Both of my parents are high functioning in the beginning stages of dementia. My mom has been in a nursing home for almost five years now and has been doing very well there. My dad was living alone until last fall when he had a stroke and is now living with me.

The problem is that I live out of state and my parents who have been married for 50 years are now unable to see each other. The other problem is that my mom feels abandoned. My dad's caregiver used to drive him three times a week to visit my mom. I've continued to pay the caregiver, but she took another job and only sees my mom once a week now (and sometimes, not even that often). There is no family nearby so she is on her own. I can't see my mom too often because of my own health problems (travel is difficult).

I've looked into transferring my mom into a nursing home near me, but the quality of the nursing homes is terrible. The nursing home my mom is in now has 0 deficiencies according to the Medicare website, but even the best one down here has 13 deficiencies and there is a two year wait (my mom is 93 years old).

My mom is very sad about this situation, which is compounded by the fact that my dad is doing so well down here and is happy for the first time in years (he tried to commit suicide at one point because he couldn't take care of himself and felt he didn't want to be a burden to me, now that he's here, he is enjoying life again and things are fine).

The really sad thing is that my mom was the one who would do anything for me and made all the major sacrifices in her life for me. She would walk through fire for me. My dad was indifferent to his role and didn't put a lot of effort into it. Therefore, I feel guilty (and so does my dad) that he's the one getting the royal treatment living with me and my mom is the one living in a nursing home alone feeling abandoned. It doesn't seem fair.

My home is very small and even squeezing my dad in was difficult, so there is no way I could bring my mom to live with me. I can't afford a bigger home due to my health problems, my husband is retired, and we don't have much money.

Any words of advice? The social worker at the nursing home says I should leave things as they are because my mom is doing so good there, but I know she is very sad.

Thanks in advance.

Hi Melissa, Sounds like you went through a lot with your dad. Thanks for sharing that with me. I've got an easier situation that that, thank heavens (at least for the moment, can't take anything for granted at this stage).

I looked at two nursing homes yesterday. One was a beautiful facility and close by, but I saw two call lights blinking and never met another staff member despite walking around the entire building (other than the Recreation Director). There was no one at the nursing stations. Maybe they were all taking care of patients in their rooms, but it made me nervous because at my mom's current NH, I've never seen a call light on, the staff is at the nursing station and visible in the hallways at ALL times.

The second NH was a privately run one and had lots of staff. The facility was old, no central air, and the semi-private rooms were so small that the beds had to be pushed right up against each other. There is a two year wait list at this facility.

Also in CT you can't be in a private room if you are on Medicaid, unlike MA where I pay extra for my mom to be in a private room.

I have more appointments scheduled this week.

My parents were in the same NH, but not until my mother had been in for almost a year with my father still living at home.He needed to be in the NH due to his increasing health issues, most especially being a fall risk and on Coumadin - a very scary combination. Though he had issues with his thinking - severe short-term memory impairment and poor judgment - he was cognizant enough "in the moment" to flat-out refuse to discuss the idea, but not enough to understand why it was necessary. He would want to visit my mother and felt bad that she was in the NH, but didn't seem to miss her so much that he wanted to be with her, despite them having been married over 50 years and having an excellent marriage. Somehow that part of his emotional makeup was also compromised. I had to go behind his back, with the help of an elder law attorney, to force him into the NH. Once there, they didn't initially have a room to place my parents in together, which turned out to be a good thing since it became obvious early on that my father was unable to remember why my mother didn't respond to him as she "should" in his mind , and sometimes he would get physically rough with her, so they ended up being in the same NH, but different rooms.

Even with advanced AD, I believe it helped my mother more to have her husband near her than vice versa. And though he couldnt' understand her problems, I know my father was glad to be near her in the only ways he could express it.When my father died , she understood. She couldnt' speak coherently any more, but I know she knew. She died 4 months later. Even Alzheimer's disease could not rob her of that 53 year connection.

So I understand your parents' desire to be together, and your decision to bring your mother closer to you and your father despite the risks of the less-than wonderful NHs, and I believe it will benefit both of them. Because you will also be closer to the NH, and better able to keep tabs on what is going on there, I hope you will be able to keep any potential problems to a bare minimum simply by your presence there, and the staff's understanding that someone does care about your mother and is watching. Having worked in a NH, I can tell you that does make a big difference. The staff pays attention to who's paying attention.

I hope it works out for you, and I hope your own health issues improve as well.

Take care.
Melissa

Just to give you an update. I've talked this over with my mom and dad as well as the social worker at mom's facility. I'm going to start exploring nursing homes down here. I begin the visits next week. My mom wants daily contact with my dad and I. That just won't be possible unless she moves down here. Thank you all for your advice and support.

Sorry I don't have any redhot ideas for you, GailSusan. I just think it sucks for them, but carewise, it IS an amazing blessing to have found a facility where she does so well, with which you feel so comfortable. And if your dad doesn't qualify for care and he's doing well with you, that's a good thing, too.

Do you and your Dad go visit her frequently? I'll bet they would really look forward to monthly visits, if you can swing it.

Thank you so much for your replies.

Mom's Buddy, My dad was in the nursing home with my mom for just over two months on private pay, but it just about broke us. It cost over $10,000 and Medicaid denied him for long-term care. He doesn't meet any of the criteria for nursing home care and he hated it there as well, so that's just not an option. In an ideal world, we would have enough money so my parents could live in assisted living, but that's not the case. In CT assisted living is private pay at the rate of $4,000+ per month.

Advocate, I call my mom every day (always have since she went into the nursing home) and my dad writes her letters several times a week and talks to her on the phone. It actually makes her long to be here even more as she knows we are having a good time and she wants to be a part of it.

The nursing homes down here are not anywhere near as good quality as the one she is in now. She can get up any time of day she wishes, which is important as she has insomnia. She has a private room with a big picture window and a rocking chair where she likes to sit and read. She has friends and the staff loves her. It is a very warm and caring environment. I haven't seen anything like that here. So it is a tradeoff between seeing her family several times a week for a few hours and being in a place 24/7 where she is very well cared for and has a good life (other than missing family).

I've asked my mom which she would prefer and she can't make up her mind. It's a tough tradeoff with too many unknowns.

Any thoughts would be appreciated.

GailSusan, what about your father living at the nursing home with your mom? I know it would not feel as good or secure to you as having him in your home, but at least they would be together, which seems to be a mighty big deal to both of them.

Don't you hate these nasty twists of fate - a couple makes it for 50 years together only to be separated near the end of their lives... so sad...

Please let us know how you work through this - there are many folks in your same predicament and also those who have walked the path before us... Best wishes!

It sounds like you have a very difficult to decision to make. Emotional health is as important as the care your mom is receiving for her health condition. If the nursing homes would be better in your area, I would suggest transferring her to one of those facilities. It's good to hear that you feel she is getting good care at the facility where she is at the moment.

I know that you can't visit very often, but is it possible to still communicate with her by writing letters (and sending pictures) or even making a home video of the family to help her feel more connected? Those are just a couple of ideas I got off the top of my head.

Hope things work out for everyone.