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My husband has been in assisted living for 6 months, but now in memory care. He has dementia which has gotten worse. When he first got in he asked my daughters to get him out. Now he has settled into the memory care, but doesn't talk much at all anymore. He used to have many times of anger and resisting help, but has settled into it. He seems to like male caregivers more. My daughters now want to move him to an apartment with 24/7 care, but I feel he might be confused and anxious with this big move. Even now he asks who are these people and why they taking care of me as if he doesn't realize he needs help. I know my daughter made a promise to him, but I wonder if it's in his best interest to move him now that he's gotten used to this place and the all encompassing help, routine and safety they provide. My daughters say they want to spend more family time while he still has some cognition but I wonder if it's in his best interest to make this big change now that he's gotten used to the situation. At this even when they see him at the facility he gets tired after a few minutes and just wants to rest. I know they're following their conscience because when he first got there they made a promise to him to try to get him out, but I wonder if a move is in his best interest. His dementia has made him much more confused and easily agitated. This leads to aggression with the caregivers. I think he does enjoy the passive socialization of sitting in the room and having meals with other people. If he's in an apartment he will be totally isolated except for the caregivers and my daughters. Is a big move like this a good idea? What do you think?

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Oh, the drama of a promise.

Things change. Tell your daughters that. Your husband is safe and well cared for right where he is. He needs socialization which he absolutely will not receive enough of in an apartment with a caregiver who'll either park herself in front of the TV or on her phone all day. Keeping someone in his condition constantly stimulated in exhausting work.

What do they plan to do when he deteriorates to the point where he will need MC-level care again, because that day is inevitable. Will they move him yet again when it'll be even more distressing to him? Is that what they consider being kind and loving? I hardly think so.

Who has the decision-making power regarding his care -- you or the daughters? That should settle the discussion if nothing else does.
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NO. Your daughter's are reacting with their hearts instead of their heads and they imagine life will somehow be better for him in a different setting. Instead he will still be confused and combative and he will also be isolated from any possibility of friendship or entertainment beyond what is available within the confines of his apartment, and beyond that your daughters will have to deal with the problems of late and/or absent caregivers who may not be the angels of mercy they hope for.
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YOU ARE CORRECT in all of your observations and comments.

”The Promise” should NEVER be made regarding the care of an older adult with multiple problems.

It sounds as though he has made a fairly comfort adjustment in a setting that is capably meeting his needs.

PLEASE don’t allow yourself to be coerced into making a change that you don’t support.

You and his children can visit frequently, enjoy your time with him where he is being well cared for, and exit gracefully when he gets agitated. As his condition changes, he will need more care, and caregiving may well become more difficult.

Stick with the present plan. If this choice was made with love and concern for his welfare, there is no good or responsible reason to change now.
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It isn't a good idea. Explain to your daughters that while he was complaining before, he has settled in now. This is where he needs to be.
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Also, there are the endless appointments that their Dad will need-these will no longer be done at the MC. Do your daughters have time for those? How will they handle his anxiety at those appointments? How will they deal with the after-effects of these appointments?

In my mother’s MC, she receives:
Nail care by a nail technician.
Toenail care by a podiatrist.
On-site meds by the in-house pharmacy.
Nurse availability 24/7.
Well visits by the doctor.
Sick visits in her room within 24 hours (usually MUCH less), by the on-call doctor.

Recently, Mom received a portable x-ray on her bowels, right there in her bedroom at the MC. The doc called me with the results within an hour. Meds prescribed for the issue were given by the next morning. Outside the facility, that would have been at least two doc appointments, and a run to the pharmacy. Actually, it probably would have been a trip to the ER, at least. I can’t imagine all of the anxiety this would have given her-and ME!

Perhaps your daughters don’t realize all of the extras they would responsible for.
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Plain and simple, yes it is a mistake to move him at this stage in his journey. Your daughters should be grateful that he has settled so nicely in MC, instead of wanting to upset the applecart, and make him have to adjust to someplace new all over again. Anyone with any kind of mental decline do much better with routine, and when that routine is disrupted, all hell can break lose. So while I believe your daughter intentions are honest and pure, realistically it just isn't a smart idea to move him from his place of comfort. Please, leave him where he is at. God bless you.
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Your daughter's making a dreadful mistake. He is content and adjusted. She clearly has ZERO idea the care involved. If this happens you need to step away from it in all ways. If you are still POA in charge of care I think that you should PREVENT this happening. I cannot imagine this going well.
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If he is happy and stable, don't mess with that.

The daughters are projecting THEIR feelings on to dad, and he will not respond the way they think he should and will be disappointed AND possibly angry.
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Absolutely not! That would be exactly contrary to the care he needs. Besides his dementia, he'll go stir crazy. You say he's getting acclimated to his MC, I don't think he'll ever get adjusted to an apartment. 24/7 care... really? That won't mean a thing compared to his isolation, lack of socializing, need for activities, and specialized care he receives in MC. 24/7 care doesn't mean appropriate memory care. In addition, 24/7 is much more expensive than full time MC. Do you have his healthcare POA? If so, you have the final call regarding his care needs.

Their promise to try to get him out reflects their lack of knowledge of the disease, the care he needs, his safety and well being. That was a big mistake. He doesn't remember any promises made and your daughters will have to swallow the fact they made that mistake. Changing his environment will surely cause confusion and possibly some unexpected negative behaviors.
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