Bye Bye Dadio

Yesterday...

Well, my sister and BIL picked up Dad and all his stuff today. I had all his stuff packed.

Dad put on a warm shirt "because its cold out there".  It was 76 and humid...

BIL secures all the stuff.  We had to redo it because of Dad's rollercart.

Dad leaves the house ad Sister escorts Dad along the sidewalk.

Dad inspects the packing job and makes suggestions.

Dad finally gets in the car...

And then they all wave goodbye.  Dad waved behind the back window, but you can't see him.

And away they went...

I'm sad that that Dad is going to the final assisted living place.  So is he.  But he beat the odds, you know?  Not everyone reaches 91. He is proud of that, and I understand.  If I live another 28 years, I'll be his age.  I see my future in his stay with me.

Dad and I hugged before he got in the car.  We cried a bit.  Well, it was a serious year he stayed here, and I will never forget it.  But he knows what his future is, and so do I.

He is suffering dementia, but he's not stupid.  He KNOWS he doesn't understand things well anymore.  He KNOWS he forgets things.  Deep in his mind, he knows that things he thinks happen aren't accurate.  He's said so, he's talked of it.  As crazy and frustrating our discussions were at times, I understand how desperately he was trying to hang on to reality.  And I know that he appreciates that I was trying to help him there.  He said so, and I'm going to believe it.  For the rest of my life...

The last moments we were together alone, he thanked me for taking such good care of him the past "couple months".  Well, it was 11 months, but it wasn't a time to quibble.  I know he meant "a long time".  Sons and Fathers sometimes get awkward speaking to each other.

The assisted living facility is where he won't be challenged about time and accuracy of memories (which I did far too often).  They will know how to speak to him in only the present tense and avoid all the inconvenient discussions of the past that I could not avoid at times.

In the past year, I learned some things about his life that I never really knew before.  He did more civilian stuff in WWII than I realized.  Like building ships.  He had a patent on a gadget once.  He was a real mechanical engineer.  I knew some of that vaguely. but in our times, Dads didn't really bother to explain their careers to the kids.  That is precious.  He may have learned a few things about me, too.  Like I "know science stuff", that I'm a (sort of) writer (he read a couple short stories I got published in a semi-vanity press and said "your mother said you wrote good stuff, but I had never read them before (meaning that he didn't care for it himself, but was impressed I wrote it) and that was good enough for me.  He has admired all the daffodils he saw this last month that I planted in past years.  He was never here at this time of year before.  He said, "you care about beauty, like your Mom".

And he said he was surprised I like Escher prints (4 hanging on the walls the whole year).  Very "engineerish" he said.

I think it was all a final compliment as he left.  Things he never said to me before.  At 62, I don't really need validation. But I don't mind it either.  You probably can't ever not like validation from your Dad.

He will be a "resident", not a parent, at the assisted living facility.  Someone they will care for and not challenge sometimes in frustration as I sometimes did.  They will not care about (or know about) the parent/child dynamics.  And that will be good for him.  Dad will end his days only around people  like him to talk to and a staff dedicated to just taking care of him. 

And now I have to figure out what to do with this blog...

Vote for the best thing...

1.  Keep talking about Dad (what little I learn).
2.  Get back to the pre-Dad yardwork and house projects.
3.  Get WAY back and become a liberal political pest.

Moving Day Minus One

 Oops, this was supposed to be posted yesterday.  So pretend it was and I'll put up today's post tomorrow...

It felt strange packing up Dad's stuff today.  It wasn't that there was all that much (there wasn't - he came up here with what fit in a sedan and he is leaving with less), it was the act of preparing to have him leave tomorrow.

I'm a bit torn about the whole thing.  Sometimes he refers to me "kicking him out", which is not very nice.  But I understand that he would very much prefer to remain in a regular house with a family member.  Moving in with a bunch of strangers has to be scary.

At the same time, he generally understands that he needs more professional care (if not today, then soon).  Sometimes I too wish that I could take care of him for longer (to delay this inevitable final move).  But I can tell that I can't take care of him much longer without turning myself into a full time nurse and I don't have the training or experience to do it much longer anyway.  Heck, I can't even simply pick him up when he falls.

I'm not feeling exactly guilty.  Indeed, I will be relieved to be free of the responsibility.  I will be relieved to not have to be around the house as much as possible, to not have to explain why I am leaving it and for how long and why.  I will enjoy being able to just go outside without worrying he will fall and hurt himself while I'm out.

I am relieved that he is taking this change in his life as well as he is.  When I first talked to him about assisted-care living, he said he didn't think I could make him leave.  I envisioned having to nearly carry him to the car and driving him away screaming he was being kidnapped (as he nearly did when my brother and I moved him from FL to here).  At least now, he seems quietly resigned to the necessity of the move.  He also understands that this move will eventually end in hospice care at the "end".

But it will feel odd not to have him here.  I'll have to re-learn my old habits.  I'll be eating WHEN I feel like it, eating WHAT I feel like, going out WHEN I want, staying up as LATE as I feel like, getting up WHEN I feel like, etc.  I may even start playing golf and going fishing again.  I didn't do those last things the year before he arrived, but for the last year I felt like I couldn't, which is a big difference.

I will focus on the thoughts that he will have better personal care and more companionship.  I will focus on the thought that, after a couple of weeks, he will actually be happier in assisted care (something I have been told by many to be "almost universally" true.  I will focus on the thought that, after a month or so, he will forget he was ever here (his memory of his place in FL was gone after only 3 months and his memory is much worse now).  Very soon, his memories will be only day-to-day and of events decades ago.  His recent past will just be absent.

There is most of the family nearby where he is moving.  I will probably visit every month.  The day he doesn't remember who I am, I will stop visiting.  I won't be visiting for my benefit. I don't have to see him to love him as my Dad.

He will eventually forget being here and who I am.  But I will remember this past year...

Dad

I brought Dad to the geriatric Dr for a brief exam and getting the assisted living place medical evaluation form filled out.  He says Dad is care level 1 (least care).  The TB test results won't be known til Weds.  If he has a lump a the site of the shot, it's positive.  Extremely unlikely though. 

Dad's blood pressure is 130/70.  Might be better than mine.  But his heart skips occasionally.  Dr says Dad is in really good "condition for his condition".  Well, yeah, he's 91 this month.  You can't escape old age.  He could maybe take an 81mg aspirin daily.  But it was barely recommended.  Almost 50-50.

So Dad has had a Dr exam, an eye exam, and a some slight dental work.  He has some new clothes that fit him, new socks, and I am getting his prescriptions filled fully for another month and some new underwear.  I got him to try on an old pair of my suspenders last evening, and he LOVES them!  Well I have had them for 20 years because I love them.  Neither of us have a real waist, and Dad has been pulling up his pants for  month now.  He showed the first "plumbers butt" yesterday, so the timing is perfect.  Suspenders are great.

Sister and Hubby are coming down Thursday.  Their pickup has a cover and tie downs and space behind the front seats inside for loose items.  That relieves some of my concerns about tying small boxes down in the back.  The move will go wonderfully.

I can't wait for the new stove to be delivered.  I made pork stew and it took hours in the microwave.  Cooked the pork last night, but the potatoes, carrots, celery, beans, and bell peppers tonight.  The hardest part was making the "sauce" (cornstarch slurry, chicken buillion paste, herbs).  The M/W is faster for what fits in it, but an oven is better for large amounts.  I was a bit nervous about how it was all coming out.  I have never made a stew in the M/V.  But it turned out rather good.  Not "best" but OK.  One thing I have learned about chicken thighs and pork shoulders; they don't overcook easily.

I did learn that my personal dry rub for pork misses something without the meat being smoked.  It was a bit on the too-sweet side.

Thinking about packing Dad's stuff...

Busy, But Relaxed

Its gardening time.  There are things I need to get done.  First is getting a couple bucketloads of compost in my trailer to add the the garden.  And then I need to add that stuff in the beds and turn the soil to mix it in.

I spread corn gluten around the lawn and flowerbeds today.  One bag in the old toolshed had gotten wet and wouldn't spread.  Big  clumps.  But there is always SOMETHING to do with anything.  There was one removed tree that I had the tree team grind up the roots (they were exposed).  And you know what breaks down shredded tree bits?  Nitrogen.  And you know what the corn gluten is?  Nitrogen.  So I put the unspreadable corn gluten on the pile of shredded tree roots!  Raked them in well.

I had pelletized corn gluten in the basement, and spread that around.  It stops seeds from growing.  Actually, it stops that one initial seed root from growing.  Corn gluten is a dipepside and causes that.  I have no idea why.  But it works. 

Later today, I have to get Dad to a Dr evaluation for the assisted care facility test.  The eye Dr says his glasses are good.    Great.  I am buying him some new clothes too.  The pants he has are SO tight around his waist he can't clasp them and he thinks that is normal.  What he NEEDS is a looser waist and suspenders, but he cant manage the suspenders.  Dressing Dad is like trying to put clothes on a cat. At least the new pants I got fit around his waist and the shortened ones fit his legs.  So he has 3 pairs that fit him well.

3 days till Dad leaves...  It feels odd.

When It Rains It Pours.

Dad's move the assisted care house is still on track. Let me get that out of the way fast.  But you would think it was the first Monday after a vacation the way the rest of things poured down. 

First, the electric oven decided to burn itself up.   I turned it on a 4 pm to slow-roast a pork shoulder (aka Boston Butt).  I noticed a bright light inside and when I opened the door to look, I discovered the "W" shaped coil at the bottom was...  melting.  I you have ever seen arc-welding on TV, that's how it looked.  And the hot spot was slowly moving along the coil

After a minute, I decided to shoot it with the all-purpose fire-extinguisher and close the oven door to smother it.  I tried it once, twice, three times and the hot arc melting wouldn't stop!  So I called the fire department for advice.  They said they were on their way.  I told them it was a single story residence, the house wasn't on fire, etc, I just needed to know what to DO about this odd problem. 

I tossed Iza and Marley and Dad out into the back yard and locked Ayla in the computer room (because that's where she ran and hid). then opened the doors and windows.  Well, there was smoke from the burning heater coil and I didn't know what was in the fumes

They arrived in just minutes.  With a hook and ladder truck and a hose truck (really?).  I had asked for an advisor in a car, but I guess its fun to pull out all the heavy equipment and drive the stuff around with the lights flashing and the horns blaring and the 27 8x10 colored glossy photographs (oh wait, that's a different story).  But I wasn't going to let them in the house with a fire house (very messy PLUS it was an electrical problem).

Three guys came in (full gear) to look at the oven.  One had an infrared thermometer and said the insides were 650 F.  I had turned the oven off, of course, but we tripped the circuit breaker too, to be safe.  They pulled the oven out from the wall and examined it.  I mentioned the possible toxic fumes, but none of the guys had the slightest idea what the heater coil was made of.  Since it hadn't killed me, I decided to ignore it.

Their advice was to let the oven cool down and then replace it.  I don't mean to be sarcastic about guys that DO risk their lives, but I couldn't help an "Ooh, you think?" moment.

It took about 1 1/2 hours to clean that damn fire extinguisher powder from the kitchen.  I regret using it, but like the guy who jumped onto the cactus said "It seemed like a good idea at the time".  I mopped the floor, I cleaned behind the pulled-out oven, I washed everything exposed on the counters, then I washed the counters.

You know what Dad said?  "The floor is wet" and "When's dinner"?

So I set about making dinner.  With no stove...  I set about cooking some Italian sausage, corn, kale, and a potato.  Do you have any idea how long that takes using a microwave oven?  I had to cook EVERYTHING separately (its a very small M/V).  THEN I had to reheat everything on Dad's plate, THEN reheat everything on mine.  Dad complained that dinner was late.  I'm not sure he remembers that the oven burned up.  And I'm not going to ask; I just won't have to worry about his memory in 5 days! 

I have my Consumer Reports 2013 Guide out on the dining table to get a new oven...

I got a call from Dad's tax preparers.  They filed an extension for Dad, but he needs to sent a $3,000+ check by their best estimate.

Then Brother called to arrange to pick up Dad Thursday.  The idea he needed to transport Dad's bed and "stuff" was a complete surprise to him (he said).  Sister told me later she had discussed all those details with him.  But the highlight of the telephone call was that he needed $10K for his daughters wedding.  Oops, sorry, I'll help out with medical problems and college and taxes, but celebrations are his problem.  So he asked if Dad would help and I promised to give it my best sales pitch.

So I should mention that the unofficial stepdad of another of Dad's grandkids was looking for help with college tuition for a grandkid last week.  I had said that Dad is too confused these days, but decided to bring up both requests.  I consider college a lot more valuable than wedding ceremonies featuring lobster tails.  But I know that weddings matter too.

I spent 2 hours this evening squatting by Dad's chair and talking to him about the requests.  My knees STILL hurt.  I went in endless circles about who his grandkids were, what they needed, and how much help he felt comfortable providing.  Dad has such a hard time making decisions and keeping track of details.  I try to help (endlessly endlessly, endlessly), but when it comes to checks, he still has to agree to sign them, so he has to agree.  I tell him the requests, I tell him the situations, and offer him simple choices.  

He decided that equal help to both grand-daughters was best.  $2700 to each.  So then I had to call the Dead Sister's SO who is taking care of her kids (not his) AND Brother who is looking for wedding money for his dearest eldest daughter. 

I've sure had better days...  And, BTW, Dead Sister's SO said "Oh thank your Dad SO much for helping out"  Brother declined the check for his daughter's wedding saying he would "work on Dad
on the drive to the assisted care house...

Guess who I like better?

Its not about me.  Yeah, the past year feels like to push string all the time, but I can handle that.  It's almost just like another day at my old office.  Problems to solve, difficult people to talk into doing what is needed, etc. 

I know some other people have worse days; cancer, divorce, death, etc.

But I sure will be happy Thursday!

Taxes

I am gonna say that H&R Block tax software is GREAT.  Others might be great too.  But H&R tells you what the next questions are going to be, them asks them.  Its pretty much impossible to get the questions wrong.  Geez, they even tell you on THIS form, put the number in 1A here and 1B there, etc. 

It only took an hour and a half and I had investments to include.  Adding up all the columns on the investment report (most of which have nothing to do with earnings) took 15 minutes.  Can you believe an investment company that basically sends you a printed spreadsheet and DOESNT have the sense to put totals at the bottom!  But I filed electronically so that saved some time.  That sure was better than standing in line at the PO for an hour...

Confirmed and Planned

Brother arrives here Thursday, takes Dad and bed and clothes away.  It's a day Brother isn't scheduled to work.  Brother brings Dad to Sister's house and she brings Dad to assisted living house.

The place sounds great.  Corner room, flowering trees out the windows, some fancy bedroom furniture left behind (better than here), all the meals and snacks he wants, fancy screened porch with meals out there on nice days), talking with people his own age, TV, friends, care, etc.  And for less than his monthly retirement annuity.  He was worried about losing money staying there.  He won't (he has a better retirement annuity than I do).

Sister and I have pretty much locked down Dad's assets.  POA and all that and he can't cheated out of of it.  Anyone so much as gets a suspicious check and its all frozen at once.

We've done what we can.

A Place For Dad

Well, I got word today that the assisted living facility (ALF) will have a room for Dad April 18th.  I don't plan to think of "why" so suddenly; sad things happen.

I'm suddenly busy with making plans for next week.  And Dr appointments...  I'm glad I got Dad to a dentist this week; one thing out of the way.  And I got Dad to the eye Dr today; it turns out his cheap drugstore glasses are just fine for his needs and he has no other vision problems.

I need to get Dad to his geriatric internist Dr ASAP for the ALF medical evaluation and will call for an appointment tomorrow.  They can usually arrange an appointment in 2-3 days, so that's OK.

The difficult plans are getting Dad, his personal stuff, and bed to the ALF (near the rest of the family and about 90 miles from here.  I suggested 4 plans to my sister and am waiting for her thoughts on them.  All plans involve a family member driving down here and only one doesn't involve me driving up there.  I hope she likes the one where I don't do any driving.  LOL!

It is all a bit more sudden than I expected.  But if it all works out, I will sure be relieved.  I know that doesn't sound very kind, but I'm a bit worn out.  Even Dad says he feels bad about how much work I do to take care of him.

I won't say I'm "happy" to do it all, but I'm "willing".  I'm sure you understand the difference. 

When I retired from office work in 2006, I came home and told the cats "I'm here, forever, and I'm yours".  I felt complete freedom to just live "my way".

When Dad leaves here in bout a week, I will feel much the same way.  It's been a hard year, and it was an important experience in my life.  I would have gladly skipped the experience, but I'm sure you know what I mean. 

I'm going to speak some truth here.  I won't miss his daily presence.  He has been a demanding "guest" for 11 months.  I was perfectly happy with him living down in FL, and I will be perfectly happy with him living in the ALF for the rest of his days.  I don't have to see my family every day in order to love and care about them.

If Dad had been 10 years younger when he moved in with me, things would have been different.  We could have talked, shared some experiences, etc.  But that was not the case (and he wouldn't have moved in with me 10 years ago).  Every time for the past 4 months, I have regretted each conversation beyond "its dinnertime, go to the table".  His mental confusion has driven me nearly crazy.  Any accidental reference I made for months has caused a long, confused explanation that left me mentally exhausted.  It's not his fault, it's mine.  I should have learned what to talk to Dad about.  Meals, weather, golf channel, etc.  I talk too much when someone else is around.

But the move is about set.  I could make a joke about "the long national nightmare is over" (Ford about Nixon), but that's not really true.  I know how frustrated Dad is about is inabilities.  I know how angry he feels at himself when he can't find words (and I try to comfort him about that).  I know how frustrated he is when he can't walk easily.  I have learned how much he struggles to maintain his personal life and do what he needs to do on his own.

When I watch Dad, I see my own future.  I understand that a day will come in a future decade when I am in his shoes.  While I have a vague plan to "check out" just before I get to Dad's condition, I also realize I might not remember those plans at the right time.  Life is complicated and death is more complicated.

I will miss Dad, in a way.  This has been an intensely "togetherness" year.  But I will be gladder to get my life back.  And it will start in about a week.  I'm not doing cartwheels though the yard, but I will be relieved.

A Bump On The Road

Sometimes it seems the universe wants to throw boards onto the bike path.  The room that we were told would become available, will not be.  We didn't know the details, of course, but it seems the family got VA benefits to keep their elder at the assisted living house.

Now, the next room available will probably be from someone who is at hospice care level.  Hospice care is not long-term, of course, and the room might even come available sooner.

None of us want to see any elder taken out of assisted living care from lack of funds, and we sure don't want someone's loved one to die conveniently just to make a room available.  We will simply wait for the wheel of life to turn naturally and offer space for OUR Dad.  Meanwhile, I will "keep on keeping on" and hope Dad has good days until space at this good place is available.

I am going to decline the respite care available locally if I can.  I don't want Dad to have to move twice.  Once will be hard enough.  I can keep answering the same questions each day, the new weird questions, and the daily food difficulties (while at the same time hoping he does not get suddenly worse).

Tonight, Dad suddenly couldn't cut his chicken thigh (a favorite food).  Well, all meat has been becoming a problem.  He wiggles his knife 1/16th" and the meat moves that far too, so no cutting occurs.  He blames the meat or the knife of course.  I asked if he wanted help and he said that I couldn't possibly cut it either because it was so tough.

Well, he can't make full cutting strokes, but he was trying to cut through the bone!  I took care of it, "zip, zip, zip" and he was amazed.  I just said "Long knife-strokes, Dad" (as I've said almost every night for months).  I will take of that for all future meals.  I can get de-boned chicken thighs and serve more meals that don't require knife-work.

He does better with pork stew (roasted Boston Butt cubed up with diced potato/carrots/beans/onion and a flour-thickened herb sauce), peeled shrimp, Italian sausage smothered is slow-cooked red and green bell peppers or spaghetti with commercial meatballs (simmer crushed canned tomatoes with crushed garlic, italian seasoning, and minced onions with the meatballs for 30 minutes.  Commercial sauce has way too much sugar and salt).  No bones, and the meat is either pre-cut or easy to cut (like the sausage).  I slit the sausage down the side and remove the casing.  I've learned to make chicken breast strips (called "chicken fingers" locally) here with dipping sauces too (but Dad thinks he is supposed to eat the sauces with a spoon.

A smile:  Dad is so used to being "cheap" that a drop of sauce is all he wants...  I am so used to making grand meals ("Sunday Dinner" every day) that I hardly think twice about the effort.  That part of Dad's support is nearly invisible to me.  It really doesn't take much effort to make a sauce for two as for one.  I eat spaghetti for the tomato sauce*; Dad wants just a spoonful of ANY sauce.  Cooking for someone else is weird,

But I've learned to stop worrying HOW he eats his food (which used to drive me nuts).  If he thinks the pork stew is soup, that's fine.  If he thinks the dipping sauces are "side dishes", that's fine.  If he wants to scrape the wine/horseradish topping off his beef and put it in his salad, that's fine (as long as he eats the salad).  But I don't want to watch, LOL!  The important thing is that it all gets inside him.  But he eats his meals at a dining table (very traditionally) and I eat on a TV tray while watching science/nature DVDs (about my only TV viewing). 

OK, this has gone from Dad moving out to food.  That's OK, I love food (and at 5'7" and 163 pounds, I'm not too worried about it.  What I DO demand of my food is that it be varied and healthy.  Without ever intending to follow a diet, I find that I am close to "Paleo Diet".  Some meat, lots of non-grain veggies, not much sugar, and plenty of fruit.  I can actually eat "one potato chip" and I have one small piece of chocolate after a meal.  Good quality chocolate, though, LOL!

To connect this back to Dad though, he has to have a standard dessert, and large.  Big bowl of ice cream, a few chocolate chip cookies, I don't worry about it.  I try to get him to eat fresh fruit, buts that's actually more for the water (he avoids water).

We'll get by for the next month or so until there is a room at the assisted living facility that seems best-suited for him.  Waiting an extra month for "the best place he will spent the rest of his life" is survivable with an end to his time here in sight.

Do I want him to be out of here?  Yes.  Do I want my regular life back?  Yes.  Who wouldn't?  But I can keep going for now, and that's the important thing.  It's duty, responsibility, and respect for now.

Would I talk to him often if he was just my next-door neighbor?  Probably not.  He was an obnoxious pain decades ago.  His golf partners used to roll their eyes at the things he said.  At times, he could make Rush Limbaugh seem liberal.  But now is not the time to try to teach him anything.

My job now is to manage his "end of life" issues.

*  I once dated an ethnically Italian girl and at my first dinner there, they offered me the sauce first. I botched it by pouring a load of sauce on my pasta.  The relationship didn't last (for other reasons).  Interestingly,  a co-worker told me about HER first meal with an Italian family and SHE knew not to use much tomato sauce.  I would blame my parents for not teaching me such fine details, but they came from big sauce families.  ;)

"Laugh at the world; it won't care".

Mark

One Month

And so much to do.  Dr appointment for TB test and filling out the medical evaluation form for the assisted living house, dentist appointment for 2 bad teeth (that I didn't know about before a  month ago), eye doctor appointment for "real" reading glasses to replace those drug store magnifiers I discovered he has.  Clothes that fit.  He has been wearing 34/30 and he NEEDS 36 or 38/26.  And he really needs suspenders; belts are too complicated for him.

Its my fault, I let Dad decide what he needed  It seemed right at the time.  But I am correcting some mistakes as he moves out of my life.  I just wish I had been more forceful months ago...

Elder Care

Dad is still trying to find reasons not to move to an assisted-living facility (ALF), but I'll talk about that another day.

Today, I want to talk about me (and, by extension, some of you in a similar situation).  I have been caring for Dad since last May, and it will be this May when he moves to ALF.  There is a chinese curse "May you live in interesting times", because "interesting times" times are not easy.  It has been an "interesting" year...

I tried to think a couple of months into the future for my planning for Dad to move to an ALF.  But I planned a month too short.  Dad is having real problems right now rather suddenly and there is no where for him to go for a month.  You don't have to suggest in-home care, I'm looking into that.  And anyway, this is for others.

My point is that a month is so short a time normally, but a very long time when you are caring for an elder who needs professional care "now".  I'm not comparing myself to others.  Some people are more able to care for others than I am.  But whenever you really think "next month", think "I really should have found a good place last month".  It is so easy to think there is time, and then the day is on you.  It happens far more suddenly than you expect.

And this is a thing you seldom get to learn from for better decisions in the future.  Elder care is (usually) a one-off event.  A parent takes the care of a spouse and then that parent needs care him/her self.  That's you doing that part.  No matter what you think, how many books or newspaper articles you read, you won't be prepared.  You cannot understand dementia, and you cannot understand what it means for a person in your house who can't (please don't jump on me if you are "differently-abled") just walk around. 

Your elder parent will go from difficulty getting out of chairs to a complete inability to stand up at all in just a week.  He/She will very suddenly discover that the time it takes to get to the bathroom only 30' away is longer  than nature allows.  It just happens one day.

No one wants to send a parent to an ALF, but trust me, a month too soon is better than a month too late.  April will be a very difficult month here.  So, for what it's worth, some thoughts on things I wish I had known..

1.  Visit local ALFs months before needed.  Bring the elder.  Take pictures of the place.  Pictures provide familiarity.
2.  Get the Dr evaluation form early and bring the elder to the Dr before required.  The difference in the Dr evaluation from one month to the next can be very informative.  A geriatric Dr is best.  He/She can tell changes in abilities better than you can.
3.  Most ALFs are good, but some are more good than others.  Your elder can help you decide which suits him/her better than you can.  I didn't allow my Dad to be involved.  That was a mistake.
4.  Bedrooms matter.  Size is important.  Your elder will think of the bedroom as a primary living space.  Even if that is not the primary living space.
5.  It's "I need to talk to you", not "we need to talk" when The Conversation occurs about moving the elder to the ALF.  Explain the household situation calmly, and emphasize the elder's care.  Your own stress and tiredness are YOUR problem, not his/hers.  Stick with the elder's physical needs, not the mental ones.  The elder is SURE his/her mind is fine, but does know about physical problems.  Stay calm through endless (and repeated) questions.  There will be many.
6.  Discuss the move daily.  Repetition helps.  They forget.
7.  Get the elder new clothes that fit well.  Everyone wants to make a good initial impression.  Seriously, have you ever seen an elder with good clothes?
8.  Talk to the ALF staff about minor details.  Ask them what residents want that no one thinks of.  They know.   Sometimes its just chocolate chip cookies in the bedroom for late night snacks.  With a nice note from the child.  Or maybe a reminder of how to make a martini.
9.  Schedule visits.  Routine is very important to elders.
10.  Remember that The Conversation is NOT a debate; it's a decision.  Your decision.  There will be "you are kicking me out".  But it really is your decision.  Accept that.  You are doing what is best for your elder.  Keep it in terms of what care your elder needs, not whether you love them.  Of course you love them.  But don't allow that to be the discussion.

I am not feeling guilty now.  I've done what I could and it is time for professional help.  Professionals know how to help an elder better than I can in the last stage of life. When you have been caring for an elder, sometimes the hardest thing is to let go.  Be willing to let go...

Heck, when Dad falls down, I don't really know the best way to pull him back up.  But trained staff does.  I don't really know how to answer his really weird questions.  But trained staff does.

About all I can think of for now...