In the UK you want to obtain a power of attorney whilst you can.

Will you self fund, require simply residential care or nursing care?

Does he really require residential care Or could he live with visits throughout the day from carers?

All I know is my mom stepped up to do all this for her parents and then for my dad's mom to a lesser but still significant degree. It takes someone or else I think it's fairly safe to say the person's quality of life will suffer in their declining years.

One - make sure legal ducks are in a row.

Two- visit two or three places just to see how they operate- there are huge differences.

I was choosing pre-school and AL at the same time and the criteria are creepily similar. Staff? Facilities? Food? Activities?

Look into a progression path- but life changes do don’t solely focus on that.

Ask about staff turnover especially in management roles. 4 years into this- this has had the biggest impact.

There are huge style differences and the place I chose for my parents woul not be the place I would choose for my in laws. Just because they live very different lives and have very different activities and food preferences.

It is nice getting back to being a daughter rather than a primary caretaker- but it’s still a lot of work even when they are in a facility.

Where is your father located?

Assuming he's in a jurisdiction that recognizes such things, you'll definitely need a Durable Power of Attorney (lets your wife conduct business on his behalf once he's no longer able to do so) and an Advance Health Care Directive (lets your wife make health care decisions for him once he's no longer able to do so), and you should get those done ASAP while he still has mental capacity (assuming he has it now and that you don't already have such docs in place). His health care provider may be able to provide you with a form Advance Health Care Directive, but maybe not. Both docs typically spring into effect once he's medically declared to be incompetent, but they can also be set up to be effective immediately even if he has capacity.

Simultaneously, how much research have you done into your questions? I'd suggest that you identify a local facility and give them a call. They surely get lots of calls from people in your position and can answer just about any question you have.

I'm sorry to hear you're going through this.

ETA: If he has assets and still has capacity then you'll also want to have him execute an estate plan (will, trust, and attendant docs). The money spent on it up front will be minuscule compared to the time and expense you'll incur if he has assets and no estate plan.

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War is god

If funds are not available and he is in the US, then the next option is Medicaid. His eligibility will be determined and a wait list will be involved, as there are not enough facilities to meet demand. He might have in-home care as the next option as well.

We did this until my mother left the stove on and nearly burned down the house she was living in. I wish you and your family strength through these times, as I know it is hard from personal experience.

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DFL > DNF > DNS

Before my mother retired she had her own business managing care for the elderly. Organizing doctor appointment, home care visits, cleaning help etc., including when her clients moved in to assisted living centers. She was also an expert in governmental entitlement programs, how to apply and expedite services and so on. If you have the resources, look around to see if such a business is available to help you and your wife.

Do you have kids? Don't ignore the impact this has on them. Or on you and your wife.

My parents helped take care of my dad's parents. They would not stay at their kids' house, they insisted they sleep in their own house, no matter what. This went on for probably close to 10 years, someone had to be with them essentially 24 hours a day. Only my parents and one of my aunts really took part.

If you spend all day every day doing this it will cause problems. Relationships suffer. It wears people out. You can't do it 24/7.

There is a lot more story I could tell, but well it just gets depressing.

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I'm beginning to think that we are much more fucked than I thought.

I am going to totally second this. My primary goal in caring for my parents is doing it without sacrificing the relationship I have with my daughter. You only set a goal like that based on history... I was lucky that my mom and dad both wanted to be in a home- and said not to sacrifice my life for them. I’m guessing history again. I visit three times a week- more of stuff is going on. I go to all doctor appointments and do their finances. But, I also go to every softball game etc. Find balance and don’t forget about yourself.

Are there some funds available? There are caregiver companies that can have someone come over and do those tasks, typically from 4 hours a day to 24/7. (I run such a company). Someone coming in for a few hours a day for a days a week can keep your dad in his house. I managed the care of both my parents and an uncle. It's rough.

My wife is a gerontologist. I will be glad to put you in touch with her if you want to talk to someone that navigates these waters daily. We have both seen our parents, my father/her mother decline mentally until their deaths. So unfortunately we have more experience with this issue then either of us ever wanted,

Getting his finances in order, Power of Attorney, doctors/meds and support from friends and family need to happen ASAP. The cost of care depends in part on how well your FIL can take care of himself Is there a home to sell? Is he going to fight your suggestion to move to the point where you are going to need a lawyer before he moves? Is he going to need memory care eventually? I am glad you recognized the need to help your wife out because you both are going to have to be strong for each other through this difficult time. I wish you both a lot of luck. If you decide you want to speak to my wife just PM me. Good luck.

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"The great pleasure in life is doing what people say you cannot do."

Ya, first step is to figure out how much money he has available, and if he qualifies for assistance. I looked for almost a year for my dad, and it seemed all the good larger facilities were full with waiting lists. So luckily I took a look at private homes that cater to this crowd, and we found two that took him to the end, both were families with kids, pets, etc. A lot of people do this to make ends meet if they have a bunch of extra rooms, and they are qualified. Usually it was just 2 or 3 rooms and it was cheaper than the big clinics too.

Of course my dad had his wits about him, no dementia, just was in a wheelchair. When my mom died that was it for living on their own, and the family environment was really nice. They just took him in like a family member, and they know if it goes bad they lose out on a lot of money, so they made the most of it...

Ours started at $3k a month when he was pretty functional, and at the end it was nearly $5k because of the extra care of having to get him in and out of bed, baths, etc...

Lots of good advice here already. My brothers and I made that transition for my Dad a couple years ago, and despite one brother being a physician and another being a lawyer, it was still difficult, confusing, stressful and we made mistakes. It's just a hard process.

As others have said, Power of Attorney (for finances and medical) is key.

If he's willing to do so, a conversation about DNR orders and such is a good idea too - even if someone has a medical PoA and thus is empowered to make those kind of calls, it can be enormously helpful to know what the person himself wants to happen.

If there's an estate worth protecting, take some time to see if it can be protected. It may be too late now, given the Medicaid lookback period rules, but worth doing a little diligence. Despite being a lawyer himself, and despite my brothers and I repeatedly leaning on him to take action to protect assets, my father refused to do any estate planning and he is (literally) paying the price for that stubbornness now.

ETA: On the financial side, make sure you know where the money is - what banks/brokerage companies are used, account numbers, etc. My Dad had a few accounts that we didn't even know about. One we learned about purely by happenstance, we were in his house doing some cleaning after he had been moved to assisted living, phone rang and it was a rep from a bank we didn't even know he had dealings with.

estate attorney here. fill free to pm me. i'm in GA. durable powers of attorney and health care directives are important. this may be a medicaid question, based on what you've said. generally the old person should also make sure all beneficiary forms are filled out too, so any assets do not default to the estate.

I have a beneficiary question. My dad passed away and my mom got an insurance payout that is in a fund with the insurance company still (they actually pay pretty good rates). Can I as POA assign beneficiaries to this in accordance with her will so it doesn’t go through probate? (Just split 50/50 between my brother and I?). She is no longer competent. Can I update insurance policies for her as well?

I’ve read mixed things on changing beneficiaries as POA. I just want to avoid work later (she is on hospice now) when I have to settle the estate.

you have to read the current POA. maybe is the answer.

I went through this with both of my parents in recent years and it is not easy. As others have said, make sure their affairs are in order (estate planning, power of attorney, health care proxy etc) and also know what/where assets are.

My parents both wanted to stay in the house they built, raised us in and lived in for 47 years and as their health declined, a few of my siblings and I who were nearby and able to help take care of them took turns staying with them (one of my sisters is a nurse and coordinated things) but after a few months it was apparent that their needs were beyond what we could provide (my dad had Alzheimer's) and we found an assisted living facility nearby where they already had a few friends who had moved there, so that helped with the transition. Still, the decision to move was not easy even though it was the right thing to do, and the stress of taking care of them prior to the move on top of seeing them decline took a toll on each of us. In the end though, we were all thankful to have had the opportunity to help them with their wish to stay in their home as long as possible.

As far as cost, one thing that definitely helped was that they had purchased a long-term care policy about 20 years earlier that covered most of the monthly expense of assisted living. They also met with an estate planner and set up trusts about a year or so before they sold the house and moved. The LTC would have covered most of the five-year look back before Medicare kicked in.

Hope this helps, good luck!

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"You can never win or lose if you don't run the race." - Richard Butler

Don't have much to add since all the major keys have been covered already, only that we've gone through it all w/ my wife's parents the past few years (dad & mom were divorced long ago, so we got to go through it all it w/ 2 separate households/estates; dad already passed, and then stepdad so we're still on the hook managing my MiL ~ who can't let go of the fact that her late husband used to take care of everything, so now anything that goes wrong is somehow my wife's fault (never mind that's how he had it spelled out in his will; of course she still blames the lawyers, and/or Social Security staff, the County elder care ombudsman, etc, and my wife is always left holding the bag at the end).

My folks aren't quite there yet, but getting close enough to talk about all the things that have gone wrong on my in-law's side so I can try to nudge them to address some of the obvious pitfalls ahead of time. I'm fortunate in that besides my wife already having to face the music first, my mom is actually ready to downsize and eager give up all the yardwork, cooking & housecrap, etc, for a retirement condo or apt; problem is my dad is still super active and can't bear to part w/ a full house & garage to store all of his toys (multiple bikes, kayaks, climbing gear, etc). It absolutely sucks ~ there are usually no good options, only less bad and worse choices...

We're glad our kids are older so at least they have good memories of their grandparents already, but one of my co-workers just went through this and on top of everything else she's sad that her younger kids pretty much only remember their grandparents slobbering and stuttering around in a wheelchair. So sad.

After my dad was diagnosed with Parkinsons my parents revised their will, gave my sister and I Power of Attorney and Enduring Power of Attorney. We were prepared for a long, slow decline with my dad but his deterioration has been faster than expected, heavily exacerbated by a fall in the spring that resulted in a traumatic head injury.

My mum is still sharp and fit for her age, but can't leave dad alone for any length of time so she's tied to home. She gets 4 hours of respite care once a week and dad goes to a five hour program for seniors once a week (that he hates, but does to help keep her sane), so my sister and I are trying to go out on weekends to help out. We know it's a matter of time before dad ends up in full-time care, we're trying to figure out what's best for him, for mum and for their finances. It definitely sucks.

One of the crazy realizations is that as bad is it sucks for us, at least our folks can afford to have a range of options for how much or little care they want/need. They all have some combo of decent pensions and/or retirement accounts, insurance coverage, houses paid off, etc. Selling off the house is of course hard on everybody, but at least the proceeds will offset several more years of care, too. In my friend's case, they could even afford to pay for full-time in-home care (which is astronomically expensive even compared to what my in-laws paid or are paying for assisted living), and it STILL sucks worse than almost anything we've had to deal with so far. We try to comfort ourselves with the reminder that it's gotta suck even worse for people who can't afford as many choices.