Moving my in-laws from Assisted Living to nursing home due to needing to go on Medicaid in the next few months. Any advice?

So many difficult situations in the elder care realm.

I would wait as long as possible. No sense in giving them time to fret about it and probably drive you crazy with questions and complaints.

Probably have to come up with a theraputic lie or two to make the explanation for the big change short and sweet. And easy to repeat as many times as possible.

I know you must fell terrible. But you have to do what you have to do so find a way to make peace with it and remind yourself that you are doing the best you can and that your inlaws WILL be OK.

I would be tempted to blame it on the facility - saying they are closing temporarily for repairs. New home doesn't accept pets so you will find him a loving home. The new one has better rehab, nursing care, etc. I would try to make their room at the new facility as much as possible like the one they are in now.

I assume they’ll be able to share a room? Bring their wall pictures and bedding from the AL and try to make the room look as close to the AL room as possible. I think the physical transition from AL to NH might not be as dramatic to them as the loss of their dog. If you live close to the NH and plan to keep the dog, most NH allow and encourage pet visits. The residents and aids at Moms NH loved visits from my dog Woody, and would call his name when they saw him and I was basically chopped liver. Bringing their dog to visit might help the transition. If you’re not planning to keep the dog, I would fib and say you are and he’s fine. My Mom really missed her cat when she went to NH and constantly asked the aides where her cat was. I made a big poster for her room with the cats cute picture and a big note that “Lila is at Jeans house.” (True). That seemed to reassure her that all was well. When she’d ask for more details I’d make up stories that Lila and Woody get along great and play all day. (False). But she liked it.

Keep their dog and take to visit as often as possible.

They know they have a dog because it provides comfort to them.

My dad had a 6# chihuahua and I am not a pocket pooch person, but I took care of her and hauled her back and forth until he was placed in a facility that allowed him to have her. Rehab even allowed her to stay for hours, he just had to keep the door closed.

He cried more when she passed then for any person he has lost.

They provide a love that should not be treated lightly.

Ask the facility what they allow, you might be surprised. Maybe a couple hours a day or over night, never know.

Will their dog be able to visit on amore or less regular basis when they’re in their new home?

Would they prefer to focus that by moving, they’re improving the life of their doggy?

If in fact you have “no other alternatives” then please allow yourself to be at more of a sense of peace. Any feeling human being who is forced to become part of this tragic process MUST become resigned to feeling the weight of “no-winners” decision making. I find with my somewhat similarly abled LO that less information, quietly, calmly, and matter of factly given is inevitably what works best.

Maybe you can say you are taking the dog to doggy day care temporarily.

I see many good suggestions here. I agree to leave it to the last minute and the less said the better, doggie visits, etc. They will have each other. Best of all, they have you to care about them! There are many elderly people who have no one!

I realize you are doing the best you can, but if this were my beloved pup you were taking away from me you would be killing me. It would be like taking a diabetics insulin away. This is heartbreaking. I would be looking at all and any alternatives and, if there truly are no other, then I would be adopting that pup into my own household and making sure that there were very frequent visits. The problem really lies in society not recognizing the significance of the human/animal bond though science backs up the health (emotional and physical) benefits. Not to even mention the upset of the pup being separated. Assisted livings have plenty of rules, one of them should be that pets are allowed and that they have a staff person assigned to look after and assist with them.

I'm confused. Medicaid would not be forcing you to move them from AL to a NH.

Why are you forcing them to leave AL? If they are functioning in AL, let them stay in AL.

Putting them into a NH and depriving them of the love of their dog will kill them.

Although my husb. and I are still in our own home, he is in early dementia. I've thought about how we would fare without our standard poodle, who weighs too much to be accepted in many places. Personally, I want my own children to just lie to me, and tell me they have the dog, she is fine, and as soon as things "come together" they will bring her to visit. In no way, do I want to be told, my beloved companion has gone out of the family. I've always said, if I die before the dog, she would be huge consolation to my husband. But if she dies first, I won't be able to console him at all. He will be inconsolable.
In other words, while I can't imagine living without her, at my age, 78, I would rather be lied to than have to bear the idea she is gone from me to a place I don't know. Best of luck to you. It broke my heart to read of your dilemma. I can't imagine what it must be like for you and your parents. Love to you all, including the pet.

This broke my heart to read and I am so sorry you are having to go through this. It's such a shame NH for the most part can'r allow pets but I get it, their resident's aren't able to care for them and adding that on the list of things for staff to do... It sounds like you do have some things to work with here, it sounds like in-laws are still very much a couple, dependent on each other and their cognitive disease's balance each other well, to an extent so hopefully yo can use that to help this transition. I have no doubt loosing their house to a hurricane was...well no way to describe that...for all of you but again might help the reasoning for this if one of them can grasp it. I'm making assumptions here but how long ago did the hurricane force them into AL? Are they aware of the financial issues? If so the need for the move should make some reluctant sense. I have to agree the closer to the event the better for telling them what is happening, less time to stress out the better and the methods for doing that are multiple because it's so dependent on the individuals involved but you all obviously care so much that I'm sure you will make a good decision. I am thinking though that perhaps the plan from in-laws perspective is to settle them in, maybe the dog needs special approval and shots or something that takes time or maybe they just need to be settled in and get to know staff before Spot can be there full time. Find out how often or the parameters for Spot (my generic dog name) visiting and give it enough time for in-laws to adjust a bit to not having him or her around, if possible, before bringing for the first visit and either wean them from there or develop a routine that works for everyone. You can decide based on what needs to happen to the dog whether to keep assuring them Spot is fine and happy or things aren't working well, he/she isn't getting enough attention during the day and then maybe a relative or friend with kids who doesn't live close would love to take Spot in or is looking for a dog to adopt, would love one like Spot and wanted you to ask where he/she came from...in hopes one of them comes up with the idea that it might be best for the dog if it went to live with this other family, meaning the dog can't come visit as often but perhaps the actual now owner would be kind enough to send photos or video chat with them once in a while...something along those lines. A big part of this is knowing your audience so you and their children will be able to feel this out best but in general I have found with mom that a gradual process works best, funny that last minute info about appointments and people coming to visit works best but gradual weaning from things like her car (it has been sitting in her driveway, uninsured for 2 years, she dreamed of driving it around the property at least to "take out trash" and now finally she is saying it's time to get rid of it), I know they are different for sure but hopefully you get the comparison. Separating from a dog that passes or has to be given up is so difficult in several ways and it may contribute to progression of disease in one of them even simply because the routine of meeting the dogs needs, walking it, feeding it, holding it all stimulate the brain in ways that they say keep us healthier but your in-laws have each other so neither will miss those things as much as they would if they didn't have each other. I don't say this to make you feel worse, I'm sorry and I'm sure they are all things you've thought of, I'm just commiserating I guess. It's a shame something can't be figured out for residents of NH's who have pets, I know more and more facilities like the RH my mom was in are embracing therapy pet visits maybe they will find ways to incorporate resident's pets somehow too in foster care for instance with someone who brings them in daily for walks and cuddles or someone on site to care for them for a fee, IDK guess it all depends on the facility. Good luck!

Just wondering... is it a medical need that they move to a NH? A NH resident has to have medical need. Can the AL no longer provide the care they need? Could they remain there if augmented by more caregivers? Or is it a financial need since funds are running out? If so have you talked to the AL about possibly accepting Medicaid? I have heard that some will after a few years of private pay. Or perhaps it’s a combination of both? Either way, try to be as kind as possible and only share the minimal amount of info that they can process. I told mom she was in a higher level of assisted living (never used the term NH) “since she now had all these great people to assist her.”

PLEASE note MANY Nursing homes It not only allow but encourage dogs. We dog lovers love our dogs as much as our own children. How would you feel if someone took your child away AND put you in a home? I told my dad who is 96 that I would go down on the Titanic with my dogs rather than go on a lifeboat alone. If you don't take and love this dog and surrendered the dog to a shelter, Know that surrendered older dogs are the 1st to be put down. You will devastate the dog as well. There are Breed specific rescue networks but they are overwhelmed right now. Our neighbor was hospitalized and his sister put down his beloved dog, And the man Chris quickly died of a broken heart. Broken heart syndrome is a legitimate phenomenon, Which is why older people sometimes die close to one another. Sorry to be so a motional but I have already arranged for godparents for my dogs in the event something happens to me. I am 67 and live with my 96 yr old dad, who adores my 2 Maltese & they him. "Quality Life" 🥰

My sister (79) was in Assisted Living with her 7# dog of many years (her "child").
As her dementia increased, so did her "meanness" behavior towards "Gizmo." Several different staff mentioned it to me and then I witnessed it myself. I found a loving family with 4 kids (10-16) that loved her from first meeting. Gizmo was so excited with all the attention. I told my sister I was taking Gizmo for grooming and poor thing had heart attack and died. We both had a good cry(different reasons)...but she forgot this sadness quickly. I made sure she had a great photo of Gizmo to "talk to." Dementia is a cruel disease.

Jkrystal5,
The dog my Mom/stepfather have was also a very big concern for me. The dog is a Pitbull/terrier mix AND a rescue. The dog is everything to them. She knows something is wrong with both, but especially Mom. She won't let anyone, NOT aggressively, near Mom until she gives permission. She stays next to Mom all the time.
The #1 thing I asked was if the AL allowed dogs as their dog has become more of a service dog over the years.
The AL I was able to place them did accept the dog! They have 1 suite which is more like a very exclusive hotel room, I bought a doggie door for the patio door, they took out the swimming pool to make a gorgeous oasis area so I bought/paid for a portion of the wrought iron fencing/installment so the dog can go in/out and not bother the other residents.
Yes, I pay $500 more a month because their laundry/playtime/cleaning up after the dog/extra cleaning due to shedding is worth the $500.
I know since I live out of State, that Mom/stepfather are happy knowing the dog is there. Mom/stepfather only recognize each other and their dog. I also pay for the Vet bill. Mom/stepfather happiness is more valuable than the money, I just need to fight step-siblings to pay 50% of the bills for these extras per State community laws

Some subsidized AL facilities in my area do accept pets for a minimal monthly fee. A friend has her mother in one of them here and it is quite nice. Very clean. Three nice meals a day, many activities including movie nights. The fee depends on the resident’s income. Medicaid takes care of the rest. Perhaps your area has a similar program so they could keep their beloved dog. If they are capable of continuing to live in AL and your area has subsidized AL programs, this is when a therapeutic fib becomes acceptable. They must move to an AL facility closer to you while the current one goes under renovations, or another gentle fib. Just a suggestion for all it is worth. Peace to you and your loved ones.

What do you exactly mean by....taking their dog away from them? Do you mean that the dog will go to a shelter and be gone forever? I do not agree with that. It really doesn't seem like they need to be in a nursing home at this time if they know they have a real dog. If all else, I would hope that you would keep their dog so their dog can come and visit them at the nursing home which would help them greatly and not be so devastating for them and then there would really not be a problem. It is only right that the dog stays with family so it is not "taken away from them". Can't the dog go into the nursing home with them? IF YOU CAN'T WITH THAT NURSING HOME, CAN'T YOU FIND ANOTHER ONE THAT WILL ACCEPT DOGS?

That is sad, but of course Nursing Homes cannot accommodate a dog. I did know one facility where Alpacas visited patients. My mom's friend was in one.

Let me go on to say that some facilities may allow an emotional support animal. This is a relatively new societal trend, so I don't know - it may sound outrageous, but stranger things have happened.

While many ALs, including MC areas, will allow pets (there is at least one cat living in mom's MC unit, stays in the room, and there was a dog for many months, but he really needed more space, being a rather large dog), many others will not allow pets. I have seen other dogs (and evidence of cats) in the AL/IL areas upstairs as well.

A NH is a different story. Because they are for more specialized nursing care, it could be a combination of regulations, possible allergies, cleanliness and the problem of who will take the dog out every day, multiple times, to do its "business" and clean up after it?

While I understand that many AL/MC facilities do not accept Medicaid (mom's does not - it is private pay and won't even accept having her SS income sent directly), there are others that will accept it (if there is an opening) and may allow pets, even in the MC area. Is this not an option? Since there may be a waiting list, could you get them on it and find a short term alternative, even if it is said NH they are moving to now?

The bigger question here, as needing Medicaid speaks for itself (lack of funds to pay AL), is do these two need specialized nursing care? Mom has been in MC (from condo home to MC, no AL) for 3.5 years now. We never got a specific DX, but guessing it is vascular. She has been drifting back in time, but other than that she needs no real nursing care, especially the specialized care provided by NHs. Certainly some with dementia/ALZ can also have needs that do require specialized nursing care - the question and description posed here does not indicate one way or the other. Could they do okay in a non-NH MC facility that takes Medicaid be found that would accept the dog?

As others have said, worst case would be giving the dog up (hopefully if it comes to this, you have someone in mind, not a shelter.) Could someone in the family keep the dog and bring it for daily or regular visits with the ILs?

As for handling the situation, wait until the move is imminent - this would mean less time for them to stress over it. Perhaps you could start before the move by taking the dog out for the day here and there, to get them used to not having it all day every day? With various dementias, firm grasp on time can be lost, so just telling them there is a required waiting period (like a quarantine), or other flimsy excuses (s/he needs a bath, groom, vet visit, is visiting other relatives, etc) - something that doesn't make it final, which can impact them badly - it leaves the future open for him/her to come back (although it won't happen.) When s/he visits (assuming the NH allows visits), you can still blame the quarantine, state laws, regulations, etc, but hopefully still allow them some time with their dog.

Thank you all for your responses. Here's a few more details that should clear up a few questions many of you have asked. My in-laws lost their home to hurricane Harvey and all their belongings and now their $ are about to run out so they must go to NH which none let them have pets. My hubby and I travel for work with our two dogs so we cannot keep theirs as most RV parks do not allow more than two pets and we are unable to take theirs to see them because again we travel all over the USA for work. We tried to find other family that lives close to take him but they have their own reasons why they can't.
Thanks for all the helpful nonjudgmental comments. This is so hard to do as many of us struggle to make the right and sometimes only decision we can for our loved ones. My hubby told them today he said they were not happy but no too upset but tomorrow may be a different story. Prayers and hugs to you all as you continue your path with your LO's.

Question(s):
1. What is the breed
2. Have you found a rescue group to help
3. Petsmart/Petco generally have lists of rescue groups
4. Is there any way possible the dog can go through training to become their service animal

I saw a book yesterday at Book a Million here in Abilene TX, by a woman who helps to match rescues to people in need of companionship, generally elderly who do not have anyone come visit them, Service men/women with PTSD just all sorts of things she does for animals in need.
Just like humans, animals have someone just waiting to find each other.
I'm sorry I don't remember the author's name, it's her 2nd book and from what I understand, she was so depressed she was ready to leave until a rescue dog came into her life.
She pays forward by matching rescues with people in need of companionship/help.
A book store like Barns/Noble should be able to give you the name of the author, try contacting for possible help.
The Vets on Vets Life show in Houston TX may also be able to help find a good home.
There's a rescue group in Colorado that takes in animals for service people, people who have list their homes etc too. I use to donate to them years ago and I still get yearly cards for their Rainbow Bridge service once a year. They ask you to provide your prayer(s) for the animals you had who crossed the rainbow bridge. It's a huge ranch type animal shelter NO KILL!

The move went fairly well today. They were a little confused and not happy about the dog as was expected. Praying they adjust quickly. We will take the dog for visits until we leave town for WORK. Someone suggested we should quit traveling. As I said we travel for hubbies work and do not own a home so not traveling at this point is not an option for us but we do have family that will visit them regularly. I appreciate the support and will check out resources some of you have kindly offered!! Please remember to be kind to one another and withhold judgement because we each have a unique situation

YOU CAN KEEP THEIR DOG YOURSELF AND AS LONG AS IT HAS IT'S SHOTS UPDATED. YOU CAN TAKE THE DOG TO VISIT THEM IN THE NURSING HOME. TAKE A COPY OF SHOTS FROM THE VETS OFFICE WITH YOU THE FIRST TIME YOU GO. THEY WILL THINK HIGHLY OF YOU IF YOU DO THIS FOR THEM.
BLESSINGS FOR YOU, THE DOG AND THEM