Need info on how to put spouse in assisted living after telling her I would not do it earlier in her dementia?

Whatever you do NOW, and you have good advice below of what to check out, it does sound as though you recognize you may have made a promise you cannot keep. Forgive yourself. We are not Saints. Saints end up full of arrows, dead, being prayed to for eternity so that they can fix all that we humans understand cannot be fixed. You are a human with limitations. You comforted your wife with words she needed to hear then. Now is a whole different lifetime with two entirely different people living it. Were I the spouse I would, to my soul, understand.

The woman you "promised" to not place her in AL or MC (Memory Care) is gone.
10 years ago if you both sat down and discussed possibilities for your lives if it came to a point where her health or yours would have been put in jeopardy by caring for the other what would the discussion have been like?
I told myself and others that I would keep my Husband at home until it no longer was safe. Safe for me to care for him or safe for him. What would have happened to him if I was hurt caring for him? Who would have cared for me? How would I have felt if I hurt him?
If she is safer in a facility that is designed to care for her properly with people there 24/7/365 that is the best place for her.
You are still going to care for her but in a different way. You are still her advocate.
She will not "remember" the promise you made.
If she does continue to ask to go home you can honestly tell her that she can come home when the doctor says she can when it is safe for her to do so.
Usually when someone says they want to go home it is not an actual home but a time and place where they felt safe and well. Reassure her that she is safe, you love her and you will keep her safe.
No one knows what track a dementia will follow. Some become violent, some wander, some remain as they were, some become docile. You never know what functions will be lost when. It is all about what part of the brain is effected when and how. The important thing is safety.
Another thing to remember...never doubt a decision you make when you make it given the knowledge, facts and circumstances at the time. Over time your knowledge and or circumstances may change but at the moment you make the best decision you can.

This sounds similar to my husband’s condition. He started having hallucinations and then started wandering outside the house in the middle of the night. At first it was sporadic, a day here, then back to “normal”. Pretty soon it was more bad days than good. The hallucinations became more frequent and lasted longer, long periods of not sleeping, which of course meant I didn’t get any sleep. All the mechanisms in place, special door locks, motion lights, cameras were not enough. Medications were adjusted constantly. Soon it became unsafe for him and me. He was running outside during the pandemic, I was worried he might contract the virus on top of everything else. His hallucinations were getting out of control and I did not feel safe in our house. I had to call the cops a couple of times. Thank goodness the cops were wonderful when they came and were trained about dementia. I realized he needed professional 24 hour care that I could not provide at home. It was truly an act of love. Sometimes love requires sacrifice. It hurt me so much to accept that I had to place him in LTC. I felt guilty, there are days when I still second guess my decision, but now he is getting the care he needs and he is safe. An overnight nurse/aide may be a solution for you but in my case, it had become a 24 hour problem. My husband was sometimes up 2 to 3 days nonstop, then maybe he would sleep 24 hours. I found myself just waiting for the next round to start and dreading it. Once my husband was placed and I overcame the guilt, I have been able to sleep peacefully at night. When I visit him he looks great and is very loving. He wasn’t angry at me at all for placing him. I wish you well and know you will arrive at the decision that works for you.

It's easy to tell someone not to feel guilty about breaking a promise, but you have to. Having your spouse be mad at you is better then allowing the situation to continue until something terrible happens. There are assisted living facilities that will take care of your wife with dementia that will also let you live there too. Putting her in assisted living is an act of love to keep her safe.

This is going to sound flippant and/or cold, but it really isn't meant to be. It's just true. She won't remember your promise for long, especially if you made it once the dimentia began. And you need to keep her safe. That is the most important thing. Please dn't beat yourself up for taking care of your wife with more knowledge than you had when you made your promise. If her mind were capable of understanding how much that promise would hurt both of you, she would never have asked you to make it.

You made that promise based on what you knew and what you were dealing with at that time.  Things have changed.  If she was wandering and hallucinating at that time, I doubt you would have made the promise.  She needs safety and care and that is what you are going to make sure she gets.  You are still taking care of her. 

Make an appointment with an elder lawyer and start looking for a facility nearby.  It's going to be rough at first, but as she progresses, you will see that you made the right decision and it was in her best interest.

These times are very stressful and can take it's toll on you.  Good luck and take care of yourself.

Sorry, waited too long to answer. Have you been offered rehab? If so, take it. Medicare pays the first 20 days of care 100%. This will give u time to find an AL and have her transferred there. If u don't have the money, then transition her to LTC. Where I live rehab and NH are in the same building.

The one thing you need to do in either case is protect your half of the assets. Your wifes half would be spent down allowing her to get Medicaid. Your half would make it possible to stay in ur home and the ability to pay bills. If you need care later than the spend down and medicaid. Not sure how SS is divided but some may need to go to offset her care once on Medicaid. This will be determined by what u need to live. A lawyer versed in Medicaid should be able to help you.

The best thing to do is use the phrase "It's per doctor's orders we're doing this, dear." Which isn't far off from the truth, and in reality, IS the truth because wandering outside the home is dangerous and can kill her, as it did a man I was caring for years ago. He wandered outside in the middle of the night, insisting he lived across the street, fell, suffered a subdural hematoma and died the next day in the hospital.

You can't 'promise' someone something that's out of your control. It's like promising someone you'll keep them alive or free from disease entirely. Some things become bigger than WE are, and too much to be responsible for. That's why Memory Care ALFs are popping up on every other street corner.........because most of us are incapable of caring for our loved one at home after dementia/ALZ reaches a certain point. Let's face it.

You can go visit her every day (most ALFs allow outside visits and/or window visits) and bring her goodies and small gifts. When I worked at a Memory Care ALF before the plague hit, there were quite a few men who'd come visit their wives on a daily basis and take them out for ice cream, or just sit and visit, etc. It CAN work and it DOES work, if you accept your limitations and MAKE it work.

Wishing you the best of luck with a difficult decision.

Harry, how is it going?

As a wife I want to tell you that I would never hold my husband to a promise made in ignorance. None of us can possibly know what we will need to do to ensure that our loved ones are safe and cared for. It is a lovely sentiment but sometimes it is not realistic in the least.

During covid everything is wonky and what used to be, well used to be. So, if you have to place her to ensure both of your wellbeing, find ways that help you feel like you are showing her that you have not forgotten her and that you still love her. This will help you get through the difficulty of having to place her.

Be prepared for the hardest thing you have ever done. It stinks to have to make a decision to place a loved one, you will second guess yourself, you will doubt your decision, you will cry yourself to sleep, but you will know deep in your heart that you had no other option and she NEEDS to be right where she is for BOTH of your wellbeing.

Be kind, gentle and forgiving to yourself during the transition. It will work out, because you are her advocate and you will pick the very best facility for her needs.

I am praying that you can get a good caregiver and that you can keep her home, but if not, may you find a fabulous fitting facility.

Has your spouse been seen by a neurologist and given medication?