Thursday, March 6, 2014

My Dad’s Alzheimer’s: Making the Tough Choice

From the time my dad was officially diagnosed with Alzheimer’s, we knew that it was only a matter of time before he would not be able to continue living on his own.

We wanted to wait as long as we could because my dad loved the country home he had retired to in rural Michigan, a place where he had put so much work into in designing the house, planting more than a thousand trees, and working the land with his tractor and other equipment. It was nirvana to him that he could watch deer and geese and turkeys and other wildlife to his heart’s content.

It grew more difficult for us to let him continue to live there as his house increasingly became a mess, with garbage thrown out only when my sister or I went over and did it ourselves. My dad never seemed to notice the condition, and got offended when anyone said that it was a mess.

His hygiene deteriorated as he never seemed to shower except when he was with us and we insisted. He never did laundry; if we didn’t do it for him, he would keep wearing the same stinky clothes day after day.

His behavior grew odd in other ways, too. He wore many layers of shirts and pants, even on hot summer days. He collected things he did not need, and never got rid of anything.

The thing of it was that he never acknowledged any of it. He could easily talk about how there was no problem and he was so articulate that you could almost believe him if you didn’t see the reality of the situation yourself.

More recently it became apparent that his memory, which had been bad for some time now, had deteriorated even further. On the trip back from my sister’s house at Thanksgiving, we stayed overnight at a motel. We went out for dinner and when we returned to the motel, my dad had no idea where we were or what we were doing there even though we had checked in and used the swimming pool before going out for dinner.

As far as I was concerned, that was the last straw. That, along with the fact that my dad did not seem to be enjoying his rural home like he used to. Even before winter, it was becoming apparent that he did not go outside much. He did not work the land any more. He seemed to be staying inside with the television on all day.

But we knew it would be impossible to persuade him to leave.

He had previously resisted even minor suggestions like having someone come in once a week to clean, or to have meals delivered to him. Everything was fine, he said. He didn’t need any help.

But we knew things weren’t fine. And so we began looking for a place for him to live. Living with one of us was not an option. We would not be able to give him the level of attention that he needed, and it would put an incredible stress and strain on our family if we tried.

So we began looking for a place where my dad could be professionally cared for 24 hours, and where he would have an opportunity to socialize with staff and other residents. We especially wanted to find a place that had the ability to care for people with Alzheimer’s.

We found several places relatively near our home.

Kai went with us on three of the visits, and took great interest in finding a good place for Ojiichan.

Once our visits were complete, we made our decision, choosing a place that specializes in memory care. We were particularly swayed that the executive director there seemed to best understand how difficult it would be to get my dad to leave his home.

And that was our challenge.

How would we get him to agree to move?

The answer, we came to realize, is that we were not going to get him to agree. But we would have to move him nonetheless.

I called him and told him that I would pick him up and bring him back to our house the weekend we would be celebrating Kai’s birthday (the first time).

He was very happy to come.

He played the harmonica.

He played with Kai.

He went to Kai’s piano recital.

And celebrated Kai’s birthday.

But the next day it was time to take my dad over to the assisted living facility where he would live.

We told him that we were going out to lunch, which was true. We did not tell him that he would stay there.

As we arrived, my dad did not notice the signs that clearly noted that this was a place for assisted living, not a restaurant. As we walked in, he did not notice that the place really did not look like a restaurant at all.

The arrangements had all been planned out ahead of time. The staff took us back to a room where we would have lunch together.

My dad enjoyed the meal.

And when we were all done, one of the staff came back and told my dad that he would be staying there. The rest of us got up, quickly said our goodbyes and left before my dad could hardly realize what was happening.

It sounds harsh, doesn’t it?

But I firmly believe that in our case, there wasn’t any other way.

The thing that is hard to understand, it certainly took us a while to realize it ourselves, is that with Alzheimer’s, you have to look after your loved one's best interests even as they cannot see it for themselves. There is no reasoning with the person. They think that everything is fine. You can spend countless hours discussing and trying to persuade, and the only result will be frustration for all.

Once we finally understood that, we acted. For his own good.

Later in the afternoon, we got a call from the executive director. She told us that my dad was adjusting surprisingly well. I think that the severity of his condition actually helped make the transition easier.

Just after we had left, they had the nurse measure his blood pressure and other vitals. He told her, “This is great! I’ve never been to a restaurant that did all this before.”

We did not visit him right away to give him time to adjust to his new environment. But we got updates from the executive director every day. My dad was actually enjoying being there.

While that was surprising given our concerns that he would not want to live anywhere away from his own home, it was also understandable. He was getting a lot of attention from the nice staff members whereas previously he had very little social interactions. He had all of his meals prepared and served for him, and all of his clothes laundered. And he had a very appreciative and enthusiastic audience for when he played the harmonica.

A week after we dropped him off, my sister, brother-in-law, and I paid our first visit. (Kai felt sick just as we were to leave our house so he and my wife did not come that time.) My dad was happy to see us. He was not angry about being there. In fact, he showed us around, introduced us to everyone there, and told us how well taken care of he was.

From the following week, Kai has joined my wife and I on our weekly visits. We can now see my dad much more often than when he was living so far away.

My dad is always happy to see us.

We usually take with us the one game, Suspend, that we know my dad is capable of playing.

And we have lunch together – my wife prepares a Japanese meal that she knows my dad would enjoy. In the picture below we brought tonkatsu (a Japanese fried pork) and norimaki (rice ball).

And so all has been good.

In our case, the transition went as well as we ever hoped it would. We are relieved that my dad is in a place where he is getting the attention and care he needs. We are happy that he is happy there, and that we can see him more often.

There will be difficult days ahead as his condition worsens.

But there is also comfort in knowing that we did what we needed to do for him.


  1. Yuji, what a great start for a new life for your dad. You did a tremendously loving, caring, and necessary action. Your father looks very happy in the pictures. One of the scariest feelings for people with Alzhiemer's must be during their periods of semi lucidity where they feel lost, confused, and all alone. At the facility, your father is cared for, and he will be with others with whom he may share his life with. If during periods of understanding, he realizes where he is...he will know that he was loved enough to be taken care of the way he is. This was a great story to a normally heartbreaking situation. Great article!

    1. Thank you, Shiroi. I know you can relate to this very much.

  2. I was smiling all the way through this. No, I don't think how you did that was harsh at all. And how wonderful that the transition went so smoothly and that he's close enough now for weekly visits. Sometime we dread things and then it all falls into place so well that we can't believe it. ha. I'm so glad for you. He looks happy!

    1. He really does look happy, and that makes a big difference with us. We know we did the right thing for him regardless, but it's a big relief that he hasn't been fighting it and has been so happy. Thanks, Betsy.

  3. Yuji, I was glad to read that everything went well. It has been a long time since I've seen your father. I still remember when I visited him at his home up north many years ago. Would it be possible for you to contact me about the possibility of visiting him. I know my father would really enjoy being able to see him again. Peter Gussie


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