At what point do I overrule my parent's wishes?

I would honor my parent's wishes in this case. Caregiving is extremely hard and they made the right decision way back not to burden a relative.

Ask the dr what reason for no longer living alone - if not eating properly then that is 1 issue but if dr thinks that your LO couldn't function in an emergency like a fall etc then that may help you decide - try a weeks repite care to see how that is handled & maybe try more than 1 place - good luck

I was facing the same dilemma with my two friends for whom I am their POA. The husband was adamant that they could still live independently. Both had had their licenses revoked, so I took them shopping once a week for groceries and to their appointments and occasional religious activities. When the wife became incontinent and started to wander, due to her frontal temporal dementia, the part time people I had hired to help with her personal care told me she needed 24 hour care, otherwise I could be charged with neglect. I finally was able to persuade the husband to go to an assisted living facility with a memory care floor with the choice of a two bedroom, one bedroom or efficiency apartment. They had to go as a couple, so I picked out a one bedroom apartment for them and the day of the move, arranged to have the furniture they would use brought from their town home to the new apartment and set up just like it had been at home. The husband liked it from the beginning and never talked about going back to their town home. The care there was very good, along with the advice they gave me about how the dementia was progressing. I needed that since I have never done this before. The AL portion has all sorts of daily activities for the residents. The memory care level has their own activities, which the husband does not care to partake of. He is happy watching TV and reading the daily paper and socializing just at meals. It sounds like you have done some good research and if the facility is anything like the one I found, he will be well cared for. They like to do things to stimulate the mind and there are occasional outings, too, for the AL residents. The husband very much has his identity intact and likes living there and his new meal friends. His wife passed on in 2015 and he misses her, but accepts that she had to go. He feels very fortunate to be in this facility and the good fortune he had in meeting and marrying such a person as his wife, and to have me as a friend watching over everything. I am grateful to have found this one place that does so many things so very well. They told me he will never have to leave and they will accept public financing should he run out of money (after 18 months of regular payments) and they provide care to the very end with hospice when necessary. Since living alone is no longer an option. a good AL-MC facility can be excellent choice.

Having been in this position, here is "The Answer" that her doctor gave me when I brought all of that to him (he sees geriatrics mostly). It made the decision SIMPLE after hearing him: The Number One Priority Consideration by which you make the decision for your parent is: S-A-F-E-T-Y. He said that if they re not SAFE at HOME, then nothing else matters. Will they leave the stove on and cause a fire....will they wander outside and get lost (and worse) - will they fall down in the shower and hit their head. SAFETY...use that to be your guide. I did, and it has been the right thing....Independent Living/Assisted Living and then 2 years ago at age 96, Memorycare. The operative word here is "96" and she'll probably live "safely" to 100 , and she adapted well to both.

Couple of things to consider:

Some assisted living facilities will accept high functioning dementia residents with the acceptance that they will eventually move to memory care when needed. This is a very common practice where my mom lives. I think this would make the move much easier if the parent is willing to go.

Or your parent can live with you and go to adult day care - during the day. That worked for us, for awhile. Mom lived with me for 2 years, she went to a day center that specialized in dementia.  The  place was fabulous and she loved going.  She believed she worked there.  Since she didn't have any concept of time, she didn't live with me, she was just visiting. That may be a good alternative; I am not sure what services are in your area. 

When I moved mom to assisted living - it was hard - since she was high functioning and many of the residents were not. I moved her because her health was declining and I knew her dementia would also.  Look at what services are provided in your area for people with dementia.

It's never easy. 

More info and some clarifications. My parent is not driving and lives an hour from me, by themselves. They are the ones that want to go to a facility because all they can remember is their parent thriving when they went to the facility. The difference is that their parent did not have Alzheimer's and they do. They were diagnosed 8 years ago and their memory has gotten noticeably worse year over year. I have done countless hours of research on Alzheimer's and I have found a resounding answer that, change, is devastating to someone suffering for Alzheimer's. Therefore, standard facilities that move you from room to room or wing to wing as the disease progresses, is taking years off of your life. As someone answered above, if I were to agree to have them go to the facility I want now, they would be on lockdown, unless I went to pick them up, and they are not ready for that yet.

The person of whom I speak understands the reasons behind why I do not think they are ready and that when the time comes, yes I will move them to the facility. However, at the end of the conversation, they have forgotten everything that was talked about. All they can remember is that they don't want to move in because they don't want to be a burden.

As for the POA, yes they have been established and finances/trusts/will have all been finalized. Arguing with them to where they will move immediately, is what is on the horizon.

Some facilities offer a try and see if they like. I suggest you try that route. If you have the means for a facility hire someone to stay with your parent instead at their home. Giving up possessions, especially for the elderly, is hard. It's their last hope of independence. My mom did not want to give up driving, even tough she was found at church thank God slumped over her steering wheel. She had the best angels. She may have just been asleep but who knows. Priest drove her home. Fortunately, the priest said to me while she was with me at a church service that she should stop driving. That probably helped her in making a decision. If she goes to church, maybe your priest/pastor could mention something to her. I, also, started driving her everywhere in her car. She liked her car and it gave me "us time".

My mom has more good days than bad and I don't feel a Memory Care facility would suit her at this time.

Let him know that the minute he needs more care than you can properly give him, you'll put him in a facility but for now, he's no bother and you would rather he lives with you. A compromise.

Hi, since it seems that parents who are in that "tweener" stage, still able to function in a lot of ways, but obviously needing some assistance, it appears that moving to a facility becomes a challenging decision for most elders. There are those places with different levels of care where you stay on the same grounds but move from "community" to "community" depending on the level of care needed. Since legally (from what I have been told) a person cannot be over ruled and removed against their will, it is necessary to have your loved one on board. Speaking from personal experience of waiting for the right time, that time is best NOW, because down the road, your LO may forget his original wishes and then resist when you want to make the move. Being still high functioning, an Al/dementia place is very scary and depressing because there are many low functioning people around. All Alz facilities that I have seen are on secure floors which means your LO cannot exit alone. Again, for a high functioning LO, that equates to being on lock down. If your loved one is in an Assisted living place, there is a lot more freedom and your LO can come and go as he/she pleases. If you wait too long to choose to move into a facility, your LO may not be allowed to live in assisted living and will be required to be in a memory care community upon the move. Since to date, I've found it a challenge to locate any memory care community with different levels within memory care, once that's the only place your LO can go, he/she will be around a lot of late staged people and if your LO is still fairly high functioning it will most likely be a more difficult transition. You are blessed in that you have the financial means to arrange for outside care now. In my opinion, if cost isn't a huge barrier, the sooner the move is made, the better for all family members. The fewer changes, the better for your LO and all family members can still visit as often as they want. You just will eliminate a lot of added stress that is down the line if you make to move sooner rather then later. Good luck on your journey.

In my view, you over rule when it becomes a matter of your parent's safety. When parent's wishes go against parent's safety, safety has to come first.
My mother has a personality disorder and developed vascular dementia the past few years. She became paranoid about staff at the very nice ALF where she lived, and was very well cared for, and found another ALF she wanted to live in. I (POA medical and financial) looked into it and found that services were less than she had where she was and it would not be a suitable place for her. For example, there was no nurse on call on her floor, just a security guard. This was not enough for a 100 year old! She was quite upset at me when I said I could not stop her from moving, but I would not support or help that move, as I felt it was not in her best interests. In time and after many difficulties, she was hospitalized and diagnosed with the vascular dementia, treated and placed in a facility very suitable to her needs.

Often, if you wait too long, the window of opportunity is lost forever--
Moving slowly and methodically as you have has given you the chance to check our several places. Now take dad and mom to visit.
My old 'Client" when I worked in elder care, was ready to go---but she didn't know it! It took slow, gentle persuasion and MANY trips to the new "facility" to acclimate, before long, she accepted the family request that she move--and she thought it was her own decision!
As far as outings, ALF patients can come and go. My client routinely went to parties, luncheons, family activities...no big deal. Had she wanted to go swimming I am sure they would have made that happen.
I will add---her place was the nicest, most posh ALF I've ever been in. The food was amazing, the staff, top notch and her little apartment, just delightful. Her family spared NO expense, and often told me it was worth every penny.

Within a year of being moved, her dementia worsened, she would not have done so well in that condition, being moved from home. Eventually she did wind up in a lockdown type area of the same ALF. Still nice, but dedicated to keeping the patient safe--and from wandering.

I'd strike while the iron is hot. We waited to long to "push" Mother along and now she doesn't have the ability to make the decision and as kids, we can't do it for her, as we cannot all agree, and never will.

Good luck.

Alzheimer's has become a label. People freak when they first hear it - but not all progress to full-blown dementia (Alzheimer's is dementia).

Early onset Alzheimer's can be controlled with medication. My father was considered early onset for the 7.5 years I took care of him but it never progressed. He was on Aricept at the time. His passing had nothing to do with the Alzheimer's - it had to do with his stopping Dialysis at the age of 88. He was on the lower dosage of Aricept and it never never progressed.

If your parents can still manage well, leave them be.

It sounds like it might work out for them with the right ALF. One thing to consider is that they might not need an Alzheimer's facility just yet. An ALF can take care of them, if they're not apt to wander. One with continuity of care and an Alzheimer's wing might be best. But ALF's may offer them more privacy, more activities and group outings, and more of a sense of keeping their identity intact. Make sure you have their financial situation under control (via POA) before moving them anywhere. Best of luck and God bless.

I agree with Greggory, you will know when the time is right! We can not force someone to move. I have POA for my best friend, she wanted to remain in her own home. We explored assisted living options (for the future), living with a relative, care in home. The driving ended when she couldn't find the gas station two blocks from her house and when she finally did find it (3 days later) couldn't figure out how to put gas in the car. Her decision to quit... Then she became very ill and her neighborhood was going down hill, she decided it was time to move! She chose to move in with her daughter in law in another state (she had options with me and with her sister). The disease is progressing and we know the next step is a facility... The team ( myself, daughter in law, sister) will know when the next move is eminent and will take the necessary steps. It is hard to wait and Allow folks the time to reach these conclusions. Find a support group and join...the discussions will help you help your family members!!!

One thing you may want to consider if someone has Alzheimer's is taking away the keys. We have a local who was caught going the wrong way on I 71 and her license was immediately and permanently revoked when they found out she was demented. She lives not far from me right now but her family must make sure she never drives again because she could've killed someone that day or maybe even herself. This person may also still be high functioning but not capable of driving. A simple mistake behind the wheel can spell disaster. Another area you'll want to watch over is how your elder is spending their money or if someone is taking advantage of them. They may be high functioning, but that doesn't necessarily mean someone won't use that to their advantage

If he isn't specifically needing memory care just yet, but needs some assistance, like with meals and medication, then a place where he can transition from assisted living to memory care might work. Most of these facilities require a MOCA test to know where they are on the cognitive scale and require the financial info to see if they can afford it. I would suggest you take him there , let him meet with the director, tour a room, facilities and eat a meal. Let him see an activities calendar. The place where my dad is has an indoor pool...does this facility have one? I agree though with others that the sooner he moves the easier, and he will have the opportunity to socialize and get to know others.

All good answers IMHO. I would specify an event that he alone controls as to when he goes to the nursing home.
For my dad who was 100% against ANY nursing home, the tipping point was when he had an incident that involved any harm or injury. Lacking that I, my brothers and mother, felt it was still his decision. It didn't matter that dementia was taking hold, that he could no longer decipher the microwave instructions on the box, that we had to lay his medicine out and he would pick and choose which to take, we felt the time was just not right. He still had reasoning to control his destiny. But when he lost his way coming home from the $ store, [6 blocks from home]- ran the car over a curb 18 miles from home, it was time.
He still periodically asks why he is there, and we tell him. He promptly forgets then later, maybe that visit or the next one, he asks all over again. He is now getting the care and safe living quarters he needs.
I hope someone has been appointed as POA and he has an up to date will made. Too late now to put any real property into a trust.

I have a very good friend who was in this position. Although skeptical at first, she was glad she visited and made the decision to move into a care facility, since she did not want to live with relatives or continue to live in her home after her husband died. She greatly enjoyed living in a senior care facility, where you can live independently, and when needed, receive care at every level. The grounds are beautiful, there are educational and recreational activities, a lovely dining area, etc. She made the choice to move there, and to be as involved or not involved as she wished. It was safe and provided the care she needed. She moved in when she was very independent and still drove. As she needed more care, she moved to another facility of this kind, closer to her family.
Since you are asking about making this decision, take cues from the doctor and your parent's wishes. Take him/her to the facility and explore that option, discuss the option of having care in his/her home, as well as coming to live with you. Give your parent time to think about it. It may help to try in home care first, especially if he/she is safe at night, before moving on to another option. Each person is different, but having doctor input and considering your parent's needs and wishes as well as your peace of mind, is important.
Best wishes for making this decision.

Does the facility you researched have a continuum of care, i.e. could your loved one start in assisted or independent living and then move to the memory care area when the time comes? Your loved one could still go to swimming and activities as long as possible in assisted living.

The nice part of a facility is that your loved one will have built in socialization possibilities that won't easily exist in your home. The sooner you make the transition, the longer your loved one has to adjust, which is important for someone with dementia. Good luck with whatever you choose.

From many a caregivers point of view - including mine -  most would consider you lucky.

Lucky that you have a parent that does NOT want to be taking in and taken care of by their family. In particular- one of their children. Lucky that you have a parent that has the means to finance their choice of living arrangements and lifestyle. And lucky that your parent has remained active both physically and mentally- as well as being active and perhaps practical in their own decisions.

While you look at this choice to move into a facility as a potentially over restrictive one - could it be that your parent views it as a step in maintaining some independence - not having to be "taken care of" by their child. Perhaps they are not willing to let the often occurrence of role reversal with the child taking care of the parent take place any sooner than it needs to when dementia is involved. 

As well, could dignity and respect factor into this choice. Of course you would treat your parent with both dignity and respect - but perhaps your parent is not willing or wanting you and your family to witness their deminishing skills and abilities. And deminish they will.

To your parent this move may be in their eyes the best shot and keeping your relationship one of family - of parent and child verse caregiver and "patient".

There are multiple smaller issues as well. Maybe they'd like to remain in their own generational peer group. Maybe they believe there will be more activities available to them for keeping busy. Maybe they would like more personal space verse having family around all day, everyday.

There are a whole lot of maybes. But if this is your parents choice - personally, I think you ought to give them their earned right to make it. After all, if it doesn't work out you could always bring them to your home.

There are really two issues here: when should you make the decision on their behalf, and when can you make that decision.

Since the doctor is worried about him living alone, I take it there is no spouse involved. Is that correct?

There are 3 options:
1. Continue living at home, with round-the-clock care. This option tends to be the most expensive.
2. Move in with a family member. This is an option he has specifically rejected in the past.
3. Move into a care facility with the appropriate level of care and supervision. Apparently this is the option your parent would prefer.

Surprisingly, living with family members is not always the best option. Sometimes it is, of course, but not as often as you might suppose.

If he were in the care center you have in mind, could a family member take him to the swim classes? Go on outings with him often? Consider that he probably wouldn't be the only high-functioning person there, and those residents tend to find each other.

When should the decision be made? Now. He is no longer safe to live alone.
What can you do to make the decision for him? Persuasion only. He is high-functioning enough to make his own decision.

Are you sure they would be miserable? Does this facility have levels of care? In other words, would the resident be required to be in a locked facility or are there sections with more freedom? If they can still participate in the community, they might feel happier and more free in the facility rather than in your home.