memory, you could very well be prosecuted for neglect if something tragic *does* happen! I see only two solutions to your problem & Dad isn't gonna like either one.....he either stays with you (or some other relative) or he's gonna have to go to an assisted living facility or nursing home.

Sonofoldguy, you're going to have to just bite the bullet and be the 'bad guy' and move dad. Maybe he wouldn't have to live with you exactly, but he needs to be in asst. living or an adult foster home near you. If you're afraid of being the one he gets hopping mad at when you tell him, get the doctor to. They don't care. Sorry♥

Glad brings up a good point. The fact that you willingly got his driver's licence renewed is a clue that you need to learn a heck of lot more about dementia before you make permanent decisions for his care. Forgetting how to get home is the least of the risks. Forgetting what the brake is for in a stressful emergency like a child running into the street is a far more terrible possibility.

You dad is not merely forgetful. He has brain damage of one kind or another (depending on the kind of dementia). This is extremely serious and must be taken seriously.

Why would you renew his driver's license and registration on his car? So many of us struggle with finally getting the keys away when it is time. He may forget how to get home if he goes out in the car. That is what happened with my Mom, and her queue to stop driving which she did willingly.

It really sounds like he is beyond the point of being able to live alone, even if he had some in-home support, like a cleaning service and meals-on-wheels. You could manage his finances long-distance, but not whether he takes his insulin.

So moving in with you, or moving into a long-term-care center near you, seems to be in order. You would have to be his guardian to force that (which would involve having him found incompetent and a getting a court order.) If you can accomplish the goal with persuasion and trickery, that would be much less costly and time-consuming.

You say "we" want him to move in with you. How does you wife feel about this huge change in your household? Do you have children at home? What kind of logistics is your house able to support? Would he have his own separate bathroom? A room big enough for his own television and other personal items? Do you have plan in mind for respite care? (Hint: It is Not Possible for a caregiver to provide 24/7/365 care without regular and frequent breaks and retain sanity. Not Possible. Plan for respite before even moving him. This is one of the biggest mistakes well-meaning relatives make.) Have you and your wife both read up on dementia to have a reasonable idea of what you are getting into?

Have you thought through the financial aspects of moving a parent in with you? Can he afford to pay room and board? Make sure you have a written agreement for any money he contributes to the household, so it won't be considered a "gift" if he needs to apply for Medicaid at some point.

If he needs to go into a long-term care facility, either now or when the dementia gets beyond what can be handled in a private home, can he pay for that? If not, the sooner you start the Medicaid application process the better.

My personal opinion is that you have an obligation (and I hope a love-driven desire) to see that this old guy gets good care. You do not have an obligation to provide that care personally in your own home. Think long and hard about what is going to best for everyone. And be willing to change your plans if there is evidence they aren't working out.

Here is who I think you should talk to as you consider the alternatives for Dad:

His doctor.
A doctor in your location. A geriatrician would be my suggestion for starters.
A social worker, or a Social Services case worker.
A lawyer specializing in Elder Law. (The specialty is critical. Not you sister-in-law who practices corporate law.)

You are certainly doing the right thing to want to take care of your old guy. Your heart is in the right place! Give your brain a chance to catch up with your heart, and do the right thing in the most effective way!

Please keep us posted with how this goes.

I'm with Maggie on this. Either he goes with you or he stays on his own and you've seen how that worked out. I'm also a long distance caregiver and my Dad is much like yours. My folks are just barely hanging on in their home but it won't be long till Dad goes for a "Visit" to a memory care facility.

Sonof..., there is NO WAY he is safe to return home, that is NOT a realistic back up plan. There comes a time when roles are reversed and WE have to make the decisions, difficult as they may be. He needs 24 hour supervision, either with you or in a facility, in fact it sounds like his dementia is so advanced that it is a miracle something tragic hasn't happened before now.
I encourage you to research this site or the alzheimers's site to educate yourself on dementia so you understand what a progressive, life altering brain disease it is.

To be honest my backup plan was to move him back if I couldn't keep him at my house without destroying his happiness and that of my family.

I'd do it in a heartbeat and deal with the consequences as they arose.

I don't have much else to say on the matter. Your plan may or may not work long term or even short term...you may have some tap-dancing to do...but you'll have him at your home, safe, allowing you to problem solve from that vantage point instead of from five states away.

If he doesn't want to visit you for a vacation, tell him his house needs a new sewer line...the town told you...and it'll take at least three weeks to get done. Or some-such. Stretch the three to five as ou wait for quotes, weather delays, etc, etc.

Go for it. What do you have to lose?

BTW, you would also need to get health services set up for your father at the new place. It would be important to do quickly, since he is diabetic. He may buck at seeing a doctor that isn't his old doctor, so you would have to come up with a plan to cover that.

That would never work with my 88-yo diabetic mother with dementia. She would be wanting to go home soon after arriving. It may work with your father, depending on his personality. A good question would be is what would you do if he started insisting on going home. You need to have a good backup plan in place. You know your father, so you may be able to figure out something that would work if the first plan starts to fall through. One thing for you to consider before bringing him to live with you is if a parent isn't happy, nobody living with him/her can be happy.