How to tell a parent they are being placed in a SNF?

I'm so sorry this is happening to you. I don't know how to break the news to him unless you can say something like "unless you can walk from the bed to the bathroom, we cannot take you home." This would give him a goal to work on.

In any case, I'd try to find out what is going on that is making him not want to try to get out of bed. I can vouch for the "it hurts a lot", however, see if the hurt he is experiencing is really coming from where it is supposed to be healing or if it is somewhere else.

I would try to coax reasons out of him and address the reasons.

Hothouseflower,

My cousins went through this with my uncle. He kept saying that he would be fine at home. Of course, he wasn’t able to live at home anymore.

My uncle was a widower so he was completely alone in his house. Your situation is different.

How does your mom feel about all of this? Would she want to be the one to tell him? Do you feel that she is capable of doing that without becoming upset? Or upsetting him?

Do you think he would accept it best from your mother or someone else? Don’t allow her to say anything to him if it won’t be best for either of them.

My cousins were completely honest with their dad and said that they couldn’t care for him at home. They said that he wouldn’t be safe at home anymore. This was certainly true. Plus, my cousins had full time jobs that they were not going to quit.

My uncle even wanted to hire private caregivers in order to stay home. My cousins told him that he would end up spending more money than at a facility if he did that. He was frugal and didn’t wish to spend more money than he had to.

They asked their dad’s doctor to have a discussion with him about living in a skilled nursing facility and they said that helped tremendously.

He adjusted well to his facility. My cousins went to see him often because they were able to find a good facility nearby. He received really good care from the staff.

It is tough to go through these transitional periods in life. After your dad is settled you will begin to feel better and so will your dad.

Wishing you peace as you move forward in this journey.

I am so sorry you are going through this. I too recently had to make those same decisions for my mom. She is 88. Drove to my house for thanksgiving dinner. Fell and broke her femur. She was in and out of skilled and assisted living (same facility) however, the care was terrible. Always short staffed. I sat down with her and was very honest. I did not sugar coat anything. Her mobility is very challenging for her now. She could not go home either and my home is not wheelchair accessible. Dad used up most of her savings 7 years ago when he was in memory care for dementia. I explained that she was not going into a nursing home but assisted living was expensive. Dad left her with a nice home we could sell so she could get the care she needed. Living in AL is not bad. Although she misses being home. I did bring all her things. So it is very close to being home. Just be ready for that grieving. Their whole life is changing I also live within 15 minutes so I stop in several times a week. Check out “ a place for mom”. They helped me with every aspect Also. Many places do have spouses living together. Again. I am so sorry you are going through this. I was tormented with those decisions. But now that it’s been several months. I am 100% sure I made the right choices

I can tell you what I have done in a very similar situation.
Was it the right thing, maybe not, based on some of the answers you have received.

I believe hope is an important part of life.I never want to be the one who dashes hope. Read a little about the importance of hope.

I haven’t discussed going home or not going home in so many words and aunt has been in care for 17 months now.
I have answered the few questions I’ve gotten with a bent towards happy times.

If your dad has not asked about going home but asked about why no PT, I would speak about therapy and not bring up not going home. More about how he has to get better before doing more therapy.

If he notices he isn’t getting therapy, that’s a plus for cognition. Most facilities have some sort of range of motion therapies. Ask what is available for him. Ask about speech therapy.
It sounds like he knows he is there for therapy and so your mind jumps to what might seem a logical assumption. Therapy over. Time to go home.
Nope, time to get better in order to do more therapy. Home is not even on the table for discussion at this level of health.

Medicare pays for only so much therapy at one stretch and then they stop. After awhile dad will be eligible for more or at least my aunt was.

It will depend on his health. That’s easy enough to explain. Perhaps he needs to gain weight. Does he have a good appetite?
Perhaps he is depressed and needs an antidepressant.
Really helped my DH aunt.

The meds take awhile to have an effect. Occasionally aunt mentions that she will speak with the doctor when he comes about going home. I always say that’s a good idea or let me know what he says. Then we go along with another topic.

We don’t make any big announcements on how she is never going home. What would be the purpose of that? I’m sorry. I don’t get it. If he brings it up then a few words about how great that would be is enough and then move on. Kind of like going to heaven one day.

Aunt has come off of hospice twice to have therapy. She is still bed-bound and still in the NH.

I have had visits where she is asleep or not talking.
Currently she is talking to people she would discourage from visiting her in the past. I just take her as I find her.

What would you be doing with your dad at home? Perhaps watching tv? Some of my fondest memories were watching ballgames with my dad. Old people watch tv.

You probably can spend more time with him now just keeping him company than you could have when he was at home. Your own mood can affect dad so do try to take a walk and be ready to visit a bit when you see him. Consider an antidepressant for yourself.

Conversations about old times or how mom is doing can be enjoyable and if possible, perhaps it is time for mom to join him. He is in decline but he is still living. I think it is a good idea to discuss his situation with your mom and leave her some hope too. I assume they both know they are 94 and have to have a lot of help. He is where he can get help.
If he wants to talk about going home then just answer what he asks. He may take his cues from you about how upset he should be about it. Give him big hugs and hold his hand. Talk about how great it is that he has no pain and how glad you are to see him looking so well.
I am sorry this is hard. Wishing you well and lots of smiles for your DH and your parents.

It depends on his personality whether all of you need to be there to tell him bad news. This might be intimidating or frightening to him. I'd be in favor of one person telling him and leaving him alone for a while to process the information. Something like, "Dad, you won't be having PT for a while because you're being evaluated," and then in a day or so, "I'm sorry, but you won't being seeing the PT guy again." Then everyone being supportive and rallying around without focusing on the bad news.

I'd want to learn about it privately if it were me. Then kindness and encouragement from the troops.

If he's still capable of comprehending what people say to him and is lucid enough to ask why he isn't receiving any more PT, I'd say try telling him the truth.
Tell him that he requires more care than any of you can handle at home. Have physical therapy explain to him why he isn't getting any more. Put that on them, not you. The facility can still work with him but they won't because of insurance. Make them explain this to him.
His wife should not be the one to tell him. It should be you and your siblings.
He may still be able to live with his wife though. There are facilities that can handle a couple with different care needs.
I know how bad you feel. I felt terrible when I had to tell my father he couldn't be cared for at home. It just wasn't possible. There's really no ideal way to do it or any way to soften the blow. So just tell him the truth.
After that it becomes about giving him as much good quality of life as you can in the facility he will permanently be in. Lots of visits and treats. We do the best we can and no one can expect more from us.
Good luck to you and your family. Keep us posted.

I’ve been where you are, simply put, it sucks. Issues without fixes or answers are impossibly difficult and sad. Don’t let the sadness of it all pull you under. This is the time to gather yourself and be dad’s advocate and cheerleader, fake it til you make when needed. Care for you first, then hold his hand and reassure him. I’m sorry your family is at this place, but know your dad is blessed to have you all

Please be honest. You are trying to avoid what he has a right to--his GRIEF over this loss. Don't hide behind what people call "therapeutic lies". There is really nothing therapeutic about lies, in the opinion of this old retired RN.

Tell him exactly what you said here. That you can no longer care for him at home. That the doctors don't believe he can make progress enough for him to be in family care. That you will visit and do all you can to make this better for him, but that the sad truth is that this is now home.

If you do not already know his wishes for end of life and Hospice this is the time to discuss it with him. He may be moving into aphasia if he is not communicating with you. And it sounds that his dementia may be more advanced than you know.

Please be honest. He may cry and he may rage, and is this final loss not worth that? YOU may cry, and is this not worth grieving with and for him? It IS. You can't hide this behind some glossy cover, and, honestly, to do so is cruelty. I know that is the last thing you would want.

I am so very sorry for this loss for you both? Is there a way his wife can visit with him here?

The simplest response you can give your father is that until he gets better and can walk and take better care of himself, his DOCTOR says that he cannot return home and will have to remain in the nursing facility. Always best to blame it on the doctor.
You have your hands more than full. I sure hope you're taking good care of yourself, and please remember that it's not just your mother and father that matter is this equation, you matter too!
So do whatever you have to to make sure you're taking the time to do the things that you enjoy and that bring you joy.
You certainly don't want to be in the statistics where the caregiver dies before the one(s) they're caring for from all the stress do you?

((((((hugs)))) hothouse. What a difficult situation you are in. Goes your dad have any faith - a pastor or such who could help him and you with this transition? Does the facility have a SW who could help with this?

In mother's case her transition from an ALF to an NH was handled by a coordinator who dealt with transitions and I and sig other were there. Mind you she had no expectations of coming home which is very different from your father..

It might be easier on you and family if a non family person could tell him and then you all could be there for support.

Have you discussed this with other family members?

My heart goes out to you. This is such a difficult time.

I think I would tell him, simply and honestly, what you’ve told us here.

“Dad, we cannot care for your needs at home. You need shifts of people, sometimes two at a time, to take good care of you. We are so very sad about it. You will be, as well. We are all grieving this loss. Not everything can be fixed. We will support and visit you every Wednesday.”

Whomever is the best communicator should maybe do the talking. The rest of you can be present, and tell your dad that you all love him.

It’s a huge grief. One that will continue until your Dad passes. I’m so sorry.